Veterinary medicine - Repository of PHD, master's thesis
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Izazovi i zamke pretvaranja bibliografije radova u potvrdu za napredovanje
No full textZnanstveno i akademsko napredovanja u Hrvatskoj temelji se znatnim dijelom na broju objavljenih radova, pri čemu se članci objavljeni u znanstvenim i stručnim časopisima razvrstavaju prema bibliografskim bazama podataka u kojima su zastupljeni/indeksirani. Godinama su na Medicinskom fakultetu Sveučilišta u Zagrebu najvažniji bili članci objavljeni u časopisima zastupljenim u bazi podataka Current Contents, iako su se u pravilnicima pod skupnim imenom navodile i druge
relevantne baze podataka
Surgical and endovascular treatment of vascular compression syndrome
No full textSindromi kod kojih je krvna žila pritisnuta ili uklještena drugim okolnim strukturama nazivaju se sindromima vaskularne kompresije. Po etiologiji se mogu podijeliti na stečene i kongenitalne, ali također i na sindrome nastale kompresijom mekog tkiva, kostiju, arterija, ligamenata, fibroznog tkiva, mišića i ostalih struktura koje pritišću vaskularne strukture. U ovom radu opisani su sindrom gornjeg otvora prsišta, sindrom orašara, anomalije koronarnih arterija, sindrom aduktornog kanala, Eagle sindrom, sindrom hipotenarnog čekića, May-Thurnerov sindrom, Dunbarov sindrom, sindrom lateralnog pazušnog otvora te sindrom kompresije poplitealne arterije. Simptomi se razlikuju zbog anatomske strukture koja je zahvaćena te variraju od boli, edema, bljedila do hematurije i aritmija. Patofiziološki mehanizam oštećenja započinje ozljedom i odgovorom endotela krvne žile zbog dugotrajne kompresije strukture na vanjski dio krvne žile. Komplikacije koje se mogu javiti su stenoza, poststenotička dilatacija, aneurizma te okluzije. Dijagnoza se postavlja na temelju anamneze, fizikalnog pregleda te neke od slikovnih dijagnostičkih metoda, ovisno koju strukturu želimo prikazati. Bitno je isključiti druge uzroke kompresije kao što su tumorske mase ili limfadenopatija jer im je incidencija veća, nego kod ovih sindroma. Vrlo često se koriste ultrazvučne metode u početnoj dijagnostičkoj obradi. Liječenje ovih sindroma može biti konzervativno, endovaskularno ili se pak mogu koristiti metode otvorene kirurgije jer je najčešće potrebno ukloniti uzrok kompresije kako bi došlo do poboljšanja. Kirurško liječenje komplikacija koje su nastale uslijed dugog djelovanja kompresije na žilu također je prisutno. Moderne metode dekompresije uključuju i laparoskopsku tehniku te robotski asistiranu kirurgiju, čija je primjena sve učestalija. Endovaskularne tehnike uključuju katetersku trombolizu, perkutanu mehaničku trombektomiju i perkutanu transluminalnu angioplastiku, dok se u otvorenoj kirurgiji najčešće koriste premosnice, trombektomija, trombendarterektomija, embolektomija i plastika zakrpom.Syndromes where a blood vessel is pressed or entrapped by other surrounding structures are called vascular compression syndromes. By etiology, they can be divided into acquired and congenital, but also into syndromes caused by compression of soft tissue, bones, arteries, ligaments, fibrous tissue, muscles and other structures that exert compression on vascular structures. This paper describes upper thoracic outlet syndrome, Nutcracker syndrome, coronary artery anomalies, adductor canal syndrome, Eagle syndrome, Hypothenar hammer syndrome, May-Thurner syndrome, Dunbar syndrome, Quadrilateral Space Syndrome and popliteal artery compression syndrome. Symptoms differ due to the anatomical structure that is affected and vary from pain, edema, pallor to hematuria and arrhythmias. The pathophysiological mechanism of damage begins with the injury and response of the blood vessel endothelium, due to long-term compression of the structure on the outer part of the blood vessel. Complications that can occur are stenosis, post-stenotic dilation, aneurysm and occlusion. The diagnosis is based on history, physical examination and one of the imaging diagnostic methods, depending on which structure we want to review. It is important to rule out other causes of compression such as tumor masses or lymphadenopathy because they have higher incidence. Ultrasound methods are very often used in the initial diagnostic process. The treatment of these syndromes can be conservative, endovascular, or open surgery methods can be used, because it is usually necessary to remove the cause of compression for improvement. Surgical treatment of complications caused by the long-term effect of compression on the vessel is also present. Modern methods include laparoscopic technique and robot-assisted surgery, the use of which is becoming more frequent. Most frequently employed endovascular techniques are catheter thrombolysis, percutaneous mechanical thrombectomy and percutaneous transluminal angioplasty, while open surgery usually involves bypass, thrombectomy, thrombendarterectomy, embolectomy and patch angioplasty
Frequency of chloroquine ophtalmopathy in rheumatic patients
No full textSustavni eritemski lupus je kronična autoimunosna bolest koja uzrokuje upalu i oštećenje različitih organa, uključujući kožu, zglobove, bubrege i srce. U terapiji lupusa primjenjuju se različiti lijekovi s protuupalnim/imunosupresivnim učinkom, a antimalarici su neizostavan dio terapijskih shema za liječenje lupusa.
Cilj istraživanja je bio utvrditi učestalost oftalmopatije u pacijenata sa sustavnim ertemskim lupusom koji su liječeni antimalaricima. Istražena je učestalost nuspojava antimalarika te osobitosti oftalmopatije uz primjenu terapije kroz analizu podataka prikupljenih tijekom razdoblja od 6 mjeseci iz ambulante jednog specijalista reumatologa.
U istraživanju su se koristili arhivski demografski i klinički relevantni podatci prikupljeni od 124 odrasla pacijenta, koji se liječe u Zavodu za kliničku imunologiju i reumatologiju Klinike za unutarnje bolesti Medicinskog fakulteta KBC-a Zagreb.
Analizom podataka utvrđeno je da upotreba antimalarika može biti povezana s različitim nuspojavama, među kojima je oftalmopatija bila najzastupljenija. U ispitanoj skupini pacijenata ukupna učestalost oftalmopatije iznosila je 20% (25/124) dok je ukupna učestalost ekstraokularnih nuspojava iznosila 12% (15/124).
Rezultati su pokazali da je učestalost oftalmopatije vrlo visoka te je svaka rezultirala prekidom terapije. Važno je naglasiti kako su oftalmološke nuspojave bile uglavnom posljedica dugotrajne terapije antimalaricima. Nedostupnost sigurnijeg lijeka (hidroksiklorokina) na tržištu potencijalno je rezultirala ovako visokom pojavom oftalmopatije.
Redoviti oftalmološki pregledi ključan su faktor u ranom detektiranju nuspojava antimalarika. Na taj način možemo na vrijeme prekinuti terapiju prije razvoja ireverzibilnih promjena u oku.Systemic Lupus Erythematosus is a chronic autoimmune disease that causes inflammation and damage to various organs, including the skin, joints, kidneys, and heart. Various anti-inflammatory/immunosuppressive drugs are used in the treatment of lupus, and antimalarials are an indispensable part of therapeutic regimens for lupus management.
The aim of the study was to determine the prevalence of ophthalmopathy in patients with systemic lupus erythematosus who were treated with antimalarials. The frequency of antimalarial side effects and the characteristics of ophthalmopathy associated with therapy were investigated through the analysis of data collected over a 6-month period from a specialist rheumatologist's outpatient clinic.
The study utilized archived demographic and clinically relevant data collected from 124 adult patients treated at the Department of Clinical Immunology and Rheumatology of the Internal Medicine Clinic, Medical Faculty, University Hospital Center Zagreb.
Data analysis revealed that the use of antimalarials may be associated with various side effects, among which ophthalmopathy was the most prevalent. In the examined group of patients, the overall incidence of ophthalmopathy was 20% (25/124), while the overall incidence of extraocular side effects was 12% (15/124).
The results showed that the incidence of ophthalmopathy is very high, and each case resulted in discontinuation of therapy. It is important to emphasize that ophthalmic side effects were mainly the result of long-term antimalarial therapy. The unavailability of a safer drug (hydroxychloroquine) on the market may have potentially resulted in this high occurrence of ophthalmopathy.
Regular ophthalmological examinations are a key factor in the early detection of antimalarial side effects. In this way, therapy can be discontinued in time before the development of irreversible changes in the eye
Broken heart syndrome
No full textSindrom slomljenog srca ili Takotsubo kardiomiopatija relativno je rijedak sindrom i čini 1-3 % svih slučajeva kod pacijenata koji se inicijalno prezentiraju sa simptomima sličnima akutnom koronarnom sindromu (ACS). Najčešće se javlja u žena starijih od 50 godina. Do danas nije u potpunosti razjašnjena etiologija i patofiziološki mehanizmi nastanka ovog sindroma, ali je poznato da je sindrom najčešće uzrokovan nekim jačim emocionalnim ili fizičkim stresom. Klinička slika Takotsubo sindroma (TTS) je vrlo slična ACS-u, te se pacijenti najčešće žale na bolove u prsima i otežano disanje. Pacijenti s TTS-om mogu razviti neke od komplikacija uključujući zatajivanje srca, kardiogeni šok, maligne aritmije, opstrukciju izlaznog trakta lijeve klijetke, mitralnu regurgitaciju ili formiranje tromba. Zbog nepostojanja specifičnih dijagnostičkih kriterija, dijagnoza TTS-a se postavlja isključivanjem drugih sličnih stanja, a kao pomoć mogu se koristiti i revidirani kriteriji Mayo Klinike iz 2008. godine i InterTAK dijagnostički zbroj. Od dijagnostičkih metoda koriste se elektrokardiogram (EKG), biomarkeri iz krvi, ehokardiografija, koronarna angiografija i lijeva ventrikulografija koja čini zlatni standard u postavljanju dijagnoze. Može se koristiti i magnetska rezonanca srca (CMR), no u praksi je to vrlo rijetko. Po prijemu u bolnicu pacijenti se najčešće vode pod radnom dijagnozom ACS-a, a po isključivanju istog prelazi se na suportivni oblik liječenja. Od izuzetne važnosti je na vrijeme prepoznati i liječiti komplikacije TTS-a, a veliki značaj pridaje se i prevenciji rekurencija ovog sindroma. Prognoza TTS-a je dobra te se 95 % pacijenata u potpunosti oporavi, dok je stopa bolničkog mortaliteta 5 %. Iako je prognoza dobra, TTS još uvijek nije u potpunosti istražen stoga su u budućnosti potrebna dodatna istraživanja kako bi što bolje razumjeli mehanizme nastanka sindroma i mogućnosti liječenja.Broken heart syndrome or Takotsubo cardiomyopathy is a relatively rare condition, accounting for 1-3 % of all cases in patients initially presenting with symptoms similar to acute coronary syndrome (ACS). It mostly occurs in women over the age of 50. To date, the etiology and pathophysiological mechanisms of this syndrome's development have not been fully clarified, but it is known that it is most often caused by significant emotional or physical stress. The clinical presentation of Takotsubo syndrome (TTS) is very similar to ACS, with patients most commonly complaining of chest pain and difficulty breathing. Patients with TTS may develop some complications, including heart failure, cardiogenic shock, malignant arrhythmias, left ventricular outflow tract obstruction, mitral regurgitation or thrombus formation. Due to the lack of specific diagnostic criteria, the diagnosis of TTS is made by excluding other similar conditions, with the revised Mayo Clinic criteria from 2008 and the InterTAK diagnostic score being sometimes used as helpful tools. Diagnostic methods include electrocardiogram (ECG), blood biomarkers, echocardiography, coronary angiography and left ventriculography, which constitutes the gold standard in making a diagnosis. Cardiac magnetic resonance (CMR) imaging can also be used, though it is rarely done in practice. Upon hospital admission, patients are most often treated under the working diagnosis of ACS, and after its exclusion, treatment shifts to a supportive approach. It is extremely important to recognize and treat TTS complications in a timely manner, and great importance is also placed on preventing recurrences of this syndrome. The prognosis of TTS is good, with 95 % of patients making a full recovery, while the in-hospital mortality rate is 5 %. Although the prognosis is favorable, TTS has not yet been fully investigated. Additional research is needed in the future to better understand the mechanisms of the syndrome and treatment options
The impact of maternal age on perinatal outcome
No full textOdgoda rađanja predstavlja najznačajniju promjenu reproduktivnog ponašanja u posljednjih nekoliko desetljeća. Kako se društveni trendovi pomiču prema starijoj dobi žena pri prvom porodu, postaje sve važnije razumjeti rizike povezane s takvim trudnoćama. Cilj rada bila je analiza perinatalnih ishoda žena životne dobi ≥44 godine (N=25) te usporedba s perinatalnim ishodom kod mlađih žena (N=25). Istraživanje je provedeno u Klinici za ženske bolesti i porode Kliničkog bolničkog centra Zagreb u razdoblju od 1. siječnja do 31. prosinca 2023. godine. Analizirana je životna dob trudnica, postojanje preegzistentnih bolesti, reprodukcijska anamneza komplikacije u trudnoći (gestacijski dijabetes melitus, preeklampsija, placenta previa..) i porodu (carski rez, postporođajno krvarenje) te komplikacije novorođenčeta (prematuritet, porođajna masa, Apgar-zbroj, prijem u Jedinicu intenzivnog liječenja..). Statistička analiza provedena pomoću SPSS-a primjenom Fisherovog egzaktnog testa te t-testa za neovisne uzroke uz statističku značajnost p ≤0,05. U promatranom razdoblju rođeno je ukupno 2898 živorođene djece, od kojih je 0.88% bilo novorođenčadi majki životne dobi ≥ 44 godine. Te su trudnice imale više komorbiditeta i značajno češće su imale trudnoće iz medicinski pomognute oplodnje (p=0,0036), Starija skupina trudnica imala je veći broj komplikacija u trudnoći, prosječno kraće trajanje gestacije i češći carski rez, dok je u novorođenčadi promatrane skupine porođajna masa bila značajno niža u usporedbi s mlađim trudnicama. Rezultati ovog istraživanja pokazali su da je starija životna dob majke povezana s povećanim rizikom za razvoj komplikacija u trudnoći, češćim prijevremenim porođajem, operativnim dovršenjem trudnoće i nižom porođajnom težinom novorođenčadi. U trudnica starije životne dobi često prisutni komorbiditeti dodatno opterećuju perinatalni ishod. Trudnoće i porođaji u ovoj skupini trudnica najčešće su urednog ishoda ukoliko su vođeni u centrima tercijarne razine skrbi.The postponement of childbirth represents the most significant change in reproductive behaviour in recent decades. As societal trends shift towards older maternal age at the birth of the first child. understanding the risks associated with such pregnancies becomes increasingly important. The aim of this study to analyse perinatal outcomes in women aged ≥ 44 years (N=25) and to compare these outcomes with those of younger women (N=25). The study was conducted at the Clinic for Obstetrics and Gynecology of the Clinical Hospital Center Zagreb from January 1 to December 31, 2023.. The study examined maternal age, the presence of pre-existing conditions, reproductive history, pregnancy complications (such as gestational diabetes mellitus, preeclampsia, placenta previa), delivery complications (such as cesarean section, postpartum hemorrhage), and neonatal complications (such as prematurity, birth weight, Apgar score, and admission to the Neonatal Intensive Care Unit). Statistical analysis was performed using SPSS, applying Fisher's exact test and t-test for independent samples with statistical significance set at p ≤0.05. During the observation period, a total of 2,898 live births were recorded, of which 0.88% were infants born to mothers aged ≥44 years. These pregnant women had more comorbidities and significantly more often had pregnancies resulting from medically assisted reproduction (p=0.0036). The older group of pregnant women experienced a higher number of pregnancy complications, had a shorter average gestation and a higher frequency of cesarean sections. In the neonates of this group, birth weight was significantly lower compared to those born to younger mothers. The results of this study demonstrated that advanced maternal age is associated with an increased risk of pregnancy complications, higher rates of preterm birth, operative delivery, and lower neonatal birth weight. The frequently present comorbidities in older pregnant women further burden perinatal outcomes. However, pregnancies and deliveries in this group result in favorable outcomes when managed in tertiary care centers
Psychiatric comorbidities in dermatological patients
No full textPsihodermatologija je interdisciplinarno područje u čijem je fokusu istraživanje dvosmjerne veze između stanja kože i ljudske psihe. Danas se ta veza kroz brojna istraživanja pokušava dokazati sve do molekularne razine. S ciljem lakšeg snalaženja u psihodermatološkoj terminologiji European Academy of Dermatology and Venereology (EADV), European Society for Dermatology and Psychiatry (ESDaP) i Association for Psychoneurocutaneous Medicine of North America (APMNA) osnovali su ekspertnu radnu skupinu koja je 2023. godine objavila službeni sustav klasifikacije psihodermatoloških poremećaja koji se temelji na patofiziološkim i fenomenološkim poveznicama među poremećajima. Nedvojbeno je da dermatološke i psihičke bolesti
imaju veliki utjecaj na sveopće blagostanje pojedinca i kvalitetu njegova života. Kako bi se psihijatrijski komorbiditeti u dermatoloških bolesnika pravovremeno prepoznali i liječili potrebna je uska suradnja između liječnika obiteljske medicine, dermatologa i psihijatara. Stoga psihodermatološkom pacijentu treba pristupiti holistički. Najčešći psihijatrijski komorbiditeti u dermatoloških bolesnika su: depresija, anksioznost, posttraumatski stresni poremećaj, opsesivno-kompulzivni poremećaj i tjelesni dismorfni poremećaj. U psihodermatoloških pacijenata česta je i pojava suicidalnosti. Za maksimalno uspješan rezultat u liječenju psihodermatoloških poremećaja potreban je sinergizam primjene psihoterapijskih, psihofarmakoloških i dermatoloških metoda liječenja. Iz tog razloga izvanredan model rada u kojem bi se znanja dermatologa i psihijatara međusobno upotpunjavala bile bi psihodermatološke klinike ili postojanje liaison terapijskog modela skrbi.Psychodermatology is an interdisciplinary field. In its focus is the research of the twoway connection between skin and human psyche. Nowadays, through numerous studies, attempts are being made to prove this connection down to the molecular level. With the aim of creating a more structured approach to terminology, the European Academy of Dermatology and Venereology (EADV), the European Society for Dermatology and Psychiatry (ESDaP) and the Association for Psychoneurocutaneous Medicine of North America (APMNA) established an expert working group that
published the official system of classification of psychodermatological disorders in 2023. This classification system is based on pathophysiological and phenomenological links between disorders. There is no doubt that dermatological and psychological disorders have a great impact on the overall well-being of an individual and the quality of his/her life. In order to appropriately recognize and treat psychiatric comorbidities in dermatological patients, close cooperation between family medicine doctors, dermatologists and psychiatrists is necessary. The best practice would be to offer a holistic approach to these patients. The most common psychiatric comorbidities in dermatological patients are: depression, anxiety, post-traumatic stress disorder, obsessive-compulsive disorder and body dysmorphic disorder. Suicidality is also common in psychodermatological patients. For the most successful result in treatment of psychodermatological disorders, the synergism of psychotherapeutic, psychopharmacological and dermatological treatment methods is required. For this reason, psychodermatology clinics or the existence of liaison therapeutic practice would be an outstanding model of care in which the knowledge of dermatologists and psychiatrists would complement each other
The influence of mitochondria on the degree of differentiation and aggressiveness of malignant tumors
No full textMaligni tumori jedan su od vodećih uzroka smrti u razvijenom svijetu. Njihov nastanak se povezuje s oštećenjem i mutacijama DNA, a karakterizira ih autonoman i infiltrativan rast. Jedna od glavnih karakteristika malignih tumora je metastaziranje u lokalna i udaljena tkiva i stjecanje rezistencije na terapiju. Iako njihova incidencija raste tijekom godina, razvoj novih terapija je povećao preživljenje kod nekih pacijenata. Mitohondriji su stanične organele zadužene za proizvodnju ATP-a, a ujedno su i važan izvor reaktivnih kisikovih spojeva. Imaju niz funkcija u regulaciji metabolizma, signalizaciji, a povezuje ih se s patofiziologijom tumora. Dinamika mitohondrija koja uključuje procese fisije i fuzije također je uključena u regulaciju diferenciranosti stanica tumora. Cilj ovog rada je prikazati utjecaj mitohondrija na razvoj malignih tumora, njihovu diferenciranost, sposobnost invazije i metastaziranja. Osvrnut ću se i na potencijalne strategije liječenja tumora usmjerene na mitohondrije.Malignant tumors represent one of the leading causes of mortality in the developed world. Their development is closely associated with DNA damage and mutations, characterized by autonomous and infiltrative growth. One of the main characteristics of malignant tumors is their capacity to metastasize to both local and distant tissues, as well as their ability to develop resistance to therapy. Despite the rising incidence of malignant tumors over the years, the development of new therapies has improved survival in some patients. Mitochondria, the cellular organelles responsible for ATP production, are also an important source of reactive oxygen species. They play a significant role in regulating metabolism and cellular signaling and are linked to the pathophysiology of tumors. Mitochondrial dynamics, including fission and fusion processes, are also involved in regulating the differentiation of tumor cells. This study aims to explore the influence of mitochondria on the development of malignant tumors, their differentiation, and their capacity for invasion and metastasis. Additionally, potential therapeutic strategies targeting mitochondria in the treatment of tumors will be discussed
New treatment possibilities in gout
No full textUrični artritis je najčešći upalni artritis u svijetu. Glavno obilježje bolesti je taloženje kristala mononatrijevog urata koji su ključni pokretač akutne upale. Prevalencija i učestalost uričnog artritisa rastu u mnogim razvijenim zemljama svijeta, no unatoč dobrom razumijevanju patofiziologije bolesti i dostupnih terapija, opterećenje uričnim artritisom i dalje ostaje visoko, a liječenje i dalje nije optimalno. Temelj liječenja uričnog artritisa je smanjenje razine urata pomoću ULT-a, koji uključuje inhibitore ksantin oksidaze, urikozurike i rekombinantnu urikazu nalik svinjskoj. Liječenje napadaja gihta se u prvoj liniji provodi nesteroidnim protuupalnim lijekovima, kolhicinom ili glukokortikoidima, a u drugoj liniji terapije inhibitorima IL-1. Novosti u liječenju gihta uključuju nove terapije koje moduliraju upalne putove, kao što su Dapansutril koji inhibira NLRP3 i beta-karoten koji smanjuje upalu induciranu kristalima MSU. Crijevna mikrobiota također igra važnu ulogu pa se prehrambene intervencije i transplantacija fekalne mikrobiote istražuju kao nove terapijske strategije. Strategija liječenja do cilja (T2T) je nedavno uspostavljen pristup kako bi se poboljšalo liječenje gihta, s ciljem postizanja ciljne razine urata u serumu ispod 6 mg/dL. Sve ove inovacije predstavljaju napredak u liječenju uričnog artritisa.Gouty arthritis is the most common inflammatory arthritis in the world. The main feature of the disease is the deposition of monosodium urate crystals, which are the key driver of acute inflammation. The prevalence and incidence of gouty arthritis are increasing in many developed countries worldwide, but despite a good understanding of the pathophysiology of the disease and available therapies, the burden of gouty arthritis still remains high, and treatment is still suboptimal. The mainstay of treatment for gouty arthritis is urate reduction using ULT, which includes xanthine oxidase inhibitors, uricosurics, and recombinant porcine-like uricase. Treatment of gout attacks is carried out in the first line with non-steroidal anti-inflammatory drugs, colchicine or glucocorticoids, and in the second line of therapy with IL-1 inhibitors. Innovations in the treatment of gout include new therapies that modulate inflammatory pathways, such as Dapansutril, which inhibits NLRP3, and beta-carotene, which reduces inflammation induced by MSU crystals. Gut microbiota also plays an important role, so dietary interventions and faecal microbiota transplantation are being investigated as new therapeutic strategies. The treat-to-target (T2T) approach is a recently established approach to improve the management of gout, aiming to achieve a target serum urate level below 6 mg/dL. All these innovations represent progress in the treatment of gouty arthritis
Headache as an urgent neurological symptom
No full textGlavobolja je bolno stanje koje nastaje kao posljedica pojačane aktivacije nociceptora te je rezultat prijenosa boli iz intrakranijskih, ali i ekstrakranijskih struktura glave i vrata. Osnovna podjela glavobolja dijeli ih na primarne i sekundarne. U primarne uzroke glavobolja spadaju migrena, tenzijska glavobolja i druge. U uzroke sekundarne glavobolje spadaju trauma glave i/ili vrata, vaskularni poremećaji, infekcije i drugi. Iako su u bolesnika s glavoboljom, kao hitnim neurološkim simptomom diferencijalne dijagnoze, poput subarahnoidalnog krvarenja i meningitisa životno ugrožavajuće, većina akutnih, novonastalih glavobolja u bolesnika, koji se javljaju u hitnu medicinsku službu, benigne je prirode. Glavni koraci dijagnostičkog postupka u bolesnika s glavoboljom, kao hitnim neurološkim simptomom, jesu detaljna i precizna anamneza te opsežan klinički pregled koji su u većine glavobolja dovoljni za postavljanje točne dijagnoze. Pitanja o trajanju i brzini nastanka glavobolje, intenzitetu i karakteru boli te propagaciji u okolna područja tijela ključna su kako bi se olakšao diferencijalno-dijagnostički postupak te odredila etiologija glavobolje. Najvažniji je dio kliničkog pregleda kompletan neurološki pregled na osnovu kojega se može odrediti radi li se o potencijalno životno ugrožavajućem ili benignom uzroku glavobolje. U slučaju da se tijekom postupka uzimanja anamneze i kliničkog pregleda otkriju simptomi i/ili znakovi koji ukazuju na neki od sekundarnih uzroka glavobolje, indiciraju se dodatne dijagnostičke pretrage. Neuroslikovna metoda, kompjutorizirana tomografija, osnovna je dijagnostička metoda koja je indicirana kod svih bolesnika s akutnom, novonastalom glavoboljom te abnormalnostima u anamnezi i kliničkom nalazu te je metoda zlatnog standarda u dijagnostici akutnih intrakranijskih krvarenja. Lumbalna punkcija indicirana je u svih bolesnika s negativnim nalazom kompjutorizirane tomografije u svrhu isključivanja subarahnoidalnog krvarenja. Terapija glavobolje, kao hitnog neurološkog simptoma, određuje se prema etiologiji glavobolje. Primarne glavobolje najčešće se liječe simptomatski, dok se sekundarne glavobolje liječe na osnovu podliježeće etiologije bolesti.Headache is a painful condition resulting from increased activation of nociceptors and the transmission of pain from intracranial and extracranial structures of the head and neck. The basic classification of headaches divides them into primary and secondary types. Primary headaches include migraine, tension-type headache and other types of primary headaches. Secondary headaches are caused by head and/or neck trauma, vascular disorders, infections, and other causes. Although differential diagnoses in patients with headache as an urgent neurological symptom may include life-threatening conditions such as subarachnoid hemorrhage and meningitis, most acute, new-onset headaches in patients presenting to emergency medical services are benign in nature. The diagnostic procedure for patients with headache as an urgent neurological symptom includes a detailed medical history and a comprehensive clinical examination. The medical history should include the duration and speed of onset of the headache, the intensity and character of the pain, and the propagation of pain to surrounding areas. The clinical examination should include a complete neurological examination, which is crucial in determining whether the cause of the headache is potentially life-threatening or benign. If symptoms and/or signs indicating one of the secondary causes of headaches are discovered during the history-taking and clinical examination, additional diagnostic tests are indicated. Neuroimaging, particularly computed tomography, is the primary diagnostic method indicated for all patients with acute, new-onset headache and abnormalities in history and clinical findings. It is the gold standard method for diagnosing acute intracranial hemorrhages. Lumbar puncture is indicated in all patients with a negative computed tomography scan result to exclude subarachnoid hemorrhage. The treatment of headaches as an urgent neurological symptom is determined by the etiology of the headache. Primary headaches are most often treated symptomatically, while secondary headaches are treated based on the underlying disease etiology