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Epidemiological data show that Alzheimer's disease (AD) is the most common cause of acquired cognitive impairment (CI). At the same time, according to statistics, vascular CI and vascular dementia predominate in Russia, which is mainly due to imperfect diagnosis, when any pathological condition associated with cerebral dysfunction in a patient with vascular risk factors is interpreted as dyscirculatory encephalopathy or chronic brain ischemia. However, this can be asthenoneurotic syndrome, migraine, vestibular dysfunction, and a number of neurodegenerative diseases, the most common condition of which is certainly AD. What is more, the treatment of age-related diseases, with the exception of acute vascular disease, is receiving manifestly inadequate attention. All this leads to the lack of a unified methodology for the management of these patients, to the impossibility to have adequate primary medical care, to the low detection rate of CI, to the prescription of drugs without appropriate indications, and to the denial of psychological correction methods. The review highlights the challenges facing the management of patients with AD and the possible ways of their solution.

We present results of the assessment of the efficiency of hyperbaric oxygenation therapy in 104 patients with cerebrovascular diseases. Of these patients 32 had chronic cerebrovascular insufficiency and 72 showed transient disturbances of the cerebral circulation. A good effect was noted in 74 patients, a satisfactory one in 22, and a doubtful one in 8 patients. It is concluded from clinical, electrophysiological, psychophysiological, biochemical, and ophthalmoscopic examinations that hyperbaric oxygenation therapy is quite efficient when used as part of a combined therapy and as a means of prompt therapy of acute cerebrovascular crises. Observations over three to five years of patients repeatedly receiving the hyperbaric oxygenation therapy at 6 month intervals allows us to recommend it for the prevention of cerebral strokes.

Диагностика идиопатической нормотензивной гидроцефалии (иНТГ) вызывает затруднения из-за схожей симптоматики с нейродегенеративными заболеваниями. Не всегда данные магнитно-резонансной томографии (МРТ) головного мозга и инвазивные методы (тап-тест, наружный люмбальный дренаж, инфузионный тест) позволяют точно установить диагноз иНТГ, тем более когда у пациентов имеется сопутствующая патология. В связи с этим возрастает роль биомаркеров цереброспинальной жидкости (ЦСЖ) в дифференциальной диагностике иНТГ и коморбидных заболеваний на ранних стадиях. Цель исследования-анализ данных литературы о современных представлениях о биомаркерах в ликворе и их роли в дифференциальной диагностике иНТГ с нейродегенеративными заболеваниями головного мозга.

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