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Progressive Neurological Deficit in Adult Idiopathic Syringomyelia (IS): Case Report and Literature Review Yudoyono, Farid; Widhiatmo, Anugrah O.; Wirjomartani, Beny A.
Journal of Medicine and Health Vol 1, No 3 (2016)
Publisher : Maranatha Christian University

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A syringomyelia is a clinical entity of any tubular fluid-filled cavity within the spinalcord that causes slowly but relentlessly progressive symptoms as well as expansion of thecavity, which is most commonly associated with Chiari malformation Type I, which due toadvancement of imaging techniques has resulted in more incidental idiopathic syringes that arenot associated with tumor, trauma, or postinfectious causes. Idiopathic syringomyelia (IS) is apathological entity in which no overt etiology is evident for a syrinx. In this study, we describe acase in a 45 year-old woman presented with progressive difficulties in walking and also hadmyelopathic signs evidenced by hyperreflexia in the lower extremities and underwent foramenmagnum decompression and C1 lamiectomy. Idiopathic syringomyelia is a pathological entityin which no overt etiology is evident for a syrinx. It can be managed succesfully byconservative treatment but if there is a progression of neurological deficit, surgicaldecompression is a mandatory.Keywords: idiopathic syringomyelia, neurological deficit

Myelopathy caused by Ossification of Thoracic Ligamentum Flavum Yudoyono, Farid; Dahlan, Rully Hanafi; Ompusunggu, Sevline Esthetia; Hamijoyo, Laniyati; Arifin, Muhammad Zafrullah
Indonesian Journal of Rheumatology Vol 8, No 1 (2016)
Publisher : Indonesian Rheumatology Association

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Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level below. Magnetic resonance imaging and computed tomography demonstrated OLF at the right T9â11 level. Thoracicmyelopathy caused by OLF was consider and surgical intervention was performed. Posterior decompression and laminoplasty has been performed for this patient.Â Keywords: ossification of ligamentum flavum, thoracic myelopathy, laminoplasty

Progressive Neurological Deficit in Adult Idiopathic Syringomyelia (IS): Case Report and Literature Review Yudoyono, Farid; Widhiatmo, Anugrah O.; Wirjomartani, Beny A.
Journal of Medicine and Health Vol. 1 No. 3 (2016)
Publisher : Universitas Kristen Maranatha

A syringomyelia is a clinical entity of any tubular fluid-filled cavity within the spinalcord that causes slowly but relentlessly progressive symptoms as well as expansion of thecavity, which is most commonly associated with Chiari malformation Type I, which due toadvancement of imaging techniques has resulted in more incidental idiopathic syringes that arenot associated with tumor, trauma, or postinfectious causes. Idiopathic syringomyelia (IS) is apathological entity in which no overt etiology is evident for a syrinx. In this study, we describe acase in a 45 year-old woman presented with progressive difficulties in walking and also hadmyelopathic signs evidenced by hyperreflexia in the lower extremities and underwent foramenmagnum decompression and C1 lamiectomy. Idiopathic syringomyelia is a pathological entityin which no overt etiology is evident for a syrinx. It can be managed succesfully byconservative treatment but if there is a progression of neurological deficit, surgicaldecompression is a mandatory.Keywords: idiopathic syringomyelia, neurological deficit

Presurgical Aspects of Nutrition in Tuberculous Spondylitis Patients Yudoyono, Farid; Dahlan, Rully H.; Arifin, Muhammad Z.; Adam, Achmad
Journal of Medicine and Health Vol. 2 No. 1 (2018)
Publisher : Universitas Kristen Maranatha

Tuberculous spondylitis is a chronic infectious disease caused by Mycobacteriumtuberculosis on the vertebral bone. Involved less than 3% of all cases of TB, but the incidencevaries around the world, and is associated with the quality of public health and socioeconomicconditions.The purpose of this study is to investigate the presurgical aspects of nutrition inpatients with tuberculous spondylitis. A total of 39 consecutive patients between January 2011-December 2012 were evaluated retrospectively. All patients diagnosed with spondylitistuberculousis and treated with decompression, stabilization and fusion. All patients had beendiagnosed with Spondylitis tuberculousis based on history taking, physical examination,laboratory finding and MRI. Our study showed that of all subjects, ten male patients and eightfemale patients had cervical (n=1), thoracic (n=15), and lumbar (n=2) tuberculousspondylitis.The average age of the patients was 32.83 Â± 12.25 (17-56) years old. The averagepreoperative body mass index (BMI) was 16.67 Â± 1.2 kg / m2, albumin levels 3.23 Â± 0.21 g / dl,total protein level 6.2 Â± 0.34 g/dL. These were lower than normal value. We conclude thattuberculous spondylitis patients experience nutritional deficiencies presurgically andnutritional support should be considered pre-operatively.Keywords: Mycobacterium tuberculosis, nutritional state, presurgical aspect,tuberculousspondylitis

Penetrating Wound in the Skull by a Sharp Metal Object Ahmad Faried; Priandana Adya Eka Saputra; Farid Yudoyono; Muhammad Zafrullah Arifin
International Journal of Integrated Health Sciences Vol 3, No 2 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Objective: Penetrating skull injury (PSI) is a neurosurgical emergencies. Most PSI cases reported were caused by gunshot wounds. Although the diagnosis and management of those cases has been described, the actual cases, especially in our center, were quite rare.Methods: A craniectomy debridement with a supine position was performed and removal of the object was achieved. Intraoperatively, we succed control the bleeding as expected.Results: The patient was operated and hospitalized in our center; physical examination revealed neurologically intact before and after the removal of the object. The patient was sent home without any neurological deficits or other complications.Conclusions: We reported a case of penetrating skull injury in a 5-year-old girl caused by a scissors. Penetrating skull injuries were interesting due to its mechanism, management and complications. Early diagnosis and appropriate treatment should resulted in good outcomes.Keywords: Penetrating skull injury, a sharp metal object DOI: 10.15850/ijihs.v3n2.588

Intervertebral Disc Characteristic on Progressive Neurological Deficit Farid Yudoyono; Rully Hanafi Dahlan; Muhammad Zafrullah Arifin
International Journal of Integrated Health Sciences Vol 5, No 2 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Objective: To examine the intervertebral disc characteristic on magnetic resonance imaging (MRI) in lumbar herniated disc (LHD) patients with progressive neurological deficit.Methods: Patients were collected retrospectively from Dr. Hasan Sadikin General Hospital Database from 2011–2013 with LHD, had neurological deficit such as radiculopathy and cauda equine syndrome for less than four weeks with a positive sign confirmed by neurological examination and confirmatory with MRI examination.Results: A total of 14 patients with lumbar herniated disc disease (10 males, 4 females) suffered from progressive neurological deficit with an average age of (52.07±10.9) years old. Early disc height was 9.38±0.5 mm and progressive neurological deficit state disc height was 4.03±0.53 mm, which were significantly different statisticaly (p<0.01). Symptoms of radiculopathy were seen in 11 patients and cauda equine syndrome in three patients. Modic changes grade 1 was found in five patients, grade 2 in eight patients,grade 3 in one patient, Pfirmman grade 2 in eleven patients and grade 3 in three patients. Thecal sac compression 1/3 compression was seen in four patients and 2/3 compression in ten patients.Conclusions: Neurosurgeon should raise concerns on the characteristic changes of intervertebral disc in magnetic resonance imaging examination to avoid further neural injury in lumbar herniated disc patients.Keywords: Lumbar herniated disc, magnetic resonance imaging, progressive neurological deficit DOI: 10.15850/ijihs.v5n2.1042

Robotic Surgery for Giant Presacral Dumbbell-Shape Schwannoma Farid Yudoyono; Muhammad Zafrullah Arifin; Rully Hanafi Dahlan; Sevline Estethia Ompusunggu; Shin Dong Ah; Yi Seong; Ha Yoon; Yoon Do Heum; Kim Keung Nyun
International Journal of Integrated Health Sciences Vol 3, No 1 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Objective: To demonstrate the feasibility of using da Vinci robotic surgical system to perform spinal surgery.Methods: Magnetic resonance imaging (MRI) of a 29-year-old female patient complaining right pelvic pain for 1 month revealed a 17x8x10 cm non-homogeneous dumbbell shape encapsulated mass with cystic change located in the pelvic cavity and caused an anterior displacement of urinary bladder and colon.Results: There was no systemic complication and pain decrease 24 hours after surgery and during 2 years of follow up. The patient started a diet 6 hours after the surgery and was discharged 72 hours after the surgery. The pathological diagnosis of the tumor was schwannoma. Conclusions: Giant dumbbell shape presacral schwannomas are rare tumours and their surgical treatment is challenging because of the complex anatomy of the presacral. Clinical application of da Vinci robotic surgical system in the spinal surgical field is currently confined to the treatment of some specific diseases or procedures. However, robotic surgery is expected to play a practical future role as it is minimally invasive. The advent of robotic technology will prove to be a boon to the neurosurgeon.Keywords: da Vinci robotic surgical system, presacral, schwannoma DOI: 10.15850/ijihs.v3n1.407

Morphometric Analysis of the Corpus, Spinal Canal and Torg Ratio Using Midsagittal Cervical Vertebrae Computed Tomography Scan: Indonesian Population Rully Hanafi Dahlan; Priandana Adya Eka Saputra; Farid Farid Yudoyono; Sevline Esthetia Ompusunggu; Muhammad Zafrullah Arifin; Agung Budi Sutiono; Ahmad Faried
International Journal of Integrated Health Sciences Vol 2, No 1 (2014)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Objective: To determine the normal ranges of cervical spinal canal morphometry in Indonesian population and to compare the acquired data collected from other populationsMethods: Computed tomography measurements on the diameter of midsagital spinal canal and corpus of cervical vertebrae and its Torg ratio from the lower cervical (C3-C7) canal from 24 normal Indonesian adults were performed at the Radiology Department of Dr. Hasan Sadikin General Hospital. Patients who had cervical spine disorders and those under 20 years old were exluded. We used computed tomography scan midsagittal view to measure the aforementioned parameters. Results: The average diameter for the cervical spinal canals for the Indonesian population is comparable with those of other Asian populations such as Hongkong and India, albeit with smaller Torg ratio. Conclusions: This study reports the normal radiological anatomy of the midsagital spinal canal and corpus of cervical vertebrae as well as Torg ratio from the lower cervical vertebrae among Indonesian population. The measurements result of this study shows that, although slightly smaller, the measurement results for those parameters are identical with other Asian populations. Keywords: Corpus cervical vertebrae, midsagittal cervical spinal canal, Torg ratio DOI: 10.15850/ijihs.v2n1.285

Fetus inside Brain - Mature Cystic Teratoma in Posterior Fossa Farid Yudoyono; Mirna Sobarna; Agung Budi Sutiono; Muhammad Zafrullah Arifin
International Journal of Integrated Health Sciences Vol 4, No 1 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Objective: To describe a rare case of posterior fossa cystic teratoma in central nervous system. Methods: A 2-year old boy was admitted with a chief complaint of decreased consciousness with tonic clonic seizure. Non-Contrast Head Computed Tomography (NCCT) scan showed acute hydrocephalus and a well-defined extra-axial cystic lesion mass, 3.4x3.9x4.2 cm in size, in the posterior fossa.Results: Patient underwent a total resection of the tumor. No systemic complication was found in ten days following the surgery. There was no evidence of tumor recurrence one year after the surgery. The histopathologycal diagnosis of the tumor was cystic teratoma.Conclusions: Mature cyst teratoma located in the posterior fossa is a rare case. Total resection and long-term follow up is the treatment of choice for mature teratoma.Keywords: Hydrocephalus, posterior fossa, teratoma DOI: 10.15850/ijihs.v4n1.687

Myelopathy caused by Ossification of Thoracic Ligamentum Flavum Farid Yudoyono; Rully Hanafi Dahlan; Sevline Esthetia Ompusunggu; Laniyati Hamijoyo; Muhammad Zafrullah Arifin
Indonesian Journal of Rheumatology Vol. 8 No. 1 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level below. Magnetic resonance imaging and computed tomography demonstrated OLF at the right T9â€“11 level. Thoracicmyelopathy caused by OLF was consider and surgical intervention was performed. Posterior decompression and laminoplasty has been performed for this patient.Â Keywords: ossification of ligamentum flavum, thoracic myelopathy, laminoplasty

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