Faculty of Medicine

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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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    Imaging of juvenile spondyloarthritis. Part II: Ultrasonography and magnetic resonance imaging
    (Sciendo, 2017-09)
    Sudoł-Szopińska, Iwona
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    Znajdek, Michał
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    Gietka, Piotr
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    Patrovic, Lukas
    Juvenile spondyloarthropathies are mainly manifested by symptoms of peripheral arthritis and enthesitis. Early involvement of sacroiliac joints and spine is exceptionally rare in children; this usually happens in adulthood. Conventional radiographs visualize late inflammatory lesions. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presented classifications and radiographic presentation of juvenile spondyloarthropathies. This part discusses changes seen on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance also shows subchondral bone marrow edema, which is considered an early sign of inflammation. Ultrasonography and magnetic resonance imaging do not show specific lesions for any rheumatic disease. Nevertheless, they are conducted for early diagnosis, treatment monitoring and identifying complications. This article presents a spectrum of inflammatory changes and discusses the diagnostic value of ultrasonography and magnetic resonance imaging.
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    Ewing's Sarcoma and Primary Osseous Lymphoma: Spectrum of Imaging Appearances
    (Georg Thieme Verlag KG, 2019-02)
    Weber, Marc-André
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    Papakonstantinou, Olympia
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    Vanhoenacker, Filip M
    Ewing's sarcoma (ES) is a rare, highly malignant anaplastic stem cell tumor. Histologically, the tumor consists of uniform densely packed small monomorphic cells with round nuclei. The typical appearance at hematoxylin and eosin (H&E) staining is small blue round cells without any matrix formation. On conventional radiography, ES typically presents as a permeative lesion in the diaphysis of a long bone in a child. A large soft tissue component is another characteristic feature, best depicted by magnetic resonance imaging.Primary osseous lymphomas are most commonly highly malignant B-cell lymphomas. At H&E histologic staining, the tumor stroma consists of diffuse round-cell infiltrates that resembles the appearance of ES. Although there is no typical imaging appearance of an osseous lymphoma, it should be considered in an adult presenting with a Lodwick grade II or III lesion in the metaphysis or diaphysis of a large long bone, the pelvis, or the vertebral column. Histologic confirmation is mandatory.