Free-radical oxidation is one of the central mechanisms of brain damage in acute ischemia. Results of experimental and clinical studies indicating the link between the activation of the development of free-radicals and severity of ischemic stroke are presented. The authors consider possibilities of using preparations inhibiting the production of oxygen radicals and products of lipid peroxidation which can be used for treatment of patients with ischemic stroke. Results of studies using the domestic drug mexidol in these patients are analyzed. Mexidol can be prescribed in the early period of stroke, i.e. in the pre-hospitalization stage, and used in the treatment of stroke regardless of stroke type.

Neurospecific enolase (NSE), gliofibrillar acid protein (GFAP), S100 protein and autoantibodies (AAB) to these proteins have been measured in the blood of 42 patients with acute ischemic stroke. Concentrations of all parameters we re increased in patients compared to the control group. There were a positive correlations between contents of AAB to GFAP and AAB to NSE (r=0,470; p<0,015) and a reverse correlation between concentrations of NSE and AAT to NSE (r=-0,301; p<0,028). A study of the relationship between intensity of neurological deficit and AAB concentrations revealed the reverse correlation between the level of AAB to GFAP and scores on the European Stroke scale (ESS) (r=-0,509; p<0,009) at the first day of ischemic stroke, i.e. in patients with marked neurological deficit (low scores on ESS) the levels of AAB to GFAP were higher. The higher concentration of AAB to NSE was found for the satisfactory rehabilitation, while the neurological deficit was significantly more severe (p=0,034) at the AAT to NSE level less than 1,19 relative units. The more complete rehabilitation to the 21(st) day was reverse-correlated to the NSE concentration (r=-0,309; p<0,026). There was the positive correlation between the restoration of lost functions (the increase of ESS scores from the 1(st) to 21(st) days) and levels of AAB to GFAP (r=0,505; p<0,023) and AAB to S100 (r=0,450; p<0,046).

Two hundreds and eighty-seven patients, aged from 46 to 78 years, mean age 60.2 +/- 9.4 years, with confirmed diagnosis of ischemic stroke have been studied. The correlations between glycemia and severity of neurological deficit in the 1st (r = -0.433; p < 0.001) and the 21st days (r = -0.289; p < 0.05) of hospitalization were found. The glucose concentration in the venous blood plasma on an empty stomach was significantly higher in the fatal cases compared to the survived patients in the 1 (9.8 +/- 0.6 mmol/l and 5.7 +/- 0.4 mmol/l; p < 0.01), 3rd (9.1 +/- 0.4 mmol/l and 5.6 +/- 0.4 mmol/l; p < 0.05) and 5th days of stroke (9.3 +/- 0.4 mmol/l and 5.5 +/- 0.5 mmol/l; p < 0.01). The level of glycemia on an empty stomach was significantly correlated with the fatal outcome (r = 0.367; p < 0.01). The correlation between the development of lacunar infarction and the presence of previously developed diabetes mellitus type 2 (r = .0.756; p < 0.01) was also noted. The results obtained suggest a significant effect of diabetes mellitus type 2 on the course of ischemic stroke and the necessity of correction of glycemia in these patients.

Effectiveness of halidor preparation was assessed in a randomized open 8-weeks study in 44 patients with diabetes mellitus type 2 and chronic cerebral blood circulation disorders. A control group included 15 patients with the same pathologies who did not receive halidor. Administration of halidor in doses 100 mg 3 times daily led to the improvement of clinical state in 32 (72,7%) patients that was confirmed by statistically better performance (p<0,05) on the neuropsychological tests: MMSE by 14,7%, clock-drawing test by 16,8%, the Schult test by 23,5%. The blood flow in middle and posterior cerebral arteries was increased by 21 and 23%, respectively (p<0,05), and the vascular tonus was reduced. The possibility of halidor administration to patients with diabetes mellitus with concomitant chronic cerebral blood circulation disorders is discussed.