Experience of using of Cerebrolysin in comprehensive rehabilitation of a patient after ischemic stroke with motor deficit and aphasia

This report presents a clinical case of a 39-year-old patient with severe right-sided hemiparesis and complex motor aphasia in the late recovery phase of ischemic stroke (IS). Alongside comprehensive physical rehabilitation and speech therapy sessions, the patient received several courses of intravenous Cerebrolysin at a dose of 20 ml (10 infusions). Efficacy was assessed using the Modified Rankin Scale (mRS), Barthel Index, Rivermead Mobility Index, Berg Balance Scale, Hauser Ambulation Index, 10-Meter Walk Test, Modified Ashworth Scale (MAS), the Wasserman Scale for aphasia, and neuropsychological testing. Significant positive dynamics were observed during rehabilitation with pharmacological support. Motor improvements included a 2-point increase in muscle strength in the right extremities (MRC scale), a 1-point reduction in muscle tone, the emergence of active movements in the proximal upper limb, and enhanced walking speed and distance. Regarding speech, a significant regression of aphasic disorders was observed: speech comprehension and grammatical structure improved, and the number of paraphasias and perseverations decreased, objectively confirmed by a reduction in the Wasserman Scale score from 48 to 40 points. Neuropsychological testing revealed improvements in auditory-verbal memory and the dynamics of praxis. Course administration of Cerebrolysin as part of a comprehensive rehabilitation program in a patient with motor deficit and complex motor aphasia after IS demonstrated a favorable safety profile and contributed to a significant improvement in both limb motor function and speech, which is consistent with the results of previous studies. The obtained results support the recommendation for the course-based use of Cerebrolysin in multidisciplinary neurorehabilitation programs to enhance neuroplasticity processes and improve functional outcomes.