H. V. Linska

Background. The nervous system plays a key role in mediating adaptive responses of the body to external influences. Under conditions of martial law, particular attention should be given to the impact of chronic stress and combat-related factors on the central nervous system, especially on the development and course of cerebrovascular diseases, which significantly determine functional status and quality of life. Purpose – to investigate the clinical features of the development and course of cerebrovascular diseases under conditions of martial law. Materials and Methods. A total of 60 patients with chronic cerebral circulatory disorders (dyscirculatory encephalopathy stages I–II) were examined and constituted the main group, including 30 civilians and 30 military personnel. The mean age of patients was 45.2 ± 6.6 years. The comparison group consisted of 30 patients with dyscirculatory encephalopathy stages I–II examined in the pre-war period. Clinical and neurological, clinical and psychopathological, psychodiagnostic, and statistical research methods were applied. Results. Asthenic manifestations, neurocognitive impairment, and insomnia syndrome predominated in patients of the main group. Chronic psychoemotional stress and combat-related stress were identified as leading risk factors for the development of cerebrovascular diseases. Differences in disease course were observed depending on social status and the level of psychoemotional burden. Military personnel demonstrated an earlier disease onset, higher frequency of hypertensive crises, more pronounced atherosclerotic changes in the carotid arteries, elevated levels of proinflammatory cytokines, and a higher prevalence of anxiety-depressive disorders, sleep disturbances, and cognitive decline. In the civilian population, chronic forms of cerebrovascular pathology predominated, characterized by cognitive deficits, emotional lability, and asthenic syndrome associated with arterial hypertension and atherosclerosis. Conclusions. Prolonged war-related stress exceeding the adaptive capacity of the body contributes to the development and progression of cerebrovascular pathology combined with psychoemotional and cognitive disorders. The obtained results substantiate the need for differentiated treatment and neurorehabilitation approaches that consider the impact of war-related factors.

Actuality: Increasing the frequency of hypertension among the young population is a socially significant problem. The insidiousness of hypertension in young people is that it has the character of a disease with few symptoms. Since hypertension plays one of the main roles in the pathogenesis of chronic disorders of cerebral blood circulation, including both arterial and venous systems, the search for pathogenetically determined medicinal approaches to the elimination of cerebrovascular disorders, especially at a young age, continues. The purpose of the study: to study the effectiveness, tolerability and safety of the combination of Flego and Cognitium in young patients with chronic cerebral ischemia (CMI) on the background of hypertension. Methods: clinical-neurological, psychodiagnostic (asthenic state scale (ASS), anxiety scores according to the Spielberger-Hanin scale and Beck depression scale, Montreal scale of cognitive function assessment (MoCA)), ultrasound examination, general scale of clinical impression, statistical. Results: 52 patients (28 men and 24 women) at a young age with AMI on the background of hypertension were examined. The median age of the examined patients was (37.7 ± 4.6) years; among them, 23 patients suffered from hypertension of the 1st century. and 29 patients with hypertension of the second stage. Patients were randomly divided into two groups - the first - 23 (44.2%) patients (received only hypotensive drugs), the second - 29 (55.8%) patients (in addition to the standard hypotensive therapy received a combination of Phlego and Cognitium). Dynamic monitoring of patients after 2 months of treatment did not show significant changes in the distribution structure of objective clinical and neurological symptoms. However, positive dynamics of indicators of cognitive functions and the psychoemotional state of the subjects were observed, as well as a statistically significant decrease in the blood flow rate in the direct sinus at the end of the 2-month course using the combination of Phlego and Cognitium (decreased from 36.27±2.84 cm/s to 25.65±1.47 cm/s.). Conclusions: The introduction of the combination of Phlego and Cognitium into the treatment of young patients with arterial hypertension and chronic brain ischemia had a positive effect on the subjective state, on indicators of asthenia, emotional and cognitive state of the patients. A significant positive effect was noted in the dynamics of venous blood flow indicators (speed of blood flow in the direct sinus). Such treatment was well tolerated by patients, had few side effects and was combined with other drugs