№2, 2016, volume 12

Carotid artery stenting (CAS) has proved to be a valuable alternative to carotid endarterectomy in patients with carotid artery stenosis. Therefore, avoiding complications becomes crucial in CAS. The results are constantly improving because of the introduction of new embolic protection devices and small calibre stenting systems. For many years, transfemoral approach has been the most common access during CAS, mainly due to its short learning curve and possibility to accept large bore catheters. However, this approach is not always feasible because of vessel pathology or aberrant anatomy of the iliofemoral arteries and the aortic arch. Carotid artery stenting using transradial approach was safe and technically feasible, but limited data exist on radial access in carotid artery stenting. The rationale for the transradial approach was to attempt to reduce the incidence of bleeding complications at the vascular access site and to avoid the necessity for prolonged bed rest. Several pilot studies and one randomised prospective trial have confirmed the safety and efficacy of transradial approach for CAS. This article reports review of literature and our initial experience using the radial artery as access for carotid stenting.

The information about the cormorbid pathology in patients with skin and nervous systems diseases is summarized on the base of Russian and foreign scientific literature. The main attention is devoted to the combination of nervous system pathology with psoriasis and psoriatic arthritis. The high risk of cerebrovascular diseases development is pointed in psoriasis. Material concerning neuropathy caused by the cytostatics usage is represented in patients with psoriasis.

The study aims paying the attention of specialists in rare cases of pathology of the nervous system in HIV-infected patients. The clinical case of brain abscess in a 32 year-old HIV-positive patient. Against the background of the surgical and antiretroviral treatment of brain abscess in HIV-positive patients it managed to achieve a virologic response and regression of neurological symptoms. Presented clinical case can be useful for specialists in determining the tactics of treatment of brain abscess in HIV-infected patients.

The information about epidemiology and clinical polymorphism of neuropathies is summarized on the base of Russian and foreign literature. The algorithm of clinical observation in patients with polyneuropathy is presented.

The aim: the hypothesis testing of the existence of two different groups of patients with different age at disease onset in a large population of patients with methods multidimensional constellation. Materials and Methods. Analysis of 444 patients enrolled in the register of patients with myasthenia in the Samara region. The duration of disease was more than 1 year. Statistical results of the study was carried out using a multi-dimensional grouping by cluster analysis Checking the quality of the classification was carried out using discriminant analysis. Results. Transient age between the two groups was defined as 40 years. The most important criteria of distinction patients group was sex of the patient and the presence of thymic hyperplasia. Conclusion. These clinical and immunologic patterns of early-onset and late-onset myasthenia gravis can serve as a basis of formation flow forecast model of myasthenia gravis and to create an algorithm of patient management.

Objective: to draw the attention of experts on rare cause of secondary parkinsonism — a brain tumor. Material and methods. The clinical observation of the patient 52 years with Parkinson's syndrome. Brain MRI. Results. In parallel the patient had classical progressing clinic bilateral parkinsonism in combination with progressive cognitive decline. MRI research revealed the left frontal lobe tumor. Conclusions. Secondary parkinsonism as a result of intracerebral neoplasms are caused mostly by compression of basal ganglia or mesencephalon increasing tumors. Hemiparkinsonism in these cases usually precedes the other focal neurological symptoms.

The aim: the identification of patterns of formation and course of non-motor fluctuations in this disease and theirs connection with motor symptoms. Materials and Method, for realization of a research objective at 54 patients with Parkinson's disease were used special diagnostic methods, for assess the credibility — methods of mathematical statistics. Results. It was established, that with increasing duration of disease degree of severity of non-motor symptoms grow up; it is noted a direct correlation between results in scales for exploration Parkinson's disease. Conclusion. In the treatment of patients with Parkinson's disease necessary consider the non-motor fluctuations. There are a lot of scales for exploration this disturbance, but they are subjective and for their conduction need a lot of time. So, question of creation new, objective and quick in carrying out scales are open.

Migraine and epilepsy are diseases characterized by paroxysmal occurring clinical manifestations that have different mechanisms of pathogenesis. In the interictal period in 59% of patients with epilepsy there are different types of primary headache: 18%, migraine without aura, 33% from tension-type headache, and 8% not classified headache. We have analyzed clinical and electrophysiological pattern in patients with migraine and idiopathic generalized epilepsy. A preliminary analysis of the clinical picture of headaches in adult patients suffering from idiopathic generalized epilepsy suggests that migraine occurs more often in patients with idiopathic generalized epilepsy, whereas among patients with focal symptomatic epilepsy is more common patients with secondary headache

The information about cognitive impairment of patient, suffered from transient ischemic attack (TIA) is summarized on the base of Russian and foreign literature. There were considered primary risk factors and pathogenesis of the occurrence of TIA and cognitive impairment. The algorithm of examination of patients with TIA was presented.

The aim of the article is to estimate the impact of anxiety on personality characteristics of headache in young adults studying full-time. Material and Methods. We observed 92 people aged from 15 to 25 years old, socially adapted, students in schools, colleges and universities on a full-time offices. Results. The perception of headache strongly depends on the emotional state of the individual, so it is very important to take this into account in the analysis of complaints and anamnesis of patients. Conclusion. Anxiety personality disorders hinder objectifying cephalgia, leading to misdiagnosis and incorrect treatment tactically with the possible development of abuse headaches. Therefore, it is necessary to convey to the patient the importance of reducing the impact of modifiable risk factors to explain the relationship of his condition with these factors and create a positive attitude to treatment.