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The incidence of ischemic stroke remains high in many countries, despite a declining trend in the incidence of brain circulation disorders. Limited knowledge of the pathogenesis, diagnosis, clinical presentation, and treatment of this life-threatening disease can be complemented by modelling of ischemic stroke on animals, particularly, in rodents (rats, mice).The aim of review: to provide a rationale for choosing an optimal model of human ischemic stroke.Among more than 300 primary literature sources from various databases (Scopus, Web of science, RSCI, etc.), 84 sources were selected for evaluation, of which 72 were published in the recent years (2015–2019). The criteria for exclusion of sources were low relevance and outdated data.The review examined six experimental models of acute cerebrovascular events including middle cerebral artery occlusion, embolic stroke model; phototrombosis; models using thrombin, endothelin-1 and electrocoagulation of the middle cerebral artery.The review outlines the factors influencing reliability and reproducibility of research results, related to adherence to the rules of animal accommodation and acclimatization, nutrition and care, selection of anesthesia and pain relief methods, compliance with aseptic techniques, monitoring of basic physiological parameters at all stages of the ischemic stroke modeling experiment, with humane withdrawal of animals from the experiment.It was concluded that the model of ischemic stroke, based on the occlusion of the middle cerebral artery, is most promising as being the closest to features of human ischemic stroke and enabling to obtain reproducible results in the experiment.

А clinical case of a young patient with recurrent ischemic strokes is presented. The problems of diagnostic embolic strokes are discussed. We set out the algorithm for identifying patients, in whom patent foramen ovale is the most probable cause of embolic stroke. Detailed consideration of imaging diagnostic methods possibility is included. Hypothesis of probable source of cardioembolism from patent foramen ovale is presented. Recommendations for the secondary prevention of recurrent ischemic stroke, associated with patent foramen ovale, are provided. We also considered the issues of antithrombotic treatment.

Cardioembolic stroke (CS) is the one of the most severe and requiring dynamic monitoring among the all subtypes of ischemic stroke. Patients with CS require joint treatment with cardiologists. CS is characterized by a greater severity of neurological deficits, a high risk of repeated acute cerebral circulatory disorders and fatal outcomes. This review considers the main causes of CS, the etiopathogenesis of thrombus formation in the heart chambers, current verification criteria and therapeutic aspects of CS, recommendations for the prescription of anticoagulant therapy for primary and secondary preventive treatment.

Objective: To study the parameters of platelet hemostasis in patients with cardioembolic ischemic stroke on the background of atrial fibrillation and taking warfarin to assess the effectiveness of antiplatelet drugs in the prevention of recurrent ischemic strokes., Material and Methods: 93 patients with ischemic stroke on the background of atrial fibrillation were examined, of which the main group consisted of 43 patients who took warfarin and 50 patients from the reference group without warfarin. The study of the platelet link of hemostasis using inductors (adrenaline, ristomycin, arachidonic acid, collagen, ADP) in patients of both groups was carried out. In the group of patients taking warfarin there was a significant increase in platelet aggregation for adrenaline up to 57.15 [29.51; 62.61] ( p =0.0315), spontaneous aggregation 2.46 [1.39; 6.75] ( p =0.047), reduction of platelet aggregation for collagen 14.45 [4.80; 43.63] ( p =0.008). In 35 patients of the study group ( n =93), laboratory resistance to aspirin was also revealed in terms of platelet aggregation to arachidonic acid, which is a criterion for evaluating the effectiveness of preventive measures for recurrent ischemic strokes with antiplatelet drugs., Conclusion: The obtained data are additional risk factors for recurrent strokes. It is also recommended to study platelet aggregation for arachidonic acid to assess the effectiveness of antiplatelet drugs prophylaxis of recurrent ischemic strokes.

About 20-40% of ischemic stroke survivors cannot be attributed to a particular pathogenetic subtype despite a thorough diagnostic evaluation (cryptogenic stroke). Most cryptogenic strokes are likely embolic. This understanding is captured by a related concept, termed embolic stroke of undetermined source (ESUS), which is defined as a nonlacunar brain infarct without proximal arterial stenosis or cardioembolic sources. These patients are generally younger, has less disabilities and more favourable prognosis. It is assumed that in this group of patients, anticoagulants may have an advantage over antiplatelet drugs as a means of secondary prevention. Specific methods of treatment and secondary prevention of ESUS has not yet been developed.