Samsul Ashari
Department Of Neurosurgery Faculty Of Medicine Universitas Indonesia - RSUP Nasional Dr. Cipto Mangunkusuma

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Skull Ganglioneuroblastoma: A Case Report ARIEF, M RADHIAN; ASHARI, SAMSUL; MAHYUDDIN, HILMAH
Indonesian Journal of Cancer Vol 4, No 2 (2010): Apr - Jun 2010
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Ganglioneuromas and ganglioneuroblastomas are tumors of the sympathetic nervous system that originate from neural crest sympathogonia, which are completely undifferentiated cells of the sympathetic nervous system. Along with neuroblastomas, ganglioneuromas and ganglioneuroblastomas are collectively known as neuroblastic or neurogenic tumors. Ganglioneuroblastoma is an intermediate tumor, a tumor that is between benign (slow-growing and unlikely to spread) and malignant (fast-growing, aggressive, and likely to spread). We report a rare case of skull ganglioneuroblastoma in a 4 months old child who came with a progressive increasing mass volume in the forehead. No other neurologic deficit was found. Serial Brain CT Scan was performed and showed progressive increasing of the mass volume. Comprehensive management was carry out for this patient.
Brain Metastasis ashari, samsul
Indonesian Journal of Cancer Vol 4, No 5 (2010): Workshops 2010
Publisher : "Dharmais" Cancer Center Hospital

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Brain Metastasis Full text : http://www.scribd.com/doc/43593814/Brain-Metastasis
Is there any benefit from surgery for giant-dumbbell spinal tumors with prolonged paraplegia and joints contractures? a rare case report Mohamad Saekhu; Eka Susanto; Samsul Ashari; Setyowidi Nugroho
Neurologico Spinale Medico Chirurgico Vol 5 No 1 (2022)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v5i1.174

Abstract

The lack of clarity about the opportunities for significant neurologic improvement, coupled with the risk of severe postoperative complications, decompression surgery for patients with giant tumors in the cervical spine accompanied by long-lasting advanced neurological deficits places a heavy moral burden on surgeons. Here we report a three-year follow-up after surgery for an immense spinal neurofibroma in which the patient was bedridden for the past fifteen years. Our findings suggest surgery remains beneficial for patients without major postoperative complications.
Cervical Myelopathy as the Most Common Symptoms in Patients Undergoing C-Spine Surgery in the Spine Division, Department of Neurosurgery, Cipto Mangunkusumo General Hospital, from January 2012 to December 2016 Mohamad Saekhu; Jeremia Prasetya Pardede; Renindra Ananda Aman; Syaiful Ichwan; Wismaji Sadewo; Samsul Ashari; Setyowidi Nugroho
Neurologico Spinale Medico Chirurgico Vol 1 No 1 (2018)
Publisher : Indoscholar

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Abstract

Background: Cervical spine disease has the potential to reduce productivity in affected patients because of myelopathy and mood disorder (e.g. depression) which lead to decreasing of the patient’s quality of life.Objective: This study aims to elaborate on the most frequent symptoms and pathology of C-spine disease in patients who underwent a surgical procedure over the period time from January 2012 to December 2016.Method: This study is a retrospective. All patients who underwent surgery for the C-spine disease are included. The data was obtained from the records in our spine database.Result: The total number of surgical procedures for spine disease over the 5 years was 345 procedures, with 127 procedures in the C-spine which are the second most common procedures of spine surgery in Department of Neurosurgery FMUI. The C-spine diseases were more common in males, aged more than 50 years old. The most frequent disease or pathology is a degenerative disease, and yet, tumour cases show an increasing number and became the most common pathology in the year of 2016. The most common procedure is anterior cervicaldiscectomy and fusion (ACDF).Conclusion: Our study showed that the most common symptoms and pathology are myelopathies and degenerative disease respectively, which has similarity with another study in the term of the mostfrequent pathology and surgical procedure. The finding of the more advanced neurological condition by the time of surgery as the most common symptom is found to be contradictory with other studies in western countries.
THE TREND AND PROFILE OF THE THORACIC SPINE SURGERY IN NEUROSURGERY DEPARTMENT FACULTY OF MEDICINE UNIVERSITAS INDONESIA – RSUP NASIONAL DR. CIPTO MANGUNKUSUMO 2012 – 2016 Muhammad Saekhu; Bismo Nugroho; Samsul Ashari; Renindra A Aman; Hanif G Tobing; Setyowidi Nugroho
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
Publisher : Indoscholar

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Background: Spinal surgery, in general, is increasing in number. The most frequent pathology is degenerative disease, and the most common segment is cervical and lumbar. However, there is limited information concerning the thoracic spine surgeries.Objective: The aim of this study is to describe the trend and profle of the thoracic spine (T-spine) surgeries in the Department of Neurosurgery Faculty of Medicine Universitas Indonesia – RSUP Dr.Cipto Mangunkusumo from 2012 to 2016.Method: This is a retrospective study including all patients who were undergoing T-spine surgery during the period of study from January 2012 to December 2016. The number of T-spine procedureswas recorded and plotted in the trend graph. The data consisting age, gender, indication and procedure of T-spine surgery, and duration of hospital stay were recorded from medical records.Result: In the last fve years, there was an increasing trend of T-spine surgery. A total of 68 surgeries for T-spine performed with 35 female and 33 male subjects. Majority of subjects were aged 41 to 50 years old (28%), with an indication of surgery due to tumours (68%). As many as 76% T-spine surgery was carried out non-instrumented. Duration of hospital stay was 9-13 days.Conclusion: Productive age is the most common age undergoing T-spine surgeries. A spinal tumour is the most frequent indication of the T-spine surgeries
Tethered Cord Syndrome Samsul Ashari
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
Publisher : Indoscholar

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Abstract

Tethered cord syndrome (TCS) is a clinical condition of various origins, which comprises of progressive neurological, urological, and orthopaedic dysfunction, because of congenital fixation or tethering of the distal spinal cord by the terminal filum. It is believed that, if the filum elasticity is compromised by either fatty infiltration or abnormal thickening, the spine movement may cause stress upon the conus, resulting in TCS. Patients with symptomatic TCS can present with a wide variety of signs and symptoms in combination with cutaneous, orthopaedic, spinal, anorectal, and urological abnormalities. The common clinical presentations include the presence of cutaneous signs associated with open septal defects, neurogenic bladder with incontinence or urinary tract infection, leg or foot weakness, numbness and/or spasticity, differences in leg or foot length, deformities of the foot, spinal deformities, and back and leg pain. Neuroimaging is used to confirm when there is suspicion of TCS. Magnetic resonance imaging is the modality of choice in visualizing the level of the conus medullaris and for identifying a thickened and/or fatty filum. The fundamental goals of surgical intervention in TCS are to prevent future deficits in the asymptomatic patient and to improve or stabilize deficits in the symptomatic patient. These two goals are based on the fact that sectioning of the terminal filum can be done safely with minimal risk and a very low rate of morbidity. The reported complications of surgery are cerebrospinal fluid leakage (most common), wound infection, meningitis, bladder dysfunction, and neurological injury.
Skull Ganglioneuroblastoma: A Case Report M RADHIAN ARIEF; SAMSUL ASHARI; HILMAH MAHYUDDIN
Indonesian Journal of Cancer Vol 4, No 2 (2010): Apr - Jun 2010
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v4i2.92

Abstract

Ganglioneuromas and ganglioneuroblastomas are tumors of the sympathetic nervous system that originate from neural crest sympathogonia, which are completely undifferentiated cells of the sympathetic nervous system. Along with neuroblastomas, ganglioneuromas and ganglioneuroblastomas are collectively known as neuroblastic or neurogenic tumors. Ganglioneuroblastoma is an intermediate tumor, a tumor that is between benign (slow-growing and unlikely to spread) and malignant (fast-growing, aggressive, and likely to spread). We report a rare case of skull ganglioneuroblastoma in a 4 months old child who came with a progressive increasing mass volume in the forehead. No other neurologic deficit was found. Serial Brain CT Scan was performed and showed progressive increasing of the mass volume. Comprehensive management was carry out for this patient.
Spinal dermal sinus coinciding with an infected giant epidermoid cyst in an infant presenting with constipation: a case report Mohamad Saekhu; Eka Susanto; Setyo Handryastuti; Samsul Ashari; Setyowidi Nugroho
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.357-63

Abstract

Early diagnosis of spinal tumors is a prerequisite for achieving satisfactory neurological recovery. However, rare diseases tend to have a long diagnostic course.1 In addition, the clinical presentation of spinal tumors in most children is not apparent, moreover, spinal tumors may not show clinical symptoms if they are located in the lumbar spine and sized no more than one vertebra.2,3 Clinical presentations caused by tumors in the lumbar spine may include weakness of both limbs, impaired urination, and constipation.
KADAR FIBRINOGEN SEBAGAI FAKTOR PROGNOSTIK PASIEN PERDARAHAN INTRASEREBRAL SPONTAN David Tandian; Muhammad Harisyah; Hanif Gordang Tobing; Samsul Ashari; Renindra Ananda Aman; Syaiful Ichwan; Mohamad Saekhu; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.29

Abstract

         FIBRINOGEN VALUE AS PROGNOSTIC FACTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Spontaneous intracerebral haemorrhage (SIH) refers as spontaneous bleeding in the brain paren- chyma due to injury of blood vessels. Thus causing tissue inflammatory and coagulation reaction, activating the release of fibrinogen. Fibrinogen, an active substrate of coagulation cascade, also considered as the most powerful indicator of acute inflammatory response in SIH. Elevated levels of fibrinogen may be the marker for the increasing degree of brain tissue damage.Aims: Determine the correlation of fibrinogen levels with outcomes of patients with SIH who went on operative procedures.Methods: The study was conducted in Dr. Cipto Mangunkusumo hospital and its affiliation hospitals from January until August 2017. Total sampling was conducted. Preoperative Glasgow Coma Scale (GCS), blood volume, preoperative and postoperative serum fibrinogen values, and modified Rankin Scale (mRS) data were obtained and analyzed using the Spearman correlation test.Results: Significant correlation were found between the preoperative and postoperative fibrinogen with mRS score. Positive correlation coefficients were shown in both parameters, whereas the increase of preoperative and postoperative fibrinogen would increase the mRS score.Discussion: Pre and postoperative fibrinogen value showed significant association with mRS score, thereby they could be considered as prognostic predictive factors. However, because of the limited number of subject of this study to fulfill the criteria of validity study, a future study with a larger scale should be carried out.Keyword: Fibrinogen, mRS, outcome, spontaneous intracerebral haemorrhageABSTRAKPendahuluan: Perdarahan intraserebral spontan (PISS) adalah perdarahan spontan pada parenkim otak akibat kerusakan pembuluh darah pada jaringan otak. Kerusakan tersebut menimbulkan reaksi inflamasi jaringan dan koagulasi yang mengaktivasi pelepasan fibrinogen. Fibrinogen merupakan substrat aktif kaskade koagulasi yang juga merupakan penanda paling kuat respons akut inflamasi pada PISS. Adanya peningkatan kadar fibrinogen dapat menggambarkan peningkatan derajat kerusakan jaringan otak.Tujuan: Mengetahui korelasi kadar fibrinogen dengan luaran pasien dengan PISS yang dilakukan tindakan operatif.Metode: Penelitian dilakukan di RSUPN Dr. Cipto Mangunkusumo dan rumah sakit jejaring pendidikan dalam periode Januari–Agustus 2017. Sampel diambil dengan total sampling, data yang diambil adalah, Glasgow Coma Scale (GCS) preoperasi, volume perdarahan, kadar fibrinogen serum preoperasi dan pascaoperasi, dan modified Rankin Scale(mRS), kemudian dianalisis dengan tes Spearman correlation.Hasil: Dari uji statistik didapatkan hasil bermakna antara fibrinogen preoperasi mau pun pascaoperasi dengan skor mRS. Koefisien korelasi, menunjukkan korelasi positif pada keduanya, dimana peningkatan fibrinogen preoperasi dan pascaoperasi akan meningkatkan skor mRS.Diskusi: Fibrinogen pre dan pascaoperasi sebagai faktor prediksi prognostik memiliki hubungan bermakna dengan skor mRS. Namun dengan jumlah sampel penelitian yang masih belum mencukupi untuk memenuhi kriteria validitas untuk dapat diajukan sebagai faktor yang bersifat pasti, diperlukan penelitian lebih lanjut dengan sampel yang lebih besar.Kata kunci: Fibrinogen, luaran, mRS, perdarahan intraserebral spontan
INTENSITAS MIELUM PADA GAMBARAN MRI SERVIKAL SEBAGAI FAKTOR PROGNOSTIK LUARAN CERVICAL SPONDYLOSIS MYELOPATHY PASCAOPERASI Mohamad Saekhu; Jeremia Prastya Pardede; Renindra Ananda Aman; Hanif Gordang Tobing; Samsul Ashari; David Tandian; Syaiful Ichwan; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.30

Abstract

         MYELUM INTENSITY ON MRI CERVICAL AS PROGNOSTIC FACTORS IN CERVICAL SPONDYLOSIS MYELOPATHY PATIENTSABSTRACTIntroduction: Cervical spondylosis myelopathy (CSM) is a stenosis condition in cervical canal due to the cervical structural changes that compress the myelum, thus causing spinal medulla ischemia. Other than clinical factors, myelum intensity changes on MRI T1-weighted images (T1W1) and T2W1 might be useful to predict the pos-operative outcome.Aims: Identify prognostic factors in post-operative patients with CSM based on clinical symptoms and myelum intensity on cervical MRI.Methods: Retrospective study on CSM patients who underwent surgery in Neurosurgery Department, Cipto Mangunkusumo hospital, Jakarta, from January 2013 to December 2016. Magnetic resonance imaging data was obtained before the surgery, while clinical symptoms were assessed by Nurick scale before and 1 year after the surgery to evaluate outcome.Results: There were 50 subjects included in this study with mean age 51.98±9.64 years, majority male (76%), have moderate myelopathy (Nurick scale pre-operative ≤2), and time between onset and surgery mostly ≤1 year (80%). Most subject (88%) had improvement clinically, but mostly without hypointensity on cervical T1W1 MRI.Discussion: Myelum hypointensity in cervical MRI is associated with poor outcome in CSM post-surgery patients.Keywords: Cervical spondylosis myelopathy, MRI, myelum hypointensity, Nurick scaleABSTRAKPendahuluan: Cervical spondylosis myelopathy (CSM) merupakan suatu kondisi stenosis kanal servikal akibat adanya perubahan struktur servikal yang menyebabkan kompresi mielum, sehingga timbul iskemia medula spinalis. Selain faktor-faktor klinis, perubahan intensitas mielum pada MRI T1-weighted images (T1W1) dan T2W1 dapat dijadikan modalitas untuk memprediksi luaran pascaoperasi.Tujuan: Mengidentifikasi faktor prognosis luaran pasien CSM pascaoperasi berdasarkan gejala klinis dan intensitas mielum pada gambaran MRI servikal.Metode: Penelitian retrospektif terhadap penderita CSM yang dilakukan operasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Januari 2013 hingga Desember 2016. Dilakukan penilaian klinis dan gambaran MRI awal, serta luaran 1 tahun pascaoperasi menggunakan skor Nurick.Hasil: Terdapat 50 subjek dengan rerata usia 51,98±9,64 tahun, terutama laki-laki (76%), memiliki derajat mielopati ringan (skor Nurick preoperasi ≤2), dan jarak antara onset dengan waktu operasi ≤1 tahun (80%). Sebagian besar subjek (88%) mengalami perbaikan skor pascaoperasi yang mayoritas (95,4%) tidak didapatkan gambaran hipointesintas pada T1W1 MRI servikal.Diskusi: Hipointensitas mielum pada MRI servikal merupakan faktor prognosis luaran buruk pascaoperasi pada pasien CSM.Kata kunci: Cervical spondylosis myelopathy, hipointens, mielum, MRI, skala Nurick