Jasna Zidverc‐Trajkovic

University of Belgrade

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Aleksandra Radojičić

Centar za Promociju Nauke

NŠ

Nadežda Šternić

University of Belgrade

Milija Mijajlović

University of Belgrade

Aleksandra Pavlović

University of Belgrade

Zagorka Jovanović

University of Belgrade

Igor Petrušić

University of Belgrade

Ana Podgorac

Institute of Mental Health

Gordana Tomić

University of Belgrade

Tatjana Pekmezović

University of Belgrade

Marko Daković

University of Belgrade

Cooperative Institutions

University of Belgrade

Univerzitetski Klinički Centar Srbije

Centar za Promociju Nauke

Institut za Reumatologiju

University of Nis

University of Kragujevac

Oncology Institute of Vojvodina

University of Novi Sad

University of Copenhagen

Institut za filozofiju

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Comment on “Central scotoma and ‘muddled thinking’ as migraine aura” by Daroff

Cephalalgia (2013)

Igor Petrušić Jasna Zidverc‐Trajkovic Ana Podgorac Nadežda Šternić

Dear Editor, We are very grateful to Professor Daroff, as well to our patients, for their goodwill in sharing with us their experience of aura. The letter by Professor Daroff (1) is a nice example of the fact that, in spite of contemporary technology, description of symptoms is the first and necessary step to answer the questions ‘why’ and ‘how’. We are in line with Professor Daroff when it comes to using term ‘‘Confused thinking’’ rather than ‘‘Muddled thinking’’ as a better description of such a cognitive state. We could also propose ‘‘Delusional thinking’’ as more appropriate terminology, which more precisely points out the higher cortical dysfunctions associated with visual aura. The appropriate descripter for his described symptoms (2) could be ‘‘Delusional scotoma state’’, for the inability to recognize the nature and duration of his own symptoms that is manifested during reading. We agree that ‘‘. . . failure to recognize negative scotoma at once’’ (3) could be explained by higher cortical dysfunctions due to the cortical spreading depression. While ‘‘delusional’’ thinking may be a scientifically accurate term, introducing such a term could create the erroneous interpretation of a psychiatric cause for the denial during migraine. Migraine was considered to be a psychiatric or, at least a personality disorder, for a long time, before the neurobiology of the disorder became evident. We would like to have more opportunities to study these phenomena (4) in order to determine the timing and sequence of events during aura, as well as the possible localization and mechanism of the particular disorder, before labeling them with a scientific term.

Delusional disorder

10.1177/0333102413505240

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Underestimated phenomena: Higher cortical dysfunctions during migraine aura

Cephalalgia (2013)

Igor Petrušić Jasna Zidverc‐Trajkovic Ana Podgorac Nadežda Šternić

Introduction Aura occurs in 20–30% of patients with migraine. Some descriptions of aura go far beyond the most frequent visual and sensory symptoms, suggesting the involvement of different cortical areas. The aim of this prospective study was to evaluate the frequency and types of disorders of higher cortical functions (HCF) that occur during visual and/or sensory aura. Methods We interviewed 60 patients with visual and/or sensory aura about HCF disorders of praxia, gnosia, memory, and speech, during aura. Patients were divided into two groups, with and without HCF disorders, and were compared in terms of demographic data and aura characteristics. Results From all 60 patients, 65% reported at least one HCF disorder during aura. The patients with HCF disorders had longer-lasting auras (28.51 ± 16.39 vs. 19.76 ± 11.23, p = 0.016). The most common HCF disorders were motor dysphasia (82.05%) and dysnomia (30.74%). Motor dysphasia was more often reported by patients with visual as well as sensory aura ( p = 0.002). The number of HCF disorders correlated with the aura duration ( p = 0.003). Conclusion According to our results, HCF disorders during aura occur more often than previously thought. The aura duration has some influence on the HCF disorders.

10.1177/0333102413476373

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Citations (36)

Pharmacotherapy of the most frequent headaches in adults

Arhiv za farmaciju (2018)

Jasna Zidverc‐Trajkovic

Tension-type headache, migraine, cluster headache and medication overuse headache are the most frequent headaches in adults. First-line treatments for migraine attack are nonsteroidal anti-inflammatory drugs and triptans, and metoprolol, propranolol, topiramate, valproates and flunarizine (not registered in Serbia) for prophylactic therapy. Nonsteroidal anti-inflammatory drugs are recommended for attacks of tension-type headache and amitriptyline, mirtazapine and venlafaxine as prophylactic therapy. Cluster headache attack should be treated with oxygen, sumatriptan or zolmitriptan, while verapamil and prednisone are efficacious as prophylactics for episodic and lithium carbonate for chronic form of the disorder. Medication overuse headache is treated by withdrawal of overused medication with or without introduction of prophylactic treatment. Careful selection of drugs is needed for pregnancy and lactation, as well as for elderly patients.

Triptans

Zolmitriptan

Divalproex

Cluster headache

Pharmacotherapy

Flunarizine

10.5937/arhfarm1806032z

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Citations (1)

Hemodialysis headache

Clinical Nephrology (2009)

Marija Milinković Jasna Zidverc‐Trajkovic NADEZDA STERNIC Jasna Trbojević‐Stanković Ivana Marić

The aim of this study was to evaluate and analyze the incidence and features of headaches in patients undergoing hemodialysis.In this prospective study 318 patients, 119 women and 199 men, undergoing chronic HD in four hemodialysis centers in Serbia, were questioned about their problems with headaches using a questionary designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders (ICHD) from 2004. Patients were distributed in two groups according to the presence of hemodialysis headaches (HDH). The groups were compared regarding sex, age, duration of HD, primary diseases that lead to ESRD, arterial systolic and diastolic blood pressure (BP) and serum levels of hemoglobin, urea nitrogen, creatinine, sodium, potassium, calcium, phosphates, albumin, glucose and calcium-phosphate product. We also analyzed features of HDH. The results were statistically compared.Patients with HDH had significantly lower serum glucose, but higher serum phosphates and albumin than patients without headaches. Furthermore, HDH patients had higher calcium phosphate product and systolic blood pressure than non-HDH patients. Out of 318 patients included in the study, 21 (6.6%) patients had HDH. According to our results, HDH appeared more frequently in men, during the 3rd hour of HD in more than a half of the patients and lasted less then 4 h in the majority of HDH patients. In the majority of patients HDH was bilateral, non-pulsating, without associated symptoms and it appeared mostly during HD. Personal history was negative for primary headaches in all patients with HDH.We believe that the results of our investigation of more than 300 HD patients pointed to some biochemical changes, possibly implicated by pathophysiology of HDH and disclose some specific HDH features that might contribute to a better understanding of this secondary headache disorder.

Blood urea nitrogen

10.5414/cnp71158

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Additional file 5: of Headache service quality: evaluation of quality indicators in 14 specialist-care centres

Sara Schramm Derya Uludüz Raquel Gouveia Rigmor Jensen Aksel Sıva

10.6084/m9.figshare.c.3631280_d2

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Etiology of ischemic stroke among young adults of Serbia

Vojnosanitetski pregled (2008)

D Jovanović Ljiljana Beslać‐Bumbaširević R Raicević Jasna Zidverc‐Trajkovic Marko Ercegovac

Background/Aim. Etiology of ischemic stroke (IS) among young adults varies among countries. The aim of the study was to investigate the causes and risk factors of IS in the young adults of Serbia. Methods. A total of 865 patients with IS, aged 15 to 45 years, were treated throughout the period 1989-2005. Etiologic diagnostic tests were performed on the patient by the patient basis and according to their availability at the time of investigation. The most likely cause of stroke was categorized according to the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. Results. There were 486 men and 379 women, with 19% of the patients ? 30 years old. Large artery arteriosclerosis and small artery disease were confirmed in 14% of the patients, and embolism and other determined causes in 20%. Undetermined causes made up 32% of the patients, mostly those (26%) with incomplete investigations. Smoking (37%), hypertension (35%) and hyperlipidemia (35%) were the most common risk factors. Rheumatic heart diseases and prosthetic valves were the most common causes of IS. Arterial dissections and coagulation inhibitors deficiency were detected in a small number of patients. Conclusion. Etiology of IS among Serbian young adults shares characteristics of those in both western and less developed countries.

Etiology

Stroke

Hyperlipidemia

Arteriosclerosis

10.2298/vsp0811803j

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Citations (20)

Pharmacotherapy of the most frequent headaches in adults

Arhiv za farmaciju (2019)

Jasna Zidverc‐Trajkovic

Pharmacotherapy

10.5937/arhfarm1901032z

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Cerebral venous thrombosis: a retrospective unicentric analysis of clinical and neuroimaging characteristics

Neurological Sciences (2021)

Jovan Petrović Tamara Švabić Jasna Zidverc‐Trajkovic Predrag Stanarčević D Jovanović

Sigmoid sinus

Coma (optics)

Outpatient clinic

Straight sinus

10.1007/s10072-021-05514-6

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Cortical spreading depression: origins and paths as inferred from the sequence of events during migraine aura.

PubMed (2014)

Igor Petrušić Jasna Zidverc‐Trajkovic

Patients with migraine with aura often experience a variety of visual and somatosensory phenomena and disturbances of higher cortical functions. Analysis of these alterations may provide important information about the involvement of different cortical regions in cortical spreading depression (CSD). We report five cases of migraineurs who experience unusually abundant clinical phenomena during auras. These patients were selected from a cohort of migraine with aura patients who were interviewed, using a specially designed questionnaire, to evaluate the presence of higher cortical dysfunctions. On the basis of the aura symptoms they reported, we attempted to infer the origin and the possible paths of CSD in each patient. According to their reported symptoms, CSD could begin in the primary visual cortex, in the primary somatosensory cortex or simultaneously in both, and propagate to the posterior parietal cortex, the temporal lobe and Broca's area. We believe that clinical descriptions of aura could play an important role in further investigations of the pathophysiology of migraine.

Cortical Spreading Depression

Depression

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Proposal for a Migraine Aura Complexity Score

Cephalalgia (2018)

Igor Petrušić Michele Viana Marko Daković Peter J. Goadsby Jasna Zidverc‐Trajkovic

Currently, there is no scoring system for assessing the complexity of migraine aura. Our goal was to develop a Migraine Aura Complexity Score that synthesizes the quantity and quality of aura symptoms and to test its applicability in neuroimaging studies.Patients with migraine aura were interviewed in order to obtain characteristics of migraine aura. Explorative and confirmatory analyses were used to develop the Migraine Aura Complexity Score. Median values were derived from 10 consecutive migraine auras in each patient. The Migraine Aura Complexity Score was correlated with an average cortical thickness of different brain areas in studied patients. The Surface-based Morphometric Analysis approach was used to estimate cortical thickness.This study included 23 (16 females and seven males) migraineurs with aura. Confirmatory factor analysis suggested the second-order model with three-factor measurement for grading migraine aura. The first factor is linked to higher cortical dysfunction during migraine aura, while the second is associated with the degree of involvement of primary visual and somatosensory cortices; the third linked symptoms of somatosensory aura and hand and head involvement. Positive correlation of Migraine Aura Complexity Score and averaged cortical thickness were found in the left and right hemispheres overall (r = 0.568, p = 0.007; r = 0.617, p = 0.003) and in some of their regions.This study demonstrates that the Migraine Aura Complexity Score could be a valuable tool for assessing migraine aura. The score could be used in neuroradiological studies in order to achieve a stratification of patients with migraine aura.

10.1177/0333102418815487

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Citations (14)