Modern aspects of chronic cerebral ischemia pathogenetic therapy

Chronic cerebral ischemia (CCI) is one of the most common forms of cerebrovascular disease, which affects a significant number of patients, often leading to disability, cognitive impairment and dementia. The analysis of modern data on the pathogenesis and risk factors for the development of CCI, as well as on the mechanisms of action of Mexidol on various links in the pathogenesis of CCI. A systematic search was conducted in the PubMed, MEDLINE and Google Scholar databases, on Russian and English-language sites with open access publications on the problem of CCI and on the drug Mexidol in the period from 2014 to 2024. The analysis included randomized controlled trials, meta-analyses and original studies, excluded low-confidence studies, retrospective studies, literature reviews, systematic reports and descriptions of clinical cases. It has been established that the use of Mexidol leads to a significant regression of cognitive, emotional, autonomic and motor disorders in CCI. An important indicator of the effectiveness of Mexidol is the high degree of patient adherence to therapy. It is recommended to start treatment with injection of Mexidol, followed by a transition to tablet forms.