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    Dermatologische Erkrankungen bei Palliativpatienten: eine prospektive Studie an 271 Patienten
    (Wiley Online Library, 2017-06)
    Lenche Neloska
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    Andjelka Kuzmanova
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    Lidija Pavleska
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    Aneurysms of the anterior communicating artery
    (Macedonian Association of Anatomists and Morphologists, 2012)
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    Jovkovski, Spase
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    Aneurysm of the middle cerebral artery
    (Macedonian Association of Anatomists and Morphologists, 2015)
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    Jota, Gjorgi
    Aneurysms 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.
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    Aneurysm of the anterior communicating artery.
    (Macedonian Association of Anatomists and Morphologists, 2016)
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    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.
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    Branches of the Basilar Artery Examined with CT Angiography
    (EUROPEAN ASSOCIATION OF CLINICAL ANATOMY (EACA), 2019)
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    Anatomy and Variations of the Vertebrobasilar System Examined with Digital Substraction Angiography
    (John Wiley &Sons, Ltd, 2019-08)
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    The posterior circulation of the brain constitutes the vertebrobasilar system and its branches, which are responsible for about 30% of the brain blood supply. The aim of this study was to examine the anatomy and variations of vertebrobasilar system with DS angiography. We examined radiographs of 55 patients who had DS angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje. This study was approved of the Macedonian Ethical Committee. The study population included 27 male and 28 females, age range from 18-79, mean age 51.09 years. The left VA originated from the subclavian artery in 96.36% and in 3.63% had variable origin from the aortic arch. The right VA without exception had origin from the subclavian artery in 100%. Most of the SCA arise from the basilar artery as a single vessel (92.7% on right and 94.5% on left). The most common variations of the SCA were duplication (frequency 3.63% on right and 1.81% on left) and origin from PCA (frequency 3.63% bilateral). Adult configuration of PCA was present in 74.54%; fetal configuration was present in 20% and transitional configuration was present in 5.45% of the patients on the left side. On the right side adult configuration was present in 83.63%; fetal configuration was present in 14.54% and transitional configuration was present in 1.81% of the patients.Through knowledge of the anatomy and variations of the vertebrobasilar system is important to clinicians on daily basis for save performance of diagnostic and interventional procedures in radiology and for surgeons during planning and accomplishing surgical interventions. For the anatomists, the results obtained from this study present valuable teaching material for students and postgraduates.
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    Endovascular Treatment of Wide Neck Aneurysms
    (Scientific Foundation SPIROSKI, 2018-12-10)
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    Aliji, Vjolca
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    Businovska, Jasna
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    Mircevski, Vladimir
    BACKGROUND: An aneurysm is an abnormal focal dilatation of an artery. Most of the unruptured aneurysms are asymptomatic and discovered incidentally or some of them symptomatic with mass effect or nerve palsy, but rupture of aneurysm results in a potentially life-threatening subarachnoid haemorrhage. Aneurysms with wide necks are defined by neck diameters greater than 4 mm or dome-to-neck ratios less than 2 and are the most difficult to treat with the endovascular method. AIM: This study aimed to analyse the endovascular treatment of intracranial aneurysms with a wide neck. METHODS: The study population included 37 patients with 46 aneurysms referred to the University Clinic of Radiology in Skopje, the Republic of Macedonia for endovascular treatment during the period January 2013 to May 2018. This study included 24 females and 13 males, ranging in age from 25 to 74 years. RESULTS: From total 46 treated aneurysms 13 were ruptured and 33 unruptured. Six patients were with multiple aneurysms. In these study complex aneurysms were treated with combined technique, 5 with balloon-assisted coiling, 25 with stent-assisted coiling, 6 stents, 2 with flow diverter assisted coiling, 6 FD and 2 with partial coil filling without assistance device. CONCLUSION: Aneurysms with wide neck remain a challenge for endovascular treatment. But the development of new techniques and materials in the treatment of aneurysms makes endovascular treatment of intracranial aneurysms safe and feasible.
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    CORRELATION BETWEEN RISK FACTORS FOR ONSET OF DISC HERNIATION AND LOCALIZATION OF THE PATHOLOGIC CHANGE
    (Macedonian Association of Anatomists and Morphologists, 2019)
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    Anastasovski, Mirko
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    Janevski, Georgi
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    Background: Almost 70% of the population suffers from neck pain at some point during a lifetime. Our aim was to show the impact of the risk factors on the incidence of disc herniation and the localization of the pathology. Materials and methods: This was a cross-sectional study in which MRI data of the cervical spine and data from the questionnaire designed for the study were used. The focus group consisted of 98 subjects aged 35-70 years with refractory neck pain. Results: Our study showed that in male subjects 40% of the herniated discs were at level of C3/C4 and C6/C7 respectively, and 47.06% of the herniated discs were at C5/C6 level in female subjects. Sedentary work had a significant impact on the prevalence of cervical disk herniation (Chi-square=16.88; df=3; p=0.00082), most commonly found (46.15%) at C5/C6 level. Conclusion: Disc herniation is most common in the middle cervical spine (C5/6). Significant predictors for the analyzed risk factors of cervical discs herniation are: age, genetic predisposition and work-related daily slouching or straining the neck.