Background/Objectives: Displaced femoral neck fractures in older adults are associated with substantial morbidity, loss of functional independence, and reduced quality of life. Although total hip arthroplasty (THA) and hemiarthroplasty (HA) are widely used surgical options and have been extensively compared, differences in postoperative functional recovery in routine clinical practice continue to be investigated. This study aimed to compare postoperative functional outcomes between THA and HA in elderly patients with femoral neck fractures during postoperative follow-up. Methods: This prospective cohort study included 100 patients aged 70–85 years treated surgically for displaced femoral neck fractures from 1 May to 1 December 2024. Patients underwent THA (n = 57) or HA (n = 43). Functional recovery was evaluated using the Barthel Index (BI) and modified Harris Hip Score (mHHS) at 3 weeks, 3 months, and 6 months postoperatively. Changes in functional outcomes during follow-up were analyzed using repeated-measures general linear models adjusted for age, body mass index (BMI), and educational level. Exploratory binary postoperative outcomes were analyzed using logistic regression. Results: Patients treated with THA demonstrated significantly better postoperative functional outcomes compared with HA throughout follow-up. In both unadjusted and adjusted analyses, THA patients achieved consistently higher BI and mHHS scores across repeated postoperative assessments, including at 6 months postoperatively. Independent outdoor walking at 3 months postoperatively differed significantly between groups in the unadjusted analysis, although this association did not remain statistically significant after adjustment. In adjusted analyses, patients in the HA group demonstrated significantly higher odds of movement-related hip pain at 6 months postoperatively. Conclusions: THA was associated with significantly better postoperative functional outcomes compared with HA in elderly patients with femoral neck fractures. These findings highlight the importance of considering functional recovery outcomes, in addition to traditional surgical outcomes, when selecting arthroplasty strategies in geriatric hip fracture management. Given the observational study design, these findings should be interpreted as associations rather than evidence of a causal treatment effect.

Introduction: Pituitary tumors represent 10-15% of all intracranial tumors. Clinical manifestations depend on the size of the tumor such as microadenoma, macroadenoma or giant adenoma, and type of the tumor (secreting or non-secreting). Surgical treatment of pituitary adenoma can be managed via transcranial or transsphenoidal approach. Depending on the approach, there is a possibillity of postoperative complications such as meningitis, pneumocephalus, liquorrhea, transient diabetes insipidus and ect. Aim: The aim of this study was to establish the frequency of newly discovered pituitary tumors in the Emergency Center, University Clinical Center Of Serbia, during the COVID-19 pandemic in Serbia, and early postoperative complications in patients treated with an endoscopic and microscope transsphenoidal approach. Hence to analyze and compare the time period before the pandemic with the period during the pandemic. Material and methods: The study has a total of 210 patients during a time period of 8 years, where 91 patients are from the time period from January 1, 2015 to December 31, 2019; marked in the study as the period before the COVID-19 pandemic, of which 37 are male (40.7%) and 54 are female (59.3%), age range is 20 to 80 years with a mean of 55.49. While in the time period during the pandemic, the study contains 119 patients, from January 1, 2020 to March 1, 2023, of which 64 are male (53.8%) and 55 are female (46.2%), age range is 14 to 85 years with a mean of 52.10. As for statistical analysis, assessment of frequency rate and relative numbers were used as methods of descriptive statistics. Results: In 'Pre-COVID-19-Era' macroadenoma was present in 75 patients (82.4%), microadenoma in 13 patients (14.3%) and giant adenoma in 2 patients (2.2%). Postoperative complications were present in 42 patients (46.15%). Transient DI was present in 31.9% of patients. The average duration of hospitalization after surgery was 5 days. In „COVID-19-Era macroadenoma was present in 95 patients (79.83%), microadenoma in 22 patients (18.49%), and giant adenoma in 2 patients (1.69%). Transient DI developed postoperatively in 11 patients (9.24%). The average duration of hospitalization after surgery was 8 days. Conclusion: Endoscopic transsphenoidal approach to pituitary tumor surgery is a minimal invasive approach with good early postoperative outcome, lower rate of complications and short duration of hospitalization, compared to the microscope transsphenoidal approach. The duration of hospitalization depends on numerous factors where the COVID-19 pandemic can serve as an example for future similar crisis situations so that better organization and preoperative preparation of patients can be implemented. Funding: Authors received no specific funding for this work. Declaration of Interest: Authors declare no conflicts of interest. Ethical Approval: The study was approved by the local Ethics Committee of University Clinical Center of Serbia and was performed in accordance with the Helsinki declaration and its amendments. Informed consent was obtained from all the participants.

Introduction: Vestibular schwannomas are benign neoplasms of the nerve seath, and they represent the third most common endocranial tumour, following the meningioma and the pituitary adenomas. The primary symptoms of vestibular schwannomas are hearing loss, tinnitus as well as a balance disorder. The therapy of vestibular schwannoma consists of observation, surgery and radiosurgery. The majority of patients who are good candidates for surgery are already affected by significant hearing impairment, thus one of the primary goals of the surgery is the preservation of facial nerve function. Aim: To analyze the outcome of facial nerve function one-year post-surgery using clinical and neuropsychological parameters. Material and methods: This study analyzed the patient's clinical status on admission along with the neuroradiological characteristics of tumours and the neurophysiological intraoperative parameters and their effect on the facial nerve function in the early postoperative period as well as one year after the surgery using the House–Brackmann scale. Results: A total of 30 patients who underwent surgery from January 1st 2015 to December 31st 2018 at the Clinical Centre of Serbia, Neurosurgery Clinic for vestibular schwannomas were examined. The median age of the patients was 51 years. Hearing loss was present in all patients. Sensitivity drop in the innervation region of n. trigeminus was present in 7 (23.3%) patients, as was tinnitus. Cerebellar symptomatology (76%) was present in the highest percentage of patients. Conclusion: We can conclude that the most important aspects of the facial nerve function are the preoperative state of the facial nerve and the electrophysiological parameters. Although the radical procedure of surgery led to an immediate postoperative outcome, it was not significant for the ultimate outcome of treatment. Thus, radical surgery may be considered to carry the same risk of definitive impairment of the facial nerve function, just like a combination treatment with subtotal resection and stereotaxic radiosurgery.

Introduction/Aim: Patients, who stay long in hospitals, nursing homes, and especially in intensive care units, are exposed to the risk of developing chronic wounds. The term "chronic wound" refers to wounds that do not heal despite all treatment measures taken in the period of six to eight weeks. The aim of this retrospective cohort study was to analyze data on chronic pressure ulcers that were collected in intensive care units (ICU) of the Urgent Care Center of the Clinical Center of Serbia during the five-year period, with the aim of determining the factors that influence their occurrence and healing. Methods: The retrospective cohort study was conducted from January 1st, 2018 to April 1st, 2023 at the Urgent Care Center of the University Clinical Center of Serbia in the intensive care units in polytrauma, neurosurgical and surgical patients. The study included 74 patients diagnosed with chronic pressure ulcers. Data for all participants were obtained from medical history and list of discharge. Results: During in-hospital treatment in ICU, pressure ulcers were found in all 74 patients (56.8% of women and 43.2% of men), while combined chronic wounds were found in 57 (77.0%) patients. The largest number of these patients were elderly (70 and older) (31.1%) and with non-traumatic injuries (62%). All patients were tracheotomized with a gastrostomy tube placed. The localization of pressure ulcers was most often in the lumbosacral region (44.6%), followed by the trochanteric region (23.0%). The majority of patients had hypertension (90.5%), diabetes (79.7%) and chronic obstructive pulmonary disease (82.4%), while 28 patients (37.8%) died. 38 patients were underweighted (51.4%), while 11 (14.9%) patients were overweight and obese. Conclusion: Risk factors for the occurrence of pressure ulcers should be evaluated at the moment of the first contact of the doctor with the immobile patient because this is the only prerequisite for timely prevention. Special emphasis should be placed on the elderly, underweight and people with comorbidities.

The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility during stimulation of sensory branches of the trigeminal nerve. Back in 1999 when TCR was first described as such, a clinical discussion on the establishment of terminology is ongoing. We present a case of a 31-year-old male patient who was admitted to the Emergency Department due to traumatic brain injury who died with clinical manifestations of TCR. TCR can be a red flag for neurosurgeons when treating patients with traumatic brain injury.

Introduction: Pituitary tumors represent 10-15% of all intracranial tumors. Clinical manifestations depend on the size of the tumor such as microadenoma, macroadenoma or giant adenoma, and type of the tumor (secreting or non-secreting). Surgical treatment of pituitary adenoma can be managed via transcranial or transsphenoidal approach. Depending on the approach, there is a possibillity of postoperative complications such as meningitis, pneumocephalus, liquorrhea, transient diabetes insipidus and ect. Aim: The aim of this study was to establish the frequency of newly discovered pituitary tumors in the Emergency Center, University Clinical Center Of Serbia, during the COVID-19 pandemic in Serbia, and early postoperative complications in patients treated with an endoscopic and microscope transsphenoidal approach. Material and methods: During the time period during the pandemic, the study contains 119 patients, from January 1, 2020 to March 1, 2023, of which 64 are male (53.8%) and 55 are female (46.2%), age range is 14 to 85 years with a mean of 52.10. As for statistical analysis, assessment of frequency rate and relative numbers were used as methods of descriptive statistics. Results: Macroadenoma was present in 95 patients (79.83%), microadenoma in 22 patients (18.49%), and giant adenoma in 2 patients (1.69%). Transient DI developed postoperatively in 11 patients (9.24%). The average duration of hospitalization after surgery was 8 days. Conclusion: The duration of hospitalization depends on numerous factors where the COVID-19 pandemic can serve as an example for future similar crisis situations so that better organization and preoperative preparation of patients can be implemented.