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Riani Indiyarti, Riani
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Journal : Universa Medicina

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Occipito-cervical meningioma in pregnancy Indiyarti, Riani
Universa Medicina Vol 27, No 3 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.143-149

Abstract

Meningiomas are tumors that are believed to be derived from the cells and vascular elements of the meninges, and grow intracranially or in the vertebral canal. They are most common in women. The growth of meningiomas is stimulated by female sex hormones and thus may progress more rapidly in pregnant women and in women with breast cancer. The patient was a pregnant 39-year old woman (G4P3A0) of 8 months gestation. The clinical symptoms and signs were progressive upper motor neuron quadriparesis, diminished sensory functions from the level of C2 downwards, and loss of bladder and rectal control. Brain and cervical computed tomography (CT) scans done 2 months before admission showed no abnormalities. Induced delivery was terminated by forceps extraction, resulting in a baby of 2,100 g with Apgar score 7/9. After delivery, postcontrast magnetic resonance imaging (MRI) showed a large contrast-enhancing tumor mass of intradural-extramedullary location in the right occipito-cervical region. The tumor had a meningeal tail, extended into the right posterior fossa and caudally to the level of C3, with compression of the spinal cord. The patient underwent a nontotal resection to remove a tumor that microscopically had the features of a meningioma.
Ischemic stroke in a young adult male as a manifestation of Takayasu’s arteritis Indiyarti, Riani
Universa Medicina Vol 27, No 1 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.39-50

Abstract

Takayasu arteritis is a chronic, inflammatory large vessel arteriopathy that primarily affects the aorta, its main branches, and the pulmonary arteries. Fibrosis and thickening of the arterial wall often occur in later stages, resulting in a cerebrovascular accident. A 20-year old man presented with ischemic stroke of young adults due to Takayasu’s arteritis, from which he had been suffering since childhood (age 10). Physical examination showed an abdominal aortic aneurysm, renal artery stenosis, leading to renovascular hypertension, and asymmetrical blood pressure. Aneurysm of abdominal aorta was diagnosed by panaorto-arteriography. Subsequently ischemic stroke of young adults developed, because the arteritis had led to stenosis of the left anterior and middle cerebral arteries, with renovascular hypertension as additional risk factor. On this patient a percutaneous transluminal angioplasty operation of the right renal artery was performed, and it is intended to do an extra-intracranial arterial bypass. Preventive treatment is necessary to stem the extension of the arteritis to other blood vessels.
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