Publications by authors named "Martina Špero"

7 Publications

  • Page 1 of 1

Intracranial Mature Teratoma in an Adult Patient: A Case Report.

J Neurol Surg Rep 2019 Jan 3;80(1):e14-e17. Epub 2019 Apr 3.

Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia.

: Primary intracranial teratoma is a subtype of germ cell tumors, classified into three subtypes. They occur very rarely, with only several reported individual cases in adults.  We present a patient with an intermittent headache in the right frontal region. Magnetic resonance imaging (MRI) revealed a right sided high frontal parasagittal mass that compressed the falx, the right lateral ventricle, as well as the brain parenchyma. Patient underwent surgical treatment. Histopathological analysis described mature teratoma. Four months after the surgical treatment there were no signs of residual intracranial mass or relapse.  Primary intracranial teratoma in adults has a nonspecific clinical presentation. MRI reveals a solitary irregular mass with multilocularity and mixed signals derived from different tissues. The patients age, biochemical markers, and patohistological analysis are necessary to confirm the diagnosis.  Teratoma treatment strategy still remains controversial. It includes radical resection whenever possible. Since the residual portion of mature teratoma may contain part of immature or malignant tissue, tumor recurrence after surgical removal is possible. Also, new tumor mass could occur at other sites intracranial after the initial one was removed. Thus, although patients usually recover, they should be followed-up for a long period of time.
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http://dx.doi.org/10.1055/s-0039-1685213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447400PMC
January 2019

A thin line between Meniere's disease and spontaneous intracranial hypotension syndrome.

Med Glas (Zenica) 2016 Feb;13(1):31-5

Department of Radiology, University Hospital Centre, Zagreb; Croatia.

Aim: To point out the similarity of Meniere disease and spontaneous intracranial hypotension and difference of their treatment.

Methods: A case of a 54-year-old male patient with previously diagnosed Meniere's disease and newly diagnosed spontaneous intracranial hypotension syndrome is presented. Additional neuroradiological examination, Brain contrast-enhanced MRI and MR myelography were used for diagnosis.

Results: Due to deterioration of vertigo, hearing loss and tinnitus in the right ear the patient was referred to the additional neuroradiological examination which confirmed the diagnosis of spontaneous intracranial hypotension syndrome. Brain contrast-enhanced MRI showed increased pachymeningeal contrast enhancement, and MR myelography identified the location of CSF leak. The patient was successfully treated conservatively.

Conclusion: According to our knowledge this is the fifth case report of Meniere's disease and spontaneous intracranial hypotension coexistence. Both diseases have similar clinical presentation and initial treatment. We suggest procedures of additional examination when the treatment fails and initial diagnosis becomes questionable.
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http://dx.doi.org/10.17392/830-16DOI Listing
February 2016

Dynamic magnetic resonance imaging of endoscopic third ventriculostomy patency with differently acquired fast imaging with steady-state precession sequences.

Bosn J Basic Med Sci 2014 Aug 16;14(3):165-70. Epub 2014 Aug 16.

Oncology Institute of Vojvodina, Diagnostic Imaging Center, University of Novi Sad, University School of Medicine Novi Sad.

The aim of the study was to determine the possibilities of two differently acquired two-dimensional fast imaging with steady-state precession (FISP 2D) magnetic resonance sequences in estimation of the third ventricle floor fenestration patency after endoscopic third ventriculostomy (ETV) in the subjects with aqueductal stenosis/obstruction.Fifty eight subjects (37 males, 21 females, mean age 27 years) with previously successfully performed ETV underwent brain MRI on 1.5T MR imager 3-6 months after the procedure. Two different FISP 2D sequences (one included in the standard vendor provided software package, and the other, experimentally developed by our team) were performed respectively at two fixed slice positions: midsagittal and perpendicular to the ETV fenestration, and displayed in a closed-loop cinematographic format in order to estimate the patency. The ventricular volume reduction has been observed as well.Cerebrospinal fluid (CSF) flow through the ETV fenestration was observed in midsagittal plane with both FISP 2D sequences in 93.11% subjects, while in 6.89% subjects the dynamic CSF flow MRI was inconclusive. In the perpendicular plane CSF flow through the ETV fenestration was visible only by use of experimentally developed FISP 2D (TR30/FA70) sequence. Postoperative volume reduction of lateral and third ventricle was detected in 67.24% subjects.Though both FISP 2D sequences acquired in midsagittal plane may be used to estimate the effects of performed ETV, due to achieved higher CSF pulsatile flow sensitivity, only the use of FISP 2D (TR30/FA70) sequence enables the estimation of the treatment effect in perpendicular plane in the absence of phase-contrast sequences. 
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333999PMC
http://dx.doi.org/10.17305/bjbms.2014.3.37DOI Listing
August 2014

Difficulties with diagnosis and consequential poor outcome due to stigma of acquired immunodeficiency syndrome - a case report.

Pathog Glob Health 2013 Sep 1;107(6):325-8. Epub 2013 Aug 1.

University Hospital Dubrava, Zagreb, Croatia.

Low incidence of human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) has been detected in Croatia so far. Toxoplasmic encephalitis (TE) is the most common opportunistic cerebral infection in AIDS patients and is highly responsive to antiparasitic chemotherapy, if treated at an early stage. We present the case of the brain biopsy confirmed as TE on a 36-year-old female patient who at admission presented with unconsciousness and a right hemiplegia. A MSCT was performed and two hypodense lesions were diagnosed. The patient's family initially denied the presence or history of any medical problem or infection. An MRI showed multiple ring-enhanced mass lesions. An infectologist required a brain biopsy to exclude cerebral lymphoma and multiple metastases. Pathohistological analysis suggested TE. Meanwhile, patient's blood samples were found to be HIV positive. The patient was transferred to University Hospital for Infectious Diseases in Zagreb, where she died 2 days following admission. The patient's family terminally confessed that the patient had been HIV positive for 10 years and had refused any treatment. Family's denial of infection as well as 'hiding information' concerning patient's health from physicians involved in her treatment caused a delay in proper on-time patient treatment. We would like to emphasize that TE must be considered as a differential diagnosis in patients presenting with multiple cerebral lesions, including patients without acknowledged past history of HIV infection. A stigma towards HIV infection and ignorance of the disease still exist and therefore hinders proper treatment.
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http://dx.doi.org/10.1179/2047773213Y.0000000108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4001613PMC
September 2013

Normal pressure form of the spontaneous intracranial hypotension: a case report with pituitary enlargement and asymptomatic pituitary haemorrhage.

Neurol Sci 2011 Oct 12;32(5):933-5. Epub 2011 Apr 12.

Department of Radiology, University Hospital Dubrava, Avenija Gojka Suska 6, 10 000 Zagreb, Croatia.

Spontaneous intracranial hypotension is a rare condition caused by spontaneous cerebrospinal fluid leak and volume depletion. It is initially misdiagnosed as a cause of an orthostatic headache, which is the most important symptom of the syndrome. It can be presented as one of four types: classic form, normal pressure form, normal pachymeninges form and acephalgic form. The diagnosis is made based on the clinical presentation, physical examination, typical cerebrospinal fluid and magnetic resonance imaging findings. We present a case of a 29-year-old woman with uncommon normal pressure form of the spontaneous intracranial hypotension, characterized by normal cerebrospinal fluid opening pressure, and typical clinical and magnetic resonance imaging findings, including the finding of pituitary gland enlargement with asymptomatic pituitary haemorrhage as an unusual complication.
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http://dx.doi.org/10.1007/s10072-011-0584-6DOI Listing
October 2011

Preoperative staging of renal cell carcinoma using magnetic resonance imaging: comparison with pathological staging.

Clin Imaging 2010 Nov-Dec;34(6):441-7

Department of Radiology, University Hospital Dubrava, Zagreb, Croatia.

We have retrospectively assessed the accuracy of our MRI protocol on 1.0-T MRI system for preoperative staging of renal cell carcinoma using the 2002 TNM staging system and pathological staging as the gold standard. Medical records of 48 patients (mean age, 56.28 years) with 57 renal tumors were reviewed: 52 malignant renal tumors were found; most of the patients were staged T1N0M0. In our study, κ test revealed excellent agreement between all three classes of the TNM staging system.
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http://dx.doi.org/10.1016/j.clinimag.2009.09.005DOI Listing
April 2011

Creutzfeldt-Jakob disease: case report and review of the literature.

Acta Clin Croat 2010 Jun;49(2):181-7

University Department of Radiology, Dubrava University Hospital, Zagreb, Croatia.

Creutzfeldt-Jakob disease (CJD) is a rare, fatal neurodegenerative disease caused by an infectious protein called prion and is characterized by spongiform changes, neuronal loss, reactive astrocytic proliferation and accumulation of pathologic cellular protein, occurring in 3 general forms: sporadic or spontaneous, genetic or familial, and acquired form including a variant form of CJD. Clinical presentation of CJD is characterized by progressive dementia, neurologic symptoms and visual impairment, development of akinetic mutism, and eventually death, usually from respiratory infection. The diagnosis is based on clinical presentation, electroencephalogram, and typical cerebrospinal fluid and magnetic resonance imaging findings. A case is presented of a 56-year-old woman with progressive dementia, typical neurologic symptoms, positive cerebrospinal fluid and typical magnetic resonance imaging findings. The clinical, pathologic and imaging findings of this rare condition are also discussed.
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June 2010