Acta clinica Croatica
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Acta clinica Croatica · Mar 2020
Case ReportsMINIMALLY INVASIVE TREATMENT OF IDIOPATHIC SYRINGOMYELIA USING MYRINGOTOMY T-TUBES: A CASE REPORT AND TECHNICAL NOTE.
Syringomyelia is characterized by a fluid-filled cavity within the spinal cord. Expansion of the syrinx often results in the clinical course of progressive neurologic deficit. Surgery for syringomyelia generally aims to treat the underlying cause, if it is known. ⋯ Postoperative MRI revealed significant decrease in the syrinx size and clinical six-month follow-up showed improvement of clinical symptoms. This minimally invasive treatment of syringomyelia was found to be an effective method for idiopathic septated syrinx, without evident underlying cause. However, long-term follow-up and more patients are necessary for definitive evaluation of this technique.
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Acta clinica Croatica · Mar 2020
Case ReportsLARGE ANEURYSM OF BASILAR ARTERY TIP MIMICKING MIDBRAIN TUMOR AND CAUSING UNILATERAL OBSTRUCTIVE HYDROCEPHALUS: A CASE REPORT AND TECHNICAL NOTE.
Cerebral ventricular system is a sporadic location of intracranial aneurysms including those of basilar artery tip. Treatment of such aneurysms remains challenging regardless of endovascular or microsurgical techniques applied. Basilar tip aneurysm presenting as third ventricular mass is rarely associated with obstructive hydrocephalus, mimicking midbrain expansive process and urging precise diagnostics and prompt treatment. ⋯ The patient recovered fully and was discharged without neurological deficit. In conclusion, large basilar tip aneurysms associated with obstructive hydrocephalus are rare and best treated by a combination of endovascular obliteration and cerebrospinal fluid ventricular diversion. The possibility of such an aneurysm should always be considered on the differential diagnosis of cerebral ventricular growths.
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Acta clinica Croatica · Mar 2020
RELATIONSHIP BETWEEN INSULIN-LIKE GROWTH FACTOR TYPE 1 AND INTRAUTERINE GROWTH.
Insulin-like growth factor 1 (IGF-1) is a regulator of intrauterine growth, and circulating concentrations are reduced in intrauterine growth-restricted fetuses. The aim of our study was to investigate the relationship between IGF-1 levels in newborns and intrauterine growth, expressed as birth weight (BW). The research was designed as a cross-sectional study. ⋯ Only BW <33rd percentile newborns had a statistically significantly lower IGF-1 level compared to newborns with greater BW. Based on our results, it is concluded that serum IGF-1 level reflects intrauterine growth only in BW <33rd percentile newborns. This fact could be used for further therapeutic purposes.
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Acta clinica Croatica · Mar 2020
THE ROLE OF FREQUENCY DOUBLING TECHNOLOGY PERIMETRY IN EARLY DETECTION OF DIABETIC RETINOPATHY.
The aim was to assess whether standard automated perimetry (SAP) and frequency doubling technology (FDT) perimetry are able to detect the effect of diabetes mellitus (DM) on retinal function in DM patients in the early stage of disease and to analyze which method is more specific and sensitive. A randomized cross-sectional study was conducted in three different groups of patients to compare the capability of these two methods to examine visual field and to detect the change in light sensitivity. Visual function was assessed in 60 adults with normal retinal finding, 60 adults with DM without clinically detectable retinopathy and 60 adults with DM and non-proliferative diabetic retinopathy but normal visual acuity. ⋯ Analysis of parameters between diabetics and control group yielded sensitivity and specificity for medium sensitivity 71.7/61.7 (p<0.001) and 70.8/55 (p<0.002), respectively; for medium deficit 56.7/60 (p<0.058) and 77.5/43.3 (p<0.037), respectively; for LV/PSD 58.3/58.3 (p<0.042) and 33.3/83.3 (p<0.437), respectively; and for foveal sensitivity 82.5/53.3 (p<0.001) and 28.3/85 (p<0.195), respectively. We concluded that neither of these methods was sensitive and specific enough to distinguish diabetics without retinopathy from diabetics with retinopathy. Both of these methods were highly specific and sensitive to distinguish diabetics from healthy subjects, but neither of these methods proved superior.
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Acta clinica Croatica · Mar 2020
Case ReportsFROM ERECTILE DYSFUNCTION TO BRAIN SUBEPENDYMOMA: A CASE REPORT.
Endocrinopathies are relatively rare causes of erectile dysfunction. Cases of hyperprolactinemia and pituitary adenomas have been previously reported. We present a clinical case of a 27-year-old male with suspected infertility and recent symptoms of erectile dysfunction. ⋯ The resulting endocrine disorder caused problems that were subjectively at first manifested mainly as erectile dysfunction. The case is an educative example pointing to the need of taking possible intracranial lesions in consideration when starting workup in a patient presenting with erectile dysfunction. It may be of broad clinical interest not only for endocrinologists but also for practitioners in various fields.