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Renindra Ananda Aman
Departemen Bedah Saraf, Fakultas Kedokteran Universitas Indonesia, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo
Religion Humanities Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Physics Public Health Other

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KADAR FIBRINOGEN SEBAGAI FAKTOR PROGNOSTIK PASIEN PERDARAHAN INTRASEREBRAL SPONTAN David Tandian; Muhammad Harisyah; Hanif Gordang Tobing; Samsul Ashari; Renindra Ananda Aman; Syaiful Ichwan; Mohamad Saekhu; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.29

Abstract

         FIBRINOGEN VALUE AS PROGNOSTIC FACTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Spontaneous intracerebral haemorrhage (SIH) refers as spontaneous bleeding in the brain paren- chyma due to injury of blood vessels. Thus causing tissue inflammatory and coagulation reaction, activating the release of fibrinogen. Fibrinogen, an active substrate of coagulation cascade, also considered as the most powerful indicator of acute inflammatory response in SIH. Elevated levels of fibrinogen may be the marker for the increasing degree of brain tissue damage.Aims: Determine the correlation of fibrinogen levels with outcomes of patients with SIH who went on operative procedures.Methods: The study was conducted in Dr. Cipto Mangunkusumo hospital and its affiliation hospitals from January until August 2017. Total sampling was conducted. Preoperative Glasgow Coma Scale (GCS), blood volume, preoperative and postoperative serum fibrinogen values, and modified Rankin Scale (mRS) data were obtained and analyzed using the Spearman correlation test.Results: Significant correlation were found between the preoperative and postoperative fibrinogen with mRS score. Positive correlation coefficients were shown in both parameters, whereas the increase of preoperative and postoperative fibrinogen would increase the mRS score.Discussion: Pre and postoperative fibrinogen value showed significant association with mRS score, thereby they could be considered as prognostic predictive factors. However, because of the limited number of subject of this study to fulfill the criteria of validity study, a future study with a larger scale should be carried out.Keyword: Fibrinogen, mRS, outcome, spontaneous intracerebral haemorrhageABSTRAKPendahuluan: Perdarahan intraserebral spontan (PISS) adalah perdarahan spontan pada parenkim otak akibat kerusakan pembuluh darah pada jaringan otak. Kerusakan tersebut menimbulkan reaksi inflamasi jaringan dan koagulasi yang mengaktivasi pelepasan fibrinogen. Fibrinogen merupakan substrat aktif kaskade koagulasi yang juga merupakan penanda paling kuat respons akut inflamasi pada PISS. Adanya peningkatan kadar fibrinogen dapat menggambarkan peningkatan derajat kerusakan jaringan otak.Tujuan: Mengetahui korelasi kadar fibrinogen dengan luaran pasien dengan PISS yang dilakukan tindakan operatif.Metode: Penelitian dilakukan di RSUPN Dr. Cipto Mangunkusumo dan rumah sakit jejaring pendidikan dalam periode Januari–Agustus 2017. Sampel diambil dengan total sampling, data yang diambil adalah, Glasgow Coma Scale (GCS) preoperasi, volume perdarahan, kadar fibrinogen serum preoperasi dan pascaoperasi, dan modified Rankin Scale(mRS), kemudian dianalisis dengan tes Spearman correlation.Hasil: Dari uji statistik didapatkan hasil bermakna antara fibrinogen preoperasi mau pun pascaoperasi dengan skor mRS. Koefisien korelasi, menunjukkan korelasi positif pada keduanya, dimana peningkatan fibrinogen preoperasi dan pascaoperasi akan meningkatkan skor mRS.Diskusi: Fibrinogen pre dan pascaoperasi sebagai faktor prediksi prognostik memiliki hubungan bermakna dengan skor mRS. Namun dengan jumlah sampel penelitian yang masih belum mencukupi untuk memenuhi kriteria validitas untuk dapat diajukan sebagai faktor yang bersifat pasti, diperlukan penelitian lebih lanjut dengan sampel yang lebih besar.Kata kunci: Fibrinogen, luaran, mRS, perdarahan intraserebral spontan
KADAR FIBRINOGEN SEBAGAI FAKTOR PROGNOSTIK PASIEN PERDARAHAN INTRASEREBRAL SPONTAN David Tandian; Muhammad Harisyah; Hanif Gordang Tobing; Samsul Ashari; Renindra Ananda Aman; Syaiful Ichwan; Mohamad Saekhu; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.29

Abstract

         FIBRINOGEN VALUE AS PROGNOSTIC FACTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Spontaneous intracerebral haemorrhage (SIH) refers as spontaneous bleeding in the brain paren- chyma due to injury of blood vessels. Thus causing tissue inflammatory and coagulation reaction, activating the release of fibrinogen. Fibrinogen, an active substrate of coagulation cascade, also considered as the most powerful indicator of acute inflammatory response in SIH. Elevated levels of fibrinogen may be the marker for the increasing degree of brain tissue damage.Aims: Determine the correlation of fibrinogen levels with outcomes of patients with SIH who went on operative procedures.Methods: The study was conducted in Dr. Cipto Mangunkusumo hospital and its affiliation hospitals from January until August 2017. Total sampling was conducted. Preoperative Glasgow Coma Scale (GCS), blood volume, preoperative and postoperative serum fibrinogen values, and modified Rankin Scale (mRS) data were obtained and analyzed using the Spearman correlation test.Results: Significant correlation were found between the preoperative and postoperative fibrinogen with mRS score. Positive correlation coefficients were shown in both parameters, whereas the increase of preoperative and postoperative fibrinogen would increase the mRS score.Discussion: Pre and postoperative fibrinogen value showed significant association with mRS score, thereby they could be considered as prognostic predictive factors. However, because of the limited number of subject of this study to fulfill the criteria of validity study, a future study with a larger scale should be carried out.Keyword: Fibrinogen, mRS, outcome, spontaneous intracerebral haemorrhageABSTRAKPendahuluan: Perdarahan intraserebral spontan (PISS) adalah perdarahan spontan pada parenkim otak akibat kerusakan pembuluh darah pada jaringan otak. Kerusakan tersebut menimbulkan reaksi inflamasi jaringan dan koagulasi yang mengaktivasi pelepasan fibrinogen. Fibrinogen merupakan substrat aktif kaskade koagulasi yang juga merupakan penanda paling kuat respons akut inflamasi pada PISS. Adanya peningkatan kadar fibrinogen dapat menggambarkan peningkatan derajat kerusakan jaringan otak.Tujuan: Mengetahui korelasi kadar fibrinogen dengan luaran pasien dengan PISS yang dilakukan tindakan operatif.Metode: Penelitian dilakukan di RSUPN Dr. Cipto Mangunkusumo dan rumah sakit jejaring pendidikan dalam periode Januari–Agustus 2017. Sampel diambil dengan total sampling, data yang diambil adalah, Glasgow Coma Scale (GCS) preoperasi, volume perdarahan, kadar fibrinogen serum preoperasi dan pascaoperasi, dan modified Rankin Scale(mRS), kemudian dianalisis dengan tes Spearman correlation.Hasil: Dari uji statistik didapatkan hasil bermakna antara fibrinogen preoperasi mau pun pascaoperasi dengan skor mRS. Koefisien korelasi, menunjukkan korelasi positif pada keduanya, dimana peningkatan fibrinogen preoperasi dan pascaoperasi akan meningkatkan skor mRS.Diskusi: Fibrinogen pre dan pascaoperasi sebagai faktor prediksi prognostik memiliki hubungan bermakna dengan skor mRS. Namun dengan jumlah sampel penelitian yang masih belum mencukupi untuk memenuhi kriteria validitas untuk dapat diajukan sebagai faktor yang bersifat pasti, diperlukan penelitian lebih lanjut dengan sampel yang lebih besar.Kata kunci: Fibrinogen, luaran, mRS, perdarahan intraserebral spontan
INTENSITAS MIELUM PADA GAMBARAN MRI SERVIKAL SEBAGAI FAKTOR PROGNOSTIK LUARAN CERVICAL SPONDYLOSIS MYELOPATHY PASCAOPERASI Mohamad Saekhu; Jeremia Prastya Pardede; Renindra Ananda Aman; Hanif Gordang Tobing; Samsul Ashari; David Tandian; Syaiful Ichwan; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.30

Abstract

         MYELUM INTENSITY ON MRI CERVICAL AS PROGNOSTIC FACTORS IN CERVICAL SPONDYLOSIS MYELOPATHY PATIENTSABSTRACTIntroduction: Cervical spondylosis myelopathy (CSM) is a stenosis condition in cervical canal due to the cervical structural changes that compress the myelum, thus causing spinal medulla ischemia. Other than clinical factors, myelum intensity changes on MRI T1-weighted images (T1W1) and T2W1 might be useful to predict the pos-operative outcome.Aims: Identify prognostic factors in post-operative patients with CSM based on clinical symptoms and myelum intensity on cervical MRI.Methods: Retrospective study on CSM patients who underwent surgery in Neurosurgery Department, Cipto Mangunkusumo hospital, Jakarta, from January 2013 to December 2016. Magnetic resonance imaging data was obtained before the surgery, while clinical symptoms were assessed by Nurick scale before and 1 year after the surgery to evaluate outcome.Results: There were 50 subjects included in this study with mean age 51.98±9.64 years, majority male (76%), have moderate myelopathy (Nurick scale pre-operative ≤2), and time between onset and surgery mostly ≤1 year (80%). Most subject (88%) had improvement clinically, but mostly without hypointensity on cervical T1W1 MRI.Discussion: Myelum hypointensity in cervical MRI is associated with poor outcome in CSM post-surgery patients.Keywords: Cervical spondylosis myelopathy, MRI, myelum hypointensity, Nurick scaleABSTRAKPendahuluan: Cervical spondylosis myelopathy (CSM) merupakan suatu kondisi stenosis kanal servikal akibat adanya perubahan struktur servikal yang menyebabkan kompresi mielum, sehingga timbul iskemia medula spinalis. Selain faktor-faktor klinis, perubahan intensitas mielum pada MRI T1-weighted images (T1W1) dan T2W1 dapat dijadikan modalitas untuk memprediksi luaran pascaoperasi.Tujuan: Mengidentifikasi faktor prognosis luaran pasien CSM pascaoperasi berdasarkan gejala klinis dan intensitas mielum pada gambaran MRI servikal.Metode: Penelitian retrospektif terhadap penderita CSM yang dilakukan operasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Januari 2013 hingga Desember 2016. Dilakukan penilaian klinis dan gambaran MRI awal, serta luaran 1 tahun pascaoperasi menggunakan skor Nurick.Hasil: Terdapat 50 subjek dengan rerata usia 51,98±9,64 tahun, terutama laki-laki (76%), memiliki derajat mielopati ringan (skor Nurick preoperasi ≤2), dan jarak antara onset dengan waktu operasi ≤1 tahun (80%). Sebagian besar subjek (88%) mengalami perbaikan skor pascaoperasi yang mayoritas (95,4%) tidak didapatkan gambaran hipointesintas pada T1W1 MRI servikal.Diskusi: Hipointensitas mielum pada MRI servikal merupakan faktor prognosis luaran buruk pascaoperasi pada pasien CSM.Kata kunci: Cervical spondylosis myelopathy, hipointens, mielum, MRI, skala Nurick
INTENSITAS MIELUM PADA GAMBARAN MRI SERVIKAL SEBAGAI FAKTOR PROGNOSTIK LUARAN CERVICAL SPONDYLOSIS MYELOPATHY PASCAOPERASI Mohamad Saekhu; Jeremia Prastya Pardede; Renindra Ananda Aman; Hanif Gordang Tobing; Samsul Ashari; David Tandian; Syaiful Ichwan; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.30

Abstract

         MYELUM INTENSITY ON MRI CERVICAL AS PROGNOSTIC FACTORS IN CERVICAL SPONDYLOSIS MYELOPATHY PATIENTSABSTRACTIntroduction: Cervical spondylosis myelopathy (CSM) is a stenosis condition in cervical canal due to the cervical structural changes that compress the myelum, thus causing spinal medulla ischemia. Other than clinical factors, myelum intensity changes on MRI T1-weighted images (T1W1) and T2W1 might be useful to predict the pos-operative outcome.Aims: Identify prognostic factors in post-operative patients with CSM based on clinical symptoms and myelum intensity on cervical MRI.Methods: Retrospective study on CSM patients who underwent surgery in Neurosurgery Department, Cipto Mangunkusumo hospital, Jakarta, from January 2013 to December 2016. Magnetic resonance imaging data was obtained before the surgery, while clinical symptoms were assessed by Nurick scale before and 1 year after the surgery to evaluate outcome.Results: There were 50 subjects included in this study with mean age 51.98±9.64 years, majority male (76%), have moderate myelopathy (Nurick scale pre-operative ≤2), and time between onset and surgery mostly ≤1 year (80%). Most subject (88%) had improvement clinically, but mostly without hypointensity on cervical T1W1 MRI.Discussion: Myelum hypointensity in cervical MRI is associated with poor outcome in CSM post-surgery patients.Keywords: Cervical spondylosis myelopathy, MRI, myelum hypointensity, Nurick scaleABSTRAKPendahuluan: Cervical spondylosis myelopathy (CSM) merupakan suatu kondisi stenosis kanal servikal akibat adanya perubahan struktur servikal yang menyebabkan kompresi mielum, sehingga timbul iskemia medula spinalis. Selain faktor-faktor klinis, perubahan intensitas mielum pada MRI T1-weighted images (T1W1) dan T2W1 dapat dijadikan modalitas untuk memprediksi luaran pascaoperasi.Tujuan: Mengidentifikasi faktor prognosis luaran pasien CSM pascaoperasi berdasarkan gejala klinis dan intensitas mielum pada gambaran MRI servikal.Metode: Penelitian retrospektif terhadap penderita CSM yang dilakukan operasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Januari 2013 hingga Desember 2016. Dilakukan penilaian klinis dan gambaran MRI awal, serta luaran 1 tahun pascaoperasi menggunakan skor Nurick.Hasil: Terdapat 50 subjek dengan rerata usia 51,98±9,64 tahun, terutama laki-laki (76%), memiliki derajat mielopati ringan (skor Nurick preoperasi ≤2), dan jarak antara onset dengan waktu operasi ≤1 tahun (80%). Sebagian besar subjek (88%) mengalami perbaikan skor pascaoperasi yang mayoritas (95,4%) tidak didapatkan gambaran hipointesintas pada T1W1 MRI servikal.Diskusi: Hipointensitas mielum pada MRI servikal merupakan faktor prognosis luaran buruk pascaoperasi pada pasien CSM.Kata kunci: Cervical spondylosis myelopathy, hipointens, mielum, MRI, skala Nurick
PERBEDAAN NILAI LEUKOSIT PRA- DAN PASCAOPERASI SEBAGAI PREDIKTOR LUARAN FUNGSIONAL PERDARAHAN INTRASEREBRAL SPONTAN Hanif Gordang Tobing; Bismo Nugroho PPR; Mohamad Saekhu; Setyo Widi Nugroho; Affan Priyambodo; Wismaji Sadewo; Syaiful Ichwan; Renindra Ananda Aman; David Tandian; Samsul Ashari
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.68

Abstract

          DIFFERENCES BETWEEN PRE- AND POST-SURGERY LEUKOCYTE COUNTS AS FUNCTIONAL OUTCOME PREDICTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Hematoma in spontaneous intra-cerebral  hemorrhage (SICH) results inflammation due to secondary brain injury. Leukocyte, an inflammation indicator which is routinely examined, known as an outcome predictor in non- operated SICH. The role of inflammation in operated SICH is still unknown, however, pre- and post-surgery leukocyte counts can be a marker of brain tissue damage (brain injury).Aim: This study investigated the characteristics of leucocyte parameters in operated SICH patients and its correlation to functional outcome based on Glasgow Outcome Scale (GOS).Methods: This was a retrospective cohort study for SICH patients who underwent surgery at Department of Neurosurgery in Dr. Cipto Mangunkusumo National General Hospital from January 2012–March 2017. This study analyzed the association between pre-operative leucocyte level with age, pre-operative GCS, hemorrhage volume, length of hospitalization, and  six-month post-operative GOS. The correlation of differences of pre-operative and one-day post- operative leucocyte counts with six-month post-operative GOS and hematoma evacuation percentage were analyzed. The analysis was done using Pearson correlation test, Spearman, Chi-square χ2 test, Fisher exact test, and Anova test.Results: There was a significant correlation  between differences of leukocyte counts in pre- and post-surgery with GOS. A higher post-surgery leukocyte difference would lower GOS; there was a significant correlation between the leukocytes counts in pre-operative leucocyte and GCS. A higher pre-operative leukocytes counts would lower the GCS.Discussion: The differences of pre-operative and post-operative leucocyte counts is a functional outcome predictors within 6 months in operated SICH patients.Keywords: Leukocyte, outcome, spontaneous intracerebral hemorrage, surgeryABSTRAKPendahuluan: Hematoma pada perdarahan intraserebral spontan (PISS) menyebabkan inflamasi akibat cedera otak sekunder. Leukosit sebagai indikator inflamasi yang rutin diperiksa, diketahui memiliki peranan sebagai prediktor luaran pada PISS yang tidak dioperasi. Sejauh ini belum diketahui peranan inflamasi pada PISS yang dioperasi, namun kadar leukosit pra- dan pascaoperasi dapat menjadi penanda adanya kerusakan jaringan otak (brain injury).Tujuan: Untuk mengetahui karakteristik parameter leukosit pasien PISS yang dioperasi dan kaitannya dengan luaran fungsional berdasarkan skor Glasgow Outcome Scale (GOS).Metode: Studi kohort retrospektif pada pasien PISS yang dioperasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2012-Maret 2017. Dilakukan analisis antara nilai leukosit praoperasi dengan usia, GCS praoperasi, volume perdarahan, lama rawat inap, dan skor GOS 6 bulan pascaoperasi. Dilakukan analisis perbedaan nilai leukosit praoperasi dibandingkan hari pertama pascaoperasi dengan skor GOS 6 bulan pascaoperasi dan persentase evakuasi hematoma. Analisis dilakukan menggunakan korelasi Pearson, Spearman, uji Chi-square χ2  test, Uji Fisher exact test, dan Anova.Hasil: Pada uji statistik didapatkan korelasi bermakna antara perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi dengan skor GOS. Semakin tinggi nilai perbedaan leukosit pascaoperasi akan menurunkan skor GOS; didapatkan korelasi bermakna antara leukosit praoperasi dengan GCS praoperasi. Semakin tinggi leukosit praoperasi, semakin rendah GCS.Diskusi: Perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi merupakan prediktor luaran fungsional dalam 6 bulan pada pasien perdarahan intraserebral spontan yang dioperasi.Kata kunci: Leukosit, luaran, operasi, perdarahan intraserebral spontan 
PERBEDAAN NILAI LEUKOSIT PRA- DAN PASCAOPERASI SEBAGAI PREDIKTOR LUARAN FUNGSIONAL PERDARAHAN INTRASEREBRAL SPONTAN Hanif Gordang Tobing; Bismo Nugroho PPR; Mohamad Saekhu; Setyo Widi Nugroho; Affan Priyambodo; Wismaji Sadewo; Syaiful Ichwan; Renindra Ananda Aman; David Tandian; Samsul Ashari
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.68

Abstract

          DIFFERENCES BETWEEN PRE- AND POST-SURGERY LEUKOCYTE COUNTS AS FUNCTIONAL OUTCOME PREDICTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Hematoma in spontaneous intra-cerebral  hemorrhage (SICH) results inflammation due to secondary brain injury. Leukocyte, an inflammation indicator which is routinely examined, known as an outcome predictor in non- operated SICH. The role of inflammation in operated SICH is still unknown, however, pre- and post-surgery leukocyte counts can be a marker of brain tissue damage (brain injury).Aim: This study investigated the characteristics of leucocyte parameters in operated SICH patients and its correlation to functional outcome based on Glasgow Outcome Scale (GOS).Methods: This was a retrospective cohort study for SICH patients who underwent surgery at Department of Neurosurgery in Dr. Cipto Mangunkusumo National General Hospital from January 2012–March 2017. This study analyzed the association between pre-operative leucocyte level with age, pre-operative GCS, hemorrhage volume, length of hospitalization, and  six-month post-operative GOS. The correlation of differences of pre-operative and one-day post- operative leucocyte counts with six-month post-operative GOS and hematoma evacuation percentage were analyzed. The analysis was done using Pearson correlation test, Spearman, Chi-square χ2 test, Fisher exact test, and Anova test.Results: There was a significant correlation  between differences of leukocyte counts in pre- and post-surgery with GOS. A higher post-surgery leukocyte difference would lower GOS; there was a significant correlation between the leukocytes counts in pre-operative leucocyte and GCS. A higher pre-operative leukocytes counts would lower the GCS.Discussion: The differences of pre-operative and post-operative leucocyte counts is a functional outcome predictors within 6 months in operated SICH patients.Keywords: Leukocyte, outcome, spontaneous intracerebral hemorrage, surgeryABSTRAKPendahuluan: Hematoma pada perdarahan intraserebral spontan (PISS) menyebabkan inflamasi akibat cedera otak sekunder. Leukosit sebagai indikator inflamasi yang rutin diperiksa, diketahui memiliki peranan sebagai prediktor luaran pada PISS yang tidak dioperasi. Sejauh ini belum diketahui peranan inflamasi pada PISS yang dioperasi, namun kadar leukosit pra- dan pascaoperasi dapat menjadi penanda adanya kerusakan jaringan otak (brain injury).Tujuan: Untuk mengetahui karakteristik parameter leukosit pasien PISS yang dioperasi dan kaitannya dengan luaran fungsional berdasarkan skor Glasgow Outcome Scale (GOS).Metode: Studi kohort retrospektif pada pasien PISS yang dioperasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2012-Maret 2017. Dilakukan analisis antara nilai leukosit praoperasi dengan usia, GCS praoperasi, volume perdarahan, lama rawat inap, dan skor GOS 6 bulan pascaoperasi. Dilakukan analisis perbedaan nilai leukosit praoperasi dibandingkan hari pertama pascaoperasi dengan skor GOS 6 bulan pascaoperasi dan persentase evakuasi hematoma. Analisis dilakukan menggunakan korelasi Pearson, Spearman, uji Chi-square χ2  test, Uji Fisher exact test, dan Anova.Hasil: Pada uji statistik didapatkan korelasi bermakna antara perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi dengan skor GOS. Semakin tinggi nilai perbedaan leukosit pascaoperasi akan menurunkan skor GOS; didapatkan korelasi bermakna antara leukosit praoperasi dengan GCS praoperasi. Semakin tinggi leukosit praoperasi, semakin rendah GCS.Diskusi: Perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi merupakan prediktor luaran fungsional dalam 6 bulan pada pasien perdarahan intraserebral spontan yang dioperasi.Kata kunci: Leukosit, luaran, operasi, perdarahan intraserebral spontan 
PASCAOPERASI ADENOMA HIPOFISIS: HUBUNGAN ANTARA DURASI AWITAN DENGAN LUARAN KLINIS VISUS DAN LAPANG PANDANG Renindra Ananda Aman; Reki Setiawan; Retno Asti Werdhani; Samsul Ashari; David Tandian; Syaiful Ichwan; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 37 No 3 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.161

Abstract

Introduction: Pituitary adenomas can cause decrease of visual acuity (VA), narrowing visual field (VF). Several studies have showed that the duration of complaints were related significantly with clinical outcomes. As a national referral center hospital, all pituitary adenoma patients who came to our institution were referred from ophthalmologists, neurologists, and neurosurgeons from other institutions. Aim: In this study, we investigated the relationship between duration, which is calculated from the time of symptoms first appeared to the time of surgery, and outcome (VA and VF) in pituitary adenoma patients who underwent transsphenoidal surgery. Methods: A retrospective design was used on pituitary adenoma patients that underwent transsphenoidal surgery between 2015-2017 in Cipto Mangunkusumo Hospital. The duration between symptoms’ onset and surgery was calculated in months. VA and VF examinations were performed 1 day before surgery and within 1 to 2 months postoperatively. Results: There were 71 patients (36 male, 35 female) with decreased VA and narrowed VF, with a median age of 42 years (20-77 years). The median length of duration of onset for both symptoms was 12 months (1-108 months). 40.5% patients had improved VA postoperatively, with median duration of onset of 11 months. Improvement in VF was experienced in 67.6% patients, with median duration of onset of 12 months. Discussion: There was a statistically significant relationship between the duration of onset and the VF outcomes. Improvements in the VF were found in patients who underwent surgery up to 12 months after the time of onset. Keywords: Pituitary adenoma, transsphenoidal surgery, visual acuity, visual field
EVALUASI TAJAM PENGLIHATAN DAN INDEKS PROPTOSIS PASIEN MENINGIOMA SPHENOORBITA PASCAOPERASI KRANIEKTOMI Renindra Ananda Aman; Ryan Rhiveldi Keswani; Syaiful Ichwan; Samsul Ashari; Setyo Widi Nugroho
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.171

Abstract

Introduction: Sphenoorbital meningioma (SOM) is an exophytic tumor mass that infiltrates the bone at the sphenoid wing, lateral orbital walls, orbital roofs, and extends to superior orbital fissures. The classic triad of clinical features are proptosis, decreased visual acuity, and ophthalmoplegia. The outcomes of our postoperative patients have not been evaluated before. Aim: We would like to evaluate the clinical characteristics of the sphenoorbital menigioma patients before and after surgery. Methods: A cross sectional study was performed. Subjects were patients with sphenoorbital meningiomas who came to Cipto Mangunkusumo General Hospital from January 2014 through December 2015. All patients underwent craniectomy and lateral orbitotomy. We evaluated the visual acuity using the Snellen chart and proptosis index before and after surgery by measuring the protuded eye in an axial CT scan. Results: There were 66 samples in this study, and 65 of the samples were females. The age range is from 31 to 64 years. The mean proptosis index of preoperative is 18.27 and the post operative is 16.43. The mean proptosis index reduction is 1.84. Post operative visual acuity was improved only in 3 (9.7%) samples. Discussion: Sphenoorbital meningioma patients after surgery were shown markedly improvement in the proptosis index. However, the visual acuity was not markedly improved after surgery. Keywords: Proptosis index, sphenoorbital meningioma, visual acuity
HUBUNGAN WAKTU TUNGGU MENUJU OPERASI PENGANGKATAN TUMOR INTRAKRANIAL DENGAN SKALA PERFORMA KARNOFSKY PASCAOPERASI Setyo Widi Nugroho; Aryandhito Widhi Nugroho; Renindra Ananda Aman; Hanif Gordang Tobing
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.175

Abstract

Introduction: The waiting time to elective intracranial tumor removal surgery in Indonesia is unknown, let alone its association with postoperative functional outcome. Aim: To identify the waiting time to elective intracranial tumor removal and to analyze its association with poor functional outcome, defined by 3-months postoperative Karnofsky Performance Scale (KPS score) of <70. Methods: This medical record-based retrospective study was performed on intracranial tumor patients underwent elective tumor removal surgery in 2016. Multivariable logistic regression analyses were utilized to determine any significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome, adjusting for age, sex, preoperative KPS score, pre- and postoperative tumor volume, percentage of tumor removal, tumor histopathology, and grading. Results: Data were obtained from 191 patients, with histopathology distributions as follows: 49% meningiomas, 22% pituitary adenomas, 9% astrocytomas, 3% metastatic tumors, 3% primary central nervous system lymphomas, 2% oligodendrogliomas, 2% craniopharyngiomas, and 10% others. Overall median (min-max) of waiting time to elective intracranial tumor removal surgery was 35 (0-529) days. Significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome was evident in univariable analysis (OR 1.004), but not in multivariable analysis. The collinearity value of pre- and postoperative tumor volume, percentage of tumor removal with waiting time were, respectively, 5.92; 5.69; and 3.2. Discussion: There was no significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome. Strong collinearities were identified between pre- and post-operative tumor volume, percentage of tumor removal and waiting time to elective intracranial tumor removal surgery. Keywords: functional outcome, intracranial tumor, removal surgery, waiting time
HUBUNGAN WAKTU TUNGGU MENUJU OPERASI PENGANGKATAN TUMOR INTRAKRANIAL DENGAN SKALA PERFORMA KARNOFSKY PASCAOPERASI Setyo Widi Nugroho; Aryandhito Widhi Nugroho; Renindra Ananda Aman; Hanif Gordang Tobing
NEURONA Vol 37 No 4 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.175

Abstract

Introduction: The waiting time to elective intracranial tumor removal surgery in Indonesia is unknown, let alone its association with postoperative functional outcome. Aim: To identify the waiting time to elective intracranial tumor removal and to analyze its association with poor functional outcome, defined by 3-months postoperative Karnofsky Performance Scale (KPS score) of <70. Methods: This medical record-based retrospective study was performed on intracranial tumor patients underwent elective tumor removal surgery in 2016. Multivariable logistic regression analyses were utilized to determine any significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome, adjusting for age, sex, preoperative KPS score, pre- and postoperative tumor volume, percentage of tumor removal, tumor histopathology, and grading. Results: Data were obtained from 191 patients, with histopathology distributions as follows: 49% meningiomas, 22% pituitary adenomas, 9% astrocytomas, 3% metastatic tumors, 3% primary central nervous system lymphomas, 2% oligodendrogliomas, 2% craniopharyngiomas, and 10% others. Overall median (min-max) of waiting time to elective intracranial tumor removal surgery was 35 (0-529) days. Significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome was evident in univariable analysis (OR 1.004), but not in multivariable analysis. The collinearity value of pre- and postoperative tumor volume, percentage of tumor removal with waiting time were, respectively, 5.92; 5.69; and 3.2. Discussion: There was no significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome. Strong collinearities were identified between pre- and post-operative tumor volume, percentage of tumor removal and waiting time to elective intracranial tumor removal surgery. Keywords: functional outcome, intracranial tumor, removal surgery, waiting time
Co-Authors Abdi Reza Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Ahmad Yanuar Amelia, Ria Andayani, Diyah Eka Ande Fachniadin Anggraini, Neni Tri Aninditha, Tiara Aryandhito Widhi Nugroho Aryandhito Widhi Nugroho Bhayu Rizallinoor Bismo Nugroho Bismo Nugroho PPR Budiman Darmowidjojo Budiman Darmowidjojo, Budiman Calvin, Nicholas David Tandian David Tandian David Tandian David Tandian David Tandian David Tandian David Tandian Dewiputri, Salmarezka Eka Susanto Esthika Dewiasty Esthika Dewiasty, Esthika Fabianto Santoso Fauzan Herdian Fenny Tjuatja Fitrie Desbassarie, Fitrie Harris Istianggoro Henry Kodrat Hilman Mahyuddin Hilman Mahyudin Ina S. Timan Jeremia Prasetya Pardede Jeremia Prastya Pardede Kevin Gunawan Kurniawan, Azhar Farisyabdi Liza Amelia M, Sidik Martin Susanto Moh. Saekhu Mohamad Saekhu Mohammad Saekhu Muhammad Harisyah Mutmainah Mutmainah Nina Asrini Noor Nugroho, Setyo Widi Nurwahyuni, Atik Paat, Bipatra Einstein Yacobus Padmo Santjojo Paramita Ayuningtyas, Sita Pradana Soewondo Pradana Soewondo Priyambodo, Affan Purwodito, Arief Putri Auliya, Putri Rahma Putri, Herdanti Rahmad Mulyadi Rahmat Cahyanur Rahmat Cahyanur Reki Setiawan Renindra A Aman Renindra A. Aman Renindra A. Aman Retno Asti Werdhani Rini Andriani Riwanti Estiasari Ryan Rhiveldi Keswani Sadewo, Wismaji Samsul Ashari Samsul Ashari Samsul Ashari Samsul Ashari Samsul Ashari SAMSUL ASHARI, SAMSUL Setyo W. Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Soehartati A Gondhowiardjo Soehartati A. Gondhowiardjo Soehartati Gondhowiardjo Soehartati Gondhowiardjo Sofyan, Henry Riyanto Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Syarif, Ricky Rusydi Syntia Nusanti Tanjung, Gloria Tiara Aninditha Tiara Aninditha Tiara Bunga Mayang Permata Wimbo, Fitrie Desbassarie Wismaji Sadewo Wismaji Sadewo Wismaji Sadewo Wismaji Sadewo Yesi Astri Yovanka Naryai Manuhutu Yulius Seno Nugroho