Head trauma and posttraumatic epilepsy in Slavonski Brod, East Croatia, 1988-2008.

Posttraumatic epilepsy is result of head trauma. The aim of our research was to establish how many patients after head trauma developed posttraumatic epilepsy (PTE). Retrospectively we analyzed 50 patients with head trauma different severity in period from 1989 to 2008, which we werified radiological, electroenfephalographic, and psychical changes were established according pto psychiatric examination. From 50 patient with head trauma, 40 developed seizures (3 in the firs 24 hours and 6 after first 24 hours to the end of first week, 31 after first week). By introducing antiepileptic therapy (AETh), 30 patients were seizure free, 10 patients had 1-2 epileptic seizure monthly (EPA/CPA), 10 patients got prophylactic AETh in period 6-12 months. 14 patients developed psychical changes which were verified by psychiatrist. The experience and literature show that posttraumatic epilepsy is good for treating with 1 or 2 antiepileptic, and remission is more difficult in case psychiatric comorbidity.

Giant aneurysm of basilar artery.

In the article we showed the patient, a woman with unruptured giant aneurysm of basilar artery, we showed the done examinations, and therapy dilemmas about what to do in the given case. We found in literature a number of examples which suggest operation treatment, but of embolisation too, some suggest conservative treatment.

[Ocular dirofilariasis: a case report]. / Okularna dirofilarioza--prikaz bolesnice.

A case of ocular dirofilariasis in a female patient is presented. The zoonosis caused by parasites of the genus Dirofilaria is relatively rare in humans, with a higher incidence in south and central Europe, Asia and Africa. In Europe, dirofilariasis is mostly caused by the species Dirofilaria repens. In the past 50 years, the number of individuals involved has been on an increase, with about 780 cases reported in the literature to date. Dirofilaria is a parasite found in the dog, cat, racoon and bear. The parasite replicates in the animal's body and enters circulation in the form of microfilariae. These microfilariae reach the insect's digestive tract and are transmitted to another animal or human with subsequent mosquito bites. When transmitted to humans, the parasite is found in the skin and subcutaneous tissue, mucous membranes, and less frequently visceral organs. Concerning ocular involvement, infections of the eye and adnexa oculi and tumorous noninfectious growth of eyelid or orbit have been described to date. The symptoms of the disease vary and include local pain, proptosis, diplopia, palpebral and conjunctival edema, redness, feeling of foreign body, and impaired vision. The diagnosis is generally made by histologic identification of the parasite micro- and macroscopic characteristics, Dirofilaria DNA analysis by the method of polymerase chain reaction, and serology (ELISA) demonstrating the presence of Dirofilaria antibodies in serum. Treatment includes surgical excision of the parasite as an appropriate and efficient therapeutic procedure. A 76-old-female patient presented to outpatient ophthalmology clinic for occasional sensation of pain, rubbing and redness in her right eye. Initial therapy was introduced, resulting in short-lasting improvement. In two weeks, the patient was re-examined for recurrence of discomforts. Slit lamp examination performed temporally revealed a whitish motile, live parasite under the injected and chemotic bulbar conjunctiva. Upon surgical extirpation of the parasite, the diagnosis of dirofilariasis was verified by microbiologic identification.

[Prevention of tension type headache with topiramate]. / Prevencija tenzijske glavobolje topiramatom.

AIM: The aim of this study was to assess the efficacy of topiramate in the prevention of tension type headache. Tension type headache is the most common primary headache; the 1-year prevalence is 38%. Tension type headache often causes reduced quality of life. SUBJECTS AND METHODS: In this study 51 patients were included; the dose of topiramate was gradually increased to 100 mg and patients were followed up for 6 months. The number of days and decrease in headache intensity were measured by the Visual Analog Scale (VAS) from 1 to 10 before and with therapy. RESULTS: Study results showed a statistically significant decrease in the number of days with headache: the mean number of days before therapy was 13.25 and with therapy 8.65, (p=0,0001). A statistically significant decrease in headache intensity was also observed by VAS scale: before therapy 6.27 and with therapy 3.33 (p=0.0001). CONCLUSION: This study showed topiramate to be efficient in the prevention of tension type headache.