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Cranial vault reduction cranioplasty for severe hydrocephalus: Case series and technical note Suryaningtyas, Wihasto; Parenrengi, Muhammad Arifin
Folia Medica Indonesiana Vol. 56 No. 2 (2020): June
Publisher : Universitas Airlangga

Extreme hydrocephalic macrocephaly is still encountered in developing countries due to delayed treatment, rapidly progressing hydrocephalus and family socioeconomic problems. Reduction cranioplasty was used with several techniques to address the issue. The study aimed to determine the safety and feasibility of barrel-stave technique for reducing the size of extreme hydrocephalic macrocephaly. Three post-diversion patients underwent surgical reconstruction. Children with head circumference more or equal to two standard deviation above mean on given age, no active wound at the area of surgery, presentation of sufficient "potential removable fluid” that allows dura reduction and no active shunt infection were eligible. The surgical procedure includes modified pi, barrel-stave technique, and diversion of the cerebrospinal fluid and subdural collection. Clinical data were recorded. Three patients with age range of 2 month to 2 years old underwent the surgery. Two patients had shunt implanted at least 1 month before the surgery and 1 patient had an ETV procedure 3 months before the reduction. The frontal-occipital circumference before surgery ranged from 50 to 63 cm. The maximum reduction that could be achieved was 15 cm. One patient (2 months old) died within 24 hour due to failure to cope with excessive blood loss. Two patients were followed up for 3 months and 6 months without complications. Reduction cranioplasty using barrel-stave techniques is an option for children with extreme large head that poses a mechanical or cosmetic problem. Risk and pitfalls should be considered and taken care meticulously, especially the age and blood loss.

Case Report: Cranial Vault Reduction Cranioplasty for Severe Hydrocephalus Suryaningtyas, Wihasto; Parenrengi, Muhammad Arifin
Folia Medica Indonesiana Vol. 56 No. 2 (2020): June
Publisher : Universitas Airlangga

Extreme hydrocephalic macrocephaly is still encountered in developing countries due to delayed treatment, rapidly progressing hydrocephalus and family socioeconomic problems. Reduction cranioplasty was used with several techniques to address the issue. The study aimed to determine the safety and feasibility of barrel-stave technique for reducing the size of extreme hydrocephalic macrocephaly. Three post-diversion patients underwent surgical reconstruction. Children with head circumference more or equal to two standard deviation above mean on given age, no active wound at the area of surgery, presentation of sufficient "potential removable fluid” that allows dura reduction and no active shunt infection were eligible. The surgical procedure includes modified pi, barrel-stave technique, and diversion of the cerebrospinal fluid and subdural collection. Clinical data were recorded. Three patients with age range of 2 month to 2 years old underwent the surgery. Two patients had shunt implanted at least 1 month before the surgery and 1 patient had an ETV procedure 3 months before the reduction. The frontal-occipital circumference before surgery ranged from 50 to 63 cm. The maximum reduction that could be achieved was 15 cm. One patient (2 months old) died within 24 hour due to failure to cope with excessive blood loss. Two patients were followed up for 3 months and 6 months without complications. Reduction cranioplasty using barrel-stave techniques is an option for children with extreme large head that poses a mechanical or cosmetic problem. Risk and pitfalls should be considered and taken care meticulously, especially the age and blood loss.

Profile of Pediatric Central Nervous System (CNS) Tumor Patients at Dr. Soetomo General Academic Hospital Surabaya in 2017-2023 Wirawan, Putu Tanisya Putri; Fauziah, Dyah; Suryaningtyas, Wihasto; Gunawan, Prastiya Indra
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i3.55861

Central nervous system (CNS) tumors are a heterogeneous group in any region of the brain and spinal cord. They causes significant morbidity and mortality. CNS tumor is diagnosed based on clinical and radiological findings, but a definitive diagnosis requires histopathology examination. However, the demographic and histopathological profile of pediatric CNS tumor is rarely studied in Indonesia. The study aims to analyze the profiles of pediatric CNS tumor patients based on demographic and histopathological characteristics. This retrospective descriptive study was conducted using secondary data from a medical records of all pediatric CNS tumor patients at Dr. Soetomo General Academic Hospital from January 2017 to December 2023. The results show a total of 165 cases were included in this study, 60% occurred in male and 40% in female. The majority of the patients aged 5-8 years old (30.3%) and tumors commonly located within posterior fossa (21.4%). WHO grade I pilocytic astrocytoma (24.2%) is the most common histopathological subtype for benign CNS tumors followed by WHO grade IV medulloblastoma (20.6%) for malignant CNS tumor. Thus, pediatric CNS tumor was found to be more frequent in males than females, with the peak occurring in 5-8 years old. The most common location was within posterior fossa. The most common histopathological subtype was WHO grade I pilocytic astrocytoma.

Analysis of Socioeconomic Status Among Risk Factors of Pediatric Abusive Head Trauma: A Systematic Review Felice, Calista; Parenrengi, Muhammad Arifin; Gunawan, Prastiya Indra; Suryaningtyas, Wihasto
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.53600

Highlight: Most studies agreed that socioeconomic status (SES) influences the prevalence of pediatric abusive head trauma. SES is associated with other AHT risk factors and contributes to varied clinical outcomes. AHT incidence can be reduced by prevention strategies that focus on education and enhanced healthcare access. ABSTRACT Introduction: Previous studies have shown that children from low socioeconomic status (SES) families are more likely to experience abusive head trauma (AHT). However, research on this topic remains limited. Some argue that clinicians may demonstrate diagnostic bias, tending to overidentify AHT in lower-SES children, regardless of actual risk. Is low SES truly a risk factor for AHT? If so, how does it affect AHT occurrence and its relationship with other risk factors? Objective: This review was to observe the relationship of SES as one of the risk factors of pediatric AHT. Methods: A systematic review was conducted on pediatric AHT using household SES data. Children with AHT were compared to non-abusive head trauma (non-AHT) controls. Articles published between 2002 and 2022 were searched from Scopus, PubMed, and Google Scholar, following PRISMA guidelines. Exlusion criteria included duplicates, inaccessible or non-English/Indonesia articles, and studies not meeting PECO criteria. Data on child age, sex, type of head trauma, and SES were collected. Demographic characterisctics, SES, risk factors, outcome, and preventive measures were analyzed. Results: A total of 19,700 articles were found after searching Scopus, PubMed, and Google Scholar. After several screenings, 18 articles were included. Of the 18 articles, 17 included data on patients with AHT, and 6 included data on control patients. In total, there were 21,451 patients with AHT and 411,185 controls. The control group consisted of children with non-AHT and children without trauma. The mean, median , and standard deviation of the percentage of low SES patients with AHT were relatively higher than controls. A higher amount of articles agreed that SES had a significant impact. Conclusion: SES may influence pediatric AHT prevalence, but it should not be used as a determinant in diagnostic decision-making.

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