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Coronary Risk Factors and Collateral Circulation in Acute Myocardial Infarction Sumargo, Sheila; Dewanto, Julius B.; Hidayat, Syarief
Althea Medical Journal Vol 2, No 4 (2015)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (549.239 KB)

Background: Coronary arterial stenosis, the major cause of acute myocardial infarction (AMI), inducesÂ shear stress to surrounding arteriolar endothelium. This stimulates changes in endothelial cells, smoothÂ muscle cells and fibroblast to create collaterals that can provide alternative blood flow to the jeopardizedÂ myocardial area. However, coronary collateralization is various among AMI patients. The aim of this studyÂ was to analyze the correlation between coronary risk factors and collateral sirculation in AMI patients.Methods: A retrospective cross-sectional study was carried out to 148 medical records of hospitalized AMIÂ patients in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. All patients were assessed for coronaryÂ collateral circulation which were graded as good (Rentrop score 2â3) and poor (Rentrop score 0â1). RiskÂ factors noted in this study were age group, sex, hypertension, diabetes mellitus and diagnosis (ST-segmentÂ Elevation Myocardial Infarction (STEMI) or Non STEMI (NSTEMI)) according to the medical record data.Â Results: Hypertension was found to be associated with the presence of good coronary collateral circulationÂ (p=0.02, PR=1.410 [95% CI 1.030-1.930]). Sex, age group, diabetes mellitus and STEMI or NSTEMI diagnosisÂ were not statistically significant.Conclusions: Hypertension was the only coronary risk factor associated to the presence of well-developedÂ coronary collaterals. The increase of myocardial oxygen demand and flow of collateral feeding coronaryÂ artery in the setting of hypertension may contribute to the results.Â Â DOI:Â 10.15850/amj.v2n4.688

Delayed-Onset Surgical Site Infection after Sphenoid Wing Meningioma Resection: A Case Report Highlighting Diagnostic and Management Challenges Sumargo, Sheila; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1142

Background: Surgical site infections (SSIs) following craniotomy, while uncommon, pose significant risks. Delayed-onset infections can present diagnostic and management challenges. We report a case of delayed-onset SSI after sphenoid wing meningioma resection, emphasizing the importance of vigilance and prompt intervention. Case presentation: A 26-year-old male underwent craniotomy for a right sphenoid wing meningioma. He presented 13 days post-operatively with a fluctuant swelling at the surgical site. Imaging revealed a subgaleal and epidural abscess. He underwent craniectomy, debridement, and antibiotic therapy, resulting in complete resolution. Conclusion: Delayed-onset SSIs after craniotomy necessitate a high index of suspicion. Early diagnosis and aggressive management, including surgical debridement and appropriate antibiotics, are crucial for optimal outcomes.

Challenges in the Diagnosis and Management of Intracranial Abscess in Developing Countries: A Retrospective Study from a Tertiary Hospital in Indonesia Imron, Akhmad; Turbawaty, Dewi Kartika; Sumargo, Sheila; Ardisasmita, Mulya Nurmansyah
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 17 No 2 (2023): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v17i2.5800

Despite progressive development of antibiotics and surgical approaches, outcomes in patients with intracranial abscess remained far from ideal. This paper aimed to describe challenges in the diagnosis and treatment of intracranial abscess in developing countries based on study from a tertiary hospital in Indonesia. A retrospective study was performed and included patients who were suspected of intracranial abscess at a tertiary referral hospital in Indonesia between January 1, 2012 and January 1, 2020. Clinical, radiological and laboratory characteristics were analyzed. Two-hundred-and-seventy-seven patients were initially enrolled. Age (p = 0.001), GCS at admission (p = 0.009), comorbidity with hypoalbuminemia (p = 0.003) and hydrocephalus (p = 0.009) are significantly associated with patients’ GCS when discharged. Results from culture and resistance tests could only be retrieved from 66 patients, with 33 (50%) obtained negative results, while the other 33 (50%) results were positive, consisted of 20 (60.6%) were of gram-negative bacteria and 13 (39.4%) were of gram-positive bacteria. Treatments that are directed to hypoalbuminemia and hydrocephalus should also be prioritized when any of these comorbidities exist.

Recurrent Giant Parasagittal Meningioma WHO Grade I: A Case Report Highlighting the Challenges of Management and the Role of Molecular Markers Sumargo, Sheila; Selfy Oswari; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1141

Background: Meningiomas are common intracranial tumors, but their recurrence, especially in giant parasagittal locations, presents significant management challenges. This case report underscores these challenges and emphasizes the potential role of molecular markers in improving prognostication and treatment strategies. Case presentation: A 31-year-old female presented with recurrent giant parasagittal meningioma WHO Grade I. She underwent multiple surgeries and embolizations due to persistent tumor regrowth despite histologically benign features. The tumor's location, size, and involvement of critical structures posed surgical difficulties, highlighting the limitations of current management approaches. Conclusion: This case emphasizes the need for a more nuanced understanding of meningioma recurrence beyond histological grading. Molecular markers may offer valuable insights into tumor behavior and guide personalized treatment decisions, potentially improving outcomes for patients with recurrent meningiomas.

Determinants of Recurrence in Intracranial Meningioma: A Decade of Experience with Surgical and Pathological Correlations in Bandung, Indonesia Sumargo, Sheila; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1321

Background: Intracranial meningiomas are common primary central nervous system tumors, mostly benign, yet recurrence remains a significant clinical challenge influencing patient prognosis. Understanding the characteristics and determinants of recurrence, particularly in specific populations, is crucial. Data on recurrent meningioma from developing countries like Indonesia are limited. This study aimed to describe the clinicopathological features and surgical management experience of recurrent intracranial meningiomas over a 10-year period at a tertiary referral hospital in Bandung, Indonesia. Methods: A retrospective analysis was conducted on all adult patients (≥18 years) surgically treated for recurrent intracranial meningioma at the Department of Neurosurgery, Dr. Hasan Sadikin General Hospital, Bandung, between January 2012 and December 2022. Patients with incomplete records were excluded. Data collected included demographics, clinical presentation, radiological findings (tumor location, bone infiltration, tumor invasion), surgical history (number of resections, time to recurrence), and histopathological results. Descriptive statistics were used for analysis. Results: Twenty-eight patients met the inclusion criteria. The cohort was predominantly female (n=24, 85.7%) with a median age of 46 years (range 26-67). The most common presenting symptoms were protrusion (n=11, 39.3%) and headache (n=7, 25.0%). Tumors were most frequently located in the parietal (n=10, 35.7%) and sphenoorbital (n=9, 32.1%) regions. Significant bone infiltration was observed in 75.0% (n=21) of cases. Tumor invasion into adjacent structures occurred in 21.4% (n=6), most commonly involving the cavernous sinus (n=2, 7.1% of total / 33.3% of invaded). The median time to recurrence detection was 36 months (range 6-144). Most patients (n=22, 78.6%) underwent two tumor removal surgeries during the study period. Based on available histopathology (n=17), meningothelial (n=10, 35.7% of total / 58.8% of available) and transitional (n=3, 10.7% of total / 17.6% of available) subtypes were the most common WHO Grade 1 diagnoses. One case each of atypical (Grade 2) and malignant (Grade 3) meningioma were identified. Conclusion: Recurrent intracranial meningiomas predominantly affected middle-aged females, often presenting with symptoms related to mass effect in parietal and sphenoorbital locations. High rates of bone infiltration and significant tumor invasion, particularly involving the cavernous sinus, were characteristic features. Recurrence was typically diagnosed within 3 years, with meningothelial and transitional subtypes being the most frequent histologies observed in this recurrent group. These findings underscore the complex nature of meningioma recurrence and highlight the need for tailored management strategies and long-term surveillance, particularly in cases with high-risk features like bone and sinus invasion.

Navigating Spheno-Orbital Meningioma in Indonesia: Clinical Characteristics and Diagnostic Considerations from a Decade of Experience Sumargo, Sheila; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1326

Background: Spheno-orbital meningiomas (SOM) represent a distinct subgroup of meningiomas originating from the sphenoid wing, characterized by orbital extension, significant bony invasion, and hyperostosis. These tumors present diagnostic and therapeutic challenges due to their complex anatomical location near critical neurovascular structures and a notable tendency for recurrence. Understanding the specific clinical profile of SOM patients is essential for timely diagnosis and effective management strategies. This study aimed to delineate these characteristics within an Indonesian population. Methods: A retrospective, descriptive, cross-sectional study was performed using medical record data from patients diagnosed with SOM between January 2012 and December 2022 at the Department of Neurosurgery, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Data collected included patient demographics, case history (new vs. recurrent), presenting symptoms, neurological status (Glasgow Coma Scale), and radiological findings (lesion singularity/multiplicity). Total sampling was employed, and data were analyzed descriptively. Results: The study included 252 subjects. A striking female predominance was observed (95.6%), with a mean patient age of 44.3 years (range 14-79). The vast majority were new cases (94.4%). Protrusion (proptosis) was the most frequent presenting symptom (79.0%), followed by headache (11.1%), blindness (5.2%), and blurred vision (4.0%). Most patients (97.2%) were fully conscious (GCS 15) upon admission. Radiological assessment revealed single lesions in 71.4% of cases. Conclusion: In this large Indonesian cohort, SOM predominantly affected middle-aged females and typically presented with proptosis. Awareness of this distinct clinical signature is crucial for improving diagnostic accuracy and facilitating prompt, comprehensive management. The findings underscore the need for high clinical suspicion, particularly in female patients presenting with orbital symptoms.

Determinants of Recurrence in Intracranial Meningioma: A Decade of Experience with Surgical and Pathological Correlations in Bandung, Indonesia Sumargo, Sheila; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1321

Background: Intracranial meningiomas are common primary central nervous system tumors, mostly benign, yet recurrence remains a significant clinical challenge influencing patient prognosis. Understanding the characteristics and determinants of recurrence, particularly in specific populations, is crucial. Data on recurrent meningioma from developing countries like Indonesia are limited. This study aimed to describe the clinicopathological features and surgical management experience of recurrent intracranial meningiomas over a 10-year period at a tertiary referral hospital in Bandung, Indonesia. Methods: A retrospective analysis was conducted on all adult patients (≥18 years) surgically treated for recurrent intracranial meningioma at the Department of Neurosurgery, Dr. Hasan Sadikin General Hospital, Bandung, between January 2012 and December 2022. Patients with incomplete records were excluded. Data collected included demographics, clinical presentation, radiological findings (tumor location, bone infiltration, tumor invasion), surgical history (number of resections, time to recurrence), and histopathological results. Descriptive statistics were used for analysis. Results: Twenty-eight patients met the inclusion criteria. The cohort was predominantly female (n=24, 85.7%) with a median age of 46 years (range 26-67). The most common presenting symptoms were protrusion (n=11, 39.3%) and headache (n=7, 25.0%). Tumors were most frequently located in the parietal (n=10, 35.7%) and sphenoorbital (n=9, 32.1%) regions. Significant bone infiltration was observed in 75.0% (n=21) of cases. Tumor invasion into adjacent structures occurred in 21.4% (n=6), most commonly involving the cavernous sinus (n=2, 7.1% of total / 33.3% of invaded). The median time to recurrence detection was 36 months (range 6-144). Most patients (n=22, 78.6%) underwent two tumor removal surgeries during the study period. Based on available histopathology (n=17), meningothelial (n=10, 35.7% of total / 58.8% of available) and transitional (n=3, 10.7% of total / 17.6% of available) subtypes were the most common WHO Grade 1 diagnoses. One case each of atypical (Grade 2) and malignant (Grade 3) meningioma were identified. Conclusion: Recurrent intracranial meningiomas predominantly affected middle-aged females, often presenting with symptoms related to mass effect in parietal and sphenoorbital locations. High rates of bone infiltration and significant tumor invasion, particularly involving the cavernous sinus, were characteristic features. Recurrence was typically diagnosed within 3 years, with meningothelial and transitional subtypes being the most frequent histologies observed in this recurrent group. These findings underscore the complex nature of meningioma recurrence and highlight the need for tailored management strategies and long-term surveillance, particularly in cases with high-risk features like bone and sinus invasion.

Navigating Spheno-Orbital Meningioma in Indonesia: Clinical Characteristics and Diagnostic Considerations from a Decade of Experience Sumargo, Sheila; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1326

Background: Spheno-orbital meningiomas (SOM) represent a distinct subgroup of meningiomas originating from the sphenoid wing, characterized by orbital extension, significant bony invasion, and hyperostosis. These tumors present diagnostic and therapeutic challenges due to their complex anatomical location near critical neurovascular structures and a notable tendency for recurrence. Understanding the specific clinical profile of SOM patients is essential for timely diagnosis and effective management strategies. This study aimed to delineate these characteristics within an Indonesian population. Methods: A retrospective, descriptive, cross-sectional study was performed using medical record data from patients diagnosed with SOM between January 2012 and December 2022 at the Department of Neurosurgery, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Data collected included patient demographics, case history (new vs. recurrent), presenting symptoms, neurological status (Glasgow Coma Scale), and radiological findings (lesion singularity/multiplicity). Total sampling was employed, and data were analyzed descriptively. Results: The study included 252 subjects. A striking female predominance was observed (95.6%), with a mean patient age of 44.3 years (range 14-79). The vast majority were new cases (94.4%). Protrusion (proptosis) was the most frequent presenting symptom (79.0%), followed by headache (11.1%), blindness (5.2%), and blurred vision (4.0%). Most patients (97.2%) were fully conscious (GCS 15) upon admission. Radiological assessment revealed single lesions in 71.4% of cases. Conclusion: In this large Indonesian cohort, SOM predominantly affected middle-aged females and typically presented with proptosis. Awareness of this distinct clinical signature is crucial for improving diagnostic accuracy and facilitating prompt, comprehensive management. The findings underscore the need for high clinical suspicion, particularly in female patients presenting with orbital symptoms.

Recurrent Giant Parasagittal Meningioma WHO Grade I: A Case Report Highlighting the Challenges of Management and the Role of Molecular Markers Sumargo, Sheila; Selfy Oswari; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1141

Background: Meningiomas are common intracranial tumors, but their recurrence, especially in giant parasagittal locations, presents significant management challenges. This case report underscores these challenges and emphasizes the potential role of molecular markers in improving prognostication and treatment strategies. Case presentation: A 31-year-old female presented with recurrent giant parasagittal meningioma WHO Grade I. She underwent multiple surgeries and embolizations due to persistent tumor regrowth despite histologically benign features. The tumor's location, size, and involvement of critical structures posed surgical difficulties, highlighting the limitations of current management approaches. Conclusion: This case emphasizes the need for a more nuanced understanding of meningioma recurrence beyond histological grading. Molecular markers may offer valuable insights into tumor behavior and guide personalized treatment decisions, potentially improving outcomes for patients with recurrent meningiomas.

Delayed-Onset Surgical Site Infection after Sphenoid Wing Meningioma Resection: A Case Report Highlighting Diagnostic and Management Challenges Sumargo, Sheila; Guata Naibaho; Roland Sidabutar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1142

Background: Surgical site infections (SSIs) following craniotomy, while uncommon, pose significant risks. Delayed-onset infections can present diagnostic and management challenges. We report a case of delayed-onset SSI after sphenoid wing meningioma resection, emphasizing the importance of vigilance and prompt intervention. Case presentation: A 26-year-old male underwent craniotomy for a right sphenoid wing meningioma. He presented 13 days post-operatively with a fluctuant swelling at the surgical site. Imaging revealed a subgaleal and epidural abscess. He underwent craniectomy, debridement, and antibiotic therapy, resulting in complete resolution. Conclusion: Delayed-onset SSIs after craniotomy necessitate a high index of suspicion. Early diagnosis and aggressive management, including surgical debridement and appropriate antibiotics, are crucial for optimal outcomes.

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