Assessment of verticalization efficacy in acute ischemic stroke patients with concomitant cerebral venous insufficiency

Objective. The aim of the study is to evaluate the efficacy of a rehabilitation program incorporating verticalization and bovine brain cortex polypeptides, aimed at preventing the development of cardiac autonomic neuropathy in patients with acute ischemic stroke and concomitant cerebral venous insufficiency. Materials and Methods. A total of 90 patients (54 men and 36 women) with hemispheric ischemic stroke were examined. The patients were divided into three groups. Group 1 patients (n=30) received a single course of bovine brain cortex polypeptides (20 mg intramuscularly once daily for 10 days) on the background of standard background therapy during early verticalization. Group 2 patients (n=30) received background therapy during early verticalization only. Group 3 patients (n=30) received background therapy alone without verticalization. Moreover, each group was subdivided into subgroups of patients with and without clinical manifestations of cerebral venous insufficiency. The NIHSS, MMSE, and MoCA scores were used to objectively assess the severity of the condition. Cardiovascular function was evaluated before and 10–14 days after treatment using an isometric exercise test, the Valsalva maneuver, and a timed deep breathing heart rate variability test. The clinical manifestations of cerebral venous insufficiency were assessed based on characteristic symptoms of constitutional venous insufficiency. Results. In the acute period of ischemic stroke, patients with clinical manifestations of cerebral venous insufficiency who received bovine brain cortex polypeptides combined with early verticalization demonstrated the most complete regression of neurological deficits, improvement in cognitive functions, and normalization of autonomic regulation parameters. Conclusion. The administration of bovine brain cortex polypeptides combined with early verticalization is justified in patients with ischemic stroke. Treatment should follow a regimen of two courses of intramuscular injections at a dose of 20 mg daily for 10 days during the acute phase of ischemic stroke, separated by a 10-day interval (10 days of treatment + 10 days off).