CHaparoski, Aleksandar
Preferred name
CHaparoski, Aleksandar
Official Name
CHaparoski, Aleksandar
Main Affiliation
Email
aleksandar.chaparoski@medf.ukim.edu.mk
33 results
Now showing 1 - 10 of 33
- Some of the metrics are blocked by yourconsent settings
Item type:Publication, Aneurysms of the anterior communicating artery(Macedonian Association of Anatomists and Morphologists, 2012); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Importance of Perioperative Prophylaxis with Cefuroxime or Ceftriaxone in the Surgical Site Infections Prevention after Cranial and Spinal Neurosurgical Procedures(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/ Sciendo, 2017-09-01); ; ; Introduction Surgical site infections pose a significant problem in the treatment of neurosurgical procedures, regardless of the application of perioperative prophylaxis with systemic antibiotics. The infection rate in these procedures ranges from less than 1% to above 15%. Different antibiotics and administration regimes have been used in the perioperative prophylaxis so far, and there are numerous comparative studies regarding their efficiency, however, it is generally indicated that the choice thereof should be based on information and local specifics connected to the most probable bacterial causers, which would possibly contaminate the surgical site and cause infection, and moreover, the mandatory compliance with the principles of providing adequate concentration of the drug at the time of the anticipated contamination. Objective Comparing the protective effect of two perioperative prophylactic antibiotic regimes using cefuroxime (second generation cephalosporin) and ceftriaxone (third generation cephalosporin) in the prevention of postoperative surgical site infections after elective and urgent cranial and spinal neurosurgical procedures at the University Clinic for Neurosurgery in Skopje in the period of the first three months of 2016. Design of the study Prospective randomized comparative study. Outcome measures Establishing the clinical outcome represented as prevalence of superficial and deep incision and organ/space postoperative surgical site infections. Material and method We analyzed prospectively 40 patients who received parenteral antibiotic prophylaxis with two antibiotic regimes one hour before the routine neurosurgical cranial and spinal surgical procedures; the patients were randomized in two groups, according to the order of admission and participation in the study, alternately, non-selectively, those persons who fulfilled inclusion criteria were placed in one of the two programmed regimes with cefuroxime in the first, and cefotaxime in the second compared group. All relevant demographic and perioperative patient data were analyzed for both comparative groups, especially the factors known to cause disposition (predisposition) to infections. The prevalence of postoperative infections was evaluated as the primary outcome in both comparative groups, while the secondary outcome was the postoperative infection rate after cranial and spinal neurosurgical procedures at the Neurosurgical clinic in Skopje (having in consideration that so far no data have been published in this context), as well as the prevalence of the risk factors for occurrence of postoperative infections, pre-surgically in patients undergoing neurosurgical interventions locally in the Republic of Macedonia. Results A total of three cases of postoperative infections were registered, two of which classified as superficial incisional, while one case organ/space infection - meningitis (elective intervention) without etiological confirmation. Both comparative groups were statistically similar, without any statistically significant differences in the basic demographic and perioperative characteristics, especially in relation to the incidence of the factors, which, regardless of the antibiotic prophylaxis, show predisposition to postoperative infections. All three cases with infections were registered in the group of persons who received prophylaxis with ceftriaxone preoperatively, with isolated etiological S. aureus agent (elective intervention) in one of them, and methicillin resistant staphylococcus aureus (MRSA) in another (urgent intervention) with superficial incisional SSI. There was no case of SSI in the group of patients who received cefuroxime before surgery. Conclusion Administration of parenteral antibiotics before surgery reduces the incidence of postoperative infections after neurosurgical procedures, especially in cases with increased risk factors for SSI, such as ACA score of ≥ 2/3, the duration of the surgical intervention ≥ 4 hours, contaminated wound and comorbidities. Perioperative antibiotic prophylaxis should be directed to better coverage of the S.aureus arrays. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage(Walter de Gruyter GmbH, 2017-12-01); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Aneurysm of the middle cerebral artery(Macedonian Association of Anatomists and Morphologists, 2015); ; ; ; Jota, GjorgiAneurysms represent local pathological enlargement of the brain blood vessels that occur in 5% of the population. Intracranial aneurysms in 20 to 25% of the population are localized on the middle cerebral artery, and almost 80% of them reveal at the bifurcation of the middle cerebral artery. There are a number of open issues that are debated in the scientific community for aneurysms of the middle cerebral artery. The purpose of this paper is to analyze clinical features, diagnostic and therapeutic modalities of aneurysms of the middle cerebral artery. The study population enrolled 17 patients referred to the University Clinic of Neurosurgery in Skopje, R. Macedonia during a 1-year period between January and December 2014. This study included 9 (52.94%) females and 8 (47.05%) males, ranging in age from 40 to 72 years; mean age 54.5±7.78 years. From 17 treated aneurysms, 9 aneurysms (52.94%) were located on the left MCA and 8 aneurysms (47.05%) were located on the right side. Multiple aneurysms were present in 8 patients (47.05%). The diameter of the aneurysms was in range between 3 to 14 mm, mean 7.62 mm ±3.39 mm. The mean value of the aneurysm neck was 3.2 mm. In our group 12 aneurysms (70.58%) were small and 5 aneurysms (29.41%) were medium according to the size. Patients were treated operatively and aneurysm was excluded from circulation by placing permanent clip to the neck of the aneurysm. Morphological analysis and topographical characteristics of the aneurysms of the middle cerebral artery is very important to decide the treatment of the aneurysm. Use of micro neurosurgical clipping is an effective method for the treatment of aneurysms of the middle cerebral artery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Aneurysm of the anterior communicating artery.(Macedonian Association of Anatomists and Morphologists, 2016); ; ; ; Aneurysms represent local pathological enlargement of the brain blood vessels that occur in 5% of the population. Intracranial aneurysms in 30 to 37% of the population are localized on the anterior communicating artery. Rupture of aneurysms of the anterior communicating artery lead to subarachnoid hemorrhage characterized by a high rate of morbidity and mortality. There are a number of open issues that are debated in the scientific community for aneurysms the anterior communicating artery. The purpose of this paper was to analyze clinical features, diagnostic and therapeutic modalities of aneurysms of the anterior communicating artery. All patients in this study were treated operatively and aneurysm was excluded from circulation by placing permanent clip to the neck of the aneurysm. Morphological analysis and topographical characteristics of the aneurysms of the anterior communicating artery is very important to decide the treatment of the aneurysm. Use of microneurosurgical clipping is an effective method for the treatment of aneurysms of the anterior communicating artery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CARPENTER SYNDROME - CASE REPORT AND TREATMENT(Македонско лекарско друштво = Macedonian Medical Association, 2016); ; ; Agai LjIntroduction. Carpenter syndrome is a polymorphic disorder transmitted by autosomal recessive inheritance, caused by mutations in the RAB23 gene [1]. These gene- tic disorders are reflected on the biogenesis of intracra- nial structures. This syndrome was described for the first time in 1900 by the British doctor George Carpenter. It may include congenital heart diseases, mental retarda- tion, hypogonadism, obesity, umbilical hernia, develop- mental disorder, bone anomalies and frequent respiratory infections. Carpenter syndrome has two main features: craniosynostosis and more than five fingers or toes (2-4]. Aim. To present our experience in treatment of an in- fant with Carpenter syndrome including trigonocephaly and polydactyly. Case report. In May 2003, an eleven-month-old male infant with Carpenter syndrome was hospitalized in the Pediatric Department of the University Clinic of Neuro- surgery in Skopje, Republic of Macedonia. The infant was referred to our Department from the University Pediatric Clinic because of trigonocephaly and poly- dactyly with two thumbs on his right hand. The infant had already been twice hospitalized at the University Pediatric Clinic for two recurrent lung infections su- ggestive of Carpenter syndrome. The diagnosis of tri- gonocephaly and polydactyly with two thumbs on the right hand was made by physical examination, X-ray of the right infant's hand and computed tomography of the head. According to Oi and Matsumoto classification from 1986 [5], the infant had a severe form of trigonocephaly. Surgical procedure. Under general endotracheal anesthe- sia, the infant was placed supine on the operating table, a bifrontal skin incision was made and the scalp flap was created. The bifrontal craniotomy was realized into one bony piece succeeded by a modified Di Rocco's "shell" procedure including frontal translation and trans- Correspondence to: Vladimir Mirchevski, University Clinic for Neurosurgery, Clinical Center "Mother Teresa" Skopje, Macedonia, E- mail: neurosurgery skopje @yahoo. position rotating the flap for 180 degrees without /touching the orbital rims. Results. The postoperative period was uneventful ex- cept for the expected forehead swelling. The infant was discharged from the hospital on the 7 postoperative day, neurologically intact. Three months after surgery, the head had excellent esthetic appearance, with regular psychomotor development in line with the age of the patient. Six months after the first surgery the patient underwent a second plastic and reconstructive surgery in order to reduce the number of fingers. Conclusion. The early recognition and multidisciplinary approach could prevent new disabled individuals in the society. Our technique shortens the entire surgical procedure, diminishes the time under anesthesia and its complications, especially in departments where blood saving devices are not available - Some of the metrics are blocked by yourconsent settings
Item type:Publication, - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Mixed ganglioglioma and cavernous angioma in the temporal lobe - case report(International Academy of Pathology, 2018-10); ; ; ; Objective: Gangliogliomas are rare CNS tumors defined by the presence of both neoplastic ganglion and glial cells. They are recognized by the WHO classification mostly as Grade I, although some examples showing atypia have been observed, originating from the glial component. They occur mostly in the pediatric population and young adults. Association of ganglioglioma with cavernoma is extremely rare and it could be considered as an angioganglioglioma. We present a case of synchronous ganglioglioma and cavernous angioma in 57-year-old-man with epilepsy. Methods: The patient was admitted to the Department of Neurosurgery with a left side paresis, somnolent and vomiting. He acknowledges the presence of vascular mass discovered more than 30 years ago, when he got the first seizure and denied operation. CT and MRI showed an increased lesion with recent bleeding at right temporal lobe followed by edema. Craniotomy disclosed a hemorrhagic poorly demarcated tumor which was partially removed. Grossly, the tumor tissue had solid consistency and dark brown color. Standard procedure of paraffin embedded section routinely stained with H&E was performed. Results: Histological examination revealed cavernous angioma with low grade gangliglioma located at the periphery of the angioma. The vascular component was admixed and observed in some regions of the ganglioglial mass, presenting with hyalinized ectatic vascular channels, perivascular hemosiderin deposits, gliosis and vascular calcifications. Glial cells were identified by immunopositivity for GFAP, ganglion cells for Synaptophysin and Chromogranin, cavernous vessels for SMA and CD34. The proliferative index for Ki-67 was lower than 1%. Conclusion: We present an extremely rare case of mixed ganglioglioma and cavernous angioma. The term “angioganglioglioma” was proposed to define a transitional form between angioglioma and ganglioglioma. Several other cases of mixed tumor and vascular malformation have been described in the literature. Further, it may constitute a new distinct clinicopathological entity with neoplastic and hamartomatous features.