Factors affecting the survival of patients with glioblastoma multiforme.

PURPOSE: Glioblastoma multiforme (GBM) is the most aggressive malignant tumor in the brain and no therapy can achieve full recovery/cure. The aim of this study was to identify which factors could improve the survival of operated patients, and to determine which kind of therapy was most successful. METHODS: The study was conducted at the Clinic for Neurosurgery in Nis, Clinical Centre Nis and the Oncology Institute, Clinical Center Nis. A cohort of patients who underwent surgery between January 2013 and December 2015 was studied and continuous monitoring of survival lasted until June 2017. RESULTS: Patients who underwent only biopsy have 3.82- fold greater chance of death than patients with complete tumor resection (HR 3,825; p=0.001). Karnofsky performance status score significantly affected survival (preoperatively and postoperatively; p<0.001). Apart from radiotherapy, three types of chemotherapy were applied: carmustine (BCNU) - 32.80% of the patients, procarbazine/lomustine/ vincristine (PCV) - 38.80% and temozolomide - 28.40%. Kaplan-Meier overall survival showed that patients treated with temozolomide had the longest survival compared to patients treated with BCNU and/or PCV chemotherapy. CONCLUSION: The best prognosis was seen in those patients who had complete tumor resection. Patients treated with temozolomide had the best survival compared with those treated with BCNU and PCV chemotherapy.

Cervical epidural hematoma: case report.

INTRODUCTION: Cervical epidural hematoma is a rare phenomenon in children. MRI scan of the cervical spine is the method of choice in establishing diagnosis and a quick evacuation of hematoma and de- compression. CASE OUTLINE: We present a case of 11-year-old boy whose lower extremities were paralysed after a trivial injury of the cervical spine which he sustained while playing. Seven days after the injury, severe clinical symptoms appeared, and MRI of the spine showed the presence of cervical epidural hematoma. CONCLUSION: Cervical epidural hematoma in children is very rare. Adequate neurological examination, di- agnostics and urgent surgical intervention are of paramount importance for accomplishing good results. Early and persistent rehabilitation are the condition for achieving maximal recovery.

[Occlusion of maxillary artery in treatment of trigeminal neuralgia].

INTRODUCTION: This paper deals with a treating method of trigeminal neuralgia classified so far as idiopathic neuralgias and treated conservatively. The study was aimed at proving the compression of peripheral branches of N. trigeminus in those patients by vascular elements of A. maxillaris within the bone-ligament space of the scull and the face base. MATERIAL AND METHODS: The study sample consisted of 76 patients having trigeminal neuralgia. The compression was proved by clinical examination, by angiography and electrophysiological investigations. Endovascular occlusion of A. maxillaris is the original method and it was carried out in selected patients. RESULTS: This method was applied in 76 patients. Embolisation was done in 71 patients by using occlusion spiral and gelfoan was used in 3 patients. Externa carotid artery ligation was done in 2 cases. CONCLUSION: The effect of absolute improvement has been achieved and verified by electrophysiological method and subjective assessment of the patients.