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All Journal ACTA VETERINARIA INDONESIANA eJournal Kedokteran Indonesia Neurona
Nugroho, Setyo Widi
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Veterinary

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Characteristics of Patients with Carotid-Cavernous Fistula who Underwent Endovascular Intervention Sadewo, Wismaji; Nugroho, Setyo Widi; Tobing, Hanif Gordang; Priyambodo, Affan; Wimbo, Fitrie Desbassarie; Paat, Bipatra Einstein Yacobus
eJournal Kedokteran Indonesia Vol. 12 No. 2 (2024): Vol. 12 No. 2 - Agustus 2024
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.12.822.132

Abstract

Carotid cavernous fistula (CCF) is an abnormal connection between the arterial and venous systems within the cavernous sinus. Direct CCF is usually created from a tear in the intracavernous carotid artery wall. Indirect CCF often develops spontaneously and causes subtle manifestations. Direct CCF, commonly characterized by high blood flow, usually exhibits oculo-orbital venous congestion and cephalic bruit. The low-flow indirect CCF commonly presents with similar manifestations but is more subtle in nature. Generally, direct CCF requires endovascular treatment. This is done to seal the fistula while preserving the patency of the internal carotid artery (ICA). A retrospective descriptive study was conducted on 44 patients with CCF who underwent endovascular intervention at Cipto Mangunkusumo Hospital, Indonesia, between 2014 and 2021. Data from medical records were analyzed to assess patient characteristics, clinical presentations, radiological findings, and treatment modalities.Most patients presented with ocular bruit (74.4%) and proptosis (68.1%), with high-flow (59.1%) and type A (90.9%) CCF being predominant. Endovascular interventions included balloon insertion (80.9%), coil insertion (9.1%), and combined balloon and coil procedures (9.1%). When performed by an experienced interventionist, the success rates of fistula closure could be as high as 85%-99% and 70%-78% for direct and indirect fistula, respectively. CCF is a non-life-threatening condition but can lead to severe clinical consequences. Recognition of characteristics is significant in helping to guide appropriate and timely treatment for patients. Serious complications are rare.
LUARAN PERDARAHAN INTRAVENTRIKEL YANG DILAKUKAN OPERASI DI DEPARTEMEN BEDAH SARAF RSUPN DR. CIPTO MANGUNKUSUMO Sadewo, Wismaji; Amelia, Liza; Tobing, Hanif Gordang; Nugroho, Setyo Widi; Ichwan, Syaiful; Ashari, Samsul
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 1 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i1.45

Abstract

      INTRAVENTRICULAR HEMORRHAGE OUTCOME OPERATED ON NEUROSURGERY DEPARTMENT OF CIPTO MANGUNKUSUMO HOSPITALABSTRACTIntroduction: Intraventricular hemorrhage (IVH) is a spontaneous hemorrhage occurring within the ventricular system, 30-45% often associated with intracerebral hemorrhage (ICH). Evaluating accurate and precise daily activity in post-stroke patients is critical for the quality of care and measurement of post-stroke outcomes. Modified Rankin Scale (mRS) is a global disability measurement scale used for the evaluation of stroke recovery.Aims: Configuring outcome data of patient with intraventricular hemorrhage operated at neurosurgery department of Cipto Mangunkusumo Hospital based on mRS.Methods: A retrospective study with cross sectional design towards patient with intraventricular hemorrhage at neurosurgery department Cipto Mangunkusmo Hospital, Jakarta, between Januari 2019 and August 2016. Subject or family member was interviewed to assess the subject’s functional status 6 month after operation using mRS.Results: There were 23 subjects mostly under 60 years old (60.8%) with 6 months IVH overall outcomes independent (47.8%) based on mRS. Majority of the subjects were admitted in severe condition with IVH score mostly >15 (65.25), mean Glasgow Coma Scale (GCS) 7.6±2.14, and mean arterial pressure >100 (87%) with factor risk for hypertension (82.6%).Discussion: Operation procedure on patient with intraventricular hemorrhage gives a relatively good outcome although with poor baseline at the time of admission.Keywords: Intracerebral  hemorrhage, intraventricular hemorrhage, Modified Rankin ScaleABSTRAKPendahuluan: Perdarahan intraventrikel (intraventricular hemorrhage/IVH) merupakan perdarahan spontan yang terjadi di dalam sistem ventrikel, 30-45% sering berhubungan dengan perdarahan intraserebral (PIS). Evaluasi aktifitas sehari-hari yang akurat dan tepat pada pasien pascastroke sangat penting untuk kualitas perawatan dan pengukuran luaran pascaperawatan stroke. Modified Rankin Scale (mRS) merupakan skala pengukuran disabilitas yang dipakai secara global untuk evaluasi pemulihan dari stroke.Tujuan: Menelaah data luaran penderita perdarahan intraventrikel yang dilakukan operasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo berdasarkan mRS.Metode: Penelitian retrospektif secara potong lintang terhadap pasien dengan perdarahan intraventrikel yang dikelola oleh Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Januari 2010 hingga Agustus 2016. Subjek atau keluarga diwawancara untuk menilai status fungsional 6 bulan pascaoperasi menggunakan mRS.Hasil: Didapatkan 23 subjek yang sebagian besar berusia di bawah 60 tahun (60,8%) dengan luaran 6 bulan yang dalam keadaan independen (47,8%) berdasarkan mRS. Mayoritas subjek masuk dalam keadaan yang buruk dengan skor IVH terbanyak adalah >15 (65,2%), rerata Skala Koma Glasgow (SKG) 7,6±2,14, dan mean arterial pressure >100 (87%), serta memiliki faktor risiko hipertensi (82,6%).Diskusi: Tata laksana operasi pada pasien dengan perdarahan intraventrikel memberikan luaran yang cukup baik, walaupun pasien masuk dalam keadaan yang buruk.Kata kunci: Modified Rankin Scale, perdarahan intraserebral, perdarahan intraventrikel
Method Modification of Developing Ischemic Stroke Animal Models Using Intravenous Catheters in Rats Perdhana, Ika Satya; Handharyani, Ekowati; Darusman, Huda Shalahuddin; Nugroho, Setyo Widi; Maheshwari, Hera; Fitri, Arni Diana
Acta VETERINARIA Indonesiana Vol. 13 No. 1 (2025): Maret 2025
Publisher : IPB University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29244/avi.13.1.67-76

Abstract

In various parts of the world, including Indonesia, the incidence of ischemic stroke remains high, and its impact poses a significant burden. This condition is influenced by numerous limitations in ischemic stroke therapy. Research on ischemic stroke is therefore crucial to develop, making the creation of appropriate animal models a vital necessity. One of the most commonly used methods by researchers to create animal models is the Middle Cerebral Artery Occlusion (MCAO) method. However, in Indonesia, its application remains limited due to the lack of available facilities. Method modifications can be implemented to enable the development of animal models in Indonesia. This study employed modifications to the MCAO method on eight Sprague Dawley rats. The modification involved using an intravenous catheter to facilitate the insertion of the filament as an occluder in the middle cerebral artery of the rats. Based on clinical and pathological observations, it can be concluded that the modified MCAO method used in this study is suitable for creating ischemic stroke animal models. With this modification, the creation of ischemic stroke animal models can be carried out in a simpler and more cost-effective manner.
Luaran Pendekatan Operasi Mikroskopis dan Endoskopik pada Pasien Kraniofaringioma di RSUPN Dr. Cipto Mangunkusumo Ashari, Samsul; Saekhu, Mohamad; Tandian, David; Ray, Laode Maly; Nugroho, Setyo Widi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 4 (2023): Vol 39 No 4 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i4.286

Abstract

ABSTRACTIntroduction: Advances in neurosurgery technology are rising quickly. The Neurosurgery Department RSCM is currently developing minimally invasive surgical technique using transcranial endoscopy. This minimally invasive procedure have been carried out to date. However, the patient's outcome after surgery is not yet known.Aim: Acknowledging the outcome of microscopic and endoscopic surgical approaches in craniopharyngioma patients at dr. Cipto Mangunkusumo Hospital.Methods: This was a retrospective cohort study of craniopharyngioma patients who underwent either endoscopic or microscopic surgery. This study used a consecutive sampling technique, using samples from 2012 to 2021 at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The inclusion criteria were craniopharyngioma patients who were admitted to the hospital for craniotomy tumor removal procedure with an endoscopic or microscopic approach, never had surgery, had diagnosis of craniopharyngioma confirmed by clinical findings and supporting investigation. Exclusion criteria were patients with extracranial problems and endoscopic patients with extensive craniotomy. Demographic data such as age, gender, tumor location, consistency, anatomical pathology results, and history of radiotherapy were recorded. Clinical outcomes were pre- and postoperative complaints, intraoperative bleeding, postoperative complications, and recurrence. Resectability is the size of the tumor pre- and 1-month after surgery. The data were analyzed using SPSS 25.0.Results: Thirty patients were enrolled in this study. A total of 22 subjects (73%) underwent microscopic surgery and 8 subjects (27%) underwent endoscopic surgery. Intraoperative bleeding was found to be significantly smaller on the endoscopic approach than on the microscopic approach (p=0.002). The operation time of endoscopic approach was significantly shorter than microscopic approach (p=0.002). There was no significant difference in pre- and postoperative complaints, postoperative complications, recurrence, resectability and duration of hospitalization in the endoscopic approach compared to the microscopic approach in the management of craniopharyngioma patients.Conclusion: Transcranial endoscopic approach in craniopharyngioma patients has good potential as an option for surgical management of craniopharyngioma patients.Keywords: Craniopharyngioma, Transcranial Endoscopy, Microscopy
Co-Authors David Tandian David Tandian,* Muhammad Harisyah,* Hanif Gordang Tobing,* Samsul Ashari,* Renindra Ananda Aman,* Sy Ekowati Handharyani Fitri, Arni Diana HERA MAHESHWARI Huda Shalahudin Darusman Liza Amelia Mohamad Saekhu Paat, Bipatra Einstein Yacobus Perdhana, Ika Satya Priyambodo, Affan Ray, Laode Maly Sadewo, Wismaji SAMSUL ASHARI, SAMSUL Syaiful Ichwan Wimbo, Fitrie Desbassarie