Dejan Daskalov
Preferred name
Dejan Daskalov
Email
dejan.daskalov@medf.ukim.edu.mk
12 results
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Item type:Publication, MECHANICAL THROMBECTOMY IN STROKE - OUR TEN MONTHS EXPERIENCE(2019-10-24); ; ; ; Bushinoska, JasnaMechanical thrombectomy for stroke patient started in November 2018 in our country. For ten months we have 21 patient with large vessel occlusion. Our center is for now single center that provide mechanical thrombectomy for population of two million people. All stroke patient were with large vessel occlusion on CT and CTA. First patient was directly evaluated and treated in angiography suite on the basis of native CT- hyperdense MCA sign and clinical symptoms. Next patient underwent CT and CTA and one with MR/MRA. Four patient were with T occlusion, two successful recanalization and two failure. Other 17 were M1/M2 occlusion from witch tree tandem lesions ICA and M1. Patients were on age of 25 to 73 years old. We used stent retriever in all patients (solitaire or embotrap) and aspiration together and in most of patient intermediate catheter ( sofia/sofia plus) but we never used balloon guiding catheter. Time window in 18 patient was <6h and 3 of patients with wake up stroke. All patients were with NIHSS >5. TICI 2b was achieved in 8 patients, TICI 3 in 4 patients, TICI 2a in 3 patients, in one patient grade 1 and no reperfusion in 5 patients from witch one with worsening. No major hemorrhage appeared but only 4 patients previously received IV tPA. Till today no national strategy for stroke patient pathway. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Endovascular treatment of intracranial aneurysm on anterior circulation(Macedonian Association of Anatomists and Morphologists, 2018); ; ; - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Size, Localization and Risk Factors in Ruptured and Unruptured Brain Aneurysms(SciVision Publishers LLC, 2025-01-06); ; ; Brain aneurysm is a pathological focal enlargement of an artery in the brain, that is, of the inner muscle layer of the blood vessels. The vessel expands in the form of a balloon from varying degrees, where the wall of the aneurysm can become thin and rupture without warning. Brain aneurysms can form and not rupture. They are often discovered incidentally during the examination of other pathological health conditions. Aim: To assess the incidence of brain aneurysms in relation to sex and age, as well as in relation to localization, size and type, that is, bleeding and non-bleeding brain aneurysms. The study also analyzes risk factors for the occurrence and outcome of brain aneurysms. Material and Methods: In the study, 80 patients with symptoms of brain aneurysm were analyzed, and diagnostic procedures were performed to prove the brain aneurysm and establish an indication for further treatment. Results: Of the analyzed patients, 48 (60%) were women, and 32 (40%) were men. In terms of age, the patients had an average age of 56.1 ± 10.3 (31-84 years). In patients with ruptured and unruptured aneurysms, there was a statistically insignificant difference in the average age between these two groups of patients 55.8 ± 9.5 vs 56.8 ± 12.3 years. Ruptured aneurysms were significantly more often diagnosed in male patients 84.38% vs 62.5% in the female population. A statistically significant difference was detected in the distribution of small, large, and giant aneurysms between the groups of ruptured and unruptured aneurysms, where it was shown that small aneurysms were insignificantly more often bleeding 77.19% vs 56.52%, large aneurysms were insignificantly more often non-bleeding 26.09% vs 21.05%, giant aneurysms were significantly more often non-bleeding 17.39% vs 1.75%. Aneurysms were non- bleeding, that is, unruptured in 28.75%, bleeding, that is, ruptured aneurysms were diagnosed in 71.25% of patients. Risk factors were present in 69 (86.25%) patients, of which the most common risk factor was hypertension, which was present in 86.25% of the patients. Hyperlipidemia was present in 33.75% of patients, while diabetes was diagnosed in 13.75%. The risk factor of smoking was present in all patients. Conclusion: Timely diagnosis of brain aneurysms is important in determining the type of aneurysm, its localization, size, and the risk of rupture. Given that non-ruptured diagnosed aneurysms carry a high risk of rupture, the establishment of an indication for endovascular treatment is of particular importance. Control of risk factors, especially smoking and hypertension, is an important segment in the prevention of the occurrence and outcome of brain aneurysms. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Role of DWI/ADC in evaluation of brain tumor and monitoring treatment response(2016-09-22); ; ; ; DWI consists of a DW image-diffusion trace and ADC map. DW image is a T2-weighted echo planar background image attenuated by the rate of apparent diffusion and with qualitative and quantitative assessment of the ADC map provide distinction of cytotoxic and vasogenic edema. DWI/ADC is used to assess brain tumors, tumor grading by providing information about tumor cellularity- prediction of tu grade. In high grade tumors DWI/ADC evaluate diffuse unenchancing spread and terapeutic response. ADC value of high grade gliomas has been shown to be lower than that of low-grade gliomas. In extra axial meningioma low ADC in atypical vs typical subtypes. Primary neoplasms- peritumoral edema/infiltration = low ADC vs secondary lesions. Lymphoma - high DWI/ low ADC due to its cellularity. DWI/ADC of therapeutic response provide information about post oper margin of surgical resection (ischemia, pyogenic infection-reduction of ADC). Useful in following treatment response and recurrence because cytotoxic chemoradiation reduce cellularity - increase ADC. Radiation necrosis usually showed heterogeneity on DWI images and often included spotty, marked hypointensity (Chiaki Asaoa, et al.AJNR2005). DWI useful in differentiating recurrent neoplasm from radiation necrosis. Material and method: We evaluate 33 cases with brain tumor. 19 of them after operative and/or chemoradiation therapy. All of them underwent on brain MRI enhanced with DWI/ADC, B-value o and 1000s/mm2 on 1,5T SIMENS Avanto. Results: From intraaxial tumor: 4 cases of glioma gr1; 5 gr2; 3 gr3 and 9 gr4; extraaxial 7 from witch 2 atypical and 5 secondary lesions. Follow up on operated gr2 and follow up on oper. and chemoradiated gr3 and 4 with detection of postradiation necrosis, residual tumor and recidiv however transformation in higher grade. Conclusion: Information about tumor type, malignancy grade, and the presence of necrosis is useful to determine the most suitable and effective treatment procedures. Serially obtained diffusion data is useful to document and even predict cellular response to drug or radiation therapy. Today DWI/ADC is necessary tool in CNS examination. DWI practical, useful, requires less imaging time vs other advance techniques but alone insufficient. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Endovascular treatment of intracranial aneurysm - our eleven years experience(2016-09-22); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, DISTINCT MRI PHENOTYPES OF NEUROGENIC VS. NON-NEUROGENIC CERVICOBRACHIAL PAIN: A COMPARATIVE STUDY(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University in Skopje, R.Macedonia, 2025-09); ; ; ; The differentiation of cervicobrachial pain into neurogenic and non-neurogenic etiology, is crucial for appropriate clinical management. A clear distinction based on objective findings can guide therapeutic strategies. The goal of this paper is to compare the demographic, anamnestic and magnetic resonance imaging (MRI) characteristics between patients with neurogenic and non-neurogenic cervicobrachial pain. This analytical, cross-sectional study included 130 patients with symptoms of cervicobrachial syndrome referred to cervical spine MRI. Based on radiological findings of nerve root or spinal cord compression, patients were divided into a neurogenic pain group (n=85) and a non-neurogenic pain group (n=45). Demographic and anamnestic data were collected via a questionnaire. Statistical analysis was performed using Student's t-test and the X2-test. The non-neurogenic pain group was significantly younger than the neurogenic group (mean age 39.0+ 13.5 vs. 46.5+ 12.9 years, p=0.0023). The history of a motor vehicle accident (MVA) was significantly more frequent in the neurogenic group (23.5% vs. 4.4%, p=0.0058). Advanced degenerative fmdings, such as spondylosis (58.8% vs. 4.4%, p<0.0001) and Modic changes (14.1 % vs. 2.2%, p=0.031), were significantly more prevalent in the neurogenic group. Conversely, isolated disc dehydration was significantly more common in the non-neurogenic group (81.2% vs. 48.9%, p=0.00013). In conclusion, neurogenic and non-neurogenic cervicobrachial pain exhibit distinct demographic and radiological profiles. Neurogenic pain is associated with older age, a history of trauma and advanced degenerative changes. Non-neurogenic pain is more characteristic in younger patients, predominantly female, and is associated with early degenerative findings like disc dehydration. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Endovascular Thrombectomy in a 72-Year-Old Stroke Patient: A Case Study(Macedonian Association of Radiologists, 2023-11); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Coiling in Patients with Unruptured and Ruptured Brain Aneurysms(SciVision Publishers LLC, 2025-01-30); ; ;