Background: Tranexamic acid can prevent death from bleeding after trauma and postpartum hemorrhage. Objective: The aim of the paper was to assess whether tranexamic acid reduces hematoma expansion and improves outcome in adults with stroke caused by intracerebral hemorrhage. Case presentation: Administration of Tranexamic acid in a patient after a diagnosis of intracerebral hematoma, which occurred after coronary stent implantation. Intracerebral hematoma, or neurological deficit, occurs one day after cardiac surgery in the patient. The case report will present the radiological resolution of the intracerebral hematoma, as well as the improvement of the clinical picture, neurological deficit, in the patient during a one-month follow-up, after the administration of Tranexamic acid. Conclusion: Tranexemic acid is affordable, easy to administer, appears to be safe, and is widely available, so even a modest treatment effect can have an important global impact, and it is necessary to consider its more frequent use, as well as to initiate larger randomized trials.

Background: Carotid atherosclerosis is often mentioned as one of the main causes of stroke. Currently, embolization is considered the most common mechanism that causes ischemic strokes due to atherosclerotic lesions in the carotid artery. Transcranial Doppler (TCD) ultrasound provides relatively inexpensive, noninvasive, real-time measurement of blood flow characteristics and cerebrovascular hemodynamics within brain arteries. The pulsatile index measured by transcranial Doppler is a parameter that indicates the degree of elasticity of the blood vessels of the brain. Objective: The aim of this study is to determine the relationship between the value of the pulsatile index of the middle cerebral artery and the basilar artery in patients with carotid stenosis using transcranial Doppler and the value of the pulsatile index in relation to the degree of carotid stenosis. Methods: The study involved a total of 140 patients examined at the Color Doppler and Transcranial Doppler Department of the Neurology Department of the General Hospital ”Prim Dr. Abdulah Nakas” Sarajevo The patients were divided into two groups. The research was conducted in the General Hospital “Prim. dr. Abdulah Nakas” in Sarajevo at the Department for Color Doppler and Transcranial Doppler of the Department of Neurology and included patients examined in the period from February 2022 to December 2022. All patients underwent extracranial Doppler of the carotid arteries and transcranial Doppler of the middle cerebral artery and basilar artery. Results: The mean values of PI in ACM in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the average in patients with stenosis over 50%. Average values of PI in AB in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the mean values in patients with stenosis over 50%. Conclusion: Transcranial Doppler findings showed an increased pulsatile index in patients who had carotid stenosis greater than 50% compared to patients with mild carotid stenosis. The study showed that in clinical work it would be necessary to introduce the pulsatile index as an indispensable neurosonological parameter that would be included in the findings of the transcranial Doppler and thus objectify the potential risk of a cerebrovascular ischemic event.

Background: Evaluated values of body mass index (BMI), waist circumeference (WC) and waist-to-hip ratio (WHR) increase the risk of stroke, but the extent to which this is mediated by hypertension, diabetes, lipid status, smoking and alcohol consumption is not fully understood. Objective: The aim of this research is to examine the influence of modifying and non-modifying factors as well as obesity defined through BMI, WC and WHR on the occurrence of stroke. Methods: A total of 440 subjects were included in the cohort divided in to two groups. The first group were patients with stroke and another without stroke. We investigate modifable factor for stroke (hypertension (HTA), lipid status, diabetes mellitus (DM), smoking, alcohol consumption, educational status) as well as WHR, BMI and WC as determinants for obesitiy. Results: The majority of respondents in both groups had a secondary level of education. Smoking and alcohol consumption were slightly more prevalent in the group without stroke, while HTA and DM were slightly more prevalent in the group with stroke, but without a statistically significant difference. The largest number of respodents without stroke had HDL cholesterol values in the range of optimal >1.5, 70.9%, while 35.5% of respodents with stroke had values in the risk range, as well as 32.3% in the high risk range. LDL cholesterol values were on average statistically significantly higher in the group of respodents with stroke - 3.77±1.29 compared to the values in respodents without stroke - 3.20±1.20. The largest WC had patients with a hemorrhagic stroke 96.4 ± 15.5 cm. The average BMI was slightly higher in the group of patients with embolic stroke (28.5 ± 2.8) compared to patients with hemorrhagic stroke (28.4 ± 5.9) and thrombotic stroke (28.1 ± 4, 2). WHR was almost identical in all three types of stroke. Conclusion: There is correlation between modifable risk factor and obesity in stroke occurence.

Introduction: The dominant global public health challenge are non-communicable diseases. According to World Health Organization (WHO) data. The fifth leading causes of death in FB&H are diseases of the heart and coronary arteries: stroke, acute myocardial infarction, cardiac arrest, cardiomyopathy and essential hypertension. The prevention of these diseases has great importance in improving health in B&H. Objective: The aim of this study is in estimation of one-year survival and left heart systolic function after the treatment. After the data collection and evidence of their statistical value, the results of the research point to the profile of patients with a LAD disease in one-vessel coronary artery disease that should be subjected to PCI DES LAD and PCI BMS LAD, respectively, or creating guidelines for a better and more effective LAD treatment. Material and methods: The study was performed as retrospective/ prospective, clinically controlled for a period of three years. In this study was included 60 patients, which was followed in 12 months period. With the PCI BMS method was treated 63.3% and 36.7% of subjects were treated with the PCI DES in LAD. Conclusion: The number of complications in patients with one-vessel LAD coronary heart disease, treated with PCI DES and PCI BMS was statistically significant. One possible complication (4 patients) is due to the spread of the disease to other blood vessels. Due to possible complications in the treated or LAD with repeated stenosis, the complication in terms of restenosis of the previously placed stent in 75% are with BM stents justifying the use of drug eluting stent, while the progression of disease in patients (2 patients) indicates the need for detection and prevention of risk factors.

Introduction: Subarachnoid hemorrhage (SAH)represents hemorrhage in the space between arachnoidea and pia mater, due to aneurysm burst, spontaneously or as a consequence of trauma. It is condition that occurs more common in women than men, and its most common complications are rebleeding and vazospasm. As a result of vasospasm, develops ischemia in the portion of brain tissue that can cause additional neurological deficit. Transcranial Doppler Sonography (TCD) is a noninvasive ultrasound diagnostic method that allows monitoring of the state of intracerebral hemodynamics. Goal: The goal is to follow the occurrence of vasospasm after SAH, by the TCD method. Material and methods: We have analyzed 47 patients with SAH, by analyzing the presence of aneurysm, hypertension and smoking, and by the TCD method monitor the state of intracerebral hemodynamics during the first four days, then in the second and third week. Results: SAH was more common in women (61.7%) than men (38.3%), and in the age range from 22 to 64 years. Aneurism was demonstrated in 61.7% of patients, more common in women, with hypertension 68.1% also more common in women and smoking in 87.2% of patients, also more common in women. By TCD method are recorded milder, elevated blood flow velocities at a quarter of patients in the first measurement, during the second measurement at all and it had significantly greater value, and the third measurement also more increased in about a quarter of patients, so that there is a statistically significant difference in the first and second, second and third measurement for each vessel separately, but not between the first and third measurement. Conclusion: Predilection factors for SAH are aneurysms, hypertension and smoking. By using TCD method were recorded milder elevated blood flow velocity in the first days of SAH, with about a quarter of patients, significantly greater increase in blood flow velocity during the second week in all patients and also milder increase blood flow velocity in the third week of the start of SAH is a quarter of patients. TCD is the method of choice in the evaluation and management of vasospasm after SAH, which allows the prevention of delayed cerebral ischemia.

Introduction: In this article are demonstrated differences in the aspects of the metabolic syndrome (MSy) between genders, as well as the association of MSy and neuropathy. The aim: The aim of our study was that in patients with newly discovered metabolic syndrome of both sexes make comparison of fasting blood glucose levels and after oral glucose tolerance test, as well as neurophysiological parameters of n.medianus and n.ulnaris. Patients and methods: All participants were examined dermatologically. The analysis included the 36 male and 36 female respondents with a newly discovered MSy. Results: The average age of men was 52.75±7.5 (40-65) years and women 52.1±7.7 (38-67) years. The average value of fasting blood glucose in women was 5.86±0.87 (4.5-8) mmol/L, and non significantly higher in men (p=0.0969) as 6.19±0.8 (4.7-8) mmol/L. Average values of blood sugar 120 minutes after oral glucose tolerance test were not significantly different (p=0.7052), and was 5.41±1.63 (3.3-9.7) mmol/L in women and 5.27±1.52 (2.7-9.8) mmol/L in men. Median motor velocity were significantly higher in women for n.medianus on the left (p=0.0024), n.ulnaris on the left (p=0.0081) and n.ulnaris on the right side (p=0.0293), and the median motor terminal latency were significantly longer in n.ulnaris on the left (p=0.0349) and n.ulnaris on the right side (p=0.011). There was no significant difference in the sensory conductivity velocity in n.medianus and n.ulnaris between the groups, but the amplitude with the highest peak of the sensory response was significantly higher in n.medianus on the left (p=0.0269) and n.ulnaris on the left side (p=0.0009) in female patients. Conclusion: The results indicate that there are differences in neurophysiological parameters of the investigated nerves between the genders, and that tested nerve structures in the course of MSy are affected slightly more in men. There were no significant differences in skin changes between genders.