Faculty of Medicine

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    Neuroimaging, a key role in diagnosis of diffuse axonal injury. CT and MRI patterns every radiologist should know
    (EUROPEAN SOCIETY OF RADIOLOGY, 2023-03-01)
    Jovanoska, Ivona
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    Gjoreski, Aleksandar
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    Lombardo, I
    Learning objectives - to understand the common mechanisms and pathology of diffuse axonal injury (DAI) - to recognize the radiological appearances on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) - to understand the role and clinical importance of neuroimaging in patients with DAI Read more Background Diffuse axonal injury as the name implies is a traumatic stretch/disruption of axons that occurs with sudden acceleration/deceleration or rotation of the brain. Patients with DAI are most commonly injured in high-velocity vehicle crashes and DAI represents 50% of all primary intraaxial traumatic brain lesions in moderate/severe traumatic brain injury (TBI). It has 80-100% autopsy prevalence in fatal injuries and even occurs in utero if pregnant woman subjected to sufficient force. Typically, patients present with loss of consciousness at the time of accident and often... Read more Findings and procedure details Non enhanced CT is the first-choice neuroimaging tool in all emergency head trauma patients, but MRI is the modality of choice for assessing suspected diffuse axonal injury. It is a potentially difficult diagnosis to make on imaging alone. Some patients with relatively normal CT scans may have significant unexplained neurological deficit, in those cases DAI should be suggestive and confirmed with MRI. On CT the finding can be subtle or absent, but that does not categorically exclude the presence of axonal injury. Contrary to the... Read more Conclusion DAI as a diagnosis should be suggestive in TBI patients with clinical symptoms disproportionate to imaging findings. More than 30% of patients with negative CT have positive MR, so in general it is clinically developed based on clinical manifestations and MRI findings. Neuroimaging plays a significant role, by detecting the location and number of lesions, not only in diagnosis but also in determining the outcome of patients after DAI.
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    COVID -19 INDUCED AORTIC THROMBUS AND CRITICAL LIMBISHAEMIA
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2023-04-07)
    Nancheva Bogoevska, Andrea
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    Risteski, Filip
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    Gjoreski, Aleksandar
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    Jovanoska, Ivona
    50 years old male presented with livid redness on both feet, predominantly left, accompanied with severe pain and coldness. Two weeks before, he admitted to hospital due to COVID-19 bronchopneumonia. Urgent abdominal and lower extremities contrast enhanced CT was performed, which showed mural thrombus of the abdominal aorta (AA) extending from below the left renal artery to the iliac bifurcation and total occlusion of the left and partial occlusion of the right crural arteries. Interventional procedures are the first choice for initial emergency management, leaving surgery as a second and anticoagulant therapy as third option for treatment. Endovascular treatment is based on stent grafting. Covered stent graft was used to repair the AA and kissing stenting technique was used in the aortoilical part. The result was complete patency of AA and both iliacal arteries, with improved clinical status. Mural thrombi are likely to occur in large vessels as the heart and descending aorta, and less commonly in the aortic arch or the AA, causing flow reduction. Their occurrence is a rare in the absence of hypercoagulative state or inflammatory, infectious, or familial aortic ailments. In our case, Covid -19 is associate occurrence of thrombus in the AA, which throws out smaller thrombi in the peripheral circulation that causes critical limb ischemia (CLI).CT is the best modality for early diagnosis and endovascular treatment the least invasive treatment. Mural aortic thrombus accompanied by CLI is an urgent medical condition which, if not diagnosed and treated on time, can result in limb amputation or death. Endovascular stenting is first choice of treatment in patients without previous vascular disease.
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    Placement of central venous access port in the interventional radiology suite – single center experience
    (Macedonian Association of Radiologists, 2023-11)
    Jovanovska, Ivona
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    Gjoreski, Aleksandar
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    Dungevski, Gjorgi
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    Ramadani, Pranvera
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    Nancheva Bogoevska, Andrea
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    Item type:Publication,
    Sarcoidosis of the nervous system MRI - findings
    (2013-10)
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    Risteski, Filip
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    Gjoreski, Aleksandar
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