ABSTRACT Introduction: Comorbidity of depression and stroke significantly reduces the quality of life of patients after the stroke. Squeal after stroke also determines the quality of life and have impact on the occurrence of depression after the stroke. In our study we investigated the occurrence of depression in patients after different types and subtypes of stroke measured by the Hamilton scale compared to the level of disability measured by NIHSS scale. Goal: The goal was to make a comparative analysis of depression after stroke, according to gender and age, side of the lesion and the severity of neurological deficit. Material and Methods: Material for our work are 210 patients with stroke treated at the Neurology Clinic, Clinical Center of Sarajevo University in 2012, 105 male and 105 female. The mean age of the patients was 67.12±9.5 years. Ischemic stroke was present in 65% cases. There was no statistically significant difference between ischemic and hemorrhagic stroke among genders. In case of hemorrhagic M-56.7%, F-43.3%; ischemic M-48.3%, F-51.7% (chi-square=6.563, p=0.082). Depression was more prevalent among younger patients (52-60 years) with 39.2% then in the group of older patients (61-70 years) with 32% of depressed. In relation to gender there was significantly more patients with depression among women compared to men (63.8:27.2%, chi-square=14.38, p=0.00019). Depression was more frequent in patients with stroke in the left hemisphere medial localization (63%). NIHSS scale average was 16.07 with the minimum of 11 and maximum of 22, F=52.56, p=0.001. Conclusions: We can conclude that depression after stroke is more frequent in younger patients, female patients, patients with localized stroke in the medial left hemisphere and with higher disability score.

INTRODUCTION Stroke is the third leading cause of mortality, disability and dementia, but leading cause of epileptic manifestations in the elderly. Diabetes mellitus as permanently elevated blood glucose, often accompanied by dyslipidemia, is among the leading causes of atherosclerotic alteration in blood vessels and is also increasing in the world. GOAL To determine the existence and predilection of diabetes mellitus and dyslipidemia, in the development of ischemic stroke. MATERIAL AND METHODS During the 2011 are analyzed all people with stroke admitted at the Neurology Clinic. All patients underwent neurological tests and the laboratory test with special emphasis on the value of blood glucose and lipid levels, with brain CT which confirmed the existence of a stroke, EEG and internist examination. RESULTS During the one-year period the stroke was confirmed in 1184 patients, aged 33-81 years and 37% in the younger age group (up to 50 yrs.). There was 50.67% male and 49.33% female patients. Ischemic stroke was confirmed in 78.0% (56% with thrombotic and 22% with embolic genesis), of which the 32% was lacunar infarcts (up to 1.5 cm) and hemorrhagic in 22% (SAH in 4.8%, and intracerebral hemorrhage in 17.2%). The most frequent risk factors were hypertension 85%, then smoking in 65%, diabetes mellitus in 39.0%, in 27.38% dyslipidemia, previous stroke in 26.69%, in 23.57% arrhythmia In the baseline sample 30.06% of patients had previously diabetes mellitus and in 8.94% the diabetes was diagnosed during hospitalization, while dyslipidemia was known from earlier in 22.0% and in 5.38% cases was detected during the hospitalization. Among treated patients 79.01% survived, while 20.09% have a fatal outcome. CONCLUSIONS Diabetes mellitus and dyslipidemia, along with hypertension and smoking are the leading risk factors for the occurrence of stroke. By timely detection and treatment can be controlled slow atherosclerotic changes in blood vessels and thus prevent stroke.

A case is presented of a 35-year-old woman diagnosed with platybasia associated with Klippel-Feil syndrome type I. She was admitted to University Department of Neurology for clinical examination because of walking difficulties, dizziness, and intermittent vision disturbances. Neurological examination revealed a predominance of cerebellar symptomatology. Relevant diagnostic work-up included craniogram, cervical spine x-ray, computed tomography (CT) of the brain and craniocervical junction, magnetic resonance imaging of the brain, electroencephalography, ophthalmologic examination, urinary tract ultrasonography, laboratory tests, and psychological testing. CT of the craniocervical junction showed platybasia, congenital fusion of the second and third cervical vertebrae, and basilar invagination of dens axis. Platybasia is leveling of the angle between the floor of the anterior cranial fossa and posterior cranial fossa in the area of sella turcica, which is normally at 115-140 degrees. Basilar impression or invagination is moving up of the basis of the occiput and occipital condyles into the cranium, which means that the borders of the foramen magnum, condyles and adjacent bone are invaginated into the posterior fossa. Klippel-Feil syndrome type II is massive fusion of two of seven cervical vertebrae associated with short neck and low hair line.

Introduction: In the treatment of Multiple Sclerosis (MS) differ: treatment of relapse, treatment slow the progression of the disease (immunomodulators and immunosuppression), and symptomatic treatment. The aim: The aim of this study is to analyze the application of interferon therapy in the treatment of MS-E: Process the disease, patients with multiple sclerosis who have passed the commission for multiple sclerosis at the Neurology Clinic of Clinical Center of Sarajevo University as a reference center for referral to the Commission for multiple sclerosis from the Federal Ministry of Health in 2009 year in terms of total number examined, gender differences, diagnostic tests (MRI, CSF, EP), neurological findings and EDSS scores. Provide a section through the continuous support and education of patients during the introduction Betaferon in therapy with the goal of education for self-use and reduce the incidence of side effects of interferon therapy. Materials and methods: The material for the work they were histories of patients who are registered as patients who have undergone a commission for MS at Department of Neurology, University Clinical Center in Sarajevo. The evaluation was retrospective. It was used a specially designed form, which is usually applied to patients referred to this committee. After the collected material was carried out data processing. The study comprised 34 patients who have undergone a commission of which 16 patients received interferon therapy. Results: In 2009 at the Neurology Clinic CCUS have treated 34 patients who passed the committee for recommendation to interferon therapy (25 women and 9 men). The diagnosis of multiple sclerosis is safe based on the criteria of international panel in 2000. EDSS Average score for men was 1.8, 1.9 for women, the total EDSS score was 1.8. The gender ratio is 3:1 in women than in men. Sixteen patients received interferon by the Commission for multiple sclerosis, the Federal Ministry of Health and their therapy was initiated at the clinic. Conclusion: For the period of 2009, a total of 34 patients were examined with multiple sclerosis who received interferon treatment recommendations at the expense of the Federal Solidarity Fund at the Neurology Clinic CCUS Sarajevo. The average EDSS score was 1.8. There were no significant differences in neurological findings between patients who were previously treated with interferon and patients who were waiting for treatment.

INTRODUCTION Meniere's disease is a condition with sudden attacks of vertigo with nausea and vomiting accompanied by loss of hearing and buzzing sensation in the ears, most commonly unilateral. The exact cause of the disease is unknown. Betahistine is the analogue of histamine with weaker agonistic effect on histamine H1 receptors and stronger effect on histamine H3 receptors, while Cinnarizine has more effective effect on H1 receptors. GOAL The aim is to determine which drug is more effective in the treatment of Meniere's disease Betahistine or Cinnarizine. MATERIAL AND METHODS This study evaluates the effectiveness of Betahistine in 37 patients with the Meniere's syndrome accompanied by classic triad of symptoms treated in hospital conditions and Cinnarizine effect in 36 patients with a less severe clinical picture, which were treated as outpatients. To all patients were conducted laboratory tests, brain CAT (to exclude possible expansive process, MS or stroke) and TCD in order to eliminate any possible circulatory disturbances in VB basin. Group with classic Meniere's syndrome was treated at a dose of Betahistine of 3 x 16 mg and followed 8 weeks, while the second group was treated with Cinnarizine at a dose of 2 x 75 mg and also followed for 8 weeks. CONCLUSIONS Already after one month of therapy was noticed better effect in case of Betahistine in terms of symptoms reduction compared to the Cinnarizine effect.

Introduction: Multiple sclerosis is an inflammatory, autoimmune, disease of the white mass of the brain, which sometimes may involve the gray matter (subcortical and ones in the anterior horns of the spinal cord) with the chronic nature and generally with progressive course. As a possible cause of this disease state are listed genetic predisposition, early viral infections and environmental factors, with special effects of stress as a provoking factor in first episode of the disease and relapses because stress leads to modulation of the immune system and immune response to various causes. Goal: To determine the existence of intense stressful events as a factor in the development of the first episode of illness and worsening of the seizures. Material and methods: We analyzed all newly discovered cases of multiple sclerosis over a two year period (January 2010 – December 2011) during the first or second hospitalization, and worsening of seizures for previously diagnosed patients in this period. In order to confirm the MS diagnosis are taken history, neurological examination, MRI of the brain, VEP, CSF examination and for those with repeated hospitalization only follow-up of EDSS scores trough neurological examination. Results: During the two year period there were 109 newly diagnosed cases of MS from which 80 F and 29 M (ratio 2.7:1), aged 17-59 years, mean age 32.93±9.69 years and 41 patients (29 F and 12M with seizures worsening in previously diagnosed disease. Disease duration was from 6 months to 17 years. 72.94% had relapsing-remitting course of the disease (RRMS) and 27.1% had secondary progressive type (SPMS). Stress as a provoking factor preceded in 47.44% the first episode of the disease, infections (respiratory) in 18.3%, and the pregnancy with postpartum period in 8.77% women, whereas in the group of patients with previously diagnosed illness relapse (n=41) showed that the infection is most common precipitating factor which preceded relapse in 58.54% of patients, stress in 29.02%) and the pregnancy with postpartum period in 12.5% of patients. Conclusion: An intensive stressor is certainly one of the triggers for the development of Multiple Sclerosis, as the first episode and worsening of previously established disease.

INTRODUCTION in fighting sports there are many opened issues related with levels of aggression and anxiety. MATERIAL AND METHODS Our study is performed with healthy young athletes: kick boxers, karate fighters, and boxers. Examined group consisted of 55 members (45 male) with average age of 20.2 +/- 3.8 years. In analysis of level of aggression Questionnaire A-87 is used. Its purpose is assessment of aggressive behaviour in provoked situations, or measurement of impulsive aggression. Questionnaire A-87 consists of 15 items of different situations with five possible responses. RESULTS AND DISCUSSION The possible responses or reactions are the five most frequent forms of aggressive responses: a) verbal manifest aggression (VM); b) physical manifest aggression (PHM); c) indirect aggression (IND); d) verbal latent aggression (VL), and e) physical latent aggression (PHL). In the analysis of anxiety is used Beck Anxiety Inventory, BAI. Average training period was 7.8 +/- 3.6 years. Even 37 athletes during sporting carriers were injured, and most of examiners (precisely 13) experienced 3 injuries. Average value of BAI was 12.7 +/- 8.7. Average value of total aggression was 152.2 +/- 40.9; highest levels were observed in VM (33.9) and VL (30.1). Significant positive correlations of all components of aggression with level of anxiety is observed (p < 0.05), most prominent IND (r = 0.4263; p = 0.0012), and VL (r = 0.4163; p = 0.0016), and also total aggression (r = 0.4822; p = 0.0002). Slightly significant positive correlation of total aggression with age of examiners is also observed (r = 0.2668, p = 0.0489). Positive correlation VM (r = 0.4928; p = 0.0001), PHL (r = 0.2761; p = 0.0413), and total aggression (r = 0.347; p = 0.0094) is observed with number of injuries of examined athletes. Also, positive correlation (r = 0.2927, p = 0.0301) is observed with level of anxiety and number of injuries. Higher level of aggression and anxiety might change attitude of some sports authorities (especially coaches), and additional psychological training of fight sports might be necessary. CONCLUSION Assessment of basically levels of aggression and anxiety of athletes might be valuable not only in sport activities, but in overall aspects of life.

INTRODUCTION Brain tumors are a unique and heterogeneous group of tumors with which face a variety of specialties, mostly oncologists, neurologists and neurosurgeons. Due to their specific location all brain tumors are malignant, regardless of their malignant potential, because any expansion process within the skull, increased intracranial pressure and destruction of surrounding structures, which can cause neurological, quantitative disturbances of consciousness or death. GOAL The goal of this study was to record neoplastic processes of the central nervous system in patients of Neurology Clinic, Clinical Center of Sarajevo University in the twenty-year period (January 1st 1990-December 31st 2009). The study was partly retrospective and partly prospective determined by three time periods. MATERIAL AND METHODS We reviewed medical records and documentation of patients treated at Neurology Clinic, which has 102 beds. All patients' data were collected using a specially designed questionnaire for this study. RESULTS AND DISCUSSION The number of secondary tumor process for the period 2000-2005 is greater than in the period 1990-1999, while in the period 2000-2009 is increasing (17.2%-30.3%). The male-female ratio is 52:48. During the first two monitoring period there were statistically significantly more men, and in the last monitoring period there were more women. The mean patient's age was 60 years. The most common symptom was hemiparesis for all observed periods evaluated with standard diagnostic tests: CT and MRI. CONCLUSION We can conclude that CNS neoplasms in patients of Neurology Clinic, Clinical Center of Sarajevo University are present in the twenty-year period with total of 1.47%, and showed a decrease of 2.7% (1990-1999) to 0.47% for the period 2006-2009.

Stroke is a suddenly developing disorder, caused by focal disturbance of cerebral circulation, followed by neurologic deficits of varying intensity with duration longer than 1 hour; it mostly occurs in old and middle age, and rarely at a younger age. The aim of the study was to analyze the occurrence of stroke at a younger age (18-49 years). We analyzed all stroke patients aged 18-49 treated at University Department of Neurology in Sarajevo during 2009, including analysis of their risk factors. During the one-year period, there were 820 stroke patients in total, 132 (18.5%) of them aged 18-49, male to female ratio 51.35%:48.65%. The majority of strokes were of ischemic type (94.59%), with only 5.41% of hemorrhagic stroke. The following risk factors were confirmed in study patients: hypertension (64.86%), smoking (57.76%), dyslipidemia (48.65%), ischemic heart disease (43.32%), psychological stress (29.73%), diabetes mellitus type 2 (24.43%), previous stroke including transient ischemic attack (21.62%), and others. During the one-month follow-up, 27.03% of patients achieved complete recovery, whereas mild neurologic signs were retained in 54.05%, signs of severe deficit requiring assistance in 13.51%, and 5.41% of patients died. In conclusion, stroke occurs even at a younger age in certain percentage. Along with smoking, diabetes, dyslipidemia and stress, hypertension is one of the leading risk factors for stroke also at a younger age. Timely and appropriate treatment contributes to faster recovery and shorter hospital stay, while reducing overall stroke sequels. The best prevention is primary, i.e. fighting risk factors and healthy lifestyle.

INTRODUCTION Depression often accompanies various physical illnesses. OBJECTIVES Screening for unidentified depression in patients diagnosed with Diabetes mellitus. DESIGN AND METHOD a retrospective, descriptive study. SUBJECTS 100 diabetic patients, 53% female and 47% male, age group 18-85. Hopkins Symptom Checklist-25 questionnaire was used on a random sample of diabetic patients in two family medicine outpatient clinics in Health Centre Ilidza and Center, Sarajevo, in period February-May 2007. The cutoff score of > or = 1.75 was used. The occurrence of depression was analyzed with respect to the duration of Diabetes mellitus, type of treatment and average value of fasting blood glucose over the last six months. RESULTS 36% of subjects scored positive for depression symptoms, 31% of subjects in the group having the illness up to one year, 80% in the group having the illness for 11-15 years. There is a statistically significant difference in depression positive score between the group of patients using insulin, and to the group using oral hypoglycemic therapy, 73% vs. 20% (p< 0.05). In the group with average value of fasting blood glucose < or = 7 mmol/l, 15% of the patients have a positive oepression score, versus 66% of them in the group with blood glucose levels of 13-15mmol/l. CONCLUSION The number of newly found depressions in diabetic patients increases with the duration of Diabetes mellitus and with higher levels of fasting blood glucose. A systematic screening by family doctors can help identify diabetes-related depression.

UNLABELLED The adolescent idiopathic scoliosis - AIS over 40 degrees measured by Cobb, are treated by surgery. Most frequently are used corrective spondylodesis by Harrington (with hooks), by Luqe (with wires), anterior spondylodesis (with transcorporal screws). In last two decades, the posterior corrective spondylodesis by transpedicular screws is popularized. Aim of this work is to present advantages and disadvantages of posterior corrective spondylodesis of scoliosis. METHODOLOGY Twenty-three patients have been included in this study, average age of 15 y. (10-32), and mostly female gender. The dynamic and quality of postoperative flow after posterior corrective spondylodesis have been analyzed at the AIS patients on the Dept. of orthopedics and traumatology, Clinical centre University of Sarajevo during last three years. RESULTS The length of postoperative hospitalization in the analyzed group was 7 days, compared with results achieved by other methods. Faster recovery, returning to life activities, final esthetic and functional result were superior, and there was no need for revision surgery. CONCLUSION of this work is that posterior corrective spondylodesis by transpedicular screws at the AIS patients is method of choice, if all requirements of correct performing of that method are met.

INTRODUCTION Neurological findings are the main criteria for making the diagnosis of multiple sclerosis, including head and spine MRI, CSF findings and evoked potentials. OBJECTIVE Investigate and observe correlation in SSEP especially wave P22 in group of healthy examiners, as well on those suffering multiple sclerosis. Present Evoked potentials clinical application benefits in Multiple sclerosis diagnostic procedures used in Neurological Clinic, Clinical Center University of Sarajevo. EXAMINES AND METHODS: Examination is prospective and clinically applicable. Examination involved one hundred examinees in total, divided in two group where 50 examinees where confirmed with Multiple sclerosis diagnosis, and 50 others made up control group of healthy volunteers. Examination is made based on neurological findings, questionnaires for EP and MS, and SSEP done for all examinees. Statistical assessment is based upon percentage, standard deviation, Chi square test and Student t test. RESULTS average age of patients in control group is 35.28, and at the same time 34.90 in experimental group and do not have statistical significance. In both group females were dominant gender and there was no statistical significance of gender ration between two group. Wave P22 was statistical significantly extended in group of MS diagnosed patients compared to the group of healthy examinees. CONCLUSION our studies dominantly affected female gender. Studies presented statistically significant increase of SSEP abnormalities in MS diagnosed patients group compared to the group of healthy examinees, in term of extended latency of waves P22 as cortical responses. These figures shows significance of SSEP clinical use in MS diagnostically procedures, to additionally confirm definite diagnosis.