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All Journal Medical Journal of Indonesia Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Sinaps Majalah Kedokteran Neurosains Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Indonesian Journal of Cancer eJournal Kedokteran Indonesia Neurona Acta Neurologica Indonesia
Tiara Aninditha Tiara Aninditha
Departemen Neurologi FK Universitas Indonesia/RSUPN Dr. Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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PROFIL PEMERIKSAAN EVOKED POTENTIAL PADA KASUS NEUROONKOLOGI DI RSUPN DR. CIPTO MANGUNKUSUMO Tejomukti, Teddy; Aninditha, Tiara
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.476

Abstract

ABSTRACT Introduction: Functional integrity of specified cortical areas and pathways in the central nervous system can be assessed by recording electrical potency such as Evoked Potential (EP) related to sensory or motoric events. Neoplasm can disturb functional integrity in the nervous system. Methods: This was an analytic cross-sectional research with the categorical approach in patients who underwent EP in Neurological Clinic RSUPN dr. Cipto Mangunkusumo Jakarta since 2022. Data were taken from medical records from December 2022 to March 2023. Demographic data, clinical data, neoplasm data, and EP examination data were recorded. The relation between neoplasm (type, location, number of lesions) and symptoms to EP results were analysed with Chi Square test Result: There were 660 evoked potential examinations consisting of 363 SSEP, 242 VEP and 55 BAEP examinations for various neurological clinical indications, however EP examinations indicated for neurooncology cases were 45 subjects or 6.8% of all examinations. A significant relation was found between sensory (p=0.03), motor (p=0.04), and autonomic (p=0.004) symptoms with abnormal SSEP examination results. Pain was not associated with abnormal SSEPs. No significant relationship was found between the number and location of tumors with the SSEP examination. All of the study subjects (100%) had visual disturbances and abnormal features of VEP. The BAEP examination was not analyzed because the sample size was too small. Conclusion: EP may be indicated in neurooncology cases in assessing functional lesions due to tumors, both intracranial and spinal. Keywords: Evoked Potential, nervous system neoplasm
Emotional Impact of In Vitro Fertilization (IVF): Anxiety, Depression, and Their Relationship with Pregnancy Outcomes Agiananda, Feranindhya; Natadisastra, Raden Muharram; Amir, Nurmiati; Irwanto; Aninditha, Tiara; Wibisono, Sasanto; Wahmurti, Tuti; Kekalih, Aria; Karnasih, Artasya; Samjunanto, Achmad; Puspaseruni, Putri Air; Velyani, Dyani Pitra; Prayangga, Regina
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 3 July 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i3.2626

Abstract

Objectives: Infertility can significantly impact women's physical and psychological health. Numerous treatment options are commonly pursued, with IVF often considered the last resort for infertile couples. However, IVF is associated with increased stress at every stage, potentially influencing women's perceptions and experiences throughout the procedure. This research examines anxiety and depression faced by women at different stages of IVF and analyzes their association with pregnancy outcomes. Methods: This cohort study was conducted at Dr. Cipto Mangunkusumo General Hospital and Dr. Sander B. Daya Medika Clinic from May 2018 to March 2023. Data were collected using questionnaires and assessments during IVF, focusing on the evaluation of anxiety, depression, and pregnancy outcomes. Chi-square and Fisher’s exact test was used to assess associations between variables, while Friedman ANOVA was used for longitudinal analysis of anxiety and depression scores during IVF. Results: The final analysis comprised 61 participants. The study revealed significant changes in anxiety and depression throughout IVF. Both anxiety (p < 0.001, Kendall’s w = 0.19) and depression levels (p = 0.001, Kendall’s w = 0.121) showed a significant rise across the IVF timeline. There is no statistically significant association between anxiety and depression scores and pregnancy outcomes across three measurement points during IVF (p > 0.05). Conclusion: Anxiety and depression significantly increase during IVF but do not affect clinical pregnancy rates. These findings highlight the importance of mental health screening and psychiatric support during IVF to ensure women’s comfort and enable them to navigate IVF more effectively. Keywords: Anxiety, Depression, Pregnancy Outcomes, Women, In Vitro Fertilization (IVF)
Headache Characteristic in Brain Tumor Patients Sembiring, Saulina; Sofyan, Henry Riyanto; Madjid, Irma Savitri; Alvonsius Silalahi, Raymond Aris Nimrod; Albertin, Elizabeth; Aninditha, Tiara
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1197

Abstract

Background: Headache is an alarm for structural abnormalities, and it frequently manifests as an initial symptom of brain tumors, with an occurrence rate ranging between 36-80%, depending on the type and location of the tumorMethods: We conducted a retrospective cross-sectional study to observe hospitalized brain tumor patients at Dr. Cipto Mangunkusumo Hospital from January 2022 to March 2023. This study described the prevalence and the percentages of baseline characteristics.Results: Our study revealed that out of 101 brain tumor patients, predominated by females (60.4%) with a mean age of 46.2 years. Secondary brain tumors originating from breast cancer were more prevalent (13.9%). Frontal lobe location was frequent (32.3%), displaying rapid growth (66.3%), focal deficits (82.2%), and headaches (79.2%). Atypical headache was the most common phenotype (40%), often occurring either before the onset of neurological deficits (prechronous) or concurrently with them (synchronous). Discussion: The study revealed that high-grade, rapidly growing brain tumors tend to induce focal neurological deficits and headaches due to the tumor’s progressivity and mass effect. Brain tumor lesions were primarily found in the frontal lobe of the supratentorial region, displaying a mainly atypical headache phenotype. The absence of pain receptors in the parenchyma suggested that pain resulted from mechanical stimulation of other pain-sensitive structures.Conclusion: Atypical headaches occurring within 30 days before neurological deficits could indicate potential malignancy.
Validity and reliability of the Indonesian version of the Douleur Neuropathique 4 for neuropathic pain Sofyan, Henry Riyanto; Hartono, Chandra; Savitri, Irma; Alvonsius, Raymond Aris Nimrod; Hakim, Manfaluthy; Aninditha, Tiara
Medical Journal of Indonesia Vol. 34 No. 4 (2025): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257725

Abstract

BACKGROUND The Douleur Neuropathique 4 (DN4) is a widely used questionnaire for assessing neuropathic pain, demonstrating good sensitivity and specificity across various languages. Originally developed in France, cultural and linguistic differences necessitate its translation, validation, and reliability testing before use in Indonesia. This study aimed to translate, culturally adapt, and evaluate the validity and reliability of the Indonesian version of the DN4 questionnaire (DN4-Ina) for use in clinical and research settings. METHODS Translation and cross-cultural adaptation were conducted following World Health Organization guidelines in Indonesian. A cross-sectional study was conducted in the Neurology Clinic, Cipto Mangunkusumo Hospital, to assess the validity and reliability of the DN4-Ina. The study subjects were selected through consecutive sampling of adult patients with chronic pain visiting the clinic from June to December 2023. Validity and reliability were assessed using SPSS software version 25. Validity testing utilized adjusted item-total correlation analysis, while reliability testing was evaluated using the test-retest method, intraclass correlation coefficient (ICC), and Cronbach’s alpha for internal consistency. RESULTS Of 40 participants, 65% were female, with a mean age of 51.85 (13–92) years, moderate pain intensity (mean numeric rating scale of 4.25 [2.99]), and pain duration of 7.95 (4.41) months. All DN4-Ina questions showed a correlation coefficient (r) greater than the table’s value (0.312). The reliability test showed an ICC of 0.99 and a Cronbach’s alpha of 0.746. CONCLUSIONS The DN4-Ina score is a valid and reliable questionnaire for assessing neuropathic pain in the Indonesian population.
Tata Cara Pengisian Headache Diary sebagai Instrumen Pemantauan dan Diagnosis Nyeri Kepala: Sebuah Tinjauan Pustaka Henry Riyanto Sofyan; Irma Savitri; Nur Afany; Ery Riady Indrapriambada; Ahmad Rafi Faiq; Tiara Aninditha
Majalah Kedokteran Indonesia Vol 75 No 6 (2025): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.75.6-2025-2005

Abstract

Headache diary is an important tool for improving the diagnostic accuracy and clinical monitoring of headache disorders, particularly in conditions with variable or chronic patterns such as migraine. In the absence of a gold-standard diagnostic test, prospective documentation helps reduce recall bias and supports classification based on ICHD-3 criteria. This narrative review summarizes the evidence on the use of paper headache diaries (PHD) and electronic headache diaries (EHD) in clinical practice. Various studies demonstrate that both formats enhance diagnostic precision, facilitate identification of triggers and attack patterns, and support evaluation of abortive and prophylactic therapies. EHD provides additional advantages through automated time-stamping, graphical trend visualization, and easier longitudinal analysis, although its use may be limited by device availability and digital literacy. Evidence from local and international studies consistently highlights the value of headache diaries across primary, secondary, and tertiary care settings. Overall, headache diaries remain practical, effective instruments that should be integrated into routine clinical management of headache disorders.
Loss of Consciousness in Nasopharyngeal Carcinoma with Brainstem Infiltration Tiara Aninditha; Ikhlas Rahmadi; Ferucha Moulanda; Ardhi Rahman Ahani; Radius Kusuma; Henry Riyanto Sofyan; Irma Savitri
Acta Neurologica Indonesia Vol. 3 No. 03 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i03.90

Abstract

Introduction: Nasopharyngeal carcinoma (NPC) is prone to intracranial infiltration in advanced stages due to its proximity to the skull base, despite the protective bony structures. Loss of consciousness in NPC patients with brainstem involvement should be distinguished from other causes. Case Report: A 70-year-old man developed progressive symptoms, including left otalgia and trismus, within eight months before admission. CT revealed a nasopharyngeal mass infiltrating the medullary and pontine cisterns, confirmed as nonkeratinized NPC from biopsy. One month prior, he underwent tracheostomy for airway obstruction. Ten days before admission, he experienced nausea, vomiting, and altered consciousness. During hospitalization, severe hyponatremia was detected and confirmed as the main etiology, further proven by the fact that the patient only regained consciousness after hypertonic saline infusion while being unresponsive after prior dexamethasone administration. After four days, he was discharged with plans for chemotherapy and radiotherapy. Discussion: Brainstem infiltration in NPC is rare, even in advanced stages, due to the protective skull base. However, intracranial spread can occur via foramina or direct bony destruction. Loss of consciousness in NPC patients with suspected brainstem infiltration requires careful evaluation, as non-tumoral causes like hyponatremia should be considered. Tumor-induced malnutrition, impairing mastication and intake, may contribute to electrolyte imbalances. Conclusion: In NPC patients with brainstem infiltration, loss of consciousness should not be immediately attributed to direct tumor invasion. Other treatable causes, such as hyponatremia, must be promptly detected to ensure appropriate management.
Managing Elevated Intracranial Pressure as the Complication of Angiomatous Meningioma Adriana Damayanti; Tiara Aninditha; Henry Riyanto Sofyan; Irma Savitri; Rahmad Mulyadi; Mohamad Saekhu
Acta Neurologica Indonesia Vol. 3 No. 04 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i04.92

Abstract

Introduction: Meningioma is the most common central nervous system primary tumor, which can grow at the cranial base. Angiomatous meningioma, with a prevalence of 2.1%, is classified as the World Health Organization (WHO) grade I meningioma. Although considered benign, it has high Vascular Endothelial Growth Factor (VEGF) activity. Case Report: A 41-year-old woman presented with clear nasal discharge upon sitting, progressive headaches, blurred vision, and right-sided hemiparesis following prior surgeries for angiomatous meningioma. Initial symptoms included episodic headaches, later worsening with visual impairment and motor deficits. She underwent decompressive craniectomy, VP shunt placement for hydrocephalus, and cranioplasty but had a functional decline. Examination revealed decreased consciousness, anisocoria, right facial nerve palsy, spastic hemiparesis, and pressure ulcers. Imaging confirmed tumor progression with uncal herniation and hydrocephalus. After infection management, VP shunt revision improved her condition, and tumor resection was planned. The prognosis remained poor regarding survival, function, and recovery. Discussion: Although considered benign, it has high activity of Vascular Endothelial Growth Factor (VEGF). Massive peritumoral edema may lead to complications by increasing intracranial pressure (ICP). The management of elevated ICP includes tumor resection, cerebrospinal fluid (CSF) diversion, and administration of anti-edema agents. Due to its challenging access and proximity to vital structures such as cranial nerves and blood vessels, determining an appropriate management strategy poses a significant challenge to avoid disability. Conclusion: Skull base meningioma in women aged 40–70 poses a high risk of complications and disability if mismanaged, especially angiomatous meningioma with high vascularity despite being WHO Grade I.
Management High Grade Glioma in Elderly Sofyan, Henry Riyanto; Pratiwi, Intan; Fahmi Radityamurti; Anastasia Asylia Dinakrisma; Aninditha, Tiara; Savitri, Irma
Acta Neurologica Indonesia Vol. 3 No. 03 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i03.93

Abstract

Introduction: High-grade glioma (HGG) is an aggressive primary brain tumor with poor prognosis, particularly in elderly patients. Management is complex due to comorbidities, decreased functional status, and increased risk of treatment-related toxicity. Personalized approaches balancing efficacy and quality of life are essential in this population. Case Report: A 67-year-old male presented with progressive headache, limb weakness, and visual disturbances. MRI revealed a large right temporoparietal lesion suggestive of HGG. Craniotomy and biopsy confirmed a high-grade glioma. The patient had a Karnofsky Performance Status (KPS) of 40, with significant cognitive and functional impairments, along with comorbidities including diabetes and hypertension. Given his frailty, he was treated with hypofractionated radiotherapy and concurrent temozolomide. Discussion: Treatment decisions in elderly HGG patients should consider age, KPS, cognitive status, and comorbidities. Hypofractionated radiotherapy combined with temozolomide is effective and better tolerated in frail patients. Multidisciplinary care is crucial to manage physical, cognitive, and emotional needs. Cognitive assessment before therapy aids in anticipating treatment impact. Prophylactic treatment for opportunistic infections such as Pneumocystis jirovecii is recommended during chemotherapy. Conclusion: Elderly patients with HGG require individualized, multidisciplinary care. Factors such as performance status, cognitive function, and comorbidities must guide treatment to achieve optimal outcomes while preserving quality of life
Rare Case of Solitary Brain Metastasis from Colorectal Cancer Ririhena, Fiorentina C; Aninditha, Tiara; Sofyan, Henry Riyanto; Madjid, Irma Savitri
Acta Neurologica Indonesia Vol. 4 No. 02 (2026): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v4i02.94

Abstract

Introduction: Solitary brain metastasis (BM) from colorectal cancer (CRC) is rare (0.6–3.2%) and presents management challenges, especially in eloquent brain regions where surgical resection carries high risk. Stereotactic radiotherapy (SRT) is often preferred when surgery is not feasible, particularly in patients with good functional status. Case Illustration: A 49-year-old male with a KPS of 90 presented with worsening right-sided pulsating headaches for five days, accompanied by left-sided facial nerve palsy. MRI revealed a solitary intra-axial metastasis in the right temporal lobe, an eloquent region, with microbleeds and surrounding edema, suggestive of BM from rectal adenocarcinoma. Given the lesion's eloquent location, where surgery posed high risks, SRT was selected as the primary treatment modality, alongside corticosteroids for edema control and psychiatric support for depression Discussion: Solitary CRC BM in eloquent regions is a clinical dilemma. While surgery is standard for accessible lesions, SRT offers effective tumor control while reducing neurological complications, making it preferable for patients with high KPS (≥90) as it preserves cognitive function and improves survival outcomes. A multidisciplinary and holistic treatment approach, addressing both oncological and psychological aspects, is essential. Conclusion: Managing solitary CRC BM in eloquent brain regions requires special strategies. SRT was favored to reduce the risk of neurological impairment while maintaining tumor control, especially when surgery was not viable. A multidisciplinary approach is crucial to optimizing care and improving quality of life. Keywords: solitary brain metastasis, colorectal cancer, stereotactic radiotherapy, eloquent brain region
Distinguishing Spinal Cancer and Degenerative Disease: Enhancing Diagnosis and Treatment Outcomes in Plasmacytoma -, Liana Alviah Saputri; Riyanto Sofyan, Henry; Aninditha, Tiara; Savitri, Irma; Saekhu, Mohammad; Kusuma, Radius
Acta Neurologica Indonesia Vol. 4 No. 01 (2026): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction: Spinal lesions commonly exhibit overlapping clinical presentations and imaging characteristics, which can obscure the distinction between malignant and degenerative etiologies. This diagnostic ambiguity may lead to delayed or inappropriate treatment, particularly in uncommon neoplastic entities such as plasmacytoma, a solitary manifestation of plasma cell dyscrasia that often involves the spine. Case Report: We report the case of a 63-year-old male presenting with one month of persistent back pain, progressive bilateral lower limb weakness, and tingling sensations radiating from the inguinal region to the toes. Imaging studies revealed bilateral pedicle destruction at the L2 and L5 vertebrae, along with significant spinal canal and foraminal stenosis. The patient underwent decompression surgery, and histopathological analysis of the lesion confirmed the diagnosis of plasmacytoma. Discussion: Spinal plasmacytoma is a rare neoplastic condition that can clinically mimic degenerative spine disorders, often leading to delays in diagnosis and treatment. Symptoms such as chronic back pain, radiculopathy, and motor weakness are commonly attributed to more prevalent degenerative pathologies, particularly in older adults. Back pain in individuals with a history of malignancy serves as a crucial warning sign, prompting clinicians to urgently assess for potential metastatic disease in the spine. Conclusion: Increased awareness and a high index of suspicion are crucial when evaluating spinal lesions. Pain should be considered a key red flag warranting prompt assessment for possible spinal malignancy. Early diagnosis is critical, as it directly affects therapeutic decisions and overall prognosis.
Co-Authors -, Liana Alviah Saputri Adriana Damayanti Agiananda, Feranindhya Ahmad Rafi Faiq Ahmad Yanuar Albertin, Elizabeth Alvonsius Silalahi, Raymond Aris Nimrod Alvonsius, Raymond Aris Nimrod Among Wibowo Anastasia Asylia Dinakrisma Andayani, Diyah Eka Andhika Rachman Andira Larasari Anne Dina Subroto Ardhi Rahman Ahani Aria Kekalih Ariarini, Ni Nengah Rida Arthur H.P. Mawuntu Audrey Clarissa David Tandian Diafiri, Dinda Djohansjah, Joice Rosewitasari Aryanti Dyah Ayu Puspita Anggarsari Eka Susanto Elsa Susanti Eny Nurhayati Ery Riady Indrapriambada Fahmi Radityamurti Faiq, Ahmad Rafi Ferucha Moulanda Hakim, Manfaluthy Hartono, Chandra Henry Riyanto Sofyan Henry Riyanto Sofyan Henry Riyanto Sofyan Henry Riyanto Sofyan Henry Riyanto Sofyan Henry Riyanto Sofyan Hervita Diatri Humaira, Sarah Ikhlas Rahmadi Imran, Darma Indrapriambada, Ery Riady Irma Savitri Irma Savitri Irma Savitri Madjid IRWANTO Jonathan Odilo Jonathan Odilo Karnasih, Artasya Kartika Maharani Kemal Fariz Kalista Kusuma, Radius Louis Kwandou Madjid, Irma Savitri Mariana Nur Laila Maulina, Lisa Mohamad Saekhu Natadisastra, Raden Muharram Nugraeni, Tiara Nur Afany Nurmiati Amir Pratiwi, Intan Prayangga, Regina Profitasari Kusumaningrum Pukovisa Prawiroharjo, Pukovisa Puspaseruni, Putri Air Putri Auliya, Putri Radius Kusuma Rahmad Mulyadi Rahmi Ardhini Ramdinal Aviesena Zairinal Ranakusuma, Teguh Ranakusuma, Teguh A. S Renindra Ananda Aman Rini Andriani Rini Andriani Rini Andriani Rini Andriani Rini Andriani Rini Andriani Rini Andriani Ririhena, Fiorentina C Riwanti Estiasari Riyanto Sofyan, Henry Saekhu, Mohammad Samjunanto, Achmad Sari, Riska Nanda Savitri, Irma Sembiring, Saulina Sinthia, Novita Ayu Sitorus, Freddy Sofyan, Henry Riyanto Sophie Yolanda Stefen Weliadi Ali Susanto, Eka Tan Yosephine Tanjung, Gloria Tejomukti, Teddy Tiara Aninditha Velyani, Dyani Pitra Vera Nevada Wahmurti, Tuti Wibisono, Sasanto Winnugroho Wiratman Yesi Astri Yesnuar Safri, Ahmad Yetty Ramli Yulian, Erwin D.