Currently, protocols of dual antiplatelet therapy after the installation of intracranial stents are borrowed in interventional cardiology. But the presence of an extended defect of the artery wall in the neck of the aneurysm should be taken into account. Materials and methods. 200 patients with complex aneurysms after installation of flow diverters (100 patients) and embolization with stent-assisted coils (100 patients). Dual antiplatelet therapy was performed with clopidogrel 75 mg and acetylsalicylic acid 100 mg per day or with ticagrelor 90 mg 2 times a day (for insufficient reduction of functional activity of platelets). Results. The degree of aggregation decreased by an average of 54.7±19.6% (p=0.03) in the group of flow diverters, the velocity of aggregation decreased by an average of 41.5±8.1% (p=0.006), in the comparative group the degree of aggregation decreased by an average of 47.7±18.8% (p=0.04), the velocity of aggregation decreased by an average of 36.4±12.8% (p=0.03). The differences between the groups were not statistically significant. Conclusion. Monitoring of platelet aggregation capacity in the postoperative period by ADP-induced platelet aggregation is necessary to compare its possible benefits and risks for each patient and correction of dual antiplatelet therapy. Further study is required to develop common standards for dual antiplatelet therapy after the installation of intracranial stents.

We discuss now the benefits of surgical treatment to conservative methods in patients with hemodynamically significant stenosis of the carotid arteries. The principal discussion problem at present are the time from the onset of the stroke to the operation and the criteria for selecting patients for the surgical intervention. Now the greatest relevance are neurophysiological research methods spontaneous and evoked brain activity that are able to detect functional abnormalities with important prognostic value. The purpose of this study was to study the dynamics of the spectral-coherent EEG indices and somatosensory evoked potentials in patients of varying severity with ischemic atherothrombotic stroke, who underwent carotid endarterectomy on the side of the infarction in the acute period. In 105 patients with ischemic stroke, who underwent carotid endarterectomy in an acute period, spectral, coherent EEG characteristics and amplitude-latent indicators of somatosensory evoked potentials were analyzed. They compared the dynamics of power spectra, intra-hemispheric EEG, latency and amplitude of somatosensory evoked potentials and clinical indices. A significant inhibition of alpha activity on the side of both hemispheres, a decrease in the intraluminal coherence and amplitude of N20-P23 on the side of the clinically intact hemisphere in the period up to 3 weeks after the operation determines a longer recovery of the neurologic deficit in the postoperative period.

INTRODUCTION. Ultrasound is a modern, affordable and non-invasive method for diagnosing injuries of the peripheral nervous system.
OBJECTIVE. Determine the diagnostic effectiveness of ultrasound in traumatic injuries of peripheral nerves.
MATERIAL AND METHODS. In the course of the study, 154 patients were diagnosed with posttraumatic neuropathy of the nerve trunks of the upper and lower extremities treated from 2012 to 2017. All patients underwent ultrasound examination on devices of expert class with multifrequency linear high-resolution sensors with a common frequency range of ultrasonic signal from 5 to 15 MHz. To assess the effectiveness of the ultrasound method, we used a statistical analysis of sensitivity, specificity and accuracy (accuracy of the method), conducted according to the method of qualitative assessment of referential (surgical intervention or positive conservative treatment) and the studied method (ultrasound).
RESULTS. The sensitivity and specificity of ultrasound in the detection of peripheral nerve damage was 93.6% and 68.2%, respectively. The accuracy of the ultrasound examination is 86.4% at the level of false-negative and false-positive responses — 6.4% and 31.8%, respectively.
CONCLUSIONS. The general information value of the ultrasound method in detecting damage to the peripheral nerves of the limbs, is more than 80%, which allows us to consider it as the leading one in the diagnosis of this pathology.

Possibility to improve results of dorsopathy treatment using patented paracentetic method of diagnostics and treatment of intracartilage hypertension was studied.

INTRODUCTION. Cerebral hyperperfusion syndrome (CHS) is considered to be a complication of neurosurgical brain revascularization and reconstruction procedures on extracerebral arteries, resulting from increase in blood inflow to the brain exceeding metabolic demands.
OBJECTIVE: Evaluate incidence and describe clinical manifestations of the cerebral hyperperfusion syndrome following extra-intracranial bypass (ECIC bypass) surgery in patients with atherosclerotic occlusion of internal carotid artery, identify probable contributory factors for development of CHS.
RESULTS: In the studied cohort CHS was observed in 32 (23.36%) cases. The most frequent CHS symptoms observed were mental disorders and focal neurological deficitis (according to 19 records, accounting to 59.38% of CHS cases).
Statistically significant differences were demonstrated in patients with cerebral hyperperfusion syndrome concerning absolute mean transit time (MTT) value on the side of occlusion as well as its interhemispheric asymmetry, according to preoperative CT perfusion, in comparison with patients without CHS.
Based on obtained data mathematical model for calculation the probability of development of CHS was established.

AIMS. To analyze the influence of chronic psychosocial stress (CPSS) factors on the cerebral blood flow (CBF) characteristics.
MATERIALS AND METHODS. 160 locomotive machinists (LM) and machinist assistants (MA), whose profession is estimated as one of the most stressful, were enrolled in this study. 100 practically healthy volunteers were included in the control group. The activity of the stressor system was assessed by the plasma levels of stress hormones (ACTH, cortisol, adrenaline). The function of the endothelium was studied by determining the production of vasoregulators, such as nitric oxide and endothelin-1. Using ultrasound Doppler sonography, we measured the thickness of the intima-media complex of the common carotid artery, and evaluated the results of endothelium-dependent vasodilation. The blood pressure dynamics was studied using the Holter monitoring. 
RESULTS AND DISCUSSION. The effects of the CPSS factors lead to a prolonged increase in stress hormones levels in the blood and cause the vasoconstriction. On the background of the arisen vasoconstriction, the processes of endothelial dysfunction (ED) are triggered with impaired formation of nitric oxide and increased secretion of endothelin 1, that also leads to arterial hypertension. With the progression of these processes, there is a decrease in CBF. The observed increase in the size of the intima-media complex of the common carotid artery correlates with the severity of arterial hypertension and ED. The results of endothelium-dependent vasodilation test revealed abnormalities in the activity of the vascular endothelium in LM and MA groups.
CONCLUSIONS. The effects of CPSS factors lead to a decrease in CBF. The cause of such phenomenon is the development of ED and arterial hypertension, which are formed due to high levels of stress hormones circulating in the blood. These processes lead to functional failure of the vascular endothelium.

OBJECTIVE. Access different methods of surgical treatment of patients with cubital tunnel syndrome (CTS).
MATERIALS AND METHODS. Pro — and retrospective analysis of 86 patients [51 (61%) men and 32 (39%) women] with CTS at age 43,4±0.7 years was carried out. Standard decompression of the ulnar nerve was performed in 55 (64%) patients with CTS (group№ 1), 17 (20%) patients with aforementioned syndrome were surgically treated by anterior subcutaneous transposition (AST) of the ulnar nerve (group№ 2), and 14 (16%) with mini-invasive decompression (group№ 3).
RESULTS. Follow up of operated patients took place in 6 and 12 months. Results of operations was accessed by PRUNE questionnaire, nerve conduction and the amplitude of M-response obtained by electroneuromyography, degrees of motor deficit and sensory disorders immediately after surgery, in 6 and 12 months after surgical treatment. The reduction of sensitive disorders and the degree of paresis was recognized as a good result, and the reduction of only sensitive disorders as satisfactory. After 6 months, 60% of good results were observed in the first group, 47% in the second and 64% in the third.
According to intraoperative neuromonitoring, there was an increase in the M-response indices relative to the initial one by 130–220% in the group of patients with standard decompression, 43–110% in the group with anterior transposition and 138–246% in the mini-invasive group.
Increase of amplitude of M-response obtained by electroneuromyography by 5,4±0,1 millivolts (mV) was observed in patients with standard decompression, 3,2±0,1 (mV) in patients operated by AST and 5,1±0,1 by (mV) — in patients surgically treated by mini-invasive decompression in 6 months after surgery.
CONCLUSION. Mini-invasive decompression and standard decompression of the ulnar nerve are adequate methods for the surgical treatment of the cubital canal syndrome, as evidenced electrophysiologically during and after intervention using neurophysiological monitoring, as well as long-term clinical results.

The objective of the investigation was to study the effectiveness of endonasal electrophoresis of the synthetic fragment of ACTH4–10 — Semax (EES) in cognitive rehabilitation of cerebral stroke patients. 107 patients were examined at the second stage of the rehabilitation program. The patients were divided into 2 subgroups. 53 patients of the control group received standard nootropic therapy and neuropsychological procedures; 54 patients of the main group received an additional course of EES. The dynamics of the score increase by Rivermid, Karnovsky, Roshina, FAB, MMSE, mRS, HDRS, SF-36 scales was analyzed. Conclusion: 1. Both the standard scheme of cognitive rehabilitation and its combination with the EES have a positive nootropic effect, leading to a significant improvement of all cognitive functions, quality of life, activity of daily living and emotional behavior of cerebral stroke patients. 2. EES significantly improves the general functional state in stroke patients. 3. The use of EES in patients with hemorrhagic stroke has additional significant advantages in the restoration of executive functions, perception and counting. 4. EES in patients with ischemic stroke improves the recovery in counting, while slowing the recovery in speech.

OBJECTIVE. To evaluation patients` intellectual and memory impairments before and after resection of pituitary adenomas
MATERIAL AND METHODS. We performed study of 42 patients with intellectual and memory impairments. The diagnosis of the studied patients was based on clinical and laboratory data, data of radiation and instrumental methods of research. We used the transsphenoidal access for all patients. The analysis of patients` intellectual and memory impairments was carried out in the preoperative and early postoperative periods. The patient` age ranged from 22 to 63 years; the mean age was 43,95±11,3 years; the median age was 45 years.
RESULTS. We found that 40 of the 42 patients studied (95.2%) had various memory impairments in the pre-operative period. Pathological changes in short-term (operative) memory were observed only in the preoperative period in the studied patients. All 42 operated patients recovered short-term (fixation) memory to normal values in the postoperative period. Long- term memory improved in most patients in the postoperative period. The frequency of memory impairments decreased from 38.1% to 9.5% in the postoperative period. It was revealed that the appearance of confubulations increased in the postoperative period in the patients, compared with the preoperative period (71.4% and 64.3%, respectively). We found that after surgery, the number of patients with high intelligence (up to 54.8%), as well as an outstanding level of intelligence (up to 19%) increased.
CONCLUSION. On examination of various memory impairments before and after surgery in patients with pituitary adenomas, it was found that most of the memory impairments in patients regressed. Only paramnesia was more stable, which was preserved in more than half of the patients studied in the early postoperative period. The absence of various intellectual disorders in patients in pre- and postoperative periods was found. There was also an improvement in intelligence after an operative intervention.

EXTRAMEDULLARY MENINGIOMAS make up to 1.2% of the total number of meningiomas and 15–30% of all primary spinal tumors. Of these, up to 80% of meningiomas were located at the level of the thoracic spine. For the first time in our work, we encountered a patient with a thoracic spine meningioma on the background of a long — term comorbid pathology-multiple sclerosis and myasthenia gravis. In the literature we have not found publications on such cases.