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The aim of this study was to assess the neurological complications of SARS-CoV-2 infection and compare phenotypes and outcomes in infected patients with and without selected neurological manifestations.The data source was a registry established by the European Academy of Neurology during the first wave of the COVID-19 pandemic. Neurologists collected data on patients with COVID-19 seen as in- and outpatients and in emergency rooms in 23 European and seven non-European countries. Prospective and retrospective data included patient demographics, lifestyle habits, comorbidities, main COVID-19 complications, hospital and intensive care unit admissions, diagnostic tests, and outcome. Acute/subacute selected neurological manifestations in patients with COVID-19 were analysed, comparing individuals with and without each condition for several risk factors.By July 31, 2021, 1523 patients (758 men, 756 women, and nine intersex/unknown, aged 16-101 years) were registered. Neurological manifestations were diagnosed in 1213 infected patients (79.6%). At study entry, 978 patients (64.2%) had one or more chronic general or neurological comorbidities. Predominant acute/subacute neurological manifestations were cognitive dysfunction (N = 449, 29.5%), stroke (N = 392, 25.7%), sleep-wake disturbances (N = 250, 16.4%), dysautonomia (N = 224, 14.7%), peripheral neuropathy (N = 145, 9.5%), movement disorders (N = 142, 9.3%), ataxia (N = 134, 8.8%), and seizures (N = 126, 8.3%). These manifestations tended to differ with regard to age, general and neurological comorbidities, infection severity and non-neurological manifestations, extent of association with other acute/subacute neurological manifestations, and outcome.Patients with COVID-19 and neurological manifestations present with distinct phenotypes. Differences in age, general and neurological comorbidities, and infection severity characterize the various neurological manifestations of COVID-19.

Subarachnoid hemorrhage is a neurologic emergency and a detrimental cerebrovascular event with a high rate of death and complications. Recommendations have been developed and based on literature search, evaluation of the results of large international clinical trials, collective experience of the authors, and endorsed by the Croatian Society of Neurovascular Disorders, Croatian Society of Neurology including Section for Neurocritical Care, Croatian Neurosurgical Society, Croatian Society for Difficult Airway Management and Croatian Medical Association. The aim of these guidelines is to provide current and comprehensive recommendations and to assist physicians in making appropriate decisions in the management of subarachnoid hemorrhage. Evidence based information on the epidemiology, risk factors and prognosis, as well as recommendations on diagnostic work up, monitoring and management are provided, with regard to treatment possibilities in Croatia.

Svrha rada: Namjena je ovog rada iznijeti naša iskustva u stentiranju karotidnih arterija kod liječenja disekcija tih arterija. Metode: U razdoblju od 1. 6. 2006. do 31. 4. 2009. liječili smo 6 bolesnika koji su imali ukupno 6 disekcija karotidnih arterija postavljanjem samoširećih stentova (4 disekcije unutarnjih i 2 disekcije zajedničkih karotidnih arterija). Dvije su disekcije bile spontanog, dvije traumatskog, a dvije ijatrogenog uzroka. Rabili smo selektivno cerebralna zaštitna sredstva (kod 3 bolesnika), ovisno o morfologiji lezije. Bolesnike smo pratili klinički i obojenim doplerom tijekom 12 mjeseci. Rezultati: Primarni je tehnički uspjeh zahvata bio 100%-tan. U periodu praćenja nismo zabilježili kliničke i morfološke znakove neuspjeha liječenja. Ni kod jednog bolesnika nismo uočili komplikacije (cerebrovaskularni inzulti, tranzitorne ishemijske atake, stenoze ili okluzije u području stenta). Zaključak: Karotidno stentiranje, uz selektivnu upotrebu cerebralne protekcije, uspješna je, minimalno invazivna i niskorizična metoda liječenja disekcije karotidnih arterija u bolesnika kod kojih konzervativno liječenje ne rezultira boljitkom lokalnog nalaza, odnosno općeg stanja., Aim: The purpose of this paper is to present our experiences with carotid artery stenting in the treatment of dissected carotid arteries, by means of self-expandable stents and selective employment of cerebral protection devices. Methods: In the period from June 1, 2006 to April 31, 2009, 6 patients with 6 dissected carotid arteries were treated with self-expandable stents (4 internal carotid artery dissections and 2 common carotid artery dissections). Two dissections were of spontaneous origin, 2 were traumatic, and 2 were iatrogenic. We applied cerebral protection filters selectively in 3 patients, based on morphological appearance of lesions. The criterion for the usage of protection devices was caudally oriented opening of the false lumen in order to prevent the possible migration of a thrombus from the false lumen during cranio-caudal deployment of self-expandable stents. We followed-up patients clinically and by means of duplex scanning throughout 12 months. Results: Primary technical success was 100%. During the 12-month follow-up period no clinical or morphological signs of treatment failure were recorded. None of the patients suffered any complication (cerebral vascular insult, transitory ischemic attack, in-stent stenosis or occlusion). Conclusion: Carotid stenting, with selective employment of cerebral protection devices, is a successful, minimally invasive, and low risk procedure in the treatment of carotid dissections in cases when conservative treatment does not bring improvement to local finding or patients’ general condition.

The aim of this study was to determine the relative prevalence and clinical characteristics of patients with pure menstrual migraine (PMM) and menstrually related migraine (MRM), and to compare them with the women free of it in an outpatient clinic-based population. Adult menstruating women with ICHD-2 migraine were included. Demographic data were obtained by verbal report. Study women were asked to keep a headache diary for 6 months, in which they recorded information on headache characteristics, medication use and presence of menses. Iron deficiency anemia was considered to be present if the patient had received therapy for iron deficiency anemia or laboratory tests indicated low iron and/or hemoglobin levels (within one year). A total of 289 women were included, 52 (18.0%) with PMM and 116 (40.1%) with MRM, whereas 121 (41.9%) women had not observed any relationship between migraine and their menstrual cycle (non-MM). Duration of migraine attacks was longer in PMM/MRM patients (P < 0.0001). No significant difference was observed according to other migraine-associated symptoms. Women with PMM/ MRM took significantly more tryptans (P < 0.0001) and iron deficiency anemia was significantly more common in women with PMM/MRM (P = 0.008). In conclusion, this study supported earlier findings that PMM/MRM has similar clinical characteristics as non-MM, except for longer duration. In addition, iron deficiency anemia is more common in women with PMM/MRM, which may be an underlying mechanism aggravating migraine attacks.

The visualisation of vertebral artery (VA) occlusion by means of ultrasound is sometimes difficult, what depends on the localisation and diameter of the VA. We studied patients with extra- and intracranial VA occlusion in order to compare the incidence of VA hypoplasia and advantages of visualisation by power Doppler imaging (PDI). We analyzed the Color Doppler flow imaging (CDFI) and PDI of carotid arteries and VA in 31 patients with VA occlusion. The criteria for extracranial VA occlusion were: visualisation of the VA lumen with absent color coded and PD flow. The criteria for intracranial occlusion were: visualisation of the VA lumen, present PDI flow, systolic velocities less than 40cm/s, unilateral absent diastolic flow. Diameter was measured in the V2 segment. The criteria for VA hypoplasia were: diameter < 2mm, systolic velocities 0.05). The right VA was occluded more frequently extracranial (9/15 vrs. 5/16), although statistically not significant (p>0.05). The left VA was occluded more frequently intracranial (2/16 intracranial vrs. 6/15 extracranial) (p

In order to assess the incidence of different stroke subtypes we investigated 549 patients with nonfatal stroke out of 870 patients with ischemic stroke hospitalised at Neurology Department University Hospital "Sestre milosrdnice" during one year period. 311 patients were not included in the analysis due to insufficient data for the classification of the stroke subtypes. According to etiology, patients were classified into four groups: large artery disease, cardioembolism, small vessel disease and unknown or known but undetermined origin. Patients underwent clinical and neurological investigation. Electrocardiography, Color Doppler Sonography of carotid arteries, Computerised tomography of the brain and blood laboratory tests were done. The highest incidence of stroke was between 55-64 and 65-74 years in males, and between 65-74 and 75-84 in females. Small vessel disease was the leading cause in both sexes (36%). In males, second cause was the large artery disease (32%), and the third cardioembolism (24%). In males, large artery disease was the most frequent cause of stroke in age groups 45-64. In female's cardioembolism was the second leading cause (34%), and large artery disease the third (17%). Stroke is more frequent in males, and in younger age groups. Small vessel disease is the most frequent cause of nonfatal stroke in both sexes and large artery disease in younger males.

Beta stiffness index is one of the most commonly used measures of depicting mechanical arterial properties and development of preclinical atherosclerosis. Main influences on its value hold age and blood pressure levels. The goal ofthis study was to determine age standards of beta stiffness index on common carotid artery in our population using a formula modified by Kawasaki. The study was conducted in 150 healthy volunteers aged 25-75 on an Aloka 5500-SSD Prosound ultrasound platform using Band M modes. The data obtained were analyzed by appropriate statistical methods. Study results confirmed linear relationship of beta index and age. Calculation of beta index is applicable for assessment and monitoring of vascular physiology changes because it is simple for use, prompt in analysis and suitable for bed-side evaluation.