Neuropatski bol predstavlja kompleksan klinički sindrom koji nastaje kao posledica oštećenja ili bolesti somatosenzornog sistema, bilo na perifernom
 ili centralnom nivou. Karakteriše ga prisustvo bola bez spoljašnjeg nadražaja ili dugo nakon što je povreda prošla. Obično je hroničan, a pacijenti ga
 opisuju kao žarenje, peckanje, probadanje ili mravinjanje. Etiološki spektar neuropatskog bola je širok i obuhvata različite nozološke entitete:
 dijabetes melitus (dijabetička polineuropatija), postherpetičnu neuralgiju, centralne vaskularne lezije (moždani udar), traumatske povrede, multiplu
 sklerozu, tumore i jatrogene uzroke poput hirurških oštećenja nerava.  
Cilj ovog rada je da se, na osnovu važećih kliničkih smernica, najnovijih naučnih saznanja i praktičnog kliničkog iskustva, sistematizuju aktuelni
 principi u dijagnostici i terapiji neuropatskog bola. Sprovedena je ciljana analiza savremene literature dostupne u bazama PubMed, Scopus i Cochrane
 Library, sa fokusom na savremene dijagnostičke i terapijske aspekte neuropatskog bola. 
Lečenje neuropatskog bola zahteva individualizovan, multimodalan pristup, koji obuhvata farmakološke i nefarmakološke intervencije. U
 farmakoterapiji se preporučuju četiri glavne grupe lekova: triciklični antidepresivi (npr. amitriptilin), inhibitori ponovnog preuzimanja serotonina i
 noradrenalina (duloksetin), antiepileptici (gabapentin, pregabalin) i opioidi (kod rezistentnih oblika). Lokalne terapije (lidokain, kapsaicin) i
 invazivne metode (npr. neuromodulacija) u određenim kliničkim kontekstima. 
Uprkos napretku u razumevanju mehanizama nastanka neuropatskog bola, terapijski odgovori su često suboptimalni. Stoga je ključno insistirati na
 personalizovanom pristupu, koji integriše preciznu dijagnostiku i racionalnu farmakoterapiju. Pravovremeno prepoznavanje i pravilno razumevanje
 patofiziologije ovog bola predstavljaju osnovu uspešne terapije i očuvanja kvaliteta života pacijenata.
 Ključne reči: neuropatski bol, dijagnoza, terapija, multimodalni pristup.

Introduction: Nummular headache is a type of primary headache of chronic character, with a large number of described varieties in the clinical picture, and therefore the differential diagnostic consideration must include a large number of disorders related to changes in epicranial structures. Certain dermatological disorders can also include pain in a limited area of the scalp with itching, burning or burning sensation, such as Lichen Planopilaris. Case report: This is a report of a patient who was initially diagnosed with Lichen planopilaris, but after determining the parameters of the distinction and the necessary additional diagnostic procedures, a diagnosis of Nummular headache was made. Conclusion: In this presentation, we have presented another important differential diagnostic item and we believe that the work is a small contribution to everyday practice, but also to further research.

Introduction. At the very beginning of the Corona virus epidemic there was not enough data on whether hemodialysis patients have a higher risk for Corona virus infection and which factors may affect the severity of clinical picture. Objective. The aim of the study was to determine the significance of the Modified Early Warning Assessment (MEWS) score for the assessment of coronavirus disease exacerbation. Methods. The research was conducted in COVID dialysis, as a retrospective, descriptive-analytical study, at the University Clinical Center Kragujevac, Serbia, which was organized ad-hoc for treatment of SARS-Cov-2 infection positive patients, which are transfered from Center for Hemodialysis "Ćuprija". They were evaluated routine laboratory findings, demographic and gender structure, arterial blood pressure, presence of comorbidities and residual diuresis, duration of dialysis, radiological evaluation of lungs, determination of MEWS score were the parameters that were monitored. The results were monitored on admission and and in the end of treatment. Results. A statistically significant difference was registered in serum lactate dehydrogenase concentration (486 ± 107.62 vs. 423.7 ± 92.4 U/L); p = 0.022 and absolute monocyte count (0.46 ± 0.15 vs. 0.67 ± 0.34 x 103; p = 0.008). The significant increase in MEWS score was also found (b = 0.017; p = 0.030). There was a positive correlation between increase of MEWS score and age (b = 0.027; p = 0.002) and arterial hypertension as a concomitant comorbidity (b = 0.700; p = 0.033). Conclusion. In the observed period, there was a significant increase in the degree of MEWS score of dialysis patients who had SARS-Cov-2 infection.

Objective: In the available literature data, there is not much information about problems of patients with end stage kidney disease in relation to oral health. Our objective was to show the importance of oral diseases for patients on hemodialysis. Data sources: In this review article, the sources of data are review articles and scientific articles in the English language published in MEDLINE database. The choice of studies was based on keywords: Chronic kidney disease, Hemodialysis, Oral health, Periodontal diseases. Results: It is assumed that almost 90% patients with chronic kidney disease manifest some symptoms of oral disease. Therefore, it is important to determine the impact of periodontal disease on the progression of kidney failure in these individuals, to evaluate inflammatory parameters in this patient population, to assess the degree of bone loss and periodontal disease index, to determine the presence of bacterial strains, paradontopathy of gingival fluid and antibody titers, to examine correlations of proinflammatory cytokines in the gingival sulcus and serum, as well as to determine the relationship between periodontal tissue and inflammatory mediators. Periodontal diseases can increase the possibility of developing chronic kidney disease by 1.5 to 2 times. These oral diseases include gingival hyperplasia, periodontitis, xerostomia, unpleasant breath, changes in the oral mucosa, malignancies, oral infections, dental abnormalities and bone lesions. Conclusion: This requires serious cooperation between nephrologists and dentists to make proper communication possible, in order to provide quality dental care for this growing patient population in accordance with new treatment strategies.

The emergence of brain infarction depends to a great extent on the status of collateral blood circulation and is associated with hemodynamic instability. This kind of brain infarction is usually found in border vascular zones. Infarction of borderline fields arises between vascular territories ACA and ACM or between ACM and ACP, deep paraventricular infarcts in internal border zones, wound or triangular cortical infarcts, as well as major infarctions involving the entire irrigated territory of ACM.

A case of a patient is shown, who was admitted for neurological exploration, with clinical manifestations of the cerebrovascular accident in the posterior circulation (TIA V-B vascularisation). In accordance with diagnostic protocol, an endocranial CT was performed. The results of the brain CT indicated an existence of an alteration in the right pontocerebellar angle area, which was subsequently diagnosed as a n. vestibularis schwannoma in an NMR examination. After a neurosurgical deliberation, the patient was treated with a gamma knife. After this surgery, which was done in a local anesthesia, the patient's condition was well and he was discharged. Control examinations have shown minor difficulties during the stimulation of the left ear auditive structures. Control examinations involving NMR showed no signs of recidivate focal findings.

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.

Introduction: Clinical features of the ischemic neurovascular syndromes is constant and dependable from vascular territory of the affected blood vessel. Best examples are sensory and motor hemisyndromes and vision disturbances. Aim: To define motor, sensory and visual disturbances’ in patients with ischemic stroke in the border zone of the middle cerebral artery. Material and methods: Border zone ischemic stroke diagnosis was based on clinical and neurological examination and confirmed with brain computerized tomography. Estimation of the symptoms was obtained by history, and degree of functional (neurological) deficit was estimated based on NIH-NINDS scale. Results: In total 30 patients were included in the study, 12 (40%) were females 47-79 years of age (±62.3 years) and 18 (60%) males 43-79 years of age (± 58.7 years). Neurological features were clearly different based on the side of the infarct. In the group with (ACA+ACM) + (ACM+ACM) infarct localization hemiparesis is significantly more frequent. In the group with ACM+ACP infarct localization homonymous hemianopia is significantly more frequent. Initial symptom of the reversible loss of consciousness in duration of several minutes was observed in 14 (46.6%) patients. Focal seizures (clonic seizures of the face, arm and leg) were detected in 4 (13.3%) patients (all with infarcts in the anterior border zone ACA-ACM). Headache was rare manifestation seen in 5 (16.6%) patients with 4 having posterior border zone infarcts. Conclusion: Supratentorial border zone infarcts have high specificity in clinical manifestations. The implicates therapeutical approaches which are prone to specific procedures.

Introduction: During the course and development of diverse cardiological diseases different central nervous system complications may develop. These are most frequently related to the nature of the cardiovascular entity itself. Aim: To evaluate the association between atherogenesis factors and border zones strokes within the cerebral medial artery vascularization territories. Methods: In total 30 patients were enrolled in the study. Stroke diagnosis was based according to clinical and neurological examination and brain CT findings. The study analyzed risk factors correspondingly to World Health Organization criteria. Results: In majority of patients (18; 60%) arterial hypertension was diagnosed. Additionally, following condition and risk factors were identified: cardiological diseases (17; 23.3%), cigarette smoking (13, 43.3%), hypercholeterolaemia (9; 30%) and diabetes (7; 23.3%). In the group with cardiological diseases most frequent was myocardial infarction (9; 56.2%), AV block II and III (5, 29.4%), atrial fibrillation with slow ventricular response (3; 17.6%). Conclusion: Results of the study point to conclusion that myocardial infarction, AV block II and III, atrial fibrillation with slow ventricular response, iatrogenic hypertension and traditional risk factors for atherogenesis significantly influences presentation of the border zone strokes within the cerebral medial artery vascularization territories.