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Penyakit Stroke dan Infeksi Corona Virus Disease 2019 (COVID-19): Sebuah Tinjauan Literatur Kurnianto, Aditya; Tugasworo, Dodik; Retnaningsih, Retnaningsih; Andhitara, Yovita; Ardhini, Rahmi; Tamad, Fatiha Sri Utami; Agung, Locoporta; Budiman, Jethro
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar belakang: Corona virus disease 2019 (COVID-19) adalah suatu penyakit yang disebabkan oleh virus severe acute resporatory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 awalnya diketahui menyerang saluran pernapasan, namun sekarang ini manifestasi klinisnya beragam termasuk manifestasi kelainan saraf/neurologis. Kelainan neurologis yang perlu mendapat perhatian khusus karena morbiditas dan mortalitasnya yang dapat ditekan bila ditangani secara tepat waktu adalah kasus penyakit serebrovaskular/stroke. Tujuan dari tinjauan literatur ini adalah mengkaji secara teori berdasarkan literatur tentang hubungan infeksi COVID-19 dan stroke. Metode: Review literatur Pembahasan: Stroke pada COVID-19 berhubungan dengan koagulopati, antibodi antifosfolipid, dan vaskulitis. Manifestasi klinis, pemeriksaan penunjang, dan penanganan pada kasus stroke dengan COVID-19 butuh mendapat perhatian khusus. Penanganan pada stroke dengan COVID-19 difokuskan kepada keselamatan pasien dan keamanan tenaga kesehatan. Simpulan: Vasokontriksi serebral, peradangan saraf, stres oksidatif, dan trombogenesis dapat berkontribusi terhadap patofisiologi stroke selama infeksi COVID-19. Protokol perawatan di rumah sakit harus dimodifikasi untuk memberikan perawatan individual yang lebih baik untuk pasien stroke disertai COVID-19 dan keamanan bagi tenaga kesehatan.

Ensefalitis pada Infeksi Corona Virus Disease 2019 (COVID-19): Sebuah Tinjauan Literatur Retnaningsih, Retnaningsih; Kurnianto, Aditya; Tugasworo, Dodik `; Andhitara, Yovita; Ardhini, Rahmi; Satrioaji, Hari Wahono; Budiman, Jethro
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar belakang: Infeksi Corona Virus Disesase 2019 (COVID-19) pertama kali terdeteksi pada Desember 2019 di Cina dan telah menyebar dengan cepat ke seluruh dunia. World Health Organization (WHO) baru-baru ini mengumumkan COVID-19 merupakan pandemi dunia dengan lebih dari 180.000 kasus dilaporkan hingga saat ini. Manifestasi neurologis dari COVID-19 berkaitan dengan penyakit serebrovaskular akut, gangguan kesadaran, dan kasus ensefalopati nekrotik hemoragik akut. Tujuan dari tinjauan literatur ini adalah mengkaji secara teori berdasarkan literatur tentang hubungan ensefalitis dan infeksi COVID-19. Metode: Review literatur Pembahasan: Ensefalitis dapat menyertai penyakit virus, seperti pada infeksi COVID-19. Ensefalitis virus mempengaruhi anak-anak, dewasa muda, atau pasien lanjut usia. Virus severe acute resporatory syndrome coronavirus 2 (SARS-CoV-2) dapat masuk ke sistem saraf pusat melalui nervus olfaktorius. Simpulan: Diagnosis ensefalitis COVID-19 dapat ditegakkan dengan anamnesis; pemeriksaan fisik; dan pemeriksaan penunjang berupa laboratorium darah, CT scan kepala, MRI serebral, EEG, analisa cairan serebrospinal, dan pemeriksaan PCR SARS-CoV-2 dari cairan serebrospinal. Kata Kunci: COVID-19, ensefalitis, neurologi Background: Corona Virus Disease 2019 (COVID-19) infection was first detected in December 2019 in China and has spread rapidly throughout the world. World Health Organization recently announced COVID-19 is a world pandemic with more than 180,000 reported cases. Neurological manifestations of COVID-19 were an acute cerebrovascular disease, impaired consciousness, and acute hemorrhagic necrotic encephalopathy. The aim of this literature review is to analyse theoretically based on literature about encephalitis in COVID-19.Methods: A literature reviewDiscussion: Encephalitis can accompany viral diseases, such as COVID-19. Viral encephalitis affects children, young adults, or elderly patients. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the central nervous system via the olfactory nerve.Conclusion: Covid-19 encephalitis can be detected by anamnesis, physical examination, and supporting examination: blood laboratory finding, head CT scan, cerebral MRI, EEG, cerebrospinal fluid (CSF) analysis, and PCR test of SARS-CoV-2 by CSF. Keywords: COVID-19, encephalitis, neurology

The Outcome of Surgical and Radiotherapy in Central Neurocytoma: A Case Report: The Outcome of Surgical and Radiotherapy in Central Neurocytoma: A Case Report Ardhini, Rahmi; Tsaniadi Prihastomo, Krisna; Firli Bramantyo, Dion; Tugasworo, Dodik; Retnaningsih, Retnaningsih; Andhitara, Yovita Andhitara; Kurnianto, Aditya Kurnianto; Budiman, Jethro
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.554

BACKGROUND: Central neurocytoma (CN) is an infrequent and non-malignant neuro-epithelial tumor. CN is mostly found in lateral ventricle and may generate obstructive hydrocephalus. Surgical-radiation can increase patient survival and prognosis. This case report presented a rare case about 30-year-old female with CN. CASE PRESENTATION: 30-year-old female came to the hospital with severe headache and vomiting. Brain MRI showed a heterogeneous mass in right lateral ventricle causing obstructive hydrocephalus. The patient undergone partial resection. CN confirmed from histopathological analysis. Afterward, patient received 54 Gy conventional radiotherapy. 3 months after radiation, patient remain asymptomatic and no neurological deficit. Brain MRI evaluation showed slightly reduction of tumor mass (from 4,09 x 3,01 x 4,13 cm before radiation to 4,00 x 3,86 x 3,63 cm after radiation). DISCUSSION: This case report was consistent clinically, radiologically, and histopathologically with intraventricular CN. Headache and vomiting in patient due to the raised intracranial pressure from tumor mass and obstructive hydrocephalus. Headache is a significant and most frequent symptom in intraventricular tumors, may be caused by traction or compression of the pain-sensitive structures such as meningen and intracranial vasculature. Optimal management of CN still remains controversial due to their rarity. However, surgical management with gross total resection is the gold standard of treatment modality, associated with good prognosis and longer progression-free survival. CONCLUSION: Based on clinical characteristic, radiographic finding and histopathological features; this case was consistent with CN of the lateral ventricle. Surgical as the treatment option followed by radiation has led to good clinical outcome in this patient. KEYWORDS: central neurocytoma, hydrocephalus, neuro-epethelial tumor, radiotherapy

Apolipoprotein E Polymorphism and Carotid Intima Medial Thickness Progression in Post Ischemic Stroke Patient: Apolipoprotein E Polymorphism and Carotid Intima Medial Thickness Progression in Post Ischemic Stroke Patient Kurnianto, Aditya; Retnaningsih, Retnaningsih; Tugasworo, Dodik; Andhitara, Yovita; Ardhini, Rahmi; Budiman, Jethro
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 2 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Background : Apolipoprotein E (APOE) gene is believed to associate with cholesterol level, a risk factor of ischemic stroke. CIMT (carotid intima-media thickness) can be used to determine the degree of atherosclerosis. Increased CIMT may predict ischemic stroke recurrence. This study aimed to determine association between increased CIMT in post ischemic stroke patients and APOE genotype. Methods : This was an epidemiological prospective study involving 71 post ischemic stroke patients (1 month from onset), admitted from 2012 to 2013. CIMT was examined with carotid duplex ultrasound at 1st, 6th, and 12nd month after stroke onset. APOE gene polymorphism was examined using HRM (high-resolution melting) which is a simple method, accurate, and sensitive for genotyping. Results : We found 5 APOE gene variation categories, i.e. E2E3, E2E4, E3E3, E3E4, and E4E4. The most common allele was E3 and genotype groups E3E3 was the majority of the population. E2E4 allele had the highest CIMT level among others, in the 1st month, 6th month, and 12nd month after stroke, with no association with hypertension, diabetes, and hypercholesterolemia. E3E3 allele was most often associated with hypertension, diabetes mellitus, dyslipidemia, and hyperhomocysteinemia. Conclusion : The results showed that APOE genotype E2E4 may independently constitute risk factor for atherosclerosis progression (CIMT) in post ischemic stroke patients. While the E3E3 genotype was often associated with hypertension, diabetes mellitus, dyslipidemia, and hyperhomocysteinemia. Our results suggest that APOE E4 was not an important risk factor for carotid atherosclerosis in post ischemic stroke patient.

Analisis Variasi Genetik Gen Angiotensinogen M235T pada Penderita Stroke Iskemik di Rumah Sakit Umum Pusat Dr. Kariadi, Semarang secara Polymerase Chain Reaction Restriction Fragment Length Polimorfism (PCR- RFLP) Tugasworo, Dodik; Retnaningsih, Retnaningsih; Kurnianto, Aditya; Suryadi, Suryadi; Rahmawati, Dani; Rahmayanti, Rahmayanti; Budiman, Jethro
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.833

Background: Stroke is the leading cause of death and disability in the world. The incidence of ischemic stroke is influenced by genetic factors, environmental factors and their interactions. Genetic variation of the Angiotensinogen (AGT) M235T gene is associated with hypertension and diabetes mellitus, which are risk factors for stroke. Objective: To examine the genetic variation of the Angiotensinogen M235T gene in patients with Ischemic Stroke treated at Dr. Kariadi General hospital, Semarang. Method: The subjects of the study were 72 ischemic stroke patients who were treated at the outpatient clinic of the Neurology Department Dr. Kariadi Semarang in January - December 2013. DNA extraction of research subjects was performed at the CEBIOR laboratory, Diponegoro National Hospital from January to March 2020. Amplification was performed with Polymerase Chain Reaction (PCR). Digestion of PCR products was using Restriction Fragment Length Polymorphism (RFLP) method. Results: Out of 72 samples, the AGT M235T CT were found in 37 samples (51.4%), the AGT M235T TT gene was found in 35 samples (48.6%) and no samples showed the AGT M235T CC. Conclusion: There are 3 types of genetic variants of the AGT M235T gene, including the AGT M235T CT, the AGT M235T TT and the AGT M235T CC. Among the three types of variants, the variant of the AGT M235T CT gene is the most common variant found in ischemic stroke patients treated at the Dr. Kariadi General Hospital Semarang.

A 71-year Old Male Patient with 20 Hour Onset of Infarct Stroke that was Performed with Intra-Arterial Thrombolysis, Mechanical Thrombectomy, Balloon Angioplasty, and Carotid Stenting: A Case Report Kurnianto, Aditya; Andhitara, Yovita; Yudistira; Setiadi, Jeffri; Budiman, Jethro
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.961

Introduction: For above 2 decades, the definitive management for acute ischemic stroke is intravenous or intra-arterial thrombolysis (IAT), using recombinant tissue-type plasminogen activator. Recently mechanical thrombectomy (MT) was developed to overcome the problem that intravenous thrombolysis is only effective in removing large artery occlusions in the range of 10-30%. Early treatment with intra-arterial thrombolysis, permanent stent insertion and clot extraction devices evolved into the stent-retriever device used in most of the important trials and, recently, emerged aspiration tool. This case report presented 71-year-old male patient with infarct stroke who performed with MT. Case presentation: This case report presented 71-year-old male patient with the main complaint of right limbs weakness. A non-contrast head CT scan found infarction in the cortical-subcortical left parietal lobe, posterior pericornu of the right lateral ventricle and right temporal cornu periventricular; lacunar infarction in the right and left paramedian pons; old lacunar infarction in the left and right centrum semiovale, left corona radiata, right internal capsule, right parietal lobe white matter, left lentiform nucleus, left posterior crus of the internal capsule-thalamus, right thalamus, right lateral ventricular pericornu and left paramedian pons. The patient underwent cerebral digital substraction angiography (DSA), as well as IAT, MT, balloon angioplasty, and carotid stenting with good clinical outcome. Conclusion: With the overwhelming positive results of studies evaluating the safety, efficiency, and efficacy of mechanical thrombectomy; the standard of care for the treatment of patients with anterior circulation vessel occlusion is becoming clear.

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