Tarlov cyst-a rare lesion in children: case report.

Perineural cysts, also known as Tarlov cysts, are benign lesions increasingly found in patients undergoing neuroimaging studies. These cysts can very rarely be identified in children and even then, they are not so likely to be responsible for some neurological deficit. It seems to be of scientific and clinical importance to present a pediatric case with Tarlov cyst. We report a case of a patient, a 7-year-old boy, previously treated for nocturnal enuresis (bedwetting), who later developed signs and symptoms of classic urinary incontinence. Magnetic resonance imaging (MRI) showed a relatively large extradural cyst at the level of S2. The cyst was approached by laminectomy of L5 to S2, excised, and completely removed from the belonging nerve root. The patient has established normal sphincter control without even a single episode of involuntary discharge of urine. A surgery is a powerful, safe, and efficacious option for treatment in pediatric patients with sacral Tarlov cysts.

Vascularisation of the geniculate ganglion.

BACKGROUND: Lack of the relevant data in the literature and possible clinical significance of the geniculate ganglion vasculature inspired us to examine the vessels of this ganglion. MATERIALS AND METHODS: Twelve temporal bones were taken during autopsy and microdissected. Four geniculate ganglions were taken as well, serially sectioned and used for haematoxylin-eosin and trichrome staining, and for CD34 immunostaining. RESULTS: The geniculate ganglion was supplied by the petrosal artery, which averaged 1.1 in number, 0.44 mm in the outer diameter, 0.24 mm in the luminal diameter, and 17.1 mm in length. The artery approached the greater petrosal nerve, giving off 1-3 twigs to it with a mean diameter of 24 µm, and entered the nerve hiatus or a small bone opening close to the ganglion. Before the artery continued to the tympanic segment of the facial nerve, it gave rise to 1 (8.33%), 2 (75.00%) or 3 (16.67%) branches to the geniculate ganglion, which ranged in diameter between 18 µm and 56 µm (mean 29 µm). From the formed superficial network, several twigs penetrated the ganglion and built an intraganglionic plexus. The counting, performed in microscopic fields, each measuring 341.7 µm × 250.0 µm in size, contained between 20 and 38 (mean 28.1) ganglion cells, as well as from 87 to 143 microvessels (mean 99.8), so that the neuron/vessel ratio was 1:3.6. CONCLUSIONS: This is the first detailed examination of the geniculate ganglion vasculature. The obtained data could be of clinical importance, especially in relation to the Bell's palsy, ganglionitis, geniculate neuralgia, petrous bone imaging, and operations in the same region.

[Morphologic analysis of the coexisting anomalies of the arteries of the cerebral base and aneurysms: clinical study].

During operations of the aneurysms showing anatomical details is the means that leads to the aim, and it is not only a purpose in itself. Data on details that the surgeons come across during their work and which sometimes represent difficulties during interpretations of angiographic findings and planning operations, as well as the intraoperative orientations and identifications of the elements . Frequency of occurrence of such anatomical details and anomalies may be completely different from the one that autopsy series show. Knowledge of this makes the work of surgeons easier and gives a necessary feeling of confidence during operations. Thus, we decided to conduct a clinical, morphological study based on angiographic and surgical analyses of the explored segments of the Wilson circle. The study included 344 patients from the Institute for Neurosurgery, during the period of 2 years; the patients had complete angiographic diagnosing and operative exploration. Our findings confirm differences in localization of aneurysms according to sex. Aneurysms on the front communicant complex are to a great extent associated with anomalies of the front part of the Wilson circle.

[Natural course of the arteriovenous malformations of the brain].

Arteriovenous cerebral malformations represent congenital malformations. Considering the anatomical characteristics of the cerebral angiomas and their localization, in a great number of cases they demand a combined therapeutic approach--surgery, embolization and radiotherapy. Besides the constant progress of technology, 5% of all cerebral angiomas can not be completely excluded from the circulation. Therefore, the need to understand their natural course became a necessity. Our results point to the fact that they are vascular malformations of a considerably more benign clinical course than the aneurysms. Our clinical model points to an annual risk of hemorrhage which is 3.3% with total mortality of 5.3%, especially if the size of the angioma is 2.5-5 cm, localized in the motor zone of the brain, with combined type of vein drainage and arterial supply from the vertebrobasilary confluence. Epilepsy caused by the cerebral angioma is in 26.7% refractory to medicamentous therapy and in 25% (every 4th patient) will have hemorrhage with an annual risk of 0.14%.

[Therapeutic approach to pain syndromes after peripheral nerve injuries]. / Terapijski pristup bolnim sindromima posle povreda perifernih nerava.

There are a variety of reasons that pain might persist beyond the period of normal healing, and usually these reasons are complex and multifactorial. The acute phase of denervation of muscles, especially that of large ones, can be quite painful. Also, during the early months of regenerative process patient may experience associated paresthesias or dysesthesias. Such a pain pattern is selflimited, just as is the regenerative process. Neuropathy is a condition in which pain impulses are generated and perpetuated by injured, malfunctioning nervous tissue itself. Causalgia nad reflex sympathetic dystrophy are terms reserved to describe a very characteristic burning pain, accompanied by hyperesthesia and autonomic disturbances. In this study we analysed a series of 727 patients operated on Institute of neurosurgery with injury of one or more peripheral nerves, and 170 patients with brachial plexus injury.

[Standardization of the scale for evaluation of psychopathologic sequelae of traumatic stress]. / Standardizacija skale za procenu psihopatoloskih posledica traumatskog stresa.

Horovitz's scale is of questionnaire type and is used to register psychological consequences of traumatic stress with the method of self-assessment. As it is not widely known nor applied in our conditions, we got down to translate, apply and validate the scale in our examinees. The research aim was to check the practicality, applicability, objectivity discriminatory value and validity of the scale and to adopt it for our needs and our examinees who were divided into two groups: participants of war who were expected to show PTSD (posttraumatic stress disorders) (67 examinees) and non-participants of war who might have stress experiences in life (77 examinees). The result of neuropsychiatric examination, results obtained from the PTSD-interview and few other psychological tests of personal capability and personality characteristics were used as a criterion for checking up the validity of the scale. The research results demonstrated the scale to be very simple, economical and easily applicable in various conditions--especially for research, differential diagnosis and follow up effects of therapy on PTSD. In general, reliability and validity of the scale was very high, since it was in positive correlation with the neuropsychiatric examination results, PTSD interview and neuroticism tests.

[Psychotraumatic reactions in participants and non-participants in warfare--members of a special unit]. / Psihotraumatske reakcije kod ucesnika i neucesnika rata--pripadnika jedne specijalne jedinice.

The investigation was performed on a sample of members of a special parachute unit, aged 25-30 years. During combat activities in the territory of former Yugoslavia, in the period of 1991-92, they were exposed to intensive stress and psychotraumatic events which could have detrimental influence on personality and psychological functions, most frequently causing posttraumatic stress disorder. The results of investigation showed that in spite of numerous traumatic experiences, psychological stability and professional efficiency could be maintained in specially selected individuals with appropriate personality structure, who were particularly motivated and included in so-called elite units, which show high degree of group cohesion and mutual support. This investigation used for the first time the methodology, most frequently recommended in literature as standard for follow up and early diagnosis of psychological disorders caused by traumatic stress in war or everyday life. Practical value of the used methodology, which included the list of stress-inducing events, the scale of influence of stress-events and the interview for posttraumatic stress disorder, was confirmed.

Highly efficient light-emitting diodes with microcavities.

One-dimensional microcavities are optical resonators with coplanar reflectors separated by a distance on the order of the optical wavelength. Such structures quantize the energy of photons propagating along the optical axis of the cavity and thereby strongly modify the spontaneous emission properties of a photon-emitting medium inside a microcavity. This report concerns semiconductor light-emitting diodes with the photon-emitting active region of the light-emitting diodes placed inside a microcavity. These devices are shown to have strongly modified emission properties including experimental emission efficiencies that are higher by more than a factor of 5 and theoretical emission efficiencies that are higher by more than a factor of 10 than the emission efficiencies in conventional light-emitting diodes.