Introduction. Chronic subdural hematoma has become an important entity in radiological, neurological and neurosurgery practice. Classification. The classification of chronic subdural hematoma is most often done in relation to the time of the disease onset (acute, subacute and chronic), whereas the second classification is based on hematoma density using computed tomography. Clinical presentation. The clinical presentation may mimic a spectrum of various diseases and chronic subdural hematoma can be easily overlooked without radiological verification. Diagnosis. The diagnosis of chronic subdural hematoma is partly clinical and partly radiological. In most cases, computed tomography is the initial diagnostic method for detection of this disease. Many studies point to different management strategies in the diagnosis and treatment of the disease. Therapy. The therapy of chronic subdural hematoma depends on the patient?s neurological deficit, but generally it is divided into conservative and surgical treatment. Conclusion. The aim of this paper is to review chronic subdural hematomas with reference to their clinical and radiological characteristics for better understanding of these phenomena.

Background and Objectives: Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease that progressively leads to brain atrophy and the accumulation of disability over time. In this study, we used FreeSurfer to compare subcortical volumes and cortical surface areas between patients with MS and healthy controls and to investigate how regional atrophy relates to both disease lasting and clinical disability. Materials and Methods: We included 80 participants in this study, 40 patients with clinically definite MS and 40 age- and sex-matched healthy controls, all imaged on a Philips Ingenia 3.0T MRI scanner. High-resolution 3D T1-weighted MPRAGE sequences of the brain were processed using FreeSurfer 7.3.3. MS patients were stratified by disease lasting into two subgroups: ≤5 years (n = 17) and >5 years (n = 23). Subcortical volumes were normalised to estimated total intracranial volume (eTIV). Between-group differences were assessed using Welch’s t-test with Benjamini–Hochberg false discovery rate (FDR) correction. Multiple linear regression models controlled for age, sex, and the Expanded Disability Status Scale (EDSS). Results: We found statistically significant volume reductions in 48 of the 52 normalised regions examined. Thalamic volume showed the most severe reduction (mean—21.6% bilaterally) in MS patients. The corpus callosum, hippocampus, and amygdala were also prominently affected. Receiver operating characteristic (ROC) analysis of mean bilateral thalamic volume yielded an area under the curve (AUC) of 0.822 (95% CI: 0.731–0.913). Cortical surface area did not survive FDR correction in the primary comparison, though nominal reductions emerged in longer-lasting MS patients. EDSS correlated with both thalamic and hippocampal volumes in regression models. Conclusions: FreeSurfer-based volumetric analysis detected widespread grey and white matter volume differences in MS patients relative to matched controls, with changes already present in patients within the first five years of diagnosis. The high proportion of significant regions is consistent with a combined pattern of generalised and regionally accentuated atrophy. Among the regions examined, thalamic volume showed the strongest cross-sectional discrimination (AUC = 0.822; sensitivity 65%, specificity 90%) and the most consistent associations with EDSS; these findings support further evaluation of thalamic volume as a candidate imaging biomarker of neurodegeneration, although its diagnostic performance is moderate and requires external longitudinal validation before clinical deployment.

Introduction. Around 2% of all cutaneous neoplasms arise in the scalp and can be classified as either primary or metastatic. Intracranial extension is rare in cutaneous malignancies, but can generally occur if left untreated. Squamos cell carcinoma (SCC) is the second most common type of nonmelanoma skin cancer after basal cell carcinoma. About 3-8% of SCCs are located on the scalp and can cause skull and dural invasion in rare cases. Case report. A 49-year old male patient presented with a large and painful lesion in the parieto-occipital region of the head. MRI revealed a large inhomogeneous, necrotic lesion with infiltration of the underlying skull and dura. The patient underwent surgical removal of the tumor with excision of invaded skin, bone and dura with a safety margin of 1 cm followed by custom prefabricated three-dimensional printed cranioplasty with polymethylmetacrilate (PMMA). Histopathological analysis revealed invasive squamous cell carcinoma with immunohistochemistry staining revealing CK5/6 and CK7 positivity. Conclusion. Some cases of scalp SCCs can cause invasion of the underlying skull and dura if left untreated. Imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) play a crucial role in evaluating the degree of neoplastic extension and potential calvarial and dural invasion, thus being of significant importance in preoperative planning and management.

Introduction. The aorta is a major blood vessel that supplies all segments of the human body. Acute aortic syndrome is a term that implies a life-threatening aortic disease. Due to the speed of examination and widespread availability, computed tomography angiography is a front-line diagnostic modality for emergencies and diseases of the abdominal aorta. The aim of this study was to provide a wide range of potentially life-threatening abnormalities of the abdominal aorta in daily clinical and radiological practice through a series of computed tomography angiography images and three-dimensional virtual reconstruction. Abdominal aortic aneurysm is defined as a 50% increase in diameter more than the normal arterial diameter. One of the most important complications of an aneurysm is a rupture that can be acute or chronic, presenting with various clinical manifestations. Aortic dissections are caused by abnormality of the tunica media layer, forming an intimal-medial flap and two types of lumen. A penetrating aortic ulcer may erode through the internal elastic lamina of the aortic wall and allow formation of hematoma within the tunica media. Occlusive disease of the abdominal aorta may refer to the late stage of chronic aortoiliac occlusive disease, whereas the acute and/or subacute form occurs due to sudden thrombosis or occlusion. Conclusion. The recognition of specific radiological signs of abdominal aortic disease using computed tomography angiography contributes to optimal treatment of patients and reduces mortality.

Group of symptoms due to vena cava superior obstruction is named superior vena cava syndrome. A 65-year-old female, long-standing smoker was presented with a two-week history of dry cough and facial swelling. The patient noticed a palpable mass on the right side of the neck. Computer tomography scan with contrast showed extensive, irregular, non-homogenous consolidation in the right upper lobe, involving the right hilus, surrounding the aortic arch, supra aortic branches and pleural effusion at the right side of the body. Also, ultrasound examination of supra clavicular space showed enlarged pathologic hypoehogenic lymph node without an echogenic hilum. Ultrasound guided fine needle biopsy of lymph node was performed, and cytopathology findings showed metastatic lesion from primary microcellular lung cancer, IIIC stadium, cT4N3M0. Venous angioplasty was performed showing stenosis in the superior vena cava. After balloon dilatation, the stent was placed at the site of stenosis. The patient received chemio- and radiotherapy and survival time was seven months. Superior vena cava syndrome is an urgent clinical condition, and lung cancer is the leading cause of this syndrome. Computer tomography imaging findings and endovascular stent placement are important for detection and management of the superior vena cava thrombosis.

Background/Objectives: Six-month functional outcome after chronic subdural hematoma (CSDH) surgery has not been reliably predicted in Southeastern European cohorts. We asked whether machine learning (ML) classifiers outperform logistic regression. Methods: This study included a single-center retrospective cohort of 78 surgically treated CSDH patients (Novi Sad, Serbia). The primary outcome was favorable six-month outcome (Glasgow Outcome Scale 4–5). Missing covariates were multiply imputed (multiple imputation by chained equations, MICE, m = 20), and estimates were pooled using Rubin’s rules. A three-predictor model was pre-specified; six ML classifiers were trained on five preoperative predictors and evaluated using stratified 10-fold repeated cross-validation, with metrics derived from held-out predictions. Results: Favorable outcome occurred in 50/78 (64.1%). Preoperative Karnofsky Performance Status (KPS) was the only independent predictor (odds ratio, OR = 1.14 per point, 95% confidence interval, CI 1.07–1.20, p < 0.001). Cortical atrophy grade was associated univariately (OR = 0.57, 95% CI 0.34–0.96, p = 0.033) but not after adjustment for KPS (OR = 1.08, 95% CI 0.53–2.22, p = 0.833). Discrimination was indistinguishable across the six classifiers (AUC 0.870–0.885; all pairwise DeLong p ≥ 0.123); the three-predictor model reached an AUC of 0.903 (0.833–0.972). Conclusions: Preoperative KPS was the only independent predictor. No ML classifier outperformed logistic regression; a three-predictor model performed at least as well. External validation is required.