Background /Aim. Patients in neurologic intensive care unit (ICU) are especially susceptible to healthcare-associated infections (HAIs). HAIs are cause of significant morbidity and mortality. Aim of this study was to assess the incidence of HAIs, to identify significant risk factors (RFs) and causative microorganisms for HAIs and to identify RFs for in-hospital mortality in neurological ICU. Methods. Prospective cohort study was conducted in a 6-bed Active surveillance on HAIs was performed by hospital infection control team, using methodologies of European Centre for Disease Prevention and Control and National Healthcare Safety Network/ Centres for Disease Prevention and Control. Results. 148 patients with a total of 2708 patient-days were enrolled. There were 49 HAIs in 39 patients during the study period. The incidence and incidence density of HAIs were 26.3% and 18.1 per 1000 patient-days, respectively. The most frequent HAIs were urinary tract infections (15.5%), pneumonia (10.1%) and bloodstream infections (4%). RFs independently associated with HAIs in neurological ICU were urinary catheter (RR: 5.6; 95% CI: 1.153 -27.632), urinary catheter-days (RR: 1.1; 95% CI: 1.057 -1.188), central-line days (RR: 1.1; 95% CI: 1.010 -1.150), mechanical ventilation (RR: 0.3; 95% CI: 0.079 -0.859). The most common microorganism was Klebsiella spp. RFs independently associated with in-hospital mortality in neurological ICU were mechanical ventilation (RR: 6.5; 95% CI: 2.868 -14.116), Glasgow Coma Score (RR: 2.7; 95% CI: 1.135 -6,396), and age (RR: 1.03; 95% CI: 1.005 -1.055). Conclusion. Usage of invasive procedures during ICU hospitalization carries significant risk for development of HAIs. HAIs in ICU setting are most often caused by Gram-negative bacteria with substantial antimicrobial resistance. These results stress the importance of infection prevention. Key words: intensive care unit, neurology, healthcareassociated infections.Apstrakt Uvod/Cilj. Pacijenti u neurološkim jedinicama intenzivnog lečenja (JIL) su u posebnom riziku za nastanak bolničkih infekcija (BI). BI uzrokuju značajan morbiditet i mortalitet. Cilj ovog istraživanja bio je da se utvrdi incidencija BI, identifikuju faktori rizika (FR) i uzročnici BI, kao i da se ustanove FR za smrtni ishod u neurološkim JIL. Metode. U šestokrevetnoj JIL Klinike za neurologiju, Vojnomedicinske akademije sprovedena je prospektivna kohortna studija od januara 2014. godine do decembra 2016. godine. Rezultati. U studiju je uključeno 148 pacijenata praćenih tokom 2708 pacijent-dana. Registrovano je ukupno 49 BI kod 39 pacijenata. Incidencija BI je bila 26.3%, a gustina incidencije 18.1 na 1000 pacijent -dana. Najčešće BI bile su: infekcije mokraćnog sistema (15.5%), pneumonija (10.1%) i sepsa (4%). FR povezani sa nastankom BI u neurološkoj JIL su primena urinarnog katetera (RR: 5.6; 95% CI: 1.153 -27.632), dani primene urinarnog katetera (RR: 1.1; 95% CI: 1.057 -1.188), dani primene centralnog vaskularnog katetera (RR: 1.1; 95% CI: 1.010 -1.150), primena mehaničke ventilaci...

Although ischemic stroke is one of the most common neurological diseases, ischemic stroke of the hippocampus is rare, the isolated bilateral presentation with clinical signs of severe amnestic syndrome in particular. Timely recognition and modern therapeutic approach could have a favorable impact on the recovery from severe neurological, cognitive deficit. It could be suggested that in patients with the clinical image of acute anterograde amnesia and vascular risk factors the MSCT examination of the brain with computed tomography perfusion and angiography is performed immediately upon hospitalization.

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Introduction. Pulmonary arteriovenous malformation (PAVM) is pathological communication between pulmonary artery and pulmonary vein, in way that it shunts normal alveolar capillary membrane resulting in inadequate blood oxygenation in this part of the lung parenchyma Modern therapy of PAVMs includes surgical treatment or endovascular embolization. Case report. A 30-year-old female patient had signs of parestesia and weakness of the extremities on the left side of her body. On physical examination there was only cyanotic discoloration of her lips and clubbing fingers. On the chest x-ray, in the right hemithorax, in the inferior region of the lung, there was relatively homogeneous and well defined shadow, intensity of the soft tissue, which was about 35 mm. A multislice computed tomography pulmonary angiography was performed and showed, in lung parenchyma on both sides, many PAVMs, of which the largest (35 mm) was in inferior right region of the lung on crossing between apical and posterior basal lung segment with 7 mm diameter feeding artery and 9 mm diameter draining vein. The selective pulmonary angiography was per-formed by Seldingers technique. Through sheath, we placed a plug with a diameter of 10 mm. The plug was expanded and a complete occlusion of the final part of the feeding branch of this PAVM was achieved (confirmed by control angiography). In that way, the PAVM was fully shut off from the circulation. In 3 months follow-up, the patient was feeling well, without any recorded complication. Conclusion. Endovascular embolization is recommended as therapy of the first choice for all of PAVMs that have feeding artery greater than 2 mm. Endovascular embolization has high success rate with minimal complications.