Head gunshot injures are usually fatal. Elderly patients may have survived penetrating head injuries, since old bullets with lower velocity produce much less damage to brain tissue. We report a case of elderly male patient with mild head injury due to accidentally fall. Patient died a few hours after admission to Emergency Department. Autopsy finding showed one strayed projectile in the posterior horn of left lateral ventricle and one in the soft tissue of right VIII intercostal space. Later we obtained information that patient suffered multiple gunshot wounds about 35 years earlier. However, the cause of death was deterioration of long-term and severe hypertensive and atherosclerotic heart disease.

Axial non-contrast CT scan is the standard technique in patients with head and/or face injury. The three dimensional CT imaging reconstruction is becoming a gold standard in trauma of maxillofacial region enabling a clear perception of fracture lines and resulting displacement of fracture fragments. Le Fort fractures are fractures of the midface. In Le Fort type 3 fracture the craniofacial disjunction is present. A 91-yearold female had a mild facial trauma as a result of accidental fall. Axial CT scan showed artifacts, but three dimensional CT imaging reconstruction showed typical Le Fort type 3 fracture. Since clinical and 3D CT reconstruction finding were in complete contradiction, we repeated CT scan, which showed normal finding. This case is shows that in an era of incredible progress of neuroradiology, clinical examination still remains the best diagnostic tool.

Karcinom mokraćne bešike predstavlja načešći malignitet urinarnog trakta. Primarni standardni tretman tumora mokraćne bešike je transuretralna resekcija (TUR), ali procenat recidiva kod pacijenata tretiranih samo TUR-om je do 70%, a procenat progresije tumora tj, invazije u mišićni sloj je oko 30%, a to su pacijenti kojima je indikovano radikalno operativno lečenje. Intravezikalna instalacija bacillus Calmette-Guerin (BCG) nakon TUR tumora mokraćne bešike predstavlja dokazano najefikasnije pomoćno sredstvo u lečenju i profilaksi površinskih karcinoma mokraćne bešike. Cilj našeg rada je poređenje ishoda lečenja pacijenata podvrgnutih TUR sa pacijentima lečenim kombinovanom terapijom koja obuhvata sprovođenje imunoterapije intravezikalnom instalacijom BCG nakon TUR. Rezltati prikazani u radu predstavljaju izvod rezultata prospektivno-retrospektivne studije koja se od januara 2013. godine sprovodi na odeljenju Urologije KBC Zemun.

Schwannomas are benign sheat tumors composed of Schwann cells, which are covering peripheral nervs. Althought schwannomas can be found in any localisation, retroperitoneal scheannomas are extremly rare. Multiple schwannomas (neurilemomas) can be part of neurofibromatosis type II, as well as schwannomatosis. Depending on tumor localization, disease symptoms differ. We present a patient with multiple spinal as well as peripheral schwannomas as a part of schwannomatosis. Patient was successfully operated in cooperation between general surgeon and neurosurgeon.

Ovim radom obrađuje se deo problema ehinokokoze CNS-a koji se odnosi na spinalnu lokalizaciju oboljenja. Ističu se podaci o lečenim slučajevima u Neurohirurškoj Klinici u Beogradu, Specijalnoj bolnici “Vaso Čuković” u Risnu i Neurohirurškoj službi KBC Zemun. Kada je reč o kliničkoj slici detaljno se ističu: klinička slika kompresije medule spinalis, klinička slika sa udruženom spinalnom i viscelarnom ehinokokozom, klinička slika radikularne, odnosno periradikularne kompresije. Navedene su detaljno specifičnosti ovog oboljenja i teškoće pri postavljanju diferencijalne dijagnoze. Posebno se govori o mogućnostima ultrazvučne i kompjuterizovane tomografije pri postavljanju dijagnoze. Navedena je medikamentozna terapija u kombinaciji sa hirurškim zahvatom, kao i mogućnost supstitucije delova razorenog kičmenog pršljena sa Palakosom uz analizu dostupnog materijala

The most common tumor in the cerebellopontine angle (CPA) are vestibular schwannomas and meningiomas. The purpose of this study is to present proportional representation according to gender and age, incidence of histological type, as well as relation between tumor magnitude, clinical symptoms and prognosis. A group of 38 patients with PCA expansion were examined and treated in time interval from 2006 until 2010 at clinical-hospital center “KBC Zemun – Belgrade”. Gender proportion was 22 female (57,1%) and 16 male (42,9%). Middle-aged patients (from 30 to 60 years) were predominant in age proportion 20(52,6%). The most frequent tumor in the study was vestibular schwannoma (63,1%) followed by meningioma (31,6%). The rest were various histological type tumors like cholestatoma, plexus papilloma, glioma etc. (5,3%). Tumor magnitude proportion showed that the most of the scwanoma (over 95%) were grades III and IV (according to Koss classification). The leading admission symptoms were: deferent degrees of hearing loss, cerebellar disorders and trigeminal lesions. The analysis of postoperative results for 38 patients have shown: mortality rate of 13,2%, complete lesion of facial nerve(39,4%), partial lesion(33,3%) and (27,3%) without lesion of facial nerve. Lesions of lower group of cranial nerves (IX, X and XI) had 3 patients (9%) and pyramid deficit had 6(17,3%) patients. This study showed that typical PCA vestibular schwannoma is predominantly in female and elder population presented. Recommended treatment is surgical (total or subtotal extirpation), followed by adjuvant therapy for elder patients. The most frequent causes of lethal outcome are infections and hematomas in tumor bed. The leading neurological deficit after tumor extirpation is total or partial lesion of facial nerve.