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All Journal Buletin Udayana Mengabdi Jurnal Kesehatan Andalas Jurnal Farmasi Klinik Indonesia Indonesian Journal of Tropical and Infectious Disease MNJ (Malang Neurology Journal) Journal of Medicine and Health Indonesian Journal for Health Sciences (IJHS) Majalah Kedokteran Andalas ISM (Intisari Sains Medis) : Jurnal Kedokteran Al-Iqra Medical Journal : Jurnal Berkala Ilmiah Kedokteran Essential: Essence of Scientific Medical Journal Jurnal Neuroanestesi Indonesia Gema Kesehatan Journal of Medicine and Health
Agung Bagus S. Satyarsa
Fakultas Kedokteran, Universitas Udayana
Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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A Rare Case of Rapidly Progressing Vertex Epidural Hematoma in A Child: Diagnostic Pitfalls and Management Considerations Bangun, Kristian Gerry Raymond Sinarta; Satyarsa, Agung Bagus Sista; Niryana, Wayan
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.661

Abstract

Vertex Epidural Hematoma (EDH) is a rare condition, often caused by injury to the superior sagittal sinus or parietal bone fractures, typically involving diploic veins. It can be associated with sudden death. This case highlights a rapidly progressing vertex EDH in a child within 12 hours, despite initial mild symptoms. A 10-year-old boy sustained a head injury and experienced a 10-minute loss of consciousness. Upon arrival at Ngoerah General Hospital, his Glasgow Coma Scale (GCS) score was E4V5M6, and a head CT showed a small vertex EDH. Conservative management was started. Twelve hours later, the child reported worsening headaches and drowsiness, and his GCS decreased to E3V5M6. A repeat CT scan revealed significant hematoma expansion, prompting emergency surgery. During surgery, a linear fracture of the parietal bone was found, with approximately 60cc of hematoma due to diploic vein rupture. Post-surgery, the patients GCS improved without neurological deficits. As conclusion the Vertex EDH in children, though rare, demands careful monitoring. This case underscores the importance of early reevaluation, prompt imaging, and timely surgical intervention to avoid irreversible neurological damage
Pediatric Spinal Cord Contusion: A Case Report Highlighting Clinical Symptoms and Management Strategies in a 2-Year-Old Patient Chriswidarma, Dewa Gede; Adityawarma, Anak Agung Ngurah Agung Harawikrama; Lauren, Christopher; Satyarsa, Agung Bagus Sista; Suarjaya, I Putu Pramana; Mahadewa, Tjokorda Gde Bagus
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.692

Abstract

Spinal cord injuries (SCI) can be resulted in permanent disability, often caused by high-intensity incidents such as car accidents, falls, and violent crimes. Although relatively rare in children, they can have profound effects. This case report was aimed to elucidate the clinical symptoms of Th1-Th3 spinal contusion in a 2-year-old patient. A 2-year-old boy presented to a private peripheral hospital with complaints of back pain following a traffic accident. The examination revealed complete motor weakness (0/5) in both lower extremities, with preserved sacral sparing. Thoracolumbar MRI demonstrated spinal cord contusion and edema at the level of Th1-Th3. Based on history, physical examination, and supporting tests, the patient was diagnosed with SCI ASIA Impairment Scale B and upper thoracic spinal cord contusion, leading to the decision to perform laminectomy at the Th2-Th3 level. This case underscores the importance of recognizing initial symptoms in spinal cord injury cases and being vigilant for red flags in spinal trauma cases. Prompt initial trauma treatment, such as patient immobilization, is crucial. In this instance, laminectomy decompression was undertaken to address the contusion. A high level of vigilance was required as neurological symptoms could evolve or be initially obscured. Spinal cord injuries often manifest within days of an accident, although they can remain undetected for extended periods. Cord contusions may present with neurological symptoms, necessitating prompt diagnosis via spinal magnetic resonance imaging (MRI) and potential emergency surgical intervention, such as laminectomy.
Mini-Craniectomy for Traumatic for Posterior Fossa Acute Liquid Epidural Hematomas in Paediatric Patient: A Case Report Permana, Padma; Satyarsa, Agung Bagus Sista; Wardhana, Dewa Putu Wisnu
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.697

Abstract

Posterior fossa epidural hematoma (PFEDH) is a rare condition, accounting for only 0.1-0.3% of all traumatic brain injuries. Patients can rapidly deteriorate due to brainstem compression caused by bleeding in the posterior cranial fossa. Timely surgical intervention is critical, but currently, there is no consensus on the surgical indication and technical approach for pediatric PFEDH. Case Presentation: A five-year-old boy presented with occipital trauma, headache, vomiting, and altered consciousness after a fall from a 1-meter height. Primary survey was clear with a Glasgow Coma Scale (GCS) score of E3M6V4 and slow pupillary reflexes while secondary examination revealed a 1x2 cm cephalhematoma over the right posterior fossa region. Head CT scan revealed a posterior fossa liquid epidural hematoma measuring 5.4 x 2.2 x 4cm with cerebellar displacement. The patient underwent a mini-craniectomy and recovered with a relatively short operative duration, minimal blood loss, and a short hospital stay without neurological deficits. Mini-craniectomy emerges as a viable and promising alternative procedure in the management of carefully selected pediatric PFEDH cases, particularly those that are liquid or of moderate volume, allowing for efficient evacuation with minimal surgical morbidity with a good prognostic outcome
Co-Authors Adityawarma, Anak Agung Ngurah Agung Harawikrama Anak Agung Gede Fandhiananta Widyanjaya Bagus Komang Satriyasa Bangun, Kristian Gerry Raymond Sinarta Chriswidarma, Dewa Gede Cindy Liora Driansha Dewa Ngurah Suprapta Dewa Putu Wisnu Wardhana Dewi, Ni Wayan Sucindra Dharmaputra, Gde Arisetyawan Dian Reginalda Kusuma Driansha, Cindy Liora Dwi Kristian Adi Putra Elvina Veronica Elvina Veronica Feliani Sanjaya Gde Adit Putra Deva Gde Arisetyawan Dharmaputra Gede Made Cahya Trisna Pratama Gitari, Ni Made Haikal Hamas Putra Iqra Haikal Hamas Putra Iqra I G. P. Supadmanaba I Gede Rama Pradnyana Anugrahanta I Gusti Ayu Tika Indriani I Gusti Ngurah Sanjaya Putra I Ketut R Ardiana I Komang Weka I Made Jawi I Made Susila Utama I Made Swastika I Nyoman Gede Budiana I Putu Eka Widyadharma I Putu Gede Putra Darmawan I Wayan Gustawan I Wayan Niryana Isnaeni, Aulia Rahma Jefry Gilberth Koibur K.W.M. Kenwa Kadek Tresna Yuwana Krenni Sepa Krenni Sepa L.H. Wirahartato L.P.D. Virayanti Lauren, Christopher Lestari, Khairani Ayu Luh Made Mas Rusyati Made Gede Dwi Lingga Utama Made Swastika Adiguna Made VW Yani Maura Marda Mayang Sari Ni Ketut Sri Diniari Ni Luh Gede Ayu Candranita Dharmadi Ni Made Ari Purwaningrum Ni Made Ari Suryathi Ni Made Gitari Ni Nyoman Ayu Dewi Ni Nyoman Shinta Prasista Sari Ni Wayan Sucindra Dewi P.A.T. Adiputra PAT Adiputra Permana, Padma Prima S. Sudarsa Prima Saraswati Sanjiwani Sudarsa Prima Sudarsa Putu Anda Tusta Adiputra Putu Aryani Putu AT Adiputra Putu Bagus Onicha Baskaranata Putu Dhanu Aryawangsa Putu Gupta Arya Gumilang Putu Gupta Arya Gumilang Putu Pramana Suarjaya Raka-Sudewi A. A. Sang Ayu Arta Suyantari Sanjaya, Feliani Sinta Wiranata Thomas Eko Purwata Tjokorda Gde Bagus Mahadewa Veronica, Elvina Widia Danis Swari Xena Laveda Yapanto, Alvian Mohamad