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    MIGRAINE AND PATENT FORAMEN OVALE - CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023)
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    Nikoloska, Sofija
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    Nikoloski, Marko
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    Stoshevski, Bojan
    AbstractMigraine is a headache disorder, typically characterized by unilateral headache (with or without aura) of pulsating quality, which is associated with nausea, phonophobia and photophobia. The patent foramen ovale (PFO) is a remnant of the fetal circulation. Multiple studies suggest that migraine is more prevalent in subjects with PFO and vice versa, suggesting that PFO and migraine may be risk factors for each other.Case report.We present a 33-year-old female patient with unilateralhemicranialheadache,mostly on the right side, pain in the right eye, nausea, vomiting, photo and phonophobia, with previous visual difficulties with the ipsilateral eye. The complaints usually lasted2-3 days and wereassociatedmostly with the menstrual cycle. Therewerealso occasional bouts of dizziness. Ophthalmological and otorhinolaryngological nature of these complaints wasexcluded with additional investigations. In addition, nuclear magnetic resonance (NMR)of the brain, color Doppler duplex sonography(CDDS)of carotid and vertebral arteries were performed, all with normal findings. On transcranial color Doppler sonography with Bubble test, a positive finding was obtained for a Grade 4 right-left shunt and the patient was referred for cardiology assessment and evaluation. The patient was diagnosed with migraine with aura (visual) and PFO.Conclusion.Results from epidemiological studies examining the relationship between PFO and migraine are mixed at best. It is unclear if there is a causal relationship or simply a co-existence of these two conditions. Moreresearch of PFO in migraine is clearly needed before we can consider changing our views on the aforementioned conclusions.Keywords:migraine, patent foramen ovale.
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    SUBARACHNOID HAEMORRHAGE ASSOCIATED WITH CEREBRAL SINUS THROMBOSIS – A RARE CASE
    (Macedonian Association of Anatomists and Morphologists, 2022-12-29)
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    Kostova, Masha
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    RELATIONSHIP BETWEEN THE MEATABOLIC SYNDROME AND THE INDIVIDUAL METABOLIC RISCK FACTORS AND SYMPTOMATIC AND ASYMPTOMATIC CAROTID ARTERY DISEASE: IS THE WHOLE LARGER THAN ITS PARTS
    (Macedonian Association of Anatomists and Morphologists, 2021-07-26)
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    Nikoloska, Sofija
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    Stoshevski, Bojan
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    Nikoloski, Marko
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    VERTEBRAL ARTERY DISSECTION: CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2025)
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    Nikoloska, Sofija
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    Nikoloski, Marko
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    Stoshevski, Bojan
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    Autoimmune Encephalitis: A Literature Review
    (Scientific Foundation Spiroski (publications), 2023-07-15)
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    Nikoloska, Sofija
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    Stoshevski, Bojan
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    Nikoloski, Marko
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    Autoimmune encephalitis (AIE) defines brain inflammation caused by a misdirected immune response against self-antigens expressed in the central nervous system. AIE encompasses a group of non-infectious immune-mediated inflammatory disorders of the brain parenchyma often involving the cortical or deep gray matter with or without involvement of the white matter, meninges, or the spinal cord. Suggested mechanisms that may trigger AIE include tumors (paraneoplastic), infections (para-infectious), or it may be cryptogenic. This study represents a review of the common forms of AIE, exploring their causes, diagnostic approaches, and management strategies. The previous and ongoing investigations in this field have been driven by the identification of several pathogenic autoantibodies that cause polysymptomatic neuropsychiatric and neurological diseases. AIE comprises a heterogeneous group of disorders that are at least as common as infectious causes of encephalitis. Early treatment is associated with better prognosis and is crucial for the prevention of severe complications. The underlying mechanisms for activation and autoimmune response in the CNS are still unclear. Further investigations are needed to better explain how immune mechanisms affect nervous system functions.
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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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    ASSOCIATION OF THE NUMBER OF COMPONENTS OF THE METABOLIC SYNDROME AND CAROTID ARTERY DISEASE
    (Macedonian Association of Anatomists and Morphologists, 2021-07-26)
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    Nikoloska, Sofija
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    Nikoloski, Marko
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    Stoshevski, Bojan
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    CUBITAL TUNNEL SYNDROME 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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    Ristikj Stomnaroska, Daniela
    Cubital tunnel syndrome is the second most common peripheral neuropathy of the upper extremity. It is caused by compression of the ulnar nerve at the elbow region. Cubital tunnel syndrome is a neuropathy of the ulnar nerve causing symptoms of shooting pain and numbness along the medial aspect of the forearm, including the medial half of the fourth digit and the fifth digit. We present a case report of a 47-year-old male patient, an architect by profession, who complained of left elbow and forearm pain that radiated into his hand and motor weakness in the little and ring fingers of the left hand. MRI imaging of the cervical spine showed normal findings. EMNG findings revealed compressive sensorimotor neuropathy of the left ulnar nerve, with compression at the level of the elbow joint. The patient was diagnosed with cubital tunnel syndrome, caused by compression of the ulnar nerve at the elbow. The treatment was conservative, with the use of anti-inflammatory medications and physical therapy, resulting in a good clinical outcome.
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