High mortality and disability resulting from a stroke throughout the world is the cause of fi nding new opportunities to improve early diagnosis and optimize therapeutic approaches. The article presents a review of the literature devoted to the study of glial fi brillary acidic protein (GFAP) as a biomarker in the acute period of stroke, which showed that its use is possible not only to diff erentiate the ischemic and hemorrhagic process, but also to determine the degree of destruction of brain tissue, as in the fi rst hours of a stroke, and in the dynamics. In addition, the GFAP analysis can be useful for monitoring the course of the disease, control the eff ectiveness of therapy, as well as to predict outcomes.

Aim: to conduct a comparative analysis of clinical and biomechanical parameters of gait in patients at various stages of Parkinson`s Disease (PD).
Materials and methods. 171 patients with PD were examined, the median age was 67.5 ± 7.92 years. Assessment of gait impairment (GI) was conducted with computerized protocol Diers pedogait. Statistical processing was performed using Statistica 10 and Microsoft Excel 2016.
Results. When patients were divided into groups according to the stage, statistically signifi cant diff erences were obtained in terms of foot rotation angle, decrease in stride length, velocity, stride time and cadence. With a disease duration of up to 2 years and from 2 to 5 years, diff erences were found in the average time of a single step and the length of a step. With a disease duration of 5–10 years Tinetti balance tests (TBT) indicated signifi cant progression of GI, as well as the following parameters: stride length, track width, velocity, depending on lateralization — duration of the pre-swing phase, single stride time.
Conclusion. Diers pedogait is an eff ective method for detecting early sings of PD progression on the stage when clinical scales are reliable, which will allow an early correction of therapy and rehabilitation of patients. A broader introduction of biomechanical methods for examination of gait impairment into practice both in neurological departments and in rehabilitation institutions is needed.

A description of two cases of ischemic stroke with a progressive course on background of dissection of internal carotid artery (ICA) in young women is presented. In the fi rst observation patient developed headache, severe rightsided hemiparesis and sensorimotor aphasia. In digital subtraction angiography dissection subocclusion of left ICA was visualized, after that thrombectomy, intra-arterial thrombolysis and stenting were sequentially performed with achievement complete recanalization, accompanied by regress of paresis. In the second observation, mild leftsided hemiparesis developed, which grew after 4 days, hemianopsia and dysarthria appeared. Based on the results of emergency digital subtraction angiography, a dissection subocclusion of the right ICA was visualized. Using of tandem stenting, complete recanalization was achieved, accompanied by an increase in strength in the limbs and vision improvement. The literature review about the effi cacy and safety of stenting in dissection is presented. 

Syringomyelia is a chronic myelopathy with the formation of cavities in the spinal cord. The most common cause of syringomyelia is the obstruction of the cerebrospinal fl uid tract at the craniovertebral junction level in patients with Chiari malformation. The main method of treatment of syringomyelia is surgical, aimed at stopping the progression of the disease. To date, controversial data on the postoperative regression of myelopathic symptoms and factors contributing to a positive clinical outcome are presented in the world literature 
Goal of the study: to assess the dynamics of myelopathic symptoms of syringomyelia at the postoperative stage.
Material and methods. 44 patients with syringomyelia associated with Chiari 1 malformation, who underwent decompression of the posterior cranial fossa and had positive postoperative radiological dynamics of the syringomyelitis cavity were included to our retrospective study. Patients were evaluated by clinical and MRI parameters at the preoperative and distant postoperative stages.
Results. Analysis of clinical and MRI indicators at the preoperative and remote postoperative stages allowed us to determine the frequency of regression of myelopathic symptoms and to identify it’s main dynamics predictors.

The syndrome of Foix–Alajouanine (SFA) is a group of rare vascular diseases of the spinal cord. Etiological factors of development of this condition are anomalies of spinal veins, spinal dural arterio-venous fi stulas in the leading arteries, in the intramedullary network, as well as in venous collectors. The disease has a progressive and step-like course with periods of exacerbations and incomplete remissions, while the beginning can be both acute and subacute. The clinical picture is dominated by symptoms of myelopathy. Depending on the level of the lesion of the spinal cord violation of its functions can be characterized by a symptom complex of: 1) movement disorders (tetra – or paraparaesis spastic or peripheral); 2) changes in superfi cial and deep sensitivity (anesthesia, hypoesthesia, hyperesthesia at polyneuritises, conduction or segmental type, hyperpathia, allodynia, sensory ataxia); 3) infringement of functions of pelvic organs by type of Central delay or incontinence; 4) autonomic-trophic disorders. The manifestation of myelopathy may be initially asymmetric. Nonspecifi c symptoms often mask the disease, which causes diffi culties in timely diagnosis, diff erential search, establishing the true cause of disorders of the spinal cord. As a rule, only with a detailed clinical picture that determines the topical level of the lesion, and after a targeted MRI study with a vascular program, it is possible to establish a fi nal diagnosis. Lethal outcomes in this disease are possible in the case of thromboembolic complications associated with opportunistic infections of the pulmonary and urinary systems. We have presented a description of two patients with signs of progressive myelopathy at the thoracic level. One of them had background diseases – atherosclerosis and diabetes mellitus. Identifi ed the syndrome of Foix–Alajouanine vascular anomalies require immediate surgical intervention. With untimely treatment, a severe irreversible neurological defi cit, especially motor function, can form, which prevents the social adaptation of patients.

The article presents the results of safety fi ndings during international multicenter randomized double-blind, active and placebo-controlled, comparative phase 3 trial. 158 patients with relapsing-remitting multiple sclerosis were randomly assigned into 3 groups: Timexon (glatiramer acetate, manufactured by JSC «BIOCAD», Russia), copaxone-Teva (Teva Pharmaceutical Enterprise Co., Ltd., Israel) and placebo, at a ratio of 2:2:1, respectively. At the second group 63 patients received Copaxone-Teva, after 48 weeks of therapy they received Timexon. Switching between therapy was not associated with adverse eff ect frequency. There was no clinically signifi cant diff erences in profi le and frequency of adverse eff ects between the groups of Copaxone-Teva and Timexon. Also, effi cacy analysis of therapy demonstrated no diff erences between timexone group and Copaxone-Teva group in both MRI parameters and frequency of relapses. The data obtained from the present study confi rm the equivalence in safety of Timexon (CJSC BIOCAD, Russia) and Copaxone-Teva, that is important for further implementation of glatiramer acetate generic in the clinical practice of multiple sclerosis therapy.