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The posterior inferior cerebellar artery (PICA) has a unique anatomical complexity, which is of great clinical importance and is involved in many pathologies, such as aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM) and brain tumour (1). PICA has a sinuous and variable trajectory, divided into 5 segments. PICA infarction usually manifests lateral bulbar syndrome and is more likely to cause mass effects. PICA frequently compresses the bulb and cranial nerves, resulting in various neurovascular compression syndromes (NVCS) (2). The ischemic stroke caused by thromboembolism in the PICA segment is accounted for more than 2% of all cases of ischemic stroke (3). Moreover, it tends to be underdiagnosed due to the symptomatology, represented usually by vertigo which mimics a possible peripheral vestibulopathy (4). [ABSTRACT FROM AUTHOR]

OBJECTIVES Evaluation of the dosage utilities of thrombin generation markers for recommending useful doses of anticoagulant, platelet and thrombolytic agents, to avoid the risk of haemorrhage or thrombosis. Identification of the risk factors specific to the group of patients with stroke and age under 35 years. Identification of biological abnormalities in patients with haemorrhagic stroke treated surgically, with unfavourable evolution. MATERIALS AND METHODS The study included patients with haemorrhagic stroke admitted to the Sibiu County Emergency Clinical Hospital. Subjects will be divided into 2 subgroups. • Patients suffering from a haemorrhagic stroke who do not have a deficiency of coagulation factors • Patients suffering from a haemorrhagic stroke, who have a deficiency of coagulation factors, respectively in which thrombin generation is reduced: Data collected prospectively, starting with the time of inclusion in the study: age, gender, height, weight, BMI, TA, DZ, APP (associated disorders), paraclinical data (CT and / or cranial MRI, extracranial carotid Doppler ultrasound and arteriography), biochemistry : glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, creatinine; biological: HLG, platelet indices, PCR, VSH, INR, APTT, TS +, thrombin generation. The data collected retrospectively will be added to patients with biological or imaging investments made in the year preceding the episode of stroke haemorrhage. RESULTS Cerebral edema produced by intraparenchymal haematoma is significantly inhibited by thrombin inhibitors. In addition, an intracerebral 5U thrombin infusion may cause a degree of edema similar to that produced by a 50µL clot. Thrombin at high concentrations produces neuronal and astrocytic apoptosis. An indicator of neuronal viability is the concentration of lactate dehydrogenase. Small doses of thrombin (1-2U / mL) do not induce neuronal apoptosis and have protective effects, but doses above 5U / mL are correlated with the proportional release of lactate dehydrogenase. Identification of risk factors with major role in stroke pathogenesis in young people. CONCLUSIONS Thrombin is a serum protease, a component with an essential role in the coagulation cascade. It is produced immediately in the brain after a cerebral haemorrhage to stop the bleeding. In experimental studies, cerebral edema produced by intraparenchymal hematoma was significantly inhibited by thrombin inhibitors. These results suggest that thrombin is a target in stroke therapy and that studies are needed to determine whether inhibition of thrombin may reduce haemorrhagic transformation in ischemic stroke. [ABSTRACT FROM AUTHOR]

OBJECTIVES Employ the strategic use of ICT technologies in teaching/training activities by using a telemedicine approach to create an innovative best practice environment in the form of an 3D live-transmission where students and resident doctors can experience non-invasive surgery procedures. Create interactive teaching and training aids for students using 3D technology - 3D reconstruction of the skull on various pathologies: tumours, traumas ISP of 14 days 'traineeships' in a working hospital, where the course participants will get to real life working experience accompanying the whole diagnostic process. Create a reader-friendly online platform which can facilitate the access of graduates, residents and even physicians without material possibilities to new technologies and new discoveries in neurosurgery. Make a closer connection between European neurosurgery centres. Transnational collaboration at this time is not a strong one, at least in the case of Romania, the neurosurgery centres are limited to a national collaboration. This project requires transnational highly specialized know-how and expertise which is hard to be found in a single country. MATERIALS AND METHODS Use of the knowledge of bioengineering and 3D printing for the most real simulation of the neurosurgical interventions. Developing a telemedicine platform with access to the latest discoveries in neurosurgery. A handbook that will be available both in print and online on the project e-platform, which will comprise all the important information delivered during the three years project. The book will be freely-available to anyone interested. RESULTS In 3 summer schools students will be able to practice surgery in workshops on 3D printed patients. They will learn neurosurgery, because in many medical faculties is not a mandatory discipline. O3-1 - Intensive Summer Programme "Trauma in Neurosurgery"- Year 1 (08.07-2019 - 21.07.2019) O3-2 - Intensive Summer Programme "Neurovascular Surgery"- Year 2 (06.07.2020 - 19.07.2020) O3-3 - Intensive Summer Programme "Neurooncology"- Year 3 (05.07.2021 - 18.07.2021). CONCLUSIONS Based on the evaluation, questionnaires and feedback from the participants, the degree of satisfaction is very high. The workshops were above the expectations of the participants. [ABSTRACT FROM AUTHOR]