Lidija Tuškan-Mohar

Recurrent Transient Global Amnesia at High Altitude

We report the case of a 57-year-old man who experienced recurrent episodes of memory loss that resemble transient global amnesia (TGA). The first episode lasted 20 minutes, and the second was 8 hours long.

Spontaneous recanalization of internal carotid artery occlusion

ZusammenfassungWir stellen einen Fall mit spontaner Rekanalisierung eines Carotis interna Verschlusses vor, der bei einem 51-jährigen männlichem Patienten beobachtet wurde. Der Verschluss der rechten Aerteria carotis interna war asymptomatisch und ein Zufallsbefund im Rahmen der bildgebenden Untersuchung der Arteria carotis der Gegenseite. Die anschließend durchgeführte neuroradiologische Untersuchung ergab eine flammenartige Okklusion, die den Verdacht einer Dissektion der Arterie nahelegte. Die 1 und 5 Monate später durchgeführte Doppler-Ultraschall-Untersuchungen zeigten eine offene rechte Arteria Carotis mit normalem Fluss.SummaryWe present a case of spontaneous recanalization of the internal carotid artery (ICA) that occurred in a 51-year-old male patient. The occlusion of the right ICA was asymptomatic and was detected incidentally during imaging of the opposite carotid artery. The patient underwent neuroradiologic analysis and a tapered, flame-like occlusion suggestive of the right ICA dissection was detected. One month later, a carotid Doppler ultrasound demonstrated patent right carotid artery with normal spectral flow. Five-month follow-up showed that the ICA remained patent.

Epidemiology of primary central nervous system tumors in the Coast and Gorski Kotar County, Croatia, 1977-2000

Aim and Background To establish the incidence of primary tumors of the central nervous system (CNS) in the resident population of the Coast and Gorski Kotar County, Croatia, in the period 1977-2000. Methods A retrospective descriptive epidemiological study. Tumors were classified according to the World Health Organizations scheme. A total of 911 cases was identified. Information about patient gender and age at diagnosis, tumor location and histologic type was obtained from case histories, autopsy protocols and pathology reports. Age- and sex-adjusted incidence were determined by a direct standardization method. Results Histologic confirmation was obtained in 84.5% of cases. The most frequent tumors were glioblastoma in men (30.2%) and meningioma in women (29.5%). The average annual crude and world-standardized incidence was 11.2 (95% CI, 10.1-12.3) and 8.2/100,000/year (95% CI, 7.4-9.0), respectively. The highest specific age incidence was detected in the seventh decade of life, 24.7/100,000/year (95% CI, 21.4-28.8). The tumors occurred equally in each sex. The lowest incidence was detected on the islands, 7.4/100,000/year (95% CI, 5.9-9.2) and the highest along the coast, 12.7/100,000/year (95% CI, 11.4-14.0). The survey showed the highest incidence of these neoplasms in the coastal municipality of Senj, 14.7/100,000/year (95% CI, 10.3-20.5). Conclusion The descriptive epidemiological incidence of primary CNS tumors in the Coast and Gorski Kotar County, Croatia, especially those of neuroepithelial and meningeal origin, correspond to the data reported in similar studies elsewhere in the world. The incidence of these neoplasms in the area investigated is uneven. Limitations in study design preclude definitive conclusions about the causes of these differences.

Values of vanillylmandelic acid and homovanillic acid in the urine as potential prognostic biomarkers in ischaemic stroke patients

Abstract Background: Suitable biomarkers that have prognostic values are one of the key points of interest in ischaemic stroke. Increased sympathetic nervous system activity in ischaemic stroke causes multiple local and systemic effects that can be detrimental to the outcome. The mechanism of action is increased secretion and activity of catecholamines, whose end metabolic products are vanillylmandelic acid and homovanilic acid. Aim of our study was to determine whether these compounds can be used as potential prognostic biomarkers in ischaemic stroke, as a unique insight into the activity of the sympathetic nervous system. Methods: Urine samples of 96 patients with ischaemic stroke and transitory ischaemic attacks were analysed. Values of vanillylmandelic and homovanillic acids in urine were tested using liquid chromatography on the first and third day post-stroke. Severity of stroke was determined using the NIHSS scale, while functional outcome was determined using the Modified Rankin Scale. Results: Values of vanillylmandelic and homovanillic acids positively correlated with functional outcome of ischaemic stroke. Favorable outcomes correlated with decreased values, on contrary to increased values, which were associated with unfavourable outcomes. Conclusion: Determining the values of these compounds in the urine is an easily available prognostic tool for the ischaemic stroke outcome, while also influencing potential therapeutic changes.

Tihi infarkt mozga

BACKGROUND AND OBJECTIVE. Although previous studies have provided new information on bone repair, there are still gaps in knowledge about resorptive and formative processes during bone repair at the electron microscopic level. The aim of this study was to compare bone repair after the internal fracture, osteotomy, and bicortical perforation of the tibia by means of electron microscopy. MATERIAL AND METHODS. An electron microscopic study of bone repair after the internal fracture, osteotomy, and bicortical perforation of the tibia was performed on 72 male Wistar rats. Rats undergoing osteotomy and perforation were further subdivided into the control and immobilization subgroups. Bone repair was observed during the first posttraumatic weeks. RESULTS. Although bone repair in general had similar bone healing stages in all the groups, the repair process depended on the mode and degree of injury thus being different in the experimental groups. After the internal fracture, indirect ossification was observed; after osteotomy, primary periosteal, secondary endosteal ossification was noted; and after perforation, primary endosteal, secondary periosteal ossification was documented. Immobilization had an inhibitory effect on bone repair. CONCLUSIONS. The results of the present study gave new information at the electron microscopic level about intracellular changes and intercellular matrix synthesis during different types of posttraumatic bone repair and confirmed our previous reports on similar posttraumatic bone repair in histomorphometric and immunohistochemical studies.

Is there semantic specificity in overlapping-figures agnosia?

A CASE of apperceptive visual agnosia, revealing difficulties only in the performance on a standard overlapping-figures test, has been studied. Unusually, the patient demonstrated difficulties only with two semantic categories of the overlapped figures (clothes and school accessories); preserving, however, the knowledge of the same figures when presented isolated. We propose that the underlying deficit is only of a pseudo-semantic nature and is actually due to certain similarities of the two overlapping combinations, creating difficulties still on the apperception level only.