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Penetrating Neck Injury due to Foreign Body at C5 Level with Plexus Brachialis Nerve Injury: A Case Report Maximillian C. Oley; Eko Prasetyo; Ferdinan Tjungkagi; Yovanka N. Manuhutu; Diornald J. Mogi
Medical Scope Journal Vol. 4 No. 1 (2022): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v4i1.44239

Abstract

Abstract: Penetrating neck injury caused by screwdriver is a very rare case. Rapid transport to a major trauma center is needed for such patients to prevent neurological dysfunction and post traumatic tissue damage. Early and complete assessment and exact surgical procedure are very important to overcome a good outcome and prognosis. We reported a case of a 28-year-old male transferred to the emergency room after being stabbed using a screwdriver. No history of nausea, vomiting, and loss of consciousness. A screwdriver got stucked on the neck at the level of C5-C6 associated with edema but no active bleeding. The upper extremity examination revealed that the muscle contraction was 5555/4444, thumb test +/, opposition test +/-, abductor adductor test +/-, and sensory within normal limit. Radiology examination showed a metallic density of the foreign body in the cervical region penetrating from soft tissue to the vertebral body of cervical C5. The patient was diagnosed with penetrating neck injury due to foreign body in the posterior neck region at C5 level with plexus brachialis nerve injury. Foreign body removal and laminectomy were done to decompression purpose. This case need early, complete and adequate management to prevent post traumatic tissue damage, other neurological dysfunction, and mortality. On the fourth post-surgical day, the patient was discharged with stable vital signs and no neurological deficit. The regular follow up at the neurosurgical clinic showed that neither motoric nor sensoric deficit was found. In conclusion, penetrating neck injury which can cause severe morbidity and permanent disability need an adequate management to prevent any spinal cord damage and minimize any neurological dysfunction. Keywords: penetrating neck injury; spinal cord injury
Hubungan Fibronektin Serum dengan Tingkat Kesadaran Menurut Klasifikasi CT-Marshall pada Pasien Cedera Otak Sedang dan Berat akibat Trauma Diornald J. Mogi; Eko Prasetyo; Maximillian Ch. Oley; Ferdinan Tjungkagi; Yovanka N. Manuhutu
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.46563

Abstract

Abstract: Traumatic brain injury (COT) is the main cause of brain damage in the young and productive age generations. Although there is no accurate biological markers for detecting brain damages so far, many studies about fibronectin have been reported as a promising biological marker. This study aimed to obtain the relationship between serum fibronectin and level of consciousness based on CT-Marshal in patients with moderate and severe COT. This was an observational and analytical study with a cross-sectional design. Samples that met the study criteria were taken sequentially from the study hospital without differentiating exposure status (serum fibronectin levels) or outcome (CT-Marshall category). The regression test on the main variable serum fibronectin levels with awareness using the CT-Marshall category was carried out and showed significant relationship between serum fibronectin level and the patient's CT-Marshall category. The higher the serum fibronectin level, the higher the patient's CT-Marshall category which meant that a patient had a degree of severity and poor consciousness. In conclusion, there is a significant relationship between serum fibronectin level and level of consciousness based on the CT-Marshall category in traumatic brain injury patients. Keywords: traumatic brain injury; biological markers; fibronectin; level of consciousnes                                                                                                               Abstrak: Cedera otak akibat trauma (COT) merupakan penyebab utama kerusakan otak pada generasi muda dan usia produktif. Saat ini, belum terdapat penanda biologis yang akurat untuk mendeteksi kerusakan otak traumatik ataupun menilai prognosis terkait kerusakan otak traumatik namun perhatian terhadap penanda biologis telah meningkat akhir-akhir ini yaitu antara lain fibronektin. Penelitian ini bertujuan untuk mengetahui hubungan fibronektin serum dengan tingkat kesadaran menurut klasifikasi CT-Marshall pada pasien COT sedang dan berat. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Sampel yang memenuhi kriteria penelitian diambil berurutan dari rumah sakit tempat penelitian tanpa membedakan status paparan (kadar fibronektin serum) ataupun luaran (kategori CT-Marshall). Pengambilan data dilakukan hanya sekali untuk keseluruhan variabel selama masa pengumpulan data. Hasil uji regresi terhadap kadar fibronektin serum dengan kesadaran menggunakan kategori CT-Marshall mendapatkan adanya hubungan bermakna yaitu semakin tinggi kadar fibronektin serum, semakin tinggi pula kategori CT-Marshall pasien yang berarti pasien memiliki derajat keparahan dan kondisi kesadaran yang buruk. Simpulan penelitian ini ialah terdapat hubungan bermakna antara kadar fibronektin serum terhadap kesadaran menggunakan kategori CT-Marshall pada pasien cedera otak traumatik. Kata kunci: cedera otak akibat trauma; penanda biologis; fibronektin; tingkat kesadaran