Basilar artery thrombosis and Wallenberg syndrome in a patient with uncontrolled hypertension.

Presented here is a compelling case of a patient with a history of untreated hypertension, highlighting symptoms indicative of Wallenberg syndrome, including acute-onset dizziness, visual disturbances, continuous vomiting, difficulty walking, and an altered level of consciousness. This case's significance lies in its clinical presentation and in the diagnostic journey undertaken to elucidate its underlying pathology. Throughout the patient's hospitalization, a comprehensive assessment incorporating clinical, laboratory, and imaging techniques was conducted to delineate the extent of their condition. Of particular significance were the findings derived from MRI and MRA examinations of the endocranium, which provided crucial insights into the underlying pathophysiology. The MRI revealed multifocal ischemic lesions, pointing towards basilar artery thrombosis affecting both vertebral branches and displaying characteristic features associated with Wallenberg syndrome. Notably, the patient's lack of antihypertensive, anticoagulant, or antiplatelet therapy underscores the importance of addressing modifiable risk factors early in the disease course. This case serves as a poignant reminder of the complexities inherent in cerebrovascular diseases, highlighting the imperative of prompt recognition and management of predisposing factors. By presenting this case, we aim to underscore the clinical significance of timely intervention in mitigating potential complications of hypertension, such as cerebral artery thrombosis, thereby emphasizing the importance of proactive patient care and risk factor modification in clinical practice.

Cerebellar infarction risk in a mild COVID-19 case.

Thrombotic events in SARS-COV-2 disease patients are frequent, especially in patients with comorbidities such as heart failure, hypertension, cancer, diabetes mellitus, kidney failure, vascular disease, and other pulmonary illnesses. In severe cases, in particular those of hospitalized patients with other comorbidities, the development of thrombotic events in spite of anticoagulation therapy has been observed. The main thrombotic events are pulmonary thromboembolism, cerebral ischemic stroke, and peripheral artery thrombosis. Despite the severity of SARS-COV-2 disease, some patients with the aforementioned comorbidities develop thrombotic events regardless of the severity of their SARS-COV-2 infection. In this setting, the cerebellum makes no exception as an uncommon, but still possible target for thrombotic events.

Borderline ovarian tumor and MRI evaluation of a case report.

Borderline ovarian tumors or atypical proliferative tumors are abnormal cells that arise from ovarian epithelium in contrast to ovarian cancers which form from stroma, the supportive tissue of ovaries. They are not invasive and tend to grow slowly. Many patients with BOTs are asymptomatic, while others have nonspecific symptoms like abdominal pain or abdominal distension. The absence of symptoms makes Borderline Ovarian Tumor hard to diagnose until it is in an advanced size or stage. Very rarely, the borderline tumor cells change into cancer cells. It usually affects patients at the reproductive age, for whom preserving the childbearing potential plays a very important role. In this report, we present the case of 58-year-old female patient who is presented to the neurosurgeon's office with complaints of lower abdominal pain. Incidentally while investigating the intervertebral discs through a lumbar MRI, an abnormal finding was present in the coronal view, where a mass was noted on the lower right adnexal region of the abdomen. The patient was referred to a gynecologist for further investigations, This case report emphasizes the high sensitivity and specificity of contrast MRI in the diagnosis of various pelvic pathologies in female patients.

The importance of imaging in tuberous sclerosis complex (tsc) in children: Two cases.

Tuberous sclerosis complex (TSC) is an inherited, multisystemic, hamartomatous neurocutaneous disorder, with an autosomal dominant inheritance pattern. It affects multiple organs, however the most susceptible ones include the brain, skin, kidneys, lungs, the retina, and the heart. TSC is characterized by considerable clinical heterogeneity. The majority of patients present with a constellation of clinical signs and symptoms, most prominently central nervous system manifestations including epilepsy, cognitive impairment and autism spectrum disorders, cutaneous, cardiac, renal and ophthalmic manifestations. Epilepsy affects 70% - 90% of patients, representing the primary neurological feature and 1 of the foremost clinical findings of the disorder. Cardiac rhabdomyomas are the most frequent cardiac manifestations, appearing as isolated or multiple lesions. Herein, we present 2 patients diagnosed with tuberous sclerosis. A 3-month-old male patient with cardiac rhabdomyomas and hypopigmented macules and a 19-month-old male patient with partial epilepsy and mild psychomotor retardation. As brain lesions represent some of the most prevalent clinical features and early onset seizures are associated with more severe cognitive, function delay, through this article we hope to emphasize the potential role MRI can play in the diagnostic workup of TSC, to ensure a more timely diagnosis, thus modifying the natural course of the disorder and its prognosis.

A rare case of anophthalmia without any family history and antenatal risk factors.

Anophthalmia is a rare genetic disorder. It is defined as the absence of one or both eyes in a patient. It can be unilateral or bilateral. Based on the absence of anatomical structures, it is divided into primary, secondary, and degenerative anophthalmia. It occurs in an infant with a diabetic mother or any exposure to teratogens. Most of the patients have a positive family history of anophthalmia or related genetic disorder. Its diagnosis is crucial as there is a similar condition called micro ophthalmia. Sometimes it is difficult to differentiate between severe microphthalmia and anophthalmia. We present a case of a 5-day-old infant diagnosed with bilateral anophthalmia. In the majority of the cases of bilateral anophthalmia the patients usually have a positive family history of antenatal exposure to teratogenic substances. But in our case, no family history or antenatal teratogenic exposure was noted.

MRI diagnosis of Takayasu arteritis in a young woman.

Takayasu arteritis is a rare type of chronic, granulomatous vasculitis, characterized by inflammation of blood vessels of large caliber, such as the aorta, and its branches. Clinical presentation varies, depending on the severity of symptoms. Onset may be gradual, however at times, presentation may be acute, and life threatening. Herein, we present the case of a 29-year-old female, 3 months post-op, following a right carotid artery stenting procedure. The patient presented with nonspecific symptoms of malaise, arthralgia, and blurry vision. Clinical presentation and imaging findings were consistent with Takayasu's Arteritis.

Importance of MRI in the diagnosis of a rare intracranial mucocele associated with frontal paranasal osteoma: Case report and literature review.

Osteomas and cystic mucoceles are well-known benign tumors, affecting the paranasal sinuses. However, the concomitant presence of both lesions represents a rare occurrence, with only a handful of reported cases. We report a case of a frontal sinus osteoma associated with an intracranial mucocele, in a 61-year-old male patient, with a 3-month history of intermittent headaches and subsequent generalized seizures. Post-contrast MRI showed a frontal heterogeneously enhanced lesion with an adjacent non-enhanced cyst. After surgical excision, histopathological examination established the diagnosis of osteoma with mucoid cyst. Mucoceles increase in size progressively and gradually. They are mostly asymptomatic, nevertheless, once they extend intracranially, complications like infections, seizures, or other neurological disturbances, may frequently occur, indicating the necessity for surgical treatment. Imaging modalities, in particular a head MRI is paramount while contemplating the differential diagnosis of a solid and cystic intracranial lesions, owing to its high sensitivity and specificity. The aim of this case report is to underscore the importance of considering intracranial mucoceles in the differential diagnosis of cystic lesions in the anterior cranial fossa when associated with a solid, possibly obstructing mass.

The Importance of Magnetic Resonance in Detection of Cortical Dysplasia.

Focal cortical dysplasia is a malformation of cortical development in which there are abnormalities with cortical lamination, neuronal maturation, and neuronal differentiation. It is the most common cause of medically refractory epilepsy in the pediatric population and the second/third most common etiology of medically intractable seizures in adults. Herein, we present the case of 23-years-old female patient, presenting with loss of consciousness, and convulsions. A MRI revealed a 5mm cortical thickening on either side of the posterior aspect of the right superior temporal gyrus without transmantle extension towards ventricle. This abnormal area is measured about 24x16mm and there was no evidence for mesial temporal sclerosis. Both hippocampi are normal is size, morphology and signal. These features are consistent with cortical dysplasia type 1. This case report emphasizes the importance of MRI in the detection of FCD. MRI can show no abnormalities in type 1 FCD, but when the changes are apparent, they are on the temporal lobe, and seizures presents most commonly in adults.

The Role of Chest Computed Tomography in Asymptomatic Patients of Positive Coronavirus Disease 2019: A Case and Literature Review.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an ongoing global health emergency. At present, patients are the primary source of infection. A randomly diagnosed confirmed case of COVID-19 highlights the importance of computerized tomography of thorax in diagnosing asymptomatic patients. In the early phase of COVID-19, routine screenings miss patients who are virus carriers, and tracking travel history is of paramount importance to early detection and isolation of SARS-CoV-2 cases.

Colloid Cyst of the Third Ventricle: Case report and Literature Review.

BACKGROUND: Colloid cysts account for approximately 1% of all intracranial tumors and are the most common type of the neuroepithelial cysts. They are benign, that most commonly occur in the third ventricle near the Monro foramen. Sometimes they have no specific sings and symptoms and may be confused and misdiagnosed with other pathology of nervous systems, but sometimes they may produce acute hydrocephalus, brain herniation, and lead to death. OBJECTIVE: We present a case of 40 years old male patient with brain colloid cyst. DISCUSSION: The patient was admitted at Clinic of Radiology, for headache and episode of vomit. He was treated for signs and symptoms of depression since 2017. In clinical examination patient had symptoms of brain tumor. The MRI scan demonstrated a cyst in foramen Monroe region with typical signal intensities in the formation that confirm the diagnosis of colloid cyst as delated of lateral ventricle as signs of early hydrocephalus. After diagnosis the patient was recommended to consult with a Neurosurgeon for intervention. The cyst was removed and similar findings revealed also on histopathological examination. Many of colloid cysts manifest with no specific signs and symptoms that may be confused with depression. CONCLUSION: On rare occasions, they may completely and irreversibly obstruct the foramen of Monroe, resulting in sudden loss of consciousness and, if patients are not treated, in coma and death. So carefully check the MRI scans is very important, not only in diagnosis but also in planning of treatment.

The Role of Magnetic Resonance Imaging (MRI) in Diagnostics of Acoustic Schwannoma.

BACKGROUND: Acoustic neuromas are also called vestibular schwannoma, acoustic neurinoma, vestibular neuroma, and acoustic neurofibroma. These are tumors that evolve from Schwann cell sheath and can be either intracranial or extra-axial. They usually occur adjacent to the cochlear or vestibular nerve. Anatomically, acoustic neuromas tend to occupy the cerebellopontine angle. About 20% of internal carotid artery (ICA) tumors are meningiomas and may occur elsewhere in the brain. Bilateral acoustic neuromas also tend to be exclusively in individuals with type 2 neurofibromatosis. OBJECTIVE: The aim was to asses the role of MRI in evaluation of cerebellopontine angle acoustic schwannomas, the role of the cyber knife treatment in eliminating the tumor with a maximum protection of healthy tissue. METHODS: MRI, GE 1.5 Tesla unit and standard protocol: Pre-contrast MRI images of the temporal bones and posterior fossa were obtained using Ax 3D Fiesta T2W Hi-resolution; Ax 3D T1 Fat-Suppressed, Thin-slice (2mm) Coronal T2W, Sag 3D FiestaT2W Hi-resolution images. Post-contrast images were obtained using Ax 3D T1 Fat-Suppressed Cor 3D T1 Fat-suppressed sequences. FLAIR sequence axial). CASE REPORT: A woman 62 years of age, reported sudden tinnitus, dizziness, hearing loss in her left ear. After one years she began to experience vertigo, headache. RESULTS: MRI of brain temporal bone with contrast show acoustic schwannoma measuring 20x9 mm on the left cerebellopontine angle extending into and enlarging the left IAC, solid enhancing component is seen the acoustic meatus and peripheral contrast cystic component in the left cerebellopontine angle, after cyber knife treatment MRI result was the solid component of the mass, filling the left internal acoustic canal shows marked post-contrast enhancement and is measured 10x5x4mm, cystic component of it filling the left cerebellopontine angle cistern is enlarged to 25x19x12mm), it extends down till the left lateral aspect of medullary cistern, abutting the CN-XII at its entrance to left hypoglossal canal. After 5 month control show, a 15mm long and 5mm thick neoplastic soft-tissue in the left internal acoustic canal, with post-contrast enhancement, measured up to 12mm at the level of porus acusticus but cystic component of the mass in left cerebellopontine angle cistern is no longer visible in this MRI exam. CONCLUSION: The sensitivity of MRI for correctly diagnosing acoustic schwannoma was 100 % and specificity was 92.86 % with a positive predictive value of 94.12 % and accuracy of 96.67 %. MRI is considered as an excellent noninvasive investigation for pontocerebral angle Schwannoma's.

Role of MRI in Diagnosis of Ruptured Intracranial Dermoid Cyst.

INTRODUCTION: Intracranial dermoid cystic tumors account for <1% of all intracranial masses. CASE REPORT: A 52-year-old male, having headaches, nausea and is presented with a history of 2 episodes of new onset seizures. On presentation, the patient had a normal physical exam, including a complete neurological and cranial nerve exam. METHODS: Precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D - HI-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W, Flash/T2W oblique coronal plane, GRE/T2W axial. Post-contrast TSE/T1W sequence in axial, coronal and sagittal planes. Diffusion weighted and ADC mapping, postcontrast: TSE/T1W sequence in axial, coronal and sagittal planes. RESULTS: Subsequent MRI of the brain revealed an oval and lobulated 47x34x30mm (TRxAPxCC) non-enhancing T1-hyperintense mass in right cavernous sinus, with compression of surrounding mesial temporal lobe and right anterolateral aspect of mesencephalon. Findings are consistent with ruptured dermoid cyst, given the evacuated sebum content at its lower half. Sebum particles in millimetric sizes are seen within right Sylvian fissure, anterior horns of lateral ventricles and to a lesser extent within left Sylvian fissure, right parietal sulci, cerebral aqueduct, and basal cisterns. No restricted diffusion is seen, eliminating the possibility of epidermoid. A shunt catheter is evident traversing between right lateral ventricle and right parietal bone; besides, slit-like right lateral ventricle is noted (likely secondary to over-draining shunt catheter). CONCLUSION: Intracranial dermoid cysts are benign rare slow-growing tumors that upon rupture, however, widespread presence of T1 hyperintense droplets and leptomeningeal enhancement can be noted-making MRI the best imaging modality for diagnosis of this rare entity.

Radiologic Diagnosis of Spondylodiscitis, Role of Magnetic Resonance.

INTRODUCTION: Study aim is to report the Magnetic Resonance Imaging (MRI) features of acute and chronic spontaneous spondylodiscitis. CASE REPORT: 57 year old female, complaining of a fever and longstanding cervical pain worsened during physical therapy. METHODS: MR images were acquired using superconductive magnet 1.5 T, with the following sequences: sagittal PD and T2 TSE, sagittal T1 SE, axial PD and T2 TSE (lumbar spine), axial T2 GRE (cervical spine). Axial and sagittal T1 SE after administration of (gadolinium DTPA). Examination was reviewed by three radiologists and compared to CT findings. RESULTS: Patient reported cervical pain associated with fever and minimal weight loss. Blood tests were normal except hyperglycemia (DM tip II). X Ray: vertebral destruction localized at C-4 and C-5: NECT: destruction of the C-4/C-5 vertebral bodies (ventral part). MRI: Low signal of the bone marrow on T1l images, which enhanced after Gd-DTPA administration and became intermediate or high on T2 images. The steady high signal intensity of the disk on T2 images and enhancement on T1 images is typical for an acute inflammatory process. Bone Scintigrafi results: Bone changes suspicious for metastasis. Whole body CT results: apart from spine, no other significant changes. CONCLUSION: MRI is the most sensitive technique for the diagnosis of spondylodiscitis in the acute phase and comparable to CT regarding chronial stage of the disease. The present imagining essay os aimed at showing the main magnetic resonance imaging findings of tuberculous discitis.

Imaging Characteristics and Prevalence of Pancreatic Carcinoma in Kosovo During 2011-2015 - Diagnostic Method as Choice.

INTRODUCTION: Pancreatic cancer is the 10(th)most common malignancy and the 4(th)largest cancer killer in adults. AIM: The purpose of this paper is to evaluate the number of cases presented with pancreatic carcinoma during the years 2011-2015, our experience of the imaging characteristics of pancreatic carcinoma. We evaluated prevalence of the pancreatic cancers, distant metastases and other local infiltration signs among the total cases of the pancreatic cancers diagnosed in the University Clinical Center of Kosovo, with the aim to compare these research findings to similar studies made in the developed countries. This is a retrospective research study done during the period of 2011-2015. MATERIALS AND METHODOLOGY: This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, examined in the period of 2011-2015 at the University Clinical Center of Kosovo. The imaging diagnostics are performed with MSCT Sensation 64 Siemens, MSCT Emotion 6 Siemens, and 1.5T MRI Symphony Siemens, biopsy guide with MSCT Sensation 64 Siemens in the Radiologic Clinic of UCCK; while the histopathology diagnostics has been performed in Clinic of Pathology at UCCK and prevalence is taken from the number of cases Reported at the Institute of Oncology Institute of Statistics and NIPH (National Institute of Public Health of Kosovo). RESULTS: Out of a total of the 362 patients diagnosed with pancreas cancer, results is female 39.5% (n=143) and male 61.5% (n=219), report M: F (1: 1.6), 286 cases resulted in head and neck 79 % (n=286), 76 cases resulted in body and tail cancers (21%), distant metastases in first imaging modality were found in(n=155) patients 43 %, local infiltration was found in patients: gastric infiltration 15 % (n=54), duodenal and papilla infiltration 26% (n=94), local infiltration spleen 16% (n=57), local infiltration mesentery 43 % (n= 155), dilated biliary tree 34 % (n=123), regional lymph node infiltration 83 % (n= 300). Out of a total of the 362 patients diagnosed with pancreas cancer, 346 cases resulted > 2 cm and 16 cases resulted < 2 cm and with component cystic was 41.2 % (n = 149), solid with component cystic - necrotic 33% (n= 119), solid 25.7% (n= 93). The prevalence is 19.9: 100,000 inhabitants. CONCLUSIONS: Prevalence of carcinoma of the pancreas for 5 years in Kosovo has proved to be prevalence is 19.9: 100,000 inhabitants. Seventy-four percent (74 %, n= 268) of all cancers are found in Stage III and IV. From an imaging point of view, these cancers were presented in an advanced stage, mainly due to their late clinical symptoms and limited access to imaging methods in our country.

THE FREQUENCY OF RISK FACTORS ON TRENDS OF PANCREATIC CANCER IN KOSOVO.

THE AIM: The aim of this paper is to analyze different factors that influence the trends of pancreatic cancer mortality and morbidity of patients treated at the UCCK of Kosovo. Within this study, we have evaluated pancreatic cancer risk factors, durability and lethality regarding Kosovan patients who have been diagnosed and treated within Kosovo. The study in question is that of retrospective research traversing the period of 2011-2015. MATERIALS AND METHODOLOGY: This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, 2011-2015 at the University Clinical Center of Kosovo in Pristina. The main important factors included in this study are: age, sex and risk factors that altogether have considerable influence in incidence of pancreatic cancer. The imaging diagnostics are performed with the use of 2D ECHO Phillips, MSCT Sensation 64 and 6 and 1.5T MRI Symphony Siemens that are situated in the Radiologic Clinic of UCCK. The statistic data were obtained from NIPH of Kosovo and Agency of Statistics of Kosovo. RESULTS: Out of the total number of the 362 patients diagnosed with pancreatic cancer, the mortality in all age groups was higher at male patients-61.6 % of cases (n=223) with the highest number found at 51-60 years age group. The 38.4 % (n= 139) were female patients with the highest incidence frequency at F 61-70 years age group. The F/M ratio is 1:1.6. The "plane" nicotine users were found at 34 % (n=123) while the joined, nicotine/alcohol addiction was detected at 26 % (n= 94). The 18.5% (n=67) have had established diagnose of the diabetes mellitus tip II and 9.6 % (n=35) have undergone the medical treatment of the gastroduodenal peptic ulcerations. The total number of deaths is 310 (85.6%) and there are only 52 patients (14.4%) still alive. The mortality rate of the pancreatic cancer in Kosovo was 17.2 in 100.000 residents while the morbidity rate was 2.8 in 100.000 residents. DISCUSSION AND CONCLUSION: This retrospective research study intends to present the role of the risk factor, that influence the mortality and morbidity of the pancreatic cancer in Kosovo and finally, to compare these results with similar studies abroad with aim to prevent the pancreatic cancer. The analyses of the obtained statistical data shows that the nicotine addiction play important role in incidence of the pancreatic cancer as well as alcohol addiction, presence of the diseases such are diabetes mellitus tip II and gastroduodenal peptic ulcers.

Magnetic Resonance Imaging of a Case of Central Neurocytoma.

BACKGROUND: The purpose of this study is to investigate the MRI features of central neurocytoma. CASE REPORT: A 45 year old man with 3 months of worsening daily headaches. These headaches were diffuse, lasted for several hours, and mostly occurred in the morning. She was initially diagnosed and treated for migraines but later he had epileptic attack and diplopia and neurolog recomaded MRI. METHODS: precontrast MRI; TSE/T2Wsequence in axial/coronal planes; 3D-Hi-resolution T1W sagittal; FLAIR/T2W axial; FLAIR/T2W and Flash/T2W oblique coronal plane (perpendicular to temporal lobes) GRE/T2W axial plane for detection of heme products. Post-contrast TSE/T1W sequence in axial, coronal and sagittal planes. Diffusion weighted and ADC mapping MRI images for EPI sequence in axial plane. RESULTS: A 23x12mm heterogeneous mass within aqueductus cerebri, with calcified and hemorrhagic foci and extending downwards till fourth ventricle. It's originating from the right paramedian posterior aqueductal wall (tectum), and also extending to and involving the tegmentum of mesencephalon at its right paramedian aspect. CSF flow obstruction secondary to described aqueductal mass, with resultant triventricular hydrocephalus). Marked transependymal CSF leak can be noted at periventricular white matter, secondary to severe hydrocephalus. After IV injection of contrast media, this mass shows mild-to-moderate heterogenous speckled enhancement. CONCLUSION: MRI is helpful in defining tumor extension, which is important in preoperative planning. Although IN is a relatively rare lesion, it should be considered in the differential diagnosis of intraventricular lesions in the presence of such typical MR findings. However, a definitive diagnosis requires immunochemical study and electron microscopy.

Pancreatic Carcinoma: the Disease that Kills.

The purpose of this case report is to demonstrate the clinical symptoms and laboratory changes that have occurred very late and were very few in number even the imaging studies performed at that time showed an intensive local tumor growth associated with the wide infiltration of the both adjacent and distant upper abdominal structures. A 71-year-old male patient who was a chronic alcohol abuser and ex smoker (quit smoking 8 years earlier) presented with symptoms of mild pain on epigastric region that irradiated toward the back and significant weight loss. The initial ultrasonography (US) examination was performed, followed by the lab tests and multidetector computed tomography (MDCT) examination. The diagnostic studies confirmed the presence of the pancreatic's body mass. The ordered laparoscopic evaluation established definitive diagnosis. Initial US examination showed heterogeneous pseudo-cystic changes and slight edema of the pancreatic parenchyma associated with the multiple oval hyperechogenic lesions of liver - the signs highly suggestive of secondary metastatic deposits. The other imaging findings that were obtained with the use of the MDCT confirmed the presence of an expansive primary process of the body of the pancreas associated with the secondary metastatic changes in liver. In addition, the consecutive lymphadenopathy was revealed along hepatoduodenal ligament, retropancreatic region and intraperitoneal compartment. Tumor markers resulted with the high values of the AFP of 2.3, CA19-9 of 423.0 U/mL, and CEA of 219.0 ng/mL. The specimen of the tumor tissue taken during laparoscopic biopsy was sent for histologic examination and the final result was "metastatic adenocarcinoma of pancreas". Pancreatic body carcinoma has always been associated with poor prognosis because diagnosis is made at the advanced stage of the disease. Therefore, poor prognosis might be improved if early diagnosis could be made. Recent researches confirmed genetic predisposition for this disease at certain group of patients and this "high risk" group has to be followed up with regular imaging studies and lab analysis.

Magnetic Resonance Imaging Verification of a Case of Sacrococcygeal Teratoma.

Although rare, sacrococcygeal teratoma is the most common congenital neoplasm, occurring in 1 in 40,000 infants. Approximately 75% of affected infants are female. The aim of the present study was to correlate ultrasonography and magnetic resonance imaging (MRI) findings in patients with fetal sacrococcygeal teratoma. Three pregnant women in 27th week of gestation underwent fetal MRI after ultrasonography examination, with findings suggestive for fetal sacrococcygeal teratoma. Tumor size, location, extent and content were evaluated both by MRI and ultrasonography. Findings regarding tumor location, size and content were similar for both methods. There was a large well-circumscribed mixed, cystic/solid oval mass, originating from right sacro-gluteal region and projecting into the amniotic cavity, 132 × 110 × 76 mm in size. The mass had a heterogeneous appearance. The T1 high signal suggested fat component of the tumor, while T1 and T2 hypointense components suggested calcified/bony components. There was also T1 hypointense component consistent with cystic and fluid component. The imaging findings were characteristic for sacrococcygeal teratoma. There was not obvious lumbar or thoracic spinal involvement. There was no gross intrapelvic or abdominal extension, and even sacrum and coccyx appeared deformed. The amount of amniotic fluid was increased. MRI was superior to ultrasonography in the evaluation of the exact tumor extent, accurately demonstrating pelvic involvement in all of the three cases. Fetal MRI has shown to be a valuable adjunct to obstetric sonography in the evaluation of fetal sacrococcygeal teratoma, because of its higher accuracy in the determination of tumors extent and content, playing a significant role in the therapeutic planning and increasing the chances of cure for these fetuses.

Brucellosis associated with deep vein thrombosis.

Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.

Surgical treatment of neurologic complications of bacterial meningitis in children in Kosovo.

UNLABELLED: Neurologic complications of bacterial meningitis can occur any time during the course of the disease and some of them need neurosurgical aproach. OBJECTIVE: to determine the incidence of neurologic complications of bacterial meningitis in children requring neurosurgical treatment. MATERIAL AND METHODOLOGY: a total of 277 children were followed and treated for bacterial meningitis at the Clinic of Infectious Diseases in Prishtina. The authors have analyzed cases who developed acute neurologic complications and treatment procedures. RESULTS: of the 277 children treated for bacterial meningitis, due to the suspicion for neurologic complications, 109 children underwent a head computerized tomography scan. About 47 cases (43%) had evident structural abnormalities while only 15/277 cases (5%) required neurosurgical treatment; 9/38 cases with subdural collections, 5 cases with hydrocephalus and 1 case of spinal abscess. CONCLUSION: Neurosurgical intervention were not common in pediatric bacterial meningitis cases (5%) but were highly significant in cases complicated with acute neurologic complications (32%).