Diagnosis and therapy of cognitive impairment in chronic cerebral ischemia

Chronic cerebral ischemia is a common condition associated with progressive brain damage that manifests itself in various neurological disorders, including cognitive impairment. One of the etiologic factors of vascular disorders is arterial hypertension. The article discusses types of cognitive impairment and pathogenetic mechanisms of their formation. The role of the glymphatic system of the brain, the role of neuroinflammation in the implementation of cognitive impairment are discussed. The described clinical case shows the need to supplement basic therapy in patients with hypertension with drugs of other groups, in particular pentoxifylline, to improve the effectiveness of therapy. The article reviews the latest clinical and experimental studies of pentoxifylline, which show its positive effect on inflammation, endothelial dysfunction and, as a result, improvement of cognitive functions. The neuroprotective effect of pentoxifylline, which has been confirmed in experimental and clinical studies, is discussed. The possibility of using pentoxifylline in patients with mood disorders, major depressive disorder, bipolar disorder as an adjunct to the main therapy, and in cognitive impairment as monotherapy is discussed.