Faculty of Medicine

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Start date: 2020Subject: search.filters.subject.magnetic resonance imaging

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    CERVICAL MYELOPATHY DUE TO CERVICAL DISC HERNIATION A CASE REPORT
    (Macedonian Association of Anatomists and Morphologists, 2026-02-23)
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    Stoshevski, Bojan
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    Nikoloska, Sofija
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    Nikoloski, Marko
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    Cervical myelopathy is a progressive degenerative disorder resulting from spinal cord compression, most commonly due to spondylotic changes and intervertebral disc herniation. It presents with a wide spectrum of neurological deficits, including walking disturbance, limb weakness, sensory impairment, and upper motor neuron signs. Early recognition is essential, as advanced disease may lead to irreversible neurological damage. We present the case of a 63-year-old woman with progressive quadriparesis, walking impairment, and sensory disturbances following minor trauma. Neurological examination revealed upper motor neuron signs and intrinsic hand muscle atrophy. Magnetic resonance imaging of the cervical spine demonstrated multilevel degenerative disc disease with severe spinal canal stenosis and spinal cord compression, accompanied by intramedullary signal changes consistent with compressive myelopathy. Despite neurosurgical indication for operative treatment, the patient declined surgery and was managed conservatively with physical therapy, resulting in partial clinical improvement. This case highlights the importance of thorough clinical evaluation and neuroimaging in the diagnosis of cervical myelopathy and underscores the need for timely recognition and appropriate management to prevent long-term disability
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    VERTIGO AS AN INITIAL MANIFESTATION OF CHRONIC CEREBELLAR ABSCESS- CASE REPORT
    (Macedonian Association of Anatomists and Morphologists, 2022)
    Ristik-Stomnaroska, Daniela
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    Aleksovska, Angela
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    Chronic cerebellar abscess is a rare clinical condition, considering the protective function of the blood-brain barrier. The prevalence of brain abscess is increasing with the increase in the number of people living with HIV, especially abscesses caused by a fungal infection. We present the case of a 67 year old male patient with acute onset of dizziness, associated with nausea, vomiting and unstable gait. Initial neurological examination revealed dysarthric speech, with discrete central paresis of the facial nerve, latent left-sided ataxic hemiparesis. In order to clarify the etiology of the expansive change in the left cerebellum, a series of examinations were performed. MRI of the brain was performed with IV contrast, which showed an oval intraaxial lesion with a maximum diameter of 20 x16 mm, on the left cerebellar side. Routine biochemical analyzes was normal, Immunoassay analysis of serum detected a multiple increase in the serum concentration of Immunglobulin E. In consultation with an infectologist, several samples of cerebrospinal fluid were sent for microbiological, parasitological (antibodies to toxoplasmosis, echinococcus and cysticercosis) and serological analysis. The patient was referred to a hematologist again, when a PET scan was performed which showed the presence of metabolically inactive lymph nodes, the same with benign characteristics. A craniotomy and surgical extirpation of the lesion were performed in consultation with a neurosurgeon. The treatment of brain abscesses is multidisciplinary and includes: a neurologist, infectologist, radiologist, neurosurgeon and an internal medicine specialist.
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    INSULINOMA OF THE TAIL OF THE PANCREAS – A CASE REPORT
    (Georgian Business Press LLC, 2023-05)
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    Pavlevska Elena
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    Jovanoska Todorova Biljana
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    Insulinoma is a rare neuroendocrine functional tumor of the pancreas of unknown etiology which manifests itself through hypoglycemic symptoms which resolve by administering glycose. Common autonomic symptoms of insulinoma include diaphroresis, tremor, and palpitations, whereas neuroglycopenenic symptoms include confusion, behavioural changes, personality changes, visual disturbances, seizure, and coma. In most cases, these are benign solitary tumors of the pancreas, and in 5% of the cases they are associated with MEN1 syndrome. A characteristic of the diagnosis is the presence of hypoglycemia, and increased levels of C-peptide and insulin. Further radiological verification (non-invasive imaging procedures: computed tomography and magnetic resonance imaging; and invasive modalities, such as endoscopic ultrasonography and arterial stimulation venous sampling) of the tumor are required as well as its surgical extraction. We present a case of a middle-aged male with history of recurrent hypoglycemic episodes with vertigo, sweating, tremors, anxiety, fatigue, and loss of consciousness, all of which resolved after eating food. The diagnoses were confirmed after we performed non-invasive imaging procedure, such as Computed Tomography and Magnetic Resonance Imaging. The patient underwent successful resection of the tumor, and his symptoms showed complete resolution. Despite the low incidence of these tumors, they should be suspected, in cases where the patient presents with repetitive hypoglycemic episodes, with symptoms, which resolve after eating a meal. Timely diagnosis and adequate treatment in most cases equals to complete withdrawal of symptoms.