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Fidha Ramayani
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Pendekatan Diagnosis dan Tatalaksana Syringomyelia Sekunder dengan Komplikasi Gagal Nafas Dzulfiqar; Fidha Ramayani; Ari Wahyuni
Medula Vol 9 No 4 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i4.214

Abstract

Syringomyelia is a rare condition characterized by fluid-filled cavities called syrinx in spinal cord. Enlarging syrinx often cause progressive neurological damage, through combination of direct pressure on neural tissue and ischemia. Syringomyelia divided into primary and secondary based on it’s cause. More than half of secondary syringomyelia cases are caused by Chiari Malformation (CM) type I. Prevalence of CM is higher in children and younger adult than older adult. Diagnosis is effectively determined by Magnetic Resonance Imaging (MRI) and management are based on the main cause of syringomyelia. In this study, we describe a case in a 59 year-old women pesented with progressive weakness of all extremities for the past three months associated with respiratory failure. In physical examination we found flaccid type tetraplegia and absent of reflexes in all extremities. MRI result found syringomyelia from cervical 2 until 6 with MC type I. Foramen magnum decompression become primary management in syringomyelia caused by CM type I in order to return the abnormal flow of cerebrospinal fluid. Foramen magnum decompression in adults can improve the symptoms with minimal complication.
Peran Shunt Ventrikuloperitoneal dalam Strategi Pengobatan Hidrosefalus Pada Anak : Literature Review Sari, Indah Purnama; Roro Rukmi Windi Perdani; Diana Mayasari; Intanri Kurniati; Fidha Ramayani; Rizki Hanriko; Dewi Nur Fiana
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1357

Abstract

Hydrocephalus is a condition characterized by the accumulation of cerebrospinal fluid (CSF) within the brain's ventricles, presents a significant challenge in pediatric care. The increased intracranial pressure resulting from this CSF buildup can lead to severe neurological damage if left untreated. Ventricular peritoneal shunt (VP shunt) surgery remains a primary surgical intervention aimed at diverting excess CSF, thereby reducing intracranial pressure and mitigating the risk of irreversible neurological damage. This literature review provides a comprehensive review of the role of VP shunts in the management of pediatric hydrocephalus, encompassing a detailed examination of indications and contraindications for shunt placement, various surgical techniques employed, and the effective management of common post-operative complications such as infection, shunt malfunction (obstruction or overdrainage), and hemorrhage. We meticulously analyze current literature data to assess the effectiveness of VP shunts in improving neurological outcomes, fostering cognitive development, and enhancing the overall quality of life for children affected by hydrocephalus. The analysis will incorporate a review of long-term followup studies to evaluate the durability and efficacy of different shunt types and materials. Case studies and clinical experiences are integrated to provide a nuanced understanding of current clinical practices and to highlight the complexities often encountered in managing this condition. Furthermore, this literature review delves into recent advancements in shunt technology, including the development of programmable valves and less invasive surgical approaches. It also addresses the persistent challenges in optimizing hydrocephalus care, emphasizing the crucial need for a multidisciplinary approach involving neurosurgeons, pediatric neurologists, developmental pediatricians, and other healthcare professionals to ensure holistic and individualized patient care. The ultimate goal is to provide practical, evidence-based guidance for healthcare professionals in the effective and safe management of pediatric hydrocephalus using VP shunts, ultimately improving patient outcomes and quality of life.