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All Journal BALI MEDICAL JOURNAL (BMJ) The Indonesian Biomedical Journal Universa Medicina Paediatrica Indonesiana Medicinus : Jurnal Kedokteran SCRIPTA SCORE Scientific Medical Journal Jurnal Ilmu Bedah Indonesia
Eka J. Wahjoepramono
Department Of Neurosurgery, Faculty Of Medicine, Universitas Pelita Harapan, Neuroscience Center, Siloam Hospital Lippo Village, Tangerang, Banten
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Intracranial Solitary Fibrous Tumor in a 25-Year-Old Woman Prasetyo, Patricia Diana; Marisca, Stephanie; Wahjoepramono, Eka J.
Medicinus Vol. 13 No. 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8890

Abstract

Introduction: Intracranial solitary fibrous tumors (ISFTs) are extremely rare spindle cell tumors originating from dendritic mesenchymal cells expressing CD34 antigens that are usually benign, although malignant transformation had been reported. The knowledge of natural course and prognostic factors of ISFTs is still limited and the tumor is easily misdiagnosed.Case Presentation: An intra-cranial extra-axial tumor tissue resection from a 25-year-old woman was evaluated in the Surgical Pathology Laboratory. Histologic findings (cellular spindle cell tumor with ”˜patternless’ pattern, staghorn blood vessels and <5 mitoses per 10 hpf) and immunophenotype (positive for CD34, weakly and focally positive for STAT6) suggested a diagnosis of intracranial solitary fibrous tumor WHO Grade II.Discussion: ISFTs have very low incidence in the CNS and are difficult to distinguish radiologically from meningiomas, thus post operative pathological examination and immunohistochemistry markers evaluations are the mainstay for diagnosis. ISFT is associated with NAB2-STAT6 gene fusion and may exhibits a wide spectrum of histological features. STAT6 immunohistochemistry is considered as one of the most sensitive diagnostic methods, while the evaluation of CD34 expression can be used as alternative diagnostic method despite having lower sensitivity.
Identification and Interpretation of Spinal Cord Injuries in Robbery Victims: A Forensic Review Kusumaningrat, Donald Rinaldi; Wahjoepramono, Eka Julianta; Purnamasari, Dewi
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9247

Abstract

Robbery is intrinsically a violent crime and is defined as the original criminal plan of the perpetrator by committing robbery, by force committed on occasion or with the pretext of robbery. Strangulation by ligature occurs when an external force is applied to the neck causing various traumatic pathologies. If the injury is severe enough, cerebral perfusion and oxygen delivery are compromised and can lead to asphyxia and rapid neuronal death. These injuries can be encountered in a variety of clinical scenarios and may be present in suicide attempts, sports injuries, motor vehicle trauma, and may have implications in the fields of criminology and forensic pathology. In this case, a 66-year-old woman who was a victim of a robbery suffered a neck injury. After examination, there was a fracture in the cervical spine and was diagnosed with spinal cord trauma. As a result of this injury, the victim suffered permanent paralysis. The perpetrators of the robbery are threatened with criminal penalties under 364 KUHP and/or Article 351 No 3 KUHP.
WNT-Activated Medulloblastoma in A 6-Year-Old Boy Prasetyo, Patricia Diana; Wahjoepramono, Eka Julianta
Medicinus Vol. 13 No. 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7530

Abstract

Background: Medulloblastoma is the most common malignant brain tumor of childhood. Prognosis is mostly favorable, but may be affected by histological and molecular subtypes. Long-term therapy-related morbidity also remains a significant concern.Case Presentation: A 6-year-old boy with brainstem/midline cerebellum tumor. Histopathology found area of necrosis, sheets of malignant undifferentiated round cells with hyperchromatic nuclei and scanty cytoplasm, no nodule and no anaplasia. Immunohistochemistry found p53 wild-type staining pattern along with b-catenin diffuse cytoplasmic and focal nuclear staining. This indicated a diagnosis of WNT-activated medulloblastoma, World Health Organization (WHO) grade IV, with classic histological features.Discussion: WNT-activated medulloblastomas with classic histological features and no anaplasia were reported to have the most favorable prognosis. The current patient showed negative staining for GFAP, Olig2, EMA, H3K27M, EZHIP, and LIN28A, with retained staining for INI1 and BRG1, thus excluding several differential diagnosis such as atypical teratoid/rhabdoid tumor, embryonal tumor with multilayered rosettes, small cell glioblastoma, Ewing sarcoma, high-grade neuroepithelial tumor with BCOR alteration or diffuse midline glioma. Histopathology in combination with immunohistochemical and molecular subtyping of medulloblastoma can help to refine diagnosis, exclude differential diagnosis, and improve counseling in regards to overall prognosis.
Intramedullary Spinal Cord Cavernoma: A Case Report and Literature Review Widjaya, Ingrid A; Yunus, Yesaya; Wahjoepramono, Eka Julianta; July, Julius
Medicinus Vol. 13 No. 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7533

Abstract

Background: Spinal cord intramedullary cavernous malformation (SICM) is kind of rare vascular disease, and the therapeutic strategy is still under debate. Cavernous malformation (CM) can be found throughout the central nervous system (CNS) but only rarely occur within the spinal cord. The purpose of this article is to describe natural history, clinical presentation and outcome of SICM case which treated surgicallyCase Presentation: A 70-year-old healthy woman presented with lower extremity weakness. A posterior laminectomy was performed, and a diagnosis of intramedullary spinal cord cavernous malformation was established. Neurological improvement was seen in one month after surgeryConclusion: Intramedullary CM is a rare disease but one with significant consequences if not managed appropriately. whenever safely feasible, gross total resection is suggested, to prevent rebleeding and further worsened of neurological deficit.
Findings of Fahr’s Syndrome in A Patient Suspected With Subarachnoid Hemorrhage: An Evidence-Based Case Report Gilbert Sterling Octavius; Theo Audi Yanto; Nicholas Gabriel H.R.; Eka Julianta Wahjoepramono; Harsan
SCRIPTA SCORE Scientific Medical Journal Vol. 1 No. 2 (2020): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1034.235 KB) | DOI: 10.32734/scripta.v1i2.1244

Abstract

ABSTRACT Fahr’s syndrome is an entity where there is symmetrical bilateral calcification of basal ganglia with parkinsonian and psychiatric symptoms. However, due to its rarity, clinicians tend not to include Fahr’s syndrome in their differential diagnosis. This article aims to raise awareness about the diagnosis of Fahr’s Syndrome through its unique presentation in this patient. Data was obtained primarily and secondarily. In this case, a 32 years old male was referred to our clinic with chief complaints of headache since a week prior and a seizure 5 days ago. A head CT and a CT angiography (CTA) of the circulus willisi were done and a bilateral and symmetrical calcification of the corona radiata, basal ganglia, thalamus, and nucleus dentatus were found. There is also hypocalcemia and low Parathyroid Hormone (PTH). Fahr’s Syndrome may manifest unusually and hence clinicians have to be aware of diagnosing this entity. Keywords: Fahr’s Disease, Fahr’s Syndrome ABSTRAK Sindroma Fahr’s merupakan sebuah penyakit yang ditandai dengan kalsifikasi bilateral sietris dari basal ganglia dengan gejala psikatri dan parkinsonisme. Namun, akibat jarangnya ditemukan penyakit ini, klinisi cenderung tidak memikirkan sindroma Fahr’s sebagai salah satu diagnosis banding. Artikel ini bertujuan untuk meningkatkan kewaspadaan terhadap diagnosis Sindroma Fahr’s melalui presentasi unik pada pasien ini. Data diambil secara primer dan sekunder. Pada kasus ini, seorang laki-laki berusia 32 tahun dirujuk dengan keluhan utama sakit kepala sejak satu minggu dan kejang 5 hari sebelum masuk rumah sakit. Computed Tomography (CT) scan kepala dan Computed Tomography Angiography (CTA) dari sirkulus willisi dilakukan dan ditemukan adanya kalsifikasi bilateral simetris pada korona radiata, basal ganglia, talamus dan nukleus dentatus. Pada pemeriksaan laboratorium ditemukan adanya hipokalsemia dan hormon paratiroid (PTH) yang rendah. Sindroma Fahr’s dapat datang dengan presentasi yang tidak khas sehingga para klinisi harus lebih tajam dalam mendiagnosis kasus ini. Kata kunci: Penyakit Fahr’s, Sindroma Fahr’s
Co-Authors Alexander Cahyadi, Alexander Amiruddin Aliah, Amiruddin Andi Asadul Islam Andi Asadul Islam Andi Asadul Islam As'ad, Suryani Beny Atmadja Wirjomartani Budhianto Suhadi Cahyono Kaelan, Cahyono Dewi Purnamasari Gilbert Sterling Octavius Harsan Harsan Harsan Ilham J. Patellongi, Ilham J. Ilhamjaya Patellongi Irawan Yusuf Irawan Yusuf Jan S. Purba, Jan S. Julius July Kusumaningrat, Donald Rinaldi Made Agus Mahendra Inggas, Made Agus Mahendra Marisca, Stephanie Nicholas Gabriel H.R. Prasetyo, Patricia Diana Rocksy F.V. Situmeang, Rocksy F.V. Silmi Mariya Sri Maliawan Sutisna Himawan Syarifuddin Wahid THEO AUDI YANTO, THEO AUDI Vivien Puspitasari, Vivien Widjaya, Ingrid A Yesaya Yunus Yesaya Yunus