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All Journal Indonesian Journal of Cancer Paediatrica Indonesiana Neurologico Spinale Medico Chirurgico Indonesian Journal of Cancer Neurona
Samsul Ashari
Department Of Neurosurgery Faculty Of Medicine Universitas Indonesia - RSUP Nasional Dr. Cipto Mangunkusuma
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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PERBEDAAN NILAI LEUKOSIT PRA- DAN PASCAOPERASI SEBAGAI PREDIKTOR LUARAN FUNGSIONAL PERDARAHAN INTRASEREBRAL SPONTAN Hanif Gordang Tobing; Bismo Nugroho PPR; Mohamad Saekhu; Setyo Widi Nugroho; Affan Priyambodo; Wismaji Sadewo; Syaiful Ichwan; Renindra Ananda Aman; David Tandian; Samsul Ashari
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.68

Abstract

          DIFFERENCES BETWEEN PRE- AND POST-SURGERY LEUKOCYTE COUNTS AS FUNCTIONAL OUTCOME PREDICTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Hematoma in spontaneous intra-cerebral  hemorrhage (SICH) results inflammation due to secondary brain injury. Leukocyte, an inflammation indicator which is routinely examined, known as an outcome predictor in non- operated SICH. The role of inflammation in operated SICH is still unknown, however, pre- and post-surgery leukocyte counts can be a marker of brain tissue damage (brain injury).Aim: This study investigated the characteristics of leucocyte parameters in operated SICH patients and its correlation to functional outcome based on Glasgow Outcome Scale (GOS).Methods: This was a retrospective cohort study for SICH patients who underwent surgery at Department of Neurosurgery in Dr. Cipto Mangunkusumo National General Hospital from January 2012–March 2017. This study analyzed the association between pre-operative leucocyte level with age, pre-operative GCS, hemorrhage volume, length of hospitalization, and  six-month post-operative GOS. The correlation of differences of pre-operative and one-day post- operative leucocyte counts with six-month post-operative GOS and hematoma evacuation percentage were analyzed. The analysis was done using Pearson correlation test, Spearman, Chi-square χ2 test, Fisher exact test, and Anova test.Results: There was a significant correlation  between differences of leukocyte counts in pre- and post-surgery with GOS. A higher post-surgery leukocyte difference would lower GOS; there was a significant correlation between the leukocytes counts in pre-operative leucocyte and GCS. A higher pre-operative leukocytes counts would lower the GCS.Discussion: The differences of pre-operative and post-operative leucocyte counts is a functional outcome predictors within 6 months in operated SICH patients.Keywords: Leukocyte, outcome, spontaneous intracerebral hemorrage, surgeryABSTRAKPendahuluan: Hematoma pada perdarahan intraserebral spontan (PISS) menyebabkan inflamasi akibat cedera otak sekunder. Leukosit sebagai indikator inflamasi yang rutin diperiksa, diketahui memiliki peranan sebagai prediktor luaran pada PISS yang tidak dioperasi. Sejauh ini belum diketahui peranan inflamasi pada PISS yang dioperasi, namun kadar leukosit pra- dan pascaoperasi dapat menjadi penanda adanya kerusakan jaringan otak (brain injury).Tujuan: Untuk mengetahui karakteristik parameter leukosit pasien PISS yang dioperasi dan kaitannya dengan luaran fungsional berdasarkan skor Glasgow Outcome Scale (GOS).Metode: Studi kohort retrospektif pada pasien PISS yang dioperasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2012-Maret 2017. Dilakukan analisis antara nilai leukosit praoperasi dengan usia, GCS praoperasi, volume perdarahan, lama rawat inap, dan skor GOS 6 bulan pascaoperasi. Dilakukan analisis perbedaan nilai leukosit praoperasi dibandingkan hari pertama pascaoperasi dengan skor GOS 6 bulan pascaoperasi dan persentase evakuasi hematoma. Analisis dilakukan menggunakan korelasi Pearson, Spearman, uji Chi-square χ2  test, Uji Fisher exact test, dan Anova.Hasil: Pada uji statistik didapatkan korelasi bermakna antara perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi dengan skor GOS. Semakin tinggi nilai perbedaan leukosit pascaoperasi akan menurunkan skor GOS; didapatkan korelasi bermakna antara leukosit praoperasi dengan GCS praoperasi. Semakin tinggi leukosit praoperasi, semakin rendah GCS.Diskusi: Perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi merupakan prediktor luaran fungsional dalam 6 bulan pada pasien perdarahan intraserebral spontan yang dioperasi.Kata kunci: Leukosit, luaran, operasi, perdarahan intraserebral spontan 
PASCAOPERASI ADENOMA HIPOFISIS: HUBUNGAN ANTARA DURASI AWITAN DENGAN LUARAN KLINIS VISUS DAN LAPANG PANDANG Renindra Ananda Aman; Reki Setiawan; Retno Asti Werdhani; Samsul Ashari; David Tandian; Syaiful Ichwan; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 37 No 3 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.161

Abstract

Introduction: Pituitary adenomas can cause decrease of visual acuity (VA), narrowing visual field (VF). Several studies have showed that the duration of complaints were related significantly with clinical outcomes. As a national referral center hospital, all pituitary adenoma patients who came to our institution were referred from ophthalmologists, neurologists, and neurosurgeons from other institutions. Aim: In this study, we investigated the relationship between duration, which is calculated from the time of symptoms first appeared to the time of surgery, and outcome (VA and VF) in pituitary adenoma patients who underwent transsphenoidal surgery. Methods: A retrospective design was used on pituitary adenoma patients that underwent transsphenoidal surgery between 2015-2017 in Cipto Mangunkusumo Hospital. The duration between symptoms’ onset and surgery was calculated in months. VA and VF examinations were performed 1 day before surgery and within 1 to 2 months postoperatively. Results: There were 71 patients (36 male, 35 female) with decreased VA and narrowed VF, with a median age of 42 years (20-77 years). The median length of duration of onset for both symptoms was 12 months (1-108 months). 40.5% patients had improved VA postoperatively, with median duration of onset of 11 months. Improvement in VF was experienced in 67.6% patients, with median duration of onset of 12 months. Discussion: There was a statistically significant relationship between the duration of onset and the VF outcomes. Improvements in the VF were found in patients who underwent surgery up to 12 months after the time of onset. Keywords: Pituitary adenoma, transsphenoidal surgery, visual acuity, visual field
EVALUASI TAJAM PENGLIHATAN DAN INDEKS PROPTOSIS PASIEN MENINGIOMA SPHENOORBITA PASCAOPERASI KRANIEKTOMI Renindra Ananda Aman; Ryan Rhiveldi Keswani; Syaiful Ichwan; Samsul Ashari; Setyo Widi Nugroho
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.171

Abstract

Introduction: Sphenoorbital meningioma (SOM) is an exophytic tumor mass that infiltrates the bone at the sphenoid wing, lateral orbital walls, orbital roofs, and extends to superior orbital fissures. The classic triad of clinical features are proptosis, decreased visual acuity, and ophthalmoplegia. The outcomes of our postoperative patients have not been evaluated before. Aim: We would like to evaluate the clinical characteristics of the sphenoorbital menigioma patients before and after surgery. Methods: A cross sectional study was performed. Subjects were patients with sphenoorbital meningiomas who came to Cipto Mangunkusumo General Hospital from January 2014 through December 2015. All patients underwent craniectomy and lateral orbitotomy. We evaluated the visual acuity using the Snellen chart and proptosis index before and after surgery by measuring the protuded eye in an axial CT scan. Results: There were 66 samples in this study, and 65 of the samples were females. The age range is from 31 to 64 years. The mean proptosis index of preoperative is 18.27 and the post operative is 16.43. The mean proptosis index reduction is 1.84. Post operative visual acuity was improved only in 3 (9.7%) samples. Discussion: Sphenoorbital meningioma patients after surgery were shown markedly improvement in the proptosis index. However, the visual acuity was not markedly improved after surgery. Keywords: Proptosis index, sphenoorbital meningioma, visual acuity
KOMPLIKASI VENTRIKULOPERITONEAL SHUNT PADA PASIEN PEDIATRIK USIA 0-2 TAHUN DI RUMAH SAKIT UMUM PUSAT NASIONAL DR CIPTOMANGUNKUSUMO Samsul Ashari; Bhayu Rizallinoor; Hilman Mahyudin; Moh. Saekhu; Renindra Ananda Aman; David Tandian; Abdi Reza; Setyo Widi Nugroho
NEURONA Vol 38 No 2 (2021)
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Abstract

Introduction: Ventriculoperitoneal shunt is the procedure of choice in the management of hydrocephalus. However,the ventriculoperitoneal shunt procedure also carries a risk of complications. In Indonesia, data on the incidence andprevalence of ventriculoperitoneal shunt complications have not been obtained.Aim: In this study, we examined the complications of shunts and the factors associated with the duration of timeMethods: This study is a retrospective study of pediatric patients aged 0-2 years with hydrocephalus who underwentventriculoperitoneal shunt surgery for the first time at Cipto Mangunkusumo Hospital in 2015-2020 and e????periencedcomplications. The duration of time the complications occurred was divided into before and after six months. Demographicdata, clinical data, and types of complications were analyzed descriptively.Result: From ????anuary 2015 to March 2020 at Cipto Mangunkusumo Hospital, 168 ventriculoperitoneal shuntoperations were performed at 0-2 years. It was found that 20 patients (12%) e????perienced complications with a duration offewer than si???? months by ????.8% and more than si???? months by 4.2%. The total complications that occurred were mechanicalcomplications (????.2%), infection (3.6%), and over drainage (1.2%).Discussion: The percentage of complications of ventriculoperitoneal shunt in patients aged 0-2 years at CiptoMangunkusumo Hospital, in the first si???? months was ????.8%, with the highest incidence was infection (3.6%) which waslower than the literature, while the percentage of complications of ventriculoperitoneal shunts which more than six monthswere 4.2% and caused mainly by distal malfunction (3%).Keywords: aged 0-2 years, complications, pediatric, ventriculoperitoneal shunt
RASIO NEUTROFIL LIMFOSIT SEBAGAI PREDIKTOR LUARAN KASUS CEDERA KEPALA SEDANG DAN BERAT: STUDI MULTISENTER Hanif Gordang Tobing; Yovanka Naryai Manuhutu; Syaiful Ichwan; Renindra Ananda Aman; Setyo Widi Nugroho; Samsul Ashari; David Tandian; Mohammad Saekhu; Wismaji Sadewo; Affan Priyambodo; Kevin Gunawan; Ande Fachniadin
NEURONA Vol 38 No 3 (2021)
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Abstract

Introduction: Traumatic brain injury (TBI) is the most common cause of death in populations less than 40 years old in developed and developing countries. The clinical outcome after TBI is still an issue and difficult to predict. Besides Glasgow Coma Scale (GCS), neutrophil to lymphocyte ratio (NLR) as one of the neuroinflammation biomarkers also can predict outcomes after TBI Aim: To measure the association between NLR and GCS as predictors of moderate and severe TBI outcomes. Methods: This prospective study included moderate and severe TBI patients who underwent craniotomy in a multicenter hospital from November 2019 to November 2020. Chi-square analytic test was used to determine the relationship between demographics, clinical symptoms, NLR and GCS as predictors outcome of moderate and severe TBI. Results: About 54 patients with moderate and severe TBI consist of 41 (75.9%) male and 13 (24.1%) female patients, mean age 27.6 ± 15.3 years, preoperative GCS is 13 (7 - 13), with asymmetric pupil 33 (61.1%), seizures 5 (9.3%), hemiparesis 1 (1.86%), and GCS postoperative on the fifth and seventh day is 14 (6 - 15). Preoperative NLR was 7.4 (1.9-26.2), the cut-off for NLR as a predictor for improved GCS was at 9.8 with a specificity and sensitivity of 87%. Discussion: Low NLR had an association with the patient’s improved GCS, while a high NLR had an association with a non-improving GCS, so that the relationship between RNL and GCS could be used as an outcome predictor of moderate and severe traumatic brain injury patient. Keywords: glasgow coma scale, neutrophil to lymphocyte ratio, predictor, traumatic brain injury
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)
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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
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)
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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 Abdi - Reza Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Ande Fachniadin Aryandhito Widhi Nugroho Bhayu Rizallinoor Bismo Nugroho Bismo Nugroho PPR David Tandian Eka Susanto Eka Susanto HILMAH MAHYUDDIN HILMAH MAHYUDDIN, HILMAH Hilman Mahyuddin Hilman Mahyudin Ina S. Timan Jeremia Prasetya Pardede Jeremia Prastya Pardede Kevin Gunawan Liza Amelia M RADHIAN ARIEF M RADHIAN ARIEF, M RADHIAN Martin Susanto Moh. Saekhu Mohamad Saekhu Mohammad Saekhu Muhammad Harisyah Nugroho, Setyo Widi Nugroho, Setyo Widi Padmo Santjojo Ray, Laode Maly Reki Setiawan Renindra A Aman Renindra A. Aman Renindra A. Aman Renindra Ananda Aman Retno Asti Werdhani Ryan Rhiveldi Keswani Sadewo, Wismaji Setyo Handryastuti Setyo W. Nugroho Syaiful Ichwan Yovanka Naryai Manuhutu Yulius Seno Nugroho