<p><strong>Introduction.</strong> Inadequate postoperative analgesia can affect the functioning of almost all organ systems and significantly increase morbidity and mortality. The aim of study was to analyze and assess response of patient’s painful sensations caused by surgical intervention in early stage of acute postoperative pain. <strong>Methods.</strong> This paper presents a prospective study that follows the reaction of the patient 24 hours postoperatively after different surgical procedures. The only criterion for patient’s inclusion in the study was the need for elective surgical intervention. As a source of data used were medical records with complete medical documentation. <strong>Results.</strong> The study included 126 patients. The group is divided into three subgroups: I - gallbladder surgery, II - resection of the stomach and intestines, III - surgery of hernia abdominal wall. The same analgesics are ordained postoperative: noraminofenazon, and ketoprofen. The severity of pain and testing treatment effect was carried out peacefully, at regular intervals by the appropriate scale for the assessment of the strength and quality of pain. <strong>Conclusion.</strong> At the time of the need for analgesic patients on a scale of pain showed a value of 6,84 to 7,14 (VAS - visual analog scale). Homeostatic values of variables in the early postoperative period, it remained within normal values. Administration of analgesics “at the request” of the patient not achieved satisfactory analgesia, because the first postoperative day the patients will have a severe pain (VAS - 7).</p>

Hidrocefalus je hidrodinamički poremećaj cerebrospinalnog likvora kojiuzrokuje proširenje komornog sistema i povećan pritisak na mozak. Hidrocefalusse može podijeliti na kongenitalni i stečeni, a na osnovu mehanizmanastanka, na komunikantni (neopstruktivni) i nekomunikantni (opstruktivni)koji mogu biti i kongenitalni i stečeni. Postoji i hidrocefalus normalnogpritiska te hidrocefalus “ex vacuo“, a kod novorođenčadi se može javiti ivanjski (spoljni) hidrocefalus. Kod novorođenčadi i dojenčadi glavna dijagnostičkametoda je ultrazvuk mozga, a snimanje se obavlja kroz fontanele.Nakon zatvaranja fontanele dijagnostika se provodi pomoću magnetnerezonance (MR) ili kompjuterske tomografije (CT). U uzorku bolesnika sahidrocefalusom liječenih u Službi za neurohirurgiju Kliničkog centra BanjaLuka u dvogodišnjem periodu pokazana je signifikantna dominaciju opstruktivnevrste hidrocefalusa nad ostalima.

Introduction/Objective. Tarsal dislocations are rare injuries. Usually, they are caused by high energy trauma. Depending on the type of dislocation, surgical treatment or closed reduction is used. In this study, 13 patients are presented with the aim to analyze the type of feet dislocations, their treatment and outcome. Methods. Tarsal dislocation cases treated in the University Hospital in Foca were analyzed during the period from 2009 to 2016. All the cases were clinically and radiographically examined and monitored on control examinations at least three years. The mobility of joints was measured and pain existence was estimated by visual analog scale. Results. All 13 patients with tarsal dislocation were male. Four patients were treated surgically (two patients with tarsometatarsal and one with cuboid and navicular dislocation) and other patients had non-surgical treatment. In ten patients, an excellent functional result has been achieved and in two patients with tarsometatarsal dislocation a good functional result. In one patient with cuboidal dislocation satisfactory functional result has been achieved. Conclusion. Out of the 13 reviewed patients with tarsal dislocations, functional results were rated excellent in ten dislocations, good in two, and satisfactory in one. Diagnosis and treatment of foot dislocations are demanding, but with adequate treatment of these injuries, a favorable functional outcome can be expected.

Arachnoid cysts are cavities filled with liquor, usually localized on the floor of the middle cranial fossa. Clinically, they are usually asymptomaticand can sometimes be presented with increased intracranial pressure syndrome and epileptic seizures. We present a patient who, after a slight head injury in a accident develops an increased intracranial pressure syndrome followed by an epileptic seizure. Based on the clinical course and diagnostic processing, we want to draw attention doctors who are in a position to inspect these patients that apparently slight head injuries can be complicated and dangerous for the lives of the premorbid intracranial condition of the injured.

Kratak sadržajUvod. Intrakranijalne aneurizme se definišu kao gigantske ako su veće od 25 mm i rijetke su intrakranijalne lezije. Obično se manifestuju znacima subarahnoidalnog krvarenja, ili kompresivnim "mass" efektom kao tumor, epileptičnim napadom ili znacima tromboembolije. Nakon dijagnostike, kompujuterizovane tomografije i magnetne rezonance (MRI) mozga i angiografske dijagnostike, postavljaju se indikacije za mikrovaskularni kliping ili endovaskularni tretman. Opisan je slučaj 78 godina stare bolesnice sa gigantskom aneurizmom unutrašnje karotidne arterije (ACI).Prikaz bolesnika. Žena stara 78 godina, prvi put u životu je dobila epileptični napad. Pacijentkinja je srčani bolesnik sa istorijom masivnog dijafragmalnog infarkta koji je imala prije tri mjeseca. Nakon urađenog MRI mozga i MRI angiografije dokazano je postojanje gigantske aneurizme ACI desno. S obzirom na kardijalni status i visok rizik za bilo koju vrstu intervencije, odlučili smo se na konzervativni tretman uz praćenja, kontrolu krvnog pritiska, i redovnu internističku terapiju, odgovarajući režim ishrane i antiepileptičnu terapiju, te kontrolnu MRI angiografiju za 6 mjeseci.Zaključak. Uprkos prikazanim velikim serijama i analizama nije donesen konsenzus o riziku i ishodu poslije hirurškog klipinga aneurizme ili endovaskularne procedure koji se statistički ne razlikuje značajno. Samo u posebnim slučajevima, kada je rizik za bilo koji tretman gigantske nerupturirane aneurizme visok (godine starosti, kardijalni status), a uz činjenicu da je njihova sklonost rupturi mala, treba se odlučiti na praćenje uz prevenciju drugih negativnih faktora.Ključne riječi: gigantske aneurizme, krvni sudovi mozga, hiruško liječenje, endovaskularne procedure