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Relationship of The Degree of Head Injury Based on Glasgow Coma Scale (GCS) with the Arrival of Acute Post Concussion Syndrome (PCS) Onset in Post-Head Injury Patients in General Hospital Dr.M.Djamil Padang Azriyantha, Muhammad Reza; Syaiful Saanin; Hesty Lidya Ningsih
Biomedical Journal of Indonesia Vol. 7 No. 1 (2021): Biomedical Journal of Indonesia
Publisher : Fakultas Kedokteran Universitas Sriwijaya (Faculty of Medicine, Universitas Sriwijaya) Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v7i1.273

Abstract

A B S T R A C TBackground: Traumatic brain injury is the main cause of death in the populationunder the age of 45 years, and the fourth leading cause of death in the entire ofpopulation. Based on the degree of traumatic brain injury, it is commonly categorizedbased on the Glasgow Coma Scale (GCS). Post-Concussion Syndrome (PCS) is theset of somatic, emotional / behavioral and cognitive symptoms that occur after atraumatic brain injury. The aim of this study was to find out the prevalence andcorrelation of the degree of traumatic brain injury based on the Glasgow Coma Scale(GCS) and the emersion of Post-Concussion Syndrome (PCS) acute onset in patientswith head injuries Method: This study was a cross-sectional analytic study ofpatients who experienced Post-Concussion Syndrome (PCS) after traumatic braininjury at DR. M. Djamil Hospital Padang in 2020 from June to November 2020. Datawere collected by filling in a questionnaire (The Rivermead Post ConcussionSymptoms Questionnaire) and medical record data of neurosurgical patients thatmet the inclusion and exclusion criteria. Result: : It indicated that 70 patients wereincluded in the inclusion criteria of this study. A total of 38 (54.3) respondents didnot undergo the acute onset of PCS, meanwhile respondents who experienced acuteonset of PCS were 32 (45.7) respondents. The results showed that 25 (67.6%)respondents with mild traumatic brain injury had PCS acute onset, while 4 (17.4%)respondents with moderate degree of traumatic brain injury had PCS acute onset,and 4 (17.4%) respondents had PCS acute onset PCS 3 (30%) respondentsexperienced severe traumatic brain injury with acute onset PCS and statistically thedifference in the proportion of data from each of these variables was significant witha p-value of 0.0001. The results of statistical tests showed that p value> 0.05 on thecorrelation between PCS and GCS, thus, it can be concluded that there was nocorrelation between the direction of the relationship between PCS and GCS.Conclusion There was no correlation between the degree of traumatic brain injurybased on GCS and the incidence of PCS acute onset, either it was unidirectional orvice versa in patients with head injuries at RSUP M. Djamil Padang.
Comparison of Lymphocyte Neutrophil Ratio in Head Injury Patients with Blood and without Intracranial Bleeding in Dr. M. Djamil Hospital Abdul Hafiz, Muhammad Zaki; Syaiful Saanin; Hesty Lidya Ningsih
Biomedical Journal of Indonesia Vol. 7 No. 1 (2021): Biomedical Journal of Indonesia
Publisher : Fakultas Kedokteran Universitas Sriwijaya (Faculty of Medicine, Universitas Sriwijaya) Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v7i1.275

Abstract

A B S T R A C TBackground: Head injuries occur every 15 seconds worldwide, with patientsdying every 12 minutes. The value of the Neutrophil Lymphocyte Ratio (NLR) is afactor that influences the assessment and prognostic value of patients withintracranial hemorrhage and without intracranial hemorrhage in head injury.The aim of this study was to determine the relationship between increased NLRbased on the severity of head injury patients with or without intracranialhemorrhage. Methods: This study is a retrospective cross sectional study of headinjury patients with hemorrhage and without intracranial hemorrhage who weretreated at Dr. M. Djamil Hospital Padang in 2020 from May to December 2020.Data was collected in the Medical Records Department of Dr. M. Djamil HospitalPadang who met the inclusion and exclusion criteria. Results : A total of 92patients were included in the inclusion criteria for this study. The results showedthat the mean NLR value in head injury patients was 11.72 with a variation of7.31. The mean NLR level based on the severity of mild head injury was 10.15with a variation of 6.38. The mean NLR level of moderate head injury severity was12.70 with a variation of 7.09. The mean NLR level of severe head injury, was14.69 with a variation of 9.30. The results showed that there was no difference inthe mean of NLR levels in mild head injury patients with hemorrhage and withoutintracranial hemorrhage. The results showed that there was a significantrelationship between NLR levels in moderate head injury patients withhemorrhage (14.20) and without intracranial hemorrhage (7.20) (p value = 0.029),whereas in severe head injury it could not be assessed because there was nosample without hemorrhage. Conclusion: There is an association betweenincreased NLR and intracranial bleeding in moderate head injury patients
Masquerading as an Orbital Malignancy: A Rare Presentation of Pott’s Puffy Tumor with Intraorbital Extension in a Diabetic Adult Suhery; Mardijas Efendi; Silvia Roza; Hesty Lidya Ningsih
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1506

Abstract

Background: Pott’s puffy tumor (PPT) is a rare, life-threatening clinical entity characterized by frontal bone osteomyelitis and subperiosteal abscess, typically resulting from untreated frontal sinusitis. While predominantly a pediatric diagnosis, adult presentation is exceptionally rare and often associated with immunocompromised states. The clinical mimicry of PPT, particularly when presenting with bone destruction and orbital extension, frequently leads to misdiagnosis as a malignant neoplasm. This study aims to report a rare and instructive case of Pott’s puffy tumor in a 52-year-old diabetic female. Case presentation: We report a case of a 52-year-old female with uncontrolled Type 2 Diabetes Mellitus presenting with progressive left ocular proptosis, globe displacement, and blurred vision persisting for two months. Imaging revealed a heterogeneous mass in the frontoethmoidal sinus with extensive osteolytic destruction of the orbital roof and frontal bone, initially raising strong suspicion of a sinonasal malignancy or metastasis. The patient underwent a bicoronal craniectomy and debridement. Intraoperative findings revealed a purulent subperiosteal collection and necrotic bone, confirming the diagnosis of PPT with intraorbital extension. The defect was repaired via craniofacial reconstruction using bone cement. Post-operative culture analysis confirmed a polymicrobial infection. Conclusion: This case underscores the necessity of maintaining a high index of suspicion for PPT in diabetic adults presenting with proptosis and osteolytic radiographic findings. Although rare, PPT can masquerade as a malignancy. Early recognition and a multidisciplinary approach combining aggressive surgical debridement with targeted antibiotic therapy are imperative to prevent catastrophic intracranial and orbital complications.
Masquerading as an Orbital Malignancy: A Rare Presentation of Pott’s Puffy Tumor with Intraorbital Extension in a Diabetic Adult Suhery; Mardijas Efendi; Silvia Roza; Hesty Lidya Ningsih
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1506

Abstract

Background: Pott’s puffy tumor (PPT) is a rare, life-threatening clinical entity characterized by frontal bone osteomyelitis and subperiosteal abscess, typically resulting from untreated frontal sinusitis. While predominantly a pediatric diagnosis, adult presentation is exceptionally rare and often associated with immunocompromised states. The clinical mimicry of PPT, particularly when presenting with bone destruction and orbital extension, frequently leads to misdiagnosis as a malignant neoplasm. This study aims to report a rare and instructive case of Pott’s puffy tumor in a 52-year-old diabetic female. Case presentation: We report a case of a 52-year-old female with uncontrolled Type 2 Diabetes Mellitus presenting with progressive left ocular proptosis, globe displacement, and blurred vision persisting for two months. Imaging revealed a heterogeneous mass in the frontoethmoidal sinus with extensive osteolytic destruction of the orbital roof and frontal bone, initially raising strong suspicion of a sinonasal malignancy or metastasis. The patient underwent a bicoronal craniectomy and debridement. Intraoperative findings revealed a purulent subperiosteal collection and necrotic bone, confirming the diagnosis of PPT with intraorbital extension. The defect was repaired via craniofacial reconstruction using bone cement. Post-operative culture analysis confirmed a polymicrobial infection. Conclusion: This case underscores the necessity of maintaining a high index of suspicion for PPT in diabetic adults presenting with proptosis and osteolytic radiographic findings. Although rare, PPT can masquerade as a malignancy. Early recognition and a multidisciplinary approach combining aggressive surgical debridement with targeted antibiotic therapy are imperative to prevent catastrophic intracranial and orbital complications.