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All Journal Majalah Kesehatan Indonesia Lumina: Indonesian Journal of Neurology
Stefanus Erdana Putra
Universitas Kristen Duta Wacana
Humanities Health Professions Medicine & Pharmacology Nursing Public Health

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Early Warning System through Artificial Intelligence in Intensive Care: A Diagnostic Meta-Analysis of Mortality, Deterioration of Consciousness, and Neurological Outcome Stefanus Erdana Putra; Baarid Luqman Hamidi; Benedictus Benedictus; Muhammad Hafizhan; Tyasno Koeshermanto; Retnaningsih Retnaningsih; Abdulloh Machin
Majalah Kesehatan Indonesia Vol. 7 No. 3 (2026)
Publisher : Utan Kayu Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47679/makein.2026347

Abstract

Prognostication in neurocritical care remains challenging due to patient heterogeneity and the limitations of static conventional scores. This systematic review and meta-analysis evaluated the diagnostic accuracy of artificial intelligence (AI) models as retrospective predictive and prognostic frameworks, assessing their potential utility as clinical early warning systems (EWS). Conducted via PubMed, ScienceDirect, and SCOPUS per PRISMA guidelines, the study evaluated deterioration of consciousness, mortality, and neurological outcomes. Out of 20 included studies, 18 were meta-analyzed. For mortality prediction, AI demonstrated a pooled sensitivity of 0.569, specificity of 0.810, diagnostic odds ratio (DOR) of 9.620, and area under the curve (AUC) of 0.698. In predicting deterioration in consciousness, AI achieved a pooled sensitivity of 0.648, specificity of 0.901, DOR of 38.346, and AUC of 0.796. For neurological outcomes, the pooled sensitivity was 0.864, specificity 0.865, DOR 45.566, and AUC 0.858. AI models demonstrate high accuracy in predicting long-term neurological outcomes and acceptable performance in predicting short-term deterioration in consciousness, but remain highly limited and offer no clear advantage over conventional scoring for ICU mortality. These retrospective findings provide a robust foundation for future prospective designs, though widespread clinical integration is not yet warranted.
Neuropathic Pain in Syringomyelia: A Case Report and Comprehensive Review of Clinical Management Rizaldy Taslim Pinzon; Bernadeta Amaya; Stefanus Erdana Putra
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.11011

Abstract

Introduction: Syringomyelia is an uncommon chronic spinal cord disorder characterized by the formation of a fluid-filled cavity (syrinx) within the neural parenchyma. This condition leads to progressive neurological impairment and severe neuropathic pain. This case report discusses the clinical presentation and comprehensive management of a patient with this condition. Case Presentation: A 39-year-old female presented with a two-year history of severe burning pain, sensory loss in a "cape-like" distribution, and progressive weakness of the hands. Magnetic Resonance Imaging (MRI) of the cervical and thoracic spine demonstrated a prominent, hyperintense cervicothoracic syrinx (C2–T2) secondary to adult Chiari malformation type 1 (CM1). Discussion: Initial gabapentin and amitriptyline yielded only partial pain control. Due to progressive lower motor neuron decline and refractory neuropathic pain, surgical intervention was indicated. Although foramen magnum decompression (FMD) remains the primary standard of care for restoring craniocervical CSF flow, a targeted syringo-subarachnoid shunting (SSS) procedure at the T1 level was used as a secondary rescue intervention to achieve rapid mechanical decompression of the massive, tense syrinx. Postoperatively, the patient demonstrated significant neurological improvement, with the Numeric Pain Rating Scale (NPRS) score decreasing from 7–8 to 3–4, alongside gradual motor recovery. Conclusions: Neuropathic pain in syringomyelia is complex and requires a multimodal, multidisciplinary approach. While FMD is the primary gold standard for Chiari I-associated syringomyelia, SSS represents a viable secondary option for rapid mechanical decompression in cases presenting with giant, highly symptomatic syrinxes and progressive motor decline, despite carrying higher long-term revision and complication risks. Keywords: Chiari Malformation, Chronic Pain, Neuropathic Pain, Syringomyelia, Syringo-Subarachnoid Shunt
Co-Authors Abdulloh Machin Baarid Luqman Hamidi Benedictus Benedictus Bernadeta Amaya Muhammad Hafizhan Retnaningsih Retnaningsih Rizaldy Taslim Pinzon Tyasno Koeshermanto