Browsing by Author "Stanisavljević, Nataša (36163559700)"

Objective: There is a low incidence of the medullary infarctions and sparse data about the vascular territories, as well as a correlation among the anatomic, magnetic resonance imaging (MRI) and neurologic signs. Materials and methods: Arteries of the 10 right and left sides of the brain stem were injected with India ink, fixed in formalin and microdissected. The enrolled 34 patients with medullary infarctions underwent a neurologic, MRI and Doppler examination. Results: Four types of the infarctions were distinguished according to the involved vascular territories. The isolated medial medullary infarctions (MMIs) were present in 14.7%. The complete MMIs comprised one bilateral infarction (2.9%), whilst the incomplete and partial MMIs were observed in 5.9% and 8.9%, respectively. The anterolateral infarctions (ALMIs) were very rare (2.9%). The complete and incomplete lateral infarctions (LMIs), noted in 35.3%, comprised 11.8% and 23.6%, respectively, that is, the anterior (5.9%), posterior (8.9%), deep (2.9%), and peripheral (5.9%). Dorsal ischemic lesions (DMIs) occurred in 11.8%, either as a complete (2.9%), or isolated lateral (5.9%) or medial infarctions (2.9%). The remaining ischemic regions belonged to various combined infarctions of the MMI, ALMI, LMI and DMI (35.3%). The infarctions most often affected the upper medulla (47.1%), middle (11.8%), or both (29.5%). Several motor and sensory signs were manifested following infarctions, including vestibular, cerebellar, ocular, sympathetic, respiratory and auditory symptoms. Conclusions: There was a good correlation among the vascular territories, MRI ischemia features, and neurologic findings regarding the medullary infarctions. © 2022 The Author(s)

Objectives: There are scarce data regarding pontine arteries anatomy, which is the basis for ischemic lesions following their occlusion. The aim of this study was to examine pontine vasculature and its relationships with the radiologic and neurologic features of pontine infarctions. Materials and methods: Branches of eight basilar arteries and their twigs, including the larger intrapontine branches, were microdissected following an injection of a 10% mixture of India ink and gelatin. Two additional brain stems were prepared for microscopic examination after being stained with luxol fast blue and cresyl violet. Finally, 30 patients with pontine infarctions underwent magnetic resonance imaging (MRI) in order to determine the position and size of the infarctions. Results: The perforating arteries, which averaged 5.8 in number and 0.39 mm in diameter, gave rise to paramedian and anteromedial branches, and also to anterolateral twigs (62.5%). The longer leptomeningeal and cerebellar arteries occasionally gave off perforating and anterolateral twigs, and either the lateral or posterior branches. Occlusion of some of these vessels resulted in the paramedian (30%), anterolateral (26.7%), lateral (20%), and combined infarctions (23.3%), which were most often isolated and unilateral, and rarely bilateral (10%). They were located in the lower pons (23.3%), middle (10%) or rostral (26.7%), or in two or three portions (40%). Each type of infarction usually produced characteristic neurologic signs. The clinical significance of the anatomic findings was discussed. Conclusions: There was a good correlation between the intrapontine vascular territories, the position, size and shape of the infarctions, and the type of neurologic manifestations. © 2022 The Authors

Introduction B-cell chronic lymphocytic leukemia (CLL) can be easily overlooked in pregnancy, particu-larly in cases with inadequate antenatal care. We report a case of pregnant woman diagnosed with CLL and evaluate this patient with cases in literature. Case report An asymptomatic 35-year-old woman presented with slightly elevated absolute lympho-cyte count at antenatal monitoring in her second pregnancy. Further hematological investigations dis-closed CLL with monoallelic deletion of chromosome 13q14. She was monitored during throughout the pregnancy, being asymptomatic and without treatment, and delivered a healthy child at term with no complications. After almost four years of follow up patient is without any signs of disease progression and her absolute lymphocyte counts remained on predelivery levels. This is the first published case of CLL diagnosed during pregnancy in Serbia. Rare similar cases published so far have been discussed, especially in terms of disease course, long-term prognosis and available therapeutic modalities. Conclusion Due to the fact that nowadays many women are delaying childbearing in middle age it can be expected that cancer diagnose could be more often found in pregnant women in the future. In a view of the complex nature of such condition, a multidisciplinary approach for diagnosing and treating of pregnant women is highly recommended. © 2022, Serbia Medical Society. All rights reserved.

Introduction Most patients with liver hemangiomas are unrecognized, when symptoms occur it is usually due to the size of the hemangioma. Hemangioma of the liver are benign tumors which affects women more often. Surgical indications for liver resection remain unclear. Case outline We present a patient with a giant hemangioma of the left liver lobe that was misdiagnosed in a primary care unit. The patient underwent resection of the left liver lobe and fully recovered after several days. Conclusion Symptoms, size, and risk of rupture should be considered when decision for surgery is made. Linear stapler can be useful especially when left and middle hepatic vein have common trunk. © 2023, Serbia Medical Society. All rights reserved.

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