The aim of this review is to recapitulate anatomic landmarks with special attention to the cases with deformed ventricles caused by chronic hydrocephalus. In the modern era, neuroendoscopy has had an increasingly prominent role in neurosurgery. As attention has focused the development of minimally invasive surgical methods, neuroendoscopy has advanced both as an independent treatment modality for various neurologic disorders and as an adjunct to microneurosurgery. In addition to its advantages, neuroendoscopy is associated with unique obstacles that must be anticipated and accounted to prevent complications. Use of neuronavigation which is of immense help in most of neurosurgical cases is of limited use in neuroendoscopy. Knowledge of anatomical landmarks is obligatory to successfully perform endoscopic third ventriculostomy (ETV), a golden standard in treatment for obstructive hydrocephalus. For ETV, the landmarks are choroid plexus in choroid fissure, septal and talamostriate veins to identify Foramen of Monroe. Once when foramen is traversed, navigation through third ventricle is based on paired mammillary bodies from which the surgeon can discern the midline and anterior retrochiasmatic space. In the space between retrochiasmatic recess and mammillary bodies is the flat and often thinned floor of the third ventricle. Ventriculocisternostomy is performed by blunt perforation and dilatation with Fogarty 3Fr catheter.

In our previous study the inclination of nasolacrimal canal in relation to Frankfurt horizontal plane has been analysed on 71 anatomically preparated human skulls by introducing the probe through canal. The results of that study showed that the alpha angle in the frontalplane was greater than 91 degrees in 27% of cases, i.e., nasolacrimal canals descend diverging in relation to the median plane and both probes are intersected on glabella. In 55% of cases, the alpha angle was less than 89 degrees and probes diverge on glabella, and in 18% of cases the canals were parallel to the median plane. In this study nasolacrimal ducts in patients were visualised with Omnipaque contrast that was injected with probe through the superior lacrimal punctum. Thereafter radiography was performed. These in vivo results confirm our previous results obtained on the skulls. Minimal individual variations of values of the angle were observed. These findings are very important inprobing of stenosis of nasolacrimal duct in infants, as the operator would not have to forcefully probe with rigid instrument through gentle infant nasolacrimal duct. Difficult and serious consequences for infants arise when directing the probe "via falsa" and that often happened in practice. The authors therefore suggest when using this old method ofprobing, that this "surgical" act should be performed with "soft" probe made of nylon or silver that is very pliable and does not lead to nasal or temporal rupture of the canal.

Primary melanocytic cerebral tumors form a spectrum of different lesions that range from benign to extremely malignant, such as an intracranial melanoma. This article points out some characteristics of primary melanocytic cerebral tumors and discusses their management and prognosis, based on a systematic literature review and a case of primary cerebral malignant melanoma.Because the biological characteristics of primary melanocytic cerebral tumors remain unclear, it appears that total surgical resection of the tumor followed by oncologic treatment is the mainstay of the management. The prognosis still depends on the degree of malignancy.

The terminology of the optic nerve had already been changed three times, since 1895 until 1955 when the term "nervus opticus" was introduced in the "Terminologia Anatomica". Following our study we claim that, from the aspect of phylogenetic evolution of binocular vision development as well as optical embryogenesis where opticus is evidently presented as a product of diencephalic structures, the addition of the term "nervus" to opticus is not adequate and justified. From the clinical aspect the term "nervus opticus" is also inadequate, both as a "nerve" that has no functional regenerative properties, unlike other cranial nerves, as well as from a pedagogical and didactical aspect of educating future physicians. We suggest that the term "Fasciculus Opticus Cerebralis" should be used as it much better explains the origin as well as its affiliation to the central nervous system.

Pain is an omnipresent symptom in medicine. There is hardly a branch in which it does not appear as one of the main symptoms, the effect of disease advancement, a sign of deterioration or as a complication of therapy. The removal of pain is one of the main tasks of treatment, whether it is curative or symptomatic. Therapeutic injections of local anesthetics in pain management can help keep a patient an outpatient for longer, they can facilitate physical therapy, decrease the need for peroral analgetics and delay a potential surgical procedure. This article presents a review of the basic technique and several indications for the application of therapeutic injections of local anesthetics in the treatment of pain.

Low back pain is an important public health problem. It is a relatively frequent clinical condition among active population. Chronic or acute low back pain is among the most frequent diagnosis that make people miss their work. Back pain is found also among the elderly. The exceptionally complex anatomical structure of the lumbar segment makes it prone to injuries and overstrain, as the main causes of pain symptoms. From the biomechanical point of view it is the spinal segment which is responsible for large amplitude motions (flexion and extension, lateral banding and axial rotation), which means that this segment is subject to great force i.e. strain (axial weight and lifting). All these factors may lead to injuries. Pain can be caused by changes and loss of integrity of all anatomical structures of the lumbar segment (vertebra, fasset joint, sacro-iliacal joint, muscles or ligaments). More often, the main spine problem is intervertebral disc disease (disc herniation), with compression effect on spinal nerve roots and medula. In these case, the leading symptom is sciatica (radiculopathy). Along with the above mentioned spinal conditions, there is also need to consider other possible problems associated with back pain (tumors, infections, trauma, kidney diseases). The treatment of back pain/radiculopathy is almost always conservative and in the majority of patients it leads to complete recovery. If back pain starts to be chronic, this requires neuroradiologic analysis, with surgical treatment being also an option.

The aim of this study was to determine whether hyperbaric oxygen (HBo2) treatment influences the expression of transcriptional myogenic factors in denervated rat's extensor digitorum longus muscle. Thus, expressing regulatory myogenic factors MyoD and myogenin were analyzed in denervated muscles (up to 30 days). Second group of denervated rats were afterwards treated with HBO2. Normal, innervated muscles were used as controls. Western blot analysis showed a significant upregulation of MyoD and myogenin proteins in denervated muscle during this period. Denervated muscles of rats exposed to HBO2 treatment had also significant upregulation of both transcriptional factors but the treatment had not altered their expression. The immunohistochemical analysis showed MyoD and myogenin protein expression through this period in the denervated, untreated muscles and in denervated muscles of rats treated with HBO2, too. One month denervation caused a reduction in muscle fiber cross-sectional area. The treatment with HBO2 had not reduced the degree of atrophy. The protocol of hyperbaric oxygenation (HBO) applied in this study had no beneficial effect either on transcriptional myogenic factors or on atrophy of denervated rat muscle.

Epidural injections have long been used in anesthesia for surgery on the trunk, abdomen and lower extremities. In recent years is it frequent use of epidural injections in the treatment of back pain syndrome, with the aim of injecting steroids into the epidural space to suppress inflammation in the nerve and surrounding soft tissues which is believed to be the basis for radicular pain. The epidural space can be entered with interlaminar or transforaminal approach.

Pain is an uncomfortable personal experience which is hard to define. It is percieved and coped with differently by each of us. According to the definition of the International association for the study of pain: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. This article discusses in short the patophysiology and the perception of pain in the peripheral and central nervous systems.

Management of back pain is still full of controversy and existence of “faset syndrome” was questioned for a long time. Today it is accepted as a clinical entity and it is responible for back pain in 5% to 15% of cases. Most commonly, facetogenic pain is the result of repetitive stress and/or cumulative low-level trauma, leading to inflammation and stretching of the joint capsule. No physical examination findings are pathognomonic for diagnosis. The strongest indicator for lumbar facet pain is pain reduction after anesthetic blocks. Because false-positive and, possibly, false-negative results may occur, results must be interpreted carefully. The evidence supporting intra-articular corticosteroids is limited; hence, this should be reserved for those individuals who do not respond well to anestetic only.

Pain is an omnipresent symptom in medicine. There is hardly a branch in which it does not appear as one of the main symptoms, the effect of disease advancement, a sign of deterioration or as a complication of therapy. The removal of pain is one of the main tasks of treatment, whether it is curative or symptomatic. Therapeutic injections of local anesthetics in pain management can help keep a patient an outpatient for longer, they can facilitate physical therapy, decrease the need for peroral analgetics and delay a potential surgical procedure. This article presents a review of the basic technique and several indications for the application of therapeutic injections of local anesthetics in the treatment of pain.

Introduction: Low back pain is one of the most common syndromes of the modern society. As a rule, this condition is caused by a herniated intervertebral disk. The aim of this article is to evaluate two surgical approaches to low back pain and pain radiating to the leg – a refined classical procedure, i.e. microdiscectomy, and the same procedure coupled with the implantation of a protetic device – Barricaid™. Patients and methods: Patients of both genders were included, with an age range of 18 to 70 years. The group of patients that underwent the classical approach consisted of 46 patients with the median age of 41,1 ± 8,6 years. The group of patients to whom Barricaid™ was implanted consisted of 30 patients (16 males and 14 females) with the median age of 38,2 ±9,5 years. Each of the three clinical results (VAS for leg pain, VAS for back pain and ODI), and the disk height was compared between the two groups of patients. Results: Better results were achieved in the group with the Barricaid™ implants, specifically for the VAS back pain result (97 % vs. 70 %, P = 0,016) and ODI (100 % vs. 87 %, P = 0,08). Conclusions: Our results point to the fact that maintaining the disk space and height decreases the accelerated degenerative processes of the affected spinal segment and assures more long lasting positive effects on decreasing the pain as well as the neurological symptoms.