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All Journal Jurnal Sinaps Ophthalmologica Indonesiana
Gilbert Tangkudung
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Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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MOYAMOYA DISEASE DENGAN PERDARAHAN INTRAVENTRIKULAR PADA PASIEN USIA MUDA Gilbert Tangkudung; Ricky Gunawan; Rizal Tumewah; Junita Maja Pertiwi
Jurnal Sinaps Vol. 3 No. 2 (2020): Volume 3 Nomor 2, Juni 2020
Publisher : Neurologi Manado

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (304.703 KB)

Abstract

Pendahuluan : Moyamoya Disease (MMD) adalah kasus langka yang dapat menyebabkan stroke pada usia muda. Insiden MMD sangat jarang, biasanya terjadi pada wanita di bawah usia 20.1 MMD hadir dengan berbagai kasus serebrovaskular termasuk TIA, stroke iskemik, perdarahan intrakranial, sakit kepala, atau kejang. Tipe iskemik mendominasi pada usia muda, sedangkan tipe hemoragik mendominasi pada orang dewasa.2 Perkembangan MMD progresif dan simptomatik dalam 5 tahun; hasilnya buruk jika tanpa pengobatan. Ini merupakan kasus pertama yang kami temukan. Laporan kasus : Sebuah kasus, perempuan Asia 21 tahun, mengalami sakit kepala berat dengan VAS: 9, kaku kuduk, paresis saraf wajah kanan tipe UMN, dengan pemeriksaan darah normal. NCCT Otak ditemukan perdarahan intraventrikular pada ventrikel lateral kiri. Angiografi serebral ditemukan oklusi total segmen M1 kiri, kolateral leptomeningeal dari ACA kiri ke MCA, dilatasi segmen P1 kiri, kolateral leptomeningeal PCA kiri cabang temporal ke kortikal MCA, blush koroidal di sisi kiri. Pasien didiagnosis dengan MMD (klasifikasi Suzuki stage II) dan tatalaksana pengobatan konservatif, mRS setelah perawatan adalah 0. Pasien menjalani MRI dan MRA TOF setelah 9 bulan kemudian dan ditemukan normal pada MRI dan ada penyempitan kaliber di segmen proksimal A1 kiri. Kesimpulan : MMD adalah kasus yang langka yang didiagnosis dengan angiografi serebral. Manajemen perawatan konservatif adalah pilihan pada onset awal dalam kasus ini. Namun, pemantauan ketat terhadap pemeriksaan klinis dan radiologis diperlukan. Kata Kunci: Moyamoya Disease, stroke usia muda, perdarahan intraventrikular.
DIRECT CAROTID CAVERNOSUS FISTULA: Poster Presentation - Case Report - Resident Monica Camilla Chandra; Stevanus Paliliewu; Robby Tumewu; Gilbert Tangkudung
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/n632gc31

Abstract

Abstract Introduction : Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system, most commonly due to head trauma from a basal skull fracture creating a tear in the internal carotid artery (ICA) within the cavernous sinus. Case Illustration : A 15 years old girl presented with orbital pain, swelling, swishing or buzzing sounds, headache, and vision loss. Five months ago, she had a history of traumatic injury and undergone craniotomy. From physical examination Orbital ultrasound presence with dilated superior ophthalmic vein, which appears as a hollow tubular structure with no internal echo. MRI scan show a mass suggestive carotid cavernosus fistula dextra. DSA result confirmed the diagnose as direct carotid cavernosus fistula dextra as communication between internal carotid artery and sinus cavernosus. The patient was treated with neuroprotective along medication followed by endovascular treatment from the neurointervention department. Discussion : The classic triad of CCF includes pulsatile exophthalmos, chemosis and orbital bruit. Ophthalmic manifestations of CCFs vary widely depending on underlying aetiology, type, size, location, blood flow rate and drainage route of the CCF. Patient initially undergo noninvasive imaging with orbital ultrasound and magnetic resonance imaging (MRI). Digital subtraction angiography is the gold standard in the diagnosis of CCF and must be performed before any potential intervention. Conclusion : This case describes a patient who was diagnose with direct carotid cavernous fistula of the right eye.
Co-Authors Junita Maja Pertiwi Monica Camilla Chandra Ricky Gunawan Rizal Tumewah Robby Tumewu STEVANUS PALILIEWU