The development of primary and repeated disorders of cerebral circulation, vascular dementia, transient ischemic attacks, which are a consequence of the development of acute pathology in patients with hypertensive encephalopathy, lead to a state of persistent disability and disability. Today, the emphasis of treatment is placed on the important role of oxygen deficiency, which leads to the restriction of aerobic energy production due to disturbances in the energy-synthesizing function of the mitochondrial respiratory chain, depletion of endogenous antioxidant stores and activation of lipid peroxidation of cell membranes, leading to death of brain cells. By 2018, a large evidence base for the effectiveness of the use of metabolic therapy in neurology, which takes into account an important factor of the impact of comorbidity of the pathology. The effectiveness of antioxidant therapy in acute and chronic cerebrovascular diseases is confirmed by the fact that the antioxidant improves energy metabolism in the cell, and as a metabolite of the tricarboxylic acid cycle (succinate, which provides pronounced antioxidant and antihypoxic properties) has a positive effect on the main links of pathogenesis of diseases associated with processes freely Radical oxidation. It is proved that the preparation of Mexicor reduces the manifestation of oxidative stress, inhibits free radical peroxide oxidation of lipids, improves cellular energy metabolism, activates the energy-synthesizing functions of mitochondria, enhances compensatory activation of aerobic glycolysis and reduces the degree of inhibition of oxidative processes in the Krebs cycle. The drug Mexocor has a wide spectrum of pharmacological action, which allows it to be used successfully in acute and chronic cerebrovascular diseases, accompanied by vascular comorbidity.