Introduction. The incidence of stroke is 2.5–3 cases per 1 000 population per year, mortality – 1 case per 1 000 population per year. According to various data, up to 20% of computed tomography (CT) scans performed on the first day do not reveal signs of an ischemic focus.Aim of the study. To assess the detectability of acute ischemia foci using CT, depending on the location of the foci, the timing of neuroimaging, the severity of stroke, and other indicators.Material and methods. We analyzed 100 cases of acute cerebrovascular accident (ACV) by ischemic type. The timing of the CT scan, glucose level, coagulogram parameters, NIHSS scores at admission, focus localization, the presence of atherosclerosis of the arteries of the head, and atrial fibrillation were taken into account. Patients were divided into two groups depending on the fact of detection of the focus during the primary tomographic examination. Repeated neuroimaging (magnetic resonance imaging) was performed in 54 patients.Results. In the “CT-negative” group, stem strokes predominated (p = 0.01), patients were younger (р = 0.038), and there were significantly more women than men (р = 0.00006). An increase in glucose over 8 mmol/l, on the contrary, was more often detected in the “CT-positive” group (14 cases in “CT-positive” against 5 cases in “CT-negative” group, p = 0.022). NIHSS scores ≥ 5 were found in 24 patients (47%) in the “CT-positive” group and in 13 patients (26.5%) in the “CT-negative” group (p = 0.034).Conclusions. Cases of stroke that are not detected on CT scan upon admission to the hospital are more common among women, with stem localization, are associated with low NIHSS scores. High glucose levels at admission is associated with the detection of ischemic foci during the initial CT examination.

Objective. To evaluate the effectiveness of various surgical strategies for reinnervating the facial nerve in patients who have sustained post-traumatic paralysis of the facial muscles. Material and methods. The cohort included six male patients with a mean age of 29±7 years. Depending on the level of nerve lesion—whether intra- or extratemporal—patients underwent either triple selective reinnervation or reinnervation via the hyoid nerve (XII), accompanied by intraoperative neurophysiological monitoring. Results. Evaluations using the House-Brackmann scale, needle electromyography, and eFACE scores indicated statistically significant improvements (p<0.05) by 12 months of follow-up for all patients. These findings underscore the effectiveness of a tailored approach and the importance of neuromonitoring. Conclusions. The findings from this prospective study demonstrate the clinical efficacy of a differentiated surgical approach to facial nerve reinnervation in patients with post-traumatic paralysis of the facial muscles.