Gioblastoma multiforme lo cal ized in the mo tor area is the sur gi cal chal lenge be cause of the need for more rad i cal re sec tion in or der to ex tend the life of the pa tient, and the other due to the risk that rad i cal ism could lead to ad di tional-crip pling neu ro log i cal def i cit. Method. We pres ent a se ries of 26 pa tients with Glioblastoma multiforme local ized in and around the mo tor area in front of the cen tral sulcus who were hos pi tal ized from Oc tober 2004 to Feb ru ary 2009. Dur ing all op er a tions we con ducted cor ti cal electrostimulation on dis played area of the brain, to the an a tom i cal lo ca tion of M1 seg ment of the mo tor cor tex. Re sults. Dis tance of the cen tral sulcus in re la tion to the cor o nary su ture, measured by mag netic res o nance im ag ing (MRI) was 18.38 mm±9.564 mm. The vol ume of elec tric ity required for a mo tor re sponse was 9.26±1.286 mA(min. 7mA, max. 11mA), with in creas ing dis tance from the cor o nary su ture the am per age re quired to ex plicit mo tor re sponses de creased (p<0.01). Con clu sion: The method of di rect ce re bral cor tex elec tro-stim u la tion is sim ple and safe method and a bind ing pro to col to the pa tient safe op er a tion glioblastoma multiforme local ized in the mo tor area of the brain. Key words : glioblastoma multiforme, ce re bral mo tor cor tex, electrocorticostimulation IN TRO DUC TION M a lig nant gliomas cause a to tal of 2.5% of can cer deaths per year and the third cause of death from cancer at the age of 15 to 34 years of age 1,2. Ac tual po si tion on low grade glioma brain tu mors is that they are clas si fied as ma lig nant, with an av er age survival of 4 to 9 years 3. Re sults of group of au thors in di cate that rad i cal sur gi cal re sec tion may post pone ma lig nant trans for ma tion and pro long sur vival time 4 .

The study includes a series of 39 patients with AVM of the brain that are not subjected to any method of treatment, except for the symptomatic treatment who were hospitalized and diagnosed AVM at the Institute of Neurosurgery, Clinical Center, in the period 2005-2011. Results: The structure of the patients was measured by gender are male. Average age of the respondents was 27.4 ? 7.6 years. With the average length of the follow-up of 4.8 years, new hemorrhage occurred in 24 patients (58 episodes). Predictor (p<0.01), factors for bleeding include: arterial supply from the VB and ACA basin and multiple arterial supply. Conclusion: The analysis of our series may be proposed for following model of the natural course of AVM : After initiall haemorrhage there is annual risk of rehemorrhage of 3.33%. Bleeding events were significantly more common in medium-sized AVM (2.5 - 5 cm), localized in elocvent area of the brain with combined type of venous drainage, arterial supply from the vertebrobasilar artery, anterior cerebral artery basin or combined arterial supply.

Psychosis is a set of symptoms that lead to contact disorders or even cessation of contact with reality. It can be in the form of disorders of perception, emotions, thoughts, and behavior. Psychosis has many causes, and one of them is hypothyroidism. Thyroxin is important for the global function of brain activity, cholinergic activity in the frontal cortex and hippocampus increases significantly in its presence. The diagnosis of psychotic episodes is made on the basis of autoanamnesis and heteroanamnesis, as well as psychiatric examination. The presence of: positive syndrome, disorganization and negative syndrome. After the diagnosis of a psychotic disorder, antipsychotics are included in the therapy, and upon arrival, the findings that verify hypothyroidism, include thyroxin in the therapy. The therapeutic response is achieved after a few days or a week. In patients with an acute psychosis, and especially in those with a positive personal and family history of hypothyroidism, one should think in the direction of an unrecognized endocrine disease.

Multidetector computed tomographic angiography (MDCTA) is a non-invasive, highly sophisticated and readily available diagnostic method nowadays gained primacy in the algorithm of the blood vessels of the brain. MDCTA showed the highest sensitivity and specificity for early detection of ruptured intracranial aneurysms. Saccular aneurysm geometry (shape and size), anatomic localization, and patient-dependent factors individually and together determine the risk of rupture of the aneurysm. Unruptured aneurysms in anterior communicating artery showed twice the possibility of rupture than other intracranial aneurysms. Clinical history ACoA aneurysms after rupture is particularly difficult. This justifies the efforts to determine the real risk of these aneurysms when SAH was not found on the native scan endocranium. It is here that the diagnostic value and usefulness of MDCTA examination increases significantly and its true dimension.

In tro duc tion: The ob jec tive of this study was to dem on strate the pre dic tive value and the presence of di ag nos tic comorbidity and perioperative fac tors in the out come of shunt sur gery for hydro ceph a lus. Meth ods : We ret ro spec tively an a lyzed a se ries of 32 pa tients who un der went sur gery for NTH on Neurosurgical Ser vice KBC Zemun in the 2006-2012 pe riod year. Di ag nos tic fac tors were an alyzed: clin i cal signs (gait dis tur bance, cog ni tive def icits and in con ti nence), Ev ans' in dex and lum bar punc ture. Perioperative comorbidity fac tors an a lyzed were: ar te rial hy per ten sion, di a be tes mellitus, and cerebrovascular in sult. Re sults: Of the to tal of 32 op er ated pa tients had gait dis tur bance, cog ni tive def i cits 24 and 23 uri nary incon ti nence. Im prov ing gait dis tur bance had 20, 13 had cog ni tive def i cits and 11 uri nary in con ti nence. Im prove ment of gait dis tur bance was sig nif i cantly differ ent (p<0.05) than the other two im prove clin i cal signs. Of the fac tors of perioperative comorbidities , hy per ten sion was the most com mon 24, with di a be tes mellitus showed a sta tis ti cally sig nif i cant pre dic tor of un fa vor able out come (p = 0.029). Con clu sions: gait dis tur bance proved to be the most com mon di ag nos tic NTH fac tor and the fac tor that has the best prog no sis in pa tients op er ated for NTH , while DM is the most com mon fac tor of perioperative comorbidities .