SUMMARY The aim of the study was to analyze correlation between morphological characteristics of intracranial meningiomas and Ki67 labeling index (Ki67 LI), and their influence on peritumoral brain edema (PTBE). There were 41 consecutive patients with intracranial meningiomas surgically treated at the Department of Neurosurgery, Zenica Cantonal Hospital, Zenica, Bosnia and Herzegovina, during the period from January 2010 to December 2015. We reviewed clinical data including patient age, gender, magnetic resonance imaging (MRI) characteristics of the tumor and peritumoral edema, tumor margins, intraoperative characteristics, histopathologic grade and Ki67 LI. In all cases, follow up MRI was obtained at about three months after resection and PTBE was analyzed. Our research showed the tumor volume, tumor margins, and intraoperative signs of arachnoidal and pial invasion to be associated with PTBE in intracranial meningiomas. Ki67 LI expression correlated with PTBE. This study showed the resolution of PTBE to depend on invasive behavior of meningioma and KI67 LI. PTBE, pial/cortical and arachnoidal invasion significantly influence the extent of surgical resection.

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Background: Arteriovenous malformation (bAVM) presents maldevelopment of the brain’s vessels with a direct connection between cerebral arteries and veins. By current data, patients from Spetzler Ponce A (SP) are found to benefit from the treatment. Considering the outcome, most of SP C and some of the SP B are the most debatable. Objective: Arteriovenous malformation presents maldevelopment of the brain’s vessels with a consequent direct connection between cerebral arteries and veins. The annual risk of hemorrhage in adults is reported for 2-3 %. They usually present with unilateral headaches seizures and intracranial hemorrhage. By current data, patients from Spetzler Ponce A (SP) are found to benefit from the treatment. Considering the outcome, most of SP C and some of the SP B are the most debatable. Methods: The study included a cohort of bAVM patients referred to Fujita Health University Bantane Hotokukai Hospital, Nagoya, Aichi, Japan where the main author (AA) has completed an international cerebrovascular fellowship under the mentorship of Professor Yoko Kato. Japanese Stroke Guidelines (JSG) were used for the treatment decision. Patients were graded according to the Spetzler Ponce (SP) system. Considering American Heart Association criteria (AHA), embolization was used as a part of multimodal treatment. Intraoperative microscopic video tools included Indocyanine green ICG, FLOW 800 and dual image video angiography DIVA. Clinical outcomes were measured using Modified Ranking Score (mRs). Results: A total of eleven patients with brain bAVM were studied with a median age of 32 years [IQR = 22-52]. There were ten patients presented with supratentorial and a single patient with infratentorial AVM. Patients were graded according to the Spetzler Ponce (SP) system. There were eight patients in SP A (72,7%), one in group B (9 %) while the rest of them were in C (18 %). Two patients had associated aneurysms that required treatment. The median size of the AVM nidus was 3,50 cm [IQR= 2-5]. Deep venous drainage was found in six patients while three were located in eloquent zones. Clinical outcomes were considered good by mRs <2 in eight patients, seven from the surgically treated group (72,7 % respectively). Surgery median length time was 427, 5 minutes; [IQR =320 - 463] with complete AVM resection in all patients and no mortality recorded in this cohort with the median follow up of 39,5 months [IQR = 19-59]. Conclusion: Ideal management of bAVM is still controversial. Those complex vascular lesions require multimodal treatment in a majority of cases in highly specialized centers. In SP A patients, surgery provides the best results with a positive outcome and a small number of complications. With the improvement of endovascular feeder occlusion SP B patients become prone to a more positive outcome. Nowadays, intraoperative microscopic tools such as FLOW 800, ICG and DIVA are irreplaceab...

&lt;p&gt;&lt;strong&gt;Aim&lt;br /&gt;&lt;/strong&gt; To investigate the presence, type and distribution of spontaneous brain and arachnoid herniation into the dural venous sinuses as well as a clinical significance of these herniations. &lt;br /&gt;&lt;strong&gt;Methods&lt;br /&gt;&lt;/strong&gt; This retrospective-prospective, non-randomised anatomical and clinical study included 990 patients who were referred to Magnetic Resonance Imaging at the Department of Radiology of the Cantonal Hospital in Zenica in the period from January to December 2016. The T1 and T2 sequences in axial, sagittal, and coronary section were used for brain or arachnoid herniation analysis. In all patients with intra-sinusal herniation health records were analysed and symptoms and reasons to refer for MRI examination were evaluated. &lt;br /&gt;&lt;strong&gt;Results &lt;br /&gt;&lt;/strong&gt;In 26 (2.6%) patients (19 females; 73.08%) the arachnoid or brain herniation was found. Average age of patients was 40.269&amp;plusmn;16.496 years. Arachnoid herniation was presented in 15 (57.69%) and brain herniation in 11 (42.31%) patients. Statistical significance in relation to type of herniation was not found (p=11.070). Statistical significance between the symptoms and localisation of herniation (except for nausea and vomiting and posterior fossa herniations) (p=0.05) as well us between symptoms and type of herniation was not found (p&amp;gt;0.05). &lt;br /&gt;&lt;strong&gt;Conclusion&lt;br /&gt;&lt;/strong&gt; The results suggest that there is a possibility of interconnection between arachnoid or/and brain herniations and some clinical symptoms such as nausea and vomiting.&lt;/p&gt;