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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)
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.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
Clinical efficacy of bone marrow mesenchymal stem cells in chronic spinal cord injury: A single-arm meta-analysis of clinical trials Wardhana, Dewa Putu Wisnu; Soetomo, Cindy Thiovany; Satyarsa, Agung Bagus Sista; Maliawan, Sri; Mahadewa, Tjokorda Gde Bagus
Physical Therapy Journal of Indonesia Vol. 6 No. 2 (2025): July-December 2025
Publisher : Universitas Udayana dan Diaspora Taipei Medical University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/ptji.v6i2.318

Abstract

Background: Chronic spinal cord injury (SCI) leads to irreversible neurological deficits with limited therapeutic options, making it a major challenge in neuroregenerative medicine. This study aimed to evaluate the clinical efficacy of bone marrow mesenchymal stem cells (BMMSC) therapy in patients with chronic SCI using a single-arm meta-analysis. Methods: This research was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, covering studies up to August 2024 in PubMed, CENTRAL, and ScienceDirect. Included trials applied BMMSC therapy in patients ≥1 year post-injury. A random-effects model was employed using R software. Outcomes included changes in the American Spinal Injury Association (ASIA) impairment scale, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), infralesional voluntary muscle contraction (IVMC), active muscle reinnervation (AMR), and urodynamic parameters. Heterogeneity was assessed with the I² statistic, and study quality was evaluated via ROBINS-I. This study has been registered on PROSPERO with registration number CRD42024577161. Results: Seven studies comprising 133 patients were included. AIS grade improvement was observed in 0.37 (95% CI: 0.24–0.52). Improvements were also seen in SSEP at 0.40 (95% CI: 0.18–0.67), MEP at 0.37 (95% CI: 0.25–0.51), IVMC at 0.47 (95% CI: 0.34–0.60), and AMR at 0.74 (95% CI: 0.39–0.92). Urodynamic outcomes demonstrated increased maximum cystometric capacity [0.48 (95% CI: 0.30–0.67)], improved bladder compliance [0.73 (95% CI: 0.55–0.85)], and reduced detrusor pressure [0.61 (95% CI: 0.43–0.76)]. Conclusion: BMMSC therapy was associated with clinically meaningful neurological and urodynamic improvements in chronic SCI. Standardized administration protocols and randomized controlled trials are necessary to validate efficacy and optimize treatment paradigms.
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)
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.v14i3.692

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.
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 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 Soetomo, Cindy Thiovany Sri Maliawan Thomas Eko Purwata Tjokorda Gde Bagus Mahadewa Veronica, Elvina Widia Danis Swari Xena Laveda Yapanto, Alvian Mohamad