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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Acta Neurologica Indonesia
Mesiano, Taufik
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Spinal Cord Compression Due to Intradural Extramedullary Hematopoiesis in a Young Adult with Cooley’s Anemia Mesiano, Taufik; Rasyid, Al; Kurniawan, Mohammad; Hidayat, Rakhmad; Pangeran, David; Lubis, Anna Mira; Saekhu, Mohamad; Gunawan, Kevin; Putri, Stefanie Karina; Rahmana, Arizari Haj; Harris, Salim
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.4

Abstract

Cooley's anemia, also known as beta thalassemia major, is an inherited multisystemic disorder characterized by skeletal and non-skeletal complications resulting from hemoglobinopathies. Extramedullary Hematopoiesis (EMH) is a complication of thalassemia major due to insufficient erythropoiesis expansion. The incidence rate of paraspinal EMH in beta-thalassemia is rare but tends to be on the rise. We present a case of spinal cord compression due to intradural EMH in a 21-year-old man with Beta Thalassemia major, who exhibited acute lower motor, sensory, and autonomic disorder, along with severe anemia, and electrolyte imbalance. Patients were treated with corticosteroids, blood transfusions, electrolyte correction and pain medications. Several days later, the patient experienced clinical improvement in reduced pain and motor improvement. The patient was planned to undergo elective surgery and radiotherapy after reaching the stabilized condition. Management options of spinal cord compression due to EMH include corticosteroids, adequate blood transfusion, hydroxyurea, radiotherapy, surgical decompression, exchange transfusion, or a combination of these approaches. The choice of therapy should be based on the patient's clinical condition, diagnostic evaluations, and the size of the mass exerting pressure on the spinal cord. The optimal management of EMH remains uncertain. We need further research to establish effective treatment strategies of spinal cord compression due to EMH in Cooley’s Anemia.
Nosocomial COVID-19 Infection in Acute Neurological Diseases at the Indonesian National Referral Hospital Mesiano, Taufik; Tunjungsari, Dyah; Budikayanti, Astri; Ramli, Yetty
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.6

Abstract

Introduction: Neurological diseases elevate the susceptibility to respiratory tract ailments. This study aims to evaluate the incidence of nosocomial coronavirus disease 2019 (COVID-19) among non-COVID neurology inpatients and identify associated risk factors. Objective: To assess nosocomial COVID-19 infection in non-COVID neurology inpatients and identify associated risk factors. Material and Methods: A prospective cohort study was conducted during the initial wave of the COVID-19 pandemic, encompassing all non-COVID neurology inpatients at Dr. Cipto Mangunkusumo Hospital from May to September 2020. Clinical data were collected, and bivariate and multivariate analyses were employed to examine risk factors. Result and Discussion: Among 308 subjects, 31 (10.6%) experienced nosocomial COVID-19 infection. Suspect cases constituted 77.4%, probable cases 16.1%, and confirmed cases 6%. Predominant neurological diseases included cerebrovascular disease (36.7%), CNS neoplasm (18.8%), and traumatic brain injury (15.6%). Comorbid diseases increased the infection risk by 6.53 times (95% CI 1.52-28.0), particularly non-CNS malignancy (12.37, 3.7-41.00), chronic pulmonary TB (12.29, 2.7-55.89), and hypertension (3.8, 1.3-11.4). Loss of consciousness and nasogastric tube (NGT) usage elevated the risk by 2.92 (1.37-6.21) and 4.68 (1.95-11.24) times. This study reinforces existing evidence that hospitalized patients with neurological diseases are more susceptible to COVID-19, particularly due to loss of consciousness and NGT usage. The risk is amplified with comorbidities such as non-CNS malignancy, chronic pulmonary TB, and hypertension. Conclusion: Individual neurological diseases alone did not heighten the risk of COVID-19 infection. Notably, factors like loss of consciousness, NGT usage, and comorbid diseases significantly correlate with nosocomial COVID-19 infection in non-COVID neurology inpatients.
Hemorrhagic Stroke as the Manifestation of Neuropsychiatric Systemic Lupus Erythematosus Kurniawan, Mohammad; Nurdin, Ilham; Rasyid, Al; Mesiano, Taufik; Hidayat, Rakhmad; Harris, Salim
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.8

Abstract

Stroke is a major cause of mortality and disability. It can be classified into ischemic stroke and hemorrhagic stroke. Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease that can cause neuropsychiatric systemic lupus erythematosus (NPSLE) complications, one of those manifests as stroke, which happens often in young adults. Ischemic stroke is more common in SLE patient, but hemorrhagic stroke can also ensue. We present a case of SLE in a young woman with left-sided hemiparesis and convulsion. After undergoing clinical evaluation, laboratory testing, and radiological imaging, she was diagnosed with hemorrhagic stroke. She was treated conservatively; blood pressure control, steroid administration to improve the condition, and anticonvulsants.
Optimizing Stroke Care in Indonesia: A Policy Brief on Expanding Access to Thrombolysis for Improved Outcomes Hidayat, Rakhmad; Rima, Siti Pujiwati Permata; Pangeran, David; Mesiano, Taufik; Kurniawan, Mohammad; Rasyid, Al; Harris, Salim
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.12

Abstract

Recurrent Intracerebral Hemorrhage as a Result of Cerebral Amyloid Angiopathy Kurniawan, Mohammad; Lestari, Dhara Ayu; Harris, Salim; Rasyid, Al; Mesiano, Taufik; Hidayat, Rakhmad
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.13

Abstract

Stroke is a major health problem in the world with high mortality dan morbidity rate. Hemorrhagic stroke is a type of stroke with a high mortality rate. One of the most common causes of hemorrhagic stroke in elderly is cerebral amyloid angiopathy. We present a case of recurrent hemorrhagic stroke with clinical manifestations of extremity weakness and seizure. Radiological imaging showed a lobar hemorrhage. Referring to the Boston criteria, based on the results of clinical evaluation and imaging, the patient was diagnosed with intracerebral hemorrhage et causa probable CAA without pathologic feature was established. Patients were treated with antihypertensive medicine for blood pressure control and steroid as anti-inflammatory agents with a good clinical and functional outcome.
Rekomendasi Sistem Stroke Pendekatan 8D dalam Penanganan Stroke Iskemik Akut Permana, Affan Priyambodo; Nafisah, Zharifah Fauziyyah; Mesiano, Taufik; Yunus, Reyhan Eddy; Sulistio, Septo; Habib, Hadiki; Mulyana, Radi Muharris; Albar, Imamul Aziz
Majalah Kedokteran Indonesia Vol 71 No 1 (2021): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.71.1-2021-162

Abstract

Stroke is the leading cause of death in Indonesia and leading cause of long-termdisability in the world. Ischemic stroke include 85% of all stroke cases. Ischemic stroke is caused by thromboembolic blockage or arterial stenotic by atherosclerotic plaque. Current practice shows that ischemic stroke can be treated. Treatment using intravenous thrombolytic (IV-tPA) and mechanical thrombectomy will provide better outcomes for the patient. It can be achieved when treated kurang dari 4.5 hours since onset for IV-tPA and kurang dari 6-24 hours for large vessel occlusions using mechanical thrombectomy. However, only a small number of patients can achieve this treatment due to lack of society knowledge about the sign and symptoms, transportation problems, and the stroke management system that has not been well established. Every one minute stroke patient is left untreated, 1.9 millions neurons in the brain are dead. An integrated management of the stroke system can provide better outcomes, lower the length-of-stay of the patients in hospital and reduce the cost spent for treatment. One system that is recommended for managing stroke cases is 8D that consist of detection, dispatch, delivery, door, data, decision, drug/device, and disposition. This system will help health care providers to collaborate through a multidisciplinary system for managing acute ischemic stroke cases comprehensively so that stroke patients can get proper handling and better outcomes.
Co-Authors Al Rasyid Albar, Imamul Aziz Anna Mira Lubis Budikayanti, Astri Dyah Tunjungsari, Dyah Hadiki Habib, Hadiki Kevin Gunawan Kurniawan, Mohammad Lestari, Dhara Ayu Mohamad Saekhu Mulyana, Radi Muharris Nafisah, Zharifah Fauziyyah Nurdin, Ilham Pangeran, David Permana, Affan Priyambodo Putri, Stefanie Karina Rahmana, Arizari Haj Rakhmad Hidayat Ramli, Yetty Rima, Siti Pujiwati Permata Salim Harris, Salim Sulistio, Septo Yunus, Reyhan Eddy