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New daily persistent headache - rare primary or secondary phenomena caused by carotid-cavernous fistula? A case report

100%
Ljubisavljevic S., Stojanov D., Spasic M., Zivkovic M.
Open Medicine
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2014
|
vol. 9
|
issue 2
302-305
EN
Carotid cavernous fistulas (CCF) are dural arteriovenous fistulas which include pathological communications between the arterial system and the venous cavernous sinus situated at the wall of the cavernous sinus. It can be demonstrated by wide range clinical presentations. The presented case shows a very modest clinical presentation of CCF which was present over a few months only as new daily persistent headache without initial positive findings on performed computer tomography of the head, but rapidly worsened over a period of few days.
2
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Metastatic lesions in the gastroduodenum - an unusual manifestation of malignant melanoma and pulmonary adenocarcinoma

76%
Benedeto-Stojanov D., Bjelaković G., Milentijević M., Stojanov D., Brzački V., Petrović G.
Open Medicine
|
2014
|
vol. 9
|
issue 6
762-767
EN
The gastrointestinal tract (GIT) is an unusual site for metastasis. The rate of GIT metastases detected clinically is very low because of unspecific symptoms and signs of GIT involvement, which include general weakness, tiredness, weight loss, unspecific abdominal pain, fatigue, and anemia. We report clinical, endoscopic, and pathological patterns of two patients (malignant melanoma and primary lung tumor) with metastatic lesions in the gastroduodenum. The first case is a 59-year-old man with unspecific symptoms as nausea, vomiting and abdominal pain. He underwent resection of skin melanoma on his back one year before. Upper gastrointestinal endoscopy revealed two melanotic polypoid masses with ulcerations at the tip, one in the stomach and one in the duodenal bulb. Endoscopic biopsy of these polypoid masses and immunohistochemical stains confirmed the diagnosis of metastatic malignant melanoma. The second case is a 73-year-old man with a two-day history of melena and unspecific abdominal pain. Three weeks before, the patient was operated on for the adenocarcinoma of the lung. Endoscopy of the upper gastrointestinal tract revealed irregular polypoid mass with ulcerations at the tip: three of the stomach mucosa, two in the duodenal bulb and more than ten hemorrhagic polypoid masses at the desendent duodenum. Biopsies of these lesions confirmed the diagnosis of metastatic lung adenocarcinoma. In patients with a history of malignant melanoma and lung cancer unspecific symptoms, like abdominal pain, anemia, and gastrointestinal bleeding gastroduodenal metastases should be suspected. The diagnosis requires careful endoscopic examinations of the mucosa for metastatic lesions and biopsy with special immunohistochemical stains.
3
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Lateral intra-extraspinal cervical schwannomas: Partial versus total resection

64%
Stefanović I., Bošnjaković P., Kostić A., Stefanovic S., Stojanov D., Dimov D., Radisavljević M., Jelenković B.
Open Medicine
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2012
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vol. 7
|
issue 1
66-72
EN
The study involved 27 lateral cervical schwannomas surgically treated in the last 40 years utilizing either partial or total resection. The study aims to compare the results of total and partial resection of spinal lateral schwannoma and to assess the values of partial resection of large lateral cervical schwannomas. We performed a retrospective analysis of 27 patients operated for lateral cervical schwannomas in the period 1971–2010, out of which 11 had partial resection. The average follow-up of the patients was 136.4 months, comparing pre- and postoperative clinical picture, time to relapse, dynamics of yearly growth of schwannomas, and the need for re-resection. The average period of preoperative complaint in lateral cervical schwannomas was 19.6 months. Unilateral cervicobrachialgia as a manifestation of radiculopathy was observed in 85% of LCSs, and, was, as a rule the first symptom of the disease. Surgical treatment of 27 patients with LCSs resulted in recovery or improvement of complaints in 80% of cases. The treatment effect did not depend on the degree of resection. Reoperation was done, on average, 16.3 years after partial resection. The residues of lateral cervical schwannomas stopped growing 15 years after partial resection and underwent cystic degeneration. Partial resection of lateral cervical schwannomas is an excellent alternative to total resection, not only for the elderly or in cases of increased surgical risk, but also as a method of choice since it is more readily available to a larger number of surgeons and associated with low percentages of surgically relevant relapses and high percentages of improvement.
4
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ADC is not reliable in determinating subtypes of meningiomas

64%
Ignjatović J., Stojanov D., Stojanovic N., Stefanović I., Benedeto-Stojanov D., Petrović S., Kostić A., Aracki-Trenkic A., Ignjatović N.
Open Medicine
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2014
|
vol. 9
|
issue 6
773-777
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