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All Journal Folia Medica Indonesiana Neurologico Spinale Medico Chirurgico
Subagio, Eko Agus
Spine Division, Department Of Neurosurgery, General Hospital Of Dr. Soetomo, Faculty Of Medicine, Universitas Airlangga, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Other

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Cervical spine instability and canal stenosis caused by rheumatoid arthritis Eko Agus Subagio; Seok Woo Kim
Neurologico Spinale Medico Chirurgico Vol 3 No 3 (2020)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v3i3.115

Abstract

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that impacts on weakening ligaments, synovial arthritis and cartilage damage. The effect that can occur is instability and neural compression in the upper and sub-axial cervical. The prevalence of atlantoaxial instability (AAI) is around 40-80% among rheumatoid patients, but it is interesting to examine the clinical symptoms that are not so visible despite radiological instability confirmed on the cervical spine. However, once the clinical symptoms of myelopathy occur, the mortality rate will increase sharply. We report a case of a 66-years old female who was admitted to our hospital with gait disturbance and weakness of her lower extremities. Radiographic evaluation of the cervical spine showed erosive destruction of the odontoid process of C2, anterior atlantoaxial subluxation, and thickened yellow ligaments from C3 to C7. Surgery was performed by removal of the posterior arch of C1 and laminectomy C3 to C7, posterior occipito-cervical screw fixation from C3 to C7, combined with atlantoaxial transpedicular screw fixation. A sterno sub-occipitomandibular immobilization (SOMI) orthosis was applied for postoperative immobilization for 12 weeks. Improvement of motoric status noted after surgery.
Rupture of the recurrent thoracic intramedullary spinal cord cavernoma Galih Indra Permana; Eko Agus Subagio; Muhammad Faris; Abdul Hafid Bajamal
Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i3.169

Abstract

The intramedullary spinal cord cavernoma is a rare vascular disease that occur within spinal cord or intramedullary and account for about 5%-12% of all pathology in the spinal vascular disease. We report a clinical progression of disease and evolution of the haemorrhage every years until patient underwent surgical procedure. A 63-years old male with progressive weakness of the lower extremity since 1 month before admission, worse in the left side He also complained loss of sensation at the level of the T4 and below it. Patient suffer three times rebleeding before underwent surgery. MR imaging showing intramedullary spinal cord cavernoma and a histology examination exhibited the characteristics of a cavernoma. Intramedullary spinal cord cavernoma is a rare disease that should be treated before rebleeding occur and enlargement of the lesion. Postoperative neurological function in intramedullary spinal cord cavernoma patient is determined by the preoperative neurological status.
Case Report: Ventriculoperitoneal Shunt Catheter Migration and Transanal Extrusion in Persistent Vegetative State Adult Patient Fauzi, Asra Al; Parenrengi, Muhammad Arifin; Wahyuhadi, Joni; Subagio, Eko Agus; Turchan, Agus
Folia Medica Indonesiana Vol. 55 No. 4 (2019): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.392 KB) | DOI: 10.20473/fmi.v55i4.24515

Abstract

The complications of ventriculoperitoneal (VP) shunts are many and are reported in literature extensively. The complication of transanal extrusion after bowel perforation is known although rare. This complication is very well described amongst the children. The authors describe the case of bowel perforation and transanal extrusion of a VP shunt occurring in a 51-year-old adult patient. The patient has a history of craniotomy for acute subdural hematoma after severe head injury one year ago continued with VP shunt for post-traumatic hydrocephalus. Home care with bedridden conditions is done at home until finally, the family gets the catheter extrude from the transanal. Bowel perforation and transanal extrusion of VP shunt catheter is a rare but serious problem. The exact pathogenesis of shunt-related organ perforation and extrusion through the anus is unclear, and various mechanisms have been suggested, Among many factors, age is the prominent factor for bowel perforation.1 Because of weak bowel musculature and stronger peristaltic activity, children are more susceptible to bowel perforation than adult patients. In adult shunted patient, one of the risk factors is related to PVS with chronic immobilization, as described in this case. Risk factors of bowel perforation in adult are quite distinct from children. Persistent vegetative state (PVS) with chronic immobilization is one of the risk factors to be aware of.
Co-Authors Abdul Hafid B Abdul Hafid Bajamal Budi Utomo Endra Wibisono Harmawan Fauzi, Asra Al Galih Indra Permana Jani, Januardi Rifian Januardi Rifian Jani Joni Wahyuhadi, Joni Muhammad Faris Parenrengi, Muhammad Arifin Seok Woo Kim Sri Andreani Utomo Tedy Apriawan Turchan, Agus Turchan, Agus