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ICP MONITOR PLACEMENT STEPWISE EARLY DECOMPRESSIVE CRANIECTOMY FOR THE MANAGEMENT OF SEVERE TBI PATIENTS: A CASE REPORT Dirga Rachmad Aprianto; Achmad Kurniawan; Andhika Tomy Permana; Fadillah Putri Rusdi; Akbar Wido; Bagus Sulistyono; Made Gemma Daniswara Maliawan; Tedy Apriawan; Abdul Hafid Bajamal
Molucca Medica VOLUME 11, NOMOR 2, OKTOBER 2018
Publisher : Pattimura University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (811.299 KB) | DOI: 10.30598/molmed.2018.v11.i2.35

Abstract

Pendahuluan. Peningkatan tekanan intrakranial (ICP) merupakan kejadian sekunder yang sering terjadi setelah cedera otak traumatis (TBI) dan berkorelasi dengan hasil yang buruk pada pasien. Beberapa penelitian menunjukkan bahwa kraniektomi dekompresif awal (DC) (dalam 48 jam setelah cedera) direkomendasikan untuk pasien dengan TBI berat yang membutuhkan evakuasi perdarahan intrakranial dan DC awal mampu mengurangi komplikasi TBI yang disebabkan oleh peningkatan TIK. Namun, meskipun DC awal telah dilakukan, peningkatan TIK masih dapat berlangsung karena terjadi edema otak yang masif. Metode. Sebuah kasus pasien yang dirawat dengan TBI berat dan perdarahan intrakranial. Pasien kemudian menjalani DC dan pemasangan ICP monitor setelah evakuasi perdarahan intrakranial. Selama observasi pasca operasi di ICU, cairan serebrospinal (CSF) pasien secara bertahap akan dikeluarkan jika ICP lebih dari 15mmHg. Hasil. ICP sesaat setelah dilakukan DC awal yaitu 30cm H20 (22 mmHg). Hari pertama setelah operasi, hemodinamik pasien stabil dan GCS 2X5 dengan ICP pasien sekitar 18 cmH2O. Pada hari ke 2-5, pasien hemodinamik stabil dengan GCS membaik (3X5) dengan penurunan ICP (sekitar 13-15 cmH2O). Pada hari ke-6, ICP monitor dilepaskan dan pasien dipulangkan pada hari ke 19 setelah pulih sepenuhnya. Kesimpulan. Penempatan ICP monitor dan aplikasi pelepasan CSF secara bertahap setelah DC mungkin membantu mengurangi peningkatan ICP pada pasien dengan TBI berat, dan dengan demikian mengurangi morbiditas dan mortalitas.
MANAJEMEN TRAUMA TEMBUS OTAK : LAPORAN KASUS Asadullah Asadullah; Endra Wibisono Harmawan; Resi Prastikarunia; Gunna Hutomo Putra; Heru Kustono; Setia Utama; Komang Sena Adistira Artha; Tedy Apriawan; Abdul Hafid Bajamal
Molucca Medica VOLUME 12, NOMOR 2, OKTOBER 2019
Publisher : Pattimura University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (885.194 KB) | DOI: 10.30598/molmed.2019.v12.i2.34

Abstract

Pendahuluan. Trauma tembus otak merupakan kegawatan medis yang meskipun jarang terjadi namun sering mengakibatkan mortalitas dan morbiditas yang tinggi. Penanganan trauma tembus otak sendiri masih menjadi tantangan bagi para ahli bedah saraf di seluruh dunia. Menajemen yang optimal pada penaganan trauma tembus otak memerlukan pemahaman yang komprehensif terhadap mekanisme dan patofisiologi terjadinya cedera tersebut. Sampai saat ini penanganan standar pada kasus trauma tembus otak masih menjadi perdebatan. Metode. Artikel ini berbentuk serial kasus, kami melaporkan 3 kasus trauma tembus pada institusi kami. Artikel ini disusun dari berbagai referensi dan pengalaman kasus yang pernah ditangani di Rumah Sakit Umum AkademikDr. Soetomo. Hasil. Pada pasien trauma tembus yang dilakukan kraniotomi debridement kurang dari 12 jam post trauma diikuti pemberikan antibiotik profilaksis empirik dengan ceftriaxone dan metronidazole selama 7 hari dan antikejang phenytoin selama 7 hari didapatkan keluaran yang memuaskan. Kesimpulan Manajemen trauma tembus otak memerlukan metode diagnostic yang cepat dan tepat. Pemeriksaan CT scan kepala menjadi wajib untuk penegakan diagnosis trauma tembus kepala. CT angiografi diperlukan pada kasus kasus yang dicurigai menyebabkan lesi vaskular. Yang kemudian iikuti dengan penangan operasi segera dan pemberian antibiotic yang tepat. Kata Kunci: Trauma tembus otak, kraniotomi debridement, antibiotik profilaksis empiri, CT angiografi
PROFILE OF BRAIN INJURY PATIENTS WITH COVID-19 INFECTION AT DR. SOETOMO HOSPITAL SURABAYA FOR THE PERIOD 2020 TO 2022 Darian Mulyana; Agus Turchan; Imam Subadi; Tedy Apriawan
Journal of Social Research Vol. 3 No. 2 (2024): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v3i2.1928

Abstract

In 2019, a previously unidentified coronavirus was named COVID-19. This virus can infect everyone without exception, including brain injury patients. Because this virus is relatively new, there have not been many studies examining the interaction of COVID-19 with brain injury. The purpose of this study was to examine the profile of brain injury patients with COVID-19 at Dr. Soetomo Hospital. Method This study was conducted with a descriptive observational method with a retrospective approach. The data taken came from the medical records of Dr. Soetomo Hospital. The results of 56 brain injury patients with COVID-19, the majority of whom were male, most of whom were in the age range of 40 – 59 years, mild brain injury cases were the most dominant, the average length of patient stay was 16.4 days and patient mortality was 30.4%.
Management of Traumatic Intracranial Hemorrhage on Anticoagulant Regiment: A Literature Review Apriawan, Tedy; Kartosen, Ade Anugrah; Ishlahy, Ahmad Z. S.; Broto, Endang Pati; Herjuna, Hana Ranu; Permana, Khrisna Rangga; Meizikri, Rizki; Drehem, Shaleh; Bajamal, Abdul Hafid
Jurnal Medis Islam Internasional Vol 1 No 2 (2020): June
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v1i2.1611

Abstract

Oral anticoagulant and antiplatelet are often prescribed in clinical practice. These drugs are mainly consumed by geriatric patients to prevent or treat cerebrovascular, systemic embolism, or heart condition.  Managing anticoagulated TBI patients is a challenging task for surgeons. This study aims to review available literatures regarding anticoagulated TBI patients and to suggest a treatment algorithm for such cases. Based on several retrospective and prospective studies, it might be wasteful to do a routine follow-up CT scan on anticoagulated TBI patients. The risk of new lesion development or presenting lesion progression seems to be especially low among patients with negative initial CT scan. We suggest to reserve repeat CT scan for patients with evident neurological deterioration. Tighter observation for anticoagulated patients with positive initial CT scan might be useful. Anticoagulation reversal is recommended by the American College of Cardiology, but some studies reported that reversal should be directed by INR. Acute antiplatelet cessation is still controversial for aspirin, but it is advised for clopidogrel. Preoperative management of both anticoagulant and antiplatelet should take into account the bleeding risk of the surgical procedure. Blind cessation and reversal of anticoagulant and/or antiplatelet might delay the timing of surgery and thus would better be avoided
Cranioplasty Training Innovation Using Design Thinking: AugmentedReality and Interchangeability-Based Mannequin Prototype Kuswanto, Djoko; Alifah Putri, Athirah Hersyadea; Zulaikha, Ellya; Apriawan, Tedy; Pamungkas, Yuri; Triandini, Evi; Jafari, Nadya Paramitha; Chusak, Thassaporn
MATRIK : Jurnal Manajemen, Teknik Informatika dan Rekayasa Komputer Vol. 24 No. 3 (2025)
Publisher : Universitas Bumigora

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30812/matrik.v24i3.5055

Abstract

Cranioplasty, a surgical procedure to reconstruct the anatomical structure of the human skull, is commonlyperformed in Indonesia due to the malignancy of diseases, traffic accidents, and workplaceinjuries. If left untreated, this condition can lead to serious complications. Although cranioplasty isgenerally considered a relatively easy surgery, it has a fairly high postoperative complication rate ofaround 10.3%. The decreasing availability of cadavers for anatomical studies has significantly limitedtraining opportunities. Therefore, efficient and effective training tools are essential, especially whentraditional resources are insufficient to meet educational needs. Additionally, the training capabilitiesof commercially available mannequins or replicas used in medical institutions remain limited. Themain objective of this project was to develop a smart, modular cranioplasty training mannequin designedfor repeated use, incorporating Augmented Reality (AR) technology to visualize anatomicalstructures that cannot be physically replicated. Using a design thinking approach, data was collectedthrough interviews with neurosurgeons, neurosurgery residents, and cranioplasty specialists, as well asthrough a review of relevant literature. Usability testing of the developed prototype yielded promisingresults, with high ratings for ease of use (4.8), training effectiveness (4.5), anatomical realism (4.3),and material durability (4.5) on a 5-point Likert scale. These findings demonstrated strong user approvaland confirmed the model’s potential to support surgical skill development in a practical andreproducible manner. The resulting AR-integrated training mannequin offers an innovative, engaging,and durable solution to address current challenges in neurosurgical education, especially in resourceconstrainedsettings.
Mortality Determinants in Severe Traumatic Brain Injury with Pneumonia: A Retrospective Study Apriawan, Tedy; Armando, Alivery Raihanada; Kamaruddin, Muhammad Fadhil
Indonesian Journal of Anesthesiology and Reanimation Vol. 7 No. 2 (2025): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V7I22025.66-75

Abstract

Introduction: Traumatic brain injury (TBI) is defined as an acute brain injury caused by mechanical forces to the head, excluding those related to drugs, alcohol, medications, or other conditions, such as systemic injuries, psychological trauma, or coexisting medical issues. TBI is a global public health issue responsible for significant disability and mortality, with an estimated global incidence of 69 to over 100 million new cases annually. This burden may be higher due to underreporting, particularly in low- and middle-income countries (LMICs). Several methods have been established to classify TBI, one of them is based on its severity with the Glasgow Coma Score (GCS). Pneumonia is a frequent complication in traumatic brain injury (TBI) patients, especially those on prolonged mechanical ventilation. Pneumonia could be classified based on the source of infection into ventilator-associated pneumonia (VAP), hospital-associated pneumonia (HAP), and community-acquired pneumonia (CAP). Objective: To evaluate the mortality and risk factors of severe traumatic brain injury (sTBI) with pneumonia. Methods: This study is a cross-sectional study with observational analytical investigations. The sample of this study is sTBI patients who were treated in Dr. Soetomo General Academic Hospital in 2023. Descriptive statistics were used to summarize the patients' characteristics. Chi-square tests and logistic regression were used to find relationship between factors that increase the risk of death and the development of pneumonia. Results: In 2023, we documented 832 TBI cases, of these, 479 cases (57.6%) were mild TBI, 273 cases (32.8%) were moderate brain injuries, while severe brain injuries (sTBI) with 80 cases (9.6%). Our study shows that 50% of patients with sTBI have pneumonia, and VAP itself is one of the contributing factors to mortality in this population (p<0.001). Conclusion: Of all types of pneumonia in this study, there is a statistical correlation between mortality and VAP in sTBI patients.
EDUCATION REGARDING EARLY DETECTION AND EARLY TREATMENT OF BRAIN TUMORS IN BANYUWANGI REGENCY, INDONESIA Susilo, Rahadian Indarto; Haq , Irwan Barlian Immadoel; Apriawan, Tedy; Wahyuhadi, Joni; Puspikawati, Septa Indra; Ramadhaningtyas , Erica Medina
Journal of Public Health Research and Community Health Development Vol. 9 No. 1 (2025): October
Publisher : Fakultas Ilmu Kesehatan, Kedokteran dan Ilmu Alam (FIKKIA), Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jphrecode.v9i1.68478

Abstract

Brain tumors were estimated to occur at 6.4 per 100,000 people each year. The incidence rate of brain tumors in children is reported to be 5.7% out of every 100,000 children, while in adults, the reported rate is significantly higher at 29.9% out of every 100,000 people. Banyuwangi Regency has an area of 5,782.50 km2 with a population in 2018 of 1,609,677 people with a density of around 278 people/km2. With such a large population, early detection of brain tumors is important for the public to understand. Early detection activity programs from community health centre need to be held with the hope that health workers will be able to provide education and information regarding early symptoms and signs of brain tumors as well as risk factors for brain tumors for prevention. Increasing public knowledge about alerting the early symptoms of brain tumors is one strategy that can be used to reduce death and disability rates due to brain tumors. The aim of this community service program is to increase the knowledge of the lay public and health workers regarding early detection and early treatment of brain tumors in Banyuwangi Regency. Pre- and post-test questionnaires were given before and after the material to evaluate the increase in knowledge about brain tumors for lay people and health workers in Banyuwangi Regency. The results obtained a significant increase (p < 0.01) between the pre-test and post-test scores so that this community service increases the knowledge of the community in Banyuwangi Regency.