The aim of this study was to evaluate anosognosia in acute stroke phase in order to type of stroke (ischemia, hemorrhage) and stroke localization as well as post-stroke patients recovery. Subjects and methods: In this prospective analysis were included 191 patients (96 males and 95 females) with first-ever stroke who were treated at the Department of neurology of the University Clinical Center in Tuzla. All patients were tested to anosognosia presence in acute stroke phase according to the modified Bisiach scale (7), while the level of disability was assessed using the Rankin scale (8) and level of functioning in daily activities using the Barthel index (9). Re-testing was done in week five post-stroke. Results: The average age of patients was 66.41 (mean age 10.21). Ischemic stroke had 168 patients (88%) while 23 (12%) the hemorrhagic one. The lesions localized to the right hemisphere were in 111 (58.11%) patients as well as in 80 (41.89%) patients with lesions localized to the left hemisphere. Anosognosia with no statistical significance was verified in 28% of patients in acute stroke phase, more often caused by lesions to the right hemisphere. Otherwise, significantly more frequent anosognosia was present in patients with hemorrhagic stroke mostly caused by massive lesions localized to the right hemisphere. Conclusion: Presence of anosognosia in patients with stroke vitally influenced patient’s functional status in re-testing phase just as well as in the acute stroke phase.

Introduction: The depression is a common mental disorder, especially after a stroke, which further aggravates the recovery. Aim: To analyze depression within 48 hours and fifteen days after ischemic stroke in relation to gender and location (brain hemisphere and brain circulation). Methods: We analyzed 40 patients (65.3±10.3 years), half of them were women. Mean age of women was 66.35±7.31 years and men 64.2±12.68 years (p= 0.5). Ischemic stroke was verified by computed tomography. Levels of depression were measured with self-estimated Zung’s scale. On the tests, score of 50 and higher verified depression. Criteria made by Domasio were used to determine location of the IS. Results: Mean value on depression scale in acute phase of ischemic stroke was 46.85 ± 8.6 and in subacute phase 43.4 ± 8 (p =0.06). In 19 (47.5%) patients (55% of women, 40% of men; p=0.3) depression was found during the first and in 10 (25%) patients (35% of women, 15 % of men; p=0.06) during the second evaluation (p<0.019). Mean value on depression in acute phase of illness in women was 49.1 ± 7.38, as well as in men 44.6 ± 9.22 (p=0.088) and in subacute phase in women 45.25 ± 8.04, as well as in men 41.5 ± 7.75 (p=0.16). Concerning location of ischemic stroke, there were no significant differences in levels of depression. Conclusion: Number of patients with post-stroke depression is significantly lower in subacute phase of ischemic stroke. Although the number of depressive women and their depression scores are higher, gender differences are not statistically significant. There is no correlation between post-stroke depression and location of lesion in acute and subacute phase of illness.

Epilepsy is a paroxysmal cerebral dysrhythmia defined by three important characteristics: the suddenness of the process, brain origin and the disorder of the rhythm of the electrical brain activity (1). Seizures (crises, ictus events, attacks) are common to all epilepsies. They include a variety of clinical manifestations or sudden episodes of disturbance of motor, sensibility, behaviour, perception, awareness or other psychic functions, autonomic and other regulations. The classification of seizures and epilepsy syndrome takes the central place in modern epileptology, although the classification process itself is as old as the study of epilepsy. The international classification, based mainly on the clinical form of seizure and the electroencephalographic findings, was adopted in 1981 and has been further modified. In 1989, ILAE (International League Against Epilepsy) adopted the International classification of epilepsies, epilepsy syndromes and disorders, which highlights the symptoms and signs that show the localization of initial cerebral dysfunction and its spread (2). In 2017, the ILAE released a new classification of seizure types, based upon the existing classification formulated in 1981. and its extension from 2010. The differences include the following: "partial seizures" become "focal"; consciousness is used as a classifier of focal seizures; terms such as „dyscognitive”, „simple partial”, „complex partial”, „psychic” and „secondary generalized” are eliminated; new focal seizures include automatisms, behavioural changes, hyperkinetic, autonomic, cognitive and emotional; atonic, clonic, epileptic spasms, myoclonic, and tonic seizures can be either focal or generalized phenomena; „focal seizure evolving to a bilateral tonic-clonic seizure” replace the term „secondary generalized seizure”; new generalized types of attack are absence with eyelid myoclonia, myoclonic absence, myoclonic-atonic and myoclonic-tonic-clonic and seizures of unknown onset (3). Biometeorology is an interdisciplinary science that studies the interaction system between living organisms and the environment. The biometerological warning, bioforecast, contain a description of the meteorological situation and announces the arrival of those weather conditions which may adversely affect human health in the next days. The goal of bioprognosis is the organization of preventive measures for the protection of the vulnerable groups health (4). Variations in biometeorological factors have an influence on the overall balance of the human body, as well as to changes in the condition of patients, primarily those with chronic diseases. Le Blanc and Mills (1932) stated that one of the oldest and best known disease whose association with climatic factors is mentioned, is epilepsy (5). Fluctuation in some climatic factors, e.g. air pressure, might influence one or more of the above mentioned factors, and thus lead to seizure. The purpose of this study was to determine the effect of atmospheric pressure on the specific seizure types frequency as well as on patient's subjective perception of the seizure "severity".

Introduction: Small number of studies have evaluated the mortality and the degree of functional disability of post-stroke delirium, and our aim was to determine that. Patients and Methods: Comprehensive neuropsychological assessments were performed within the first week of stroke onset, at hospital discharge, and followed-up for 3, 6 and 12 months after stroke. We used diagnostic tools such as Glasgow Coma Scale, Delirium Rating Scale, National Institutes of Health Stroke Scale and Mini-Mental State. Results: Delirious patients had a significantly higher mortality (p = 0.0005). As opposed to the type of stroke mortality was higher after ischemic (p = 0.0005). The patients without delirium had significantly better cumulative survival during the first year after stroke (p = 0.0005). Delirious patients aged ≥65 years had a significantly lower cumulative survival during the first year after stroke (p = 0.0005). In relation to the type of stroke delirious patients with ischemic had a significantly lower cumulative survival during the first year after stroke (p = 0.0005). Delirious patients had a greater degree of functional impairment at discharge (p = 0.01), three (p = 0.01), six months (p = 0.01) and one year (p = 0.01) after stroke. Conclusion: Delirious patients have a significantly higher mortality, lower cumulative survival and a greater degree of functional disability in the first year after stroke.