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All Journal Paediatrica Indonesiana Neurologico Spinale Medico Chirurgico Muhammadiyah Journal of Geriatric Neurona Acta Neurologica Indonesia
Mohamad Saekhu
Departemen Bedah Saraf, Fakultas Kedokteran, Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Is there any benefit from surgery for giant-dumbbell spinal tumors with prolonged paraplegia and joints contractures? a rare case report Mohamad Saekhu; Eka Susanto; Samsul Ashari; Setyowidi Nugroho
Neurologico Spinale Medico Chirurgico Vol 5 No 1 (2022)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v5i1.174

Abstract

The lack of clarity about the opportunities for significant neurologic improvement, coupled with the risk of severe postoperative complications, decompression surgery for patients with giant tumors in the cervical spine accompanied by long-lasting advanced neurological deficits places a heavy moral burden on surgeons. Here we report a three-year follow-up after surgery for an immense spinal neurofibroma in which the patient was bedridden for the past fifteen years. Our findings suggest surgery remains beneficial for patients without major postoperative complications.
Cervical Myelopathy as the Most Common Symptoms in Patients Undergoing C-Spine Surgery in the Spine Division, Department of Neurosurgery, Cipto Mangunkusumo General Hospital, from January 2012 to December 2016 Mohamad Saekhu; Jeremia Prasetya Pardede; Renindra Ananda Aman; Syaiful Ichwan; Wismaji Sadewo; Samsul Ashari; Setyowidi Nugroho
Neurologico Spinale Medico Chirurgico Vol 1 No 1 (2018)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (310.507 KB)

Abstract

Background: Cervical spine disease has the potential to reduce productivity in affected patients because of myelopathy and mood disorder (e.g. depression) which lead to decreasing of the patient’s quality of life.Objective: This study aims to elaborate on the most frequent symptoms and pathology of C-spine disease in patients who underwent a surgical procedure over the period time from January 2012 to December 2016.Method: This study is a retrospective. All patients who underwent surgery for the C-spine disease are included. The data was obtained from the records in our spine database.Result: The total number of surgical procedures for spine disease over the 5 years was 345 procedures, with 127 procedures in the C-spine which are the second most common procedures of spine surgery in Department of Neurosurgery FMUI. The C-spine diseases were more common in males, aged more than 50 years old. The most frequent disease or pathology is a degenerative disease, and yet, tumour cases show an increasing number and became the most common pathology in the year of 2016. The most common procedure is anterior cervicaldiscectomy and fusion (ACDF).Conclusion: Our study showed that the most common symptoms and pathology are myelopathies and degenerative disease respectively, which has similarity with another study in the term of the mostfrequent pathology and surgical procedure. The finding of the more advanced neurological condition by the time of surgery as the most common symptom is found to be contradictory with other studies in western countries.
THE TREND AND PROFILE OF THE THORACIC SPINE SURGERY IN NEUROSURGERY DEPARTMENT FACULTY OF MEDICINE UNIVERSITAS INDONESIA – RSUP NASIONAL DR. CIPTO MANGUNKUSUMO 2012 – 2016 Muhammad Saekhu; Bismo Nugroho; Samsul Ashari; Renindra A Aman; Hanif G Tobing; Setyowidi Nugroho
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.667 KB)

Abstract

Background: Spinal surgery, in general, is increasing in number. The most frequent pathology is degenerative disease, and the most common segment is cervical and lumbar. However, there is limited information concerning the thoracic spine surgeries.Objective: The aim of this study is to describe the trend and profle of the thoracic spine (T-spine) surgeries in the Department of Neurosurgery Faculty of Medicine Universitas Indonesia – RSUP Dr.Cipto Mangunkusumo from 2012 to 2016.Method: This is a retrospective study including all patients who were undergoing T-spine surgery during the period of study from January 2012 to December 2016. The number of T-spine procedureswas recorded and plotted in the trend graph. The data consisting age, gender, indication and procedure of T-spine surgery, and duration of hospital stay were recorded from medical records.Result: In the last fve years, there was an increasing trend of T-spine surgery. A total of 68 surgeries for T-spine performed with 35 female and 33 male subjects. Majority of subjects were aged 41 to 50 years old (28%), with an indication of surgery due to tumours (68%). As many as 76% T-spine surgery was carried out non-instrumented. Duration of hospital stay was 9-13 days.Conclusion: Productive age is the most common age undergoing T-spine surgeries. A spinal tumour is the most frequent indication of the T-spine surgeries
Spinal dermal sinus coinciding with an infected giant epidermoid cyst in an infant presenting with constipation: a case report Mohamad Saekhu; Eka Susanto; Setyo Handryastuti; Samsul Ashari; Setyowidi Nugroho
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.357-63

Abstract

Early diagnosis of spinal tumors is a prerequisite for achieving satisfactory neurological recovery. However, rare diseases tend to have a long diagnostic course.1 In addition, the clinical presentation of spinal tumors in most children is not apparent, moreover, spinal tumors may not show clinical symptoms if they are located in the lumbar spine and sized no more than one vertebra.2,3 Clinical presentations caused by tumors in the lumbar spine may include weakness of both limbs, impaired urination, and constipation.
KADAR FIBRINOGEN SEBAGAI FAKTOR PROGNOSTIK PASIEN PERDARAHAN INTRASEREBRAL SPONTAN David Tandian; Muhammad Harisyah; Hanif Gordang Tobing; Samsul Ashari; Renindra Ananda Aman; Syaiful Ichwan; Mohamad Saekhu; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.29

Abstract

         FIBRINOGEN VALUE AS PROGNOSTIC FACTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Spontaneous intracerebral haemorrhage (SIH) refers as spontaneous bleeding in the brain paren- chyma due to injury of blood vessels. Thus causing tissue inflammatory and coagulation reaction, activating the release of fibrinogen. Fibrinogen, an active substrate of coagulation cascade, also considered as the most powerful indicator of acute inflammatory response in SIH. Elevated levels of fibrinogen may be the marker for the increasing degree of brain tissue damage.Aims: Determine the correlation of fibrinogen levels with outcomes of patients with SIH who went on operative procedures.Methods: The study was conducted in Dr. Cipto Mangunkusumo hospital and its affiliation hospitals from January until August 2017. Total sampling was conducted. Preoperative Glasgow Coma Scale (GCS), blood volume, preoperative and postoperative serum fibrinogen values, and modified Rankin Scale (mRS) data were obtained and analyzed using the Spearman correlation test.Results: Significant correlation were found between the preoperative and postoperative fibrinogen with mRS score. Positive correlation coefficients were shown in both parameters, whereas the increase of preoperative and postoperative fibrinogen would increase the mRS score.Discussion: Pre and postoperative fibrinogen value showed significant association with mRS score, thereby they could be considered as prognostic predictive factors. However, because of the limited number of subject of this study to fulfill the criteria of validity study, a future study with a larger scale should be carried out.Keyword: Fibrinogen, mRS, outcome, spontaneous intracerebral haemorrhageABSTRAKPendahuluan: Perdarahan intraserebral spontan (PISS) adalah perdarahan spontan pada parenkim otak akibat kerusakan pembuluh darah pada jaringan otak. Kerusakan tersebut menimbulkan reaksi inflamasi jaringan dan koagulasi yang mengaktivasi pelepasan fibrinogen. Fibrinogen merupakan substrat aktif kaskade koagulasi yang juga merupakan penanda paling kuat respons akut inflamasi pada PISS. Adanya peningkatan kadar fibrinogen dapat menggambarkan peningkatan derajat kerusakan jaringan otak.Tujuan: Mengetahui korelasi kadar fibrinogen dengan luaran pasien dengan PISS yang dilakukan tindakan operatif.Metode: Penelitian dilakukan di RSUPN Dr. Cipto Mangunkusumo dan rumah sakit jejaring pendidikan dalam periode Januari–Agustus 2017. Sampel diambil dengan total sampling, data yang diambil adalah, Glasgow Coma Scale (GCS) preoperasi, volume perdarahan, kadar fibrinogen serum preoperasi dan pascaoperasi, dan modified Rankin Scale(mRS), kemudian dianalisis dengan tes Spearman correlation.Hasil: Dari uji statistik didapatkan hasil bermakna antara fibrinogen preoperasi mau pun pascaoperasi dengan skor mRS. Koefisien korelasi, menunjukkan korelasi positif pada keduanya, dimana peningkatan fibrinogen preoperasi dan pascaoperasi akan meningkatkan skor mRS.Diskusi: Fibrinogen pre dan pascaoperasi sebagai faktor prediksi prognostik memiliki hubungan bermakna dengan skor mRS. Namun dengan jumlah sampel penelitian yang masih belum mencukupi untuk memenuhi kriteria validitas untuk dapat diajukan sebagai faktor yang bersifat pasti, diperlukan penelitian lebih lanjut dengan sampel yang lebih besar.Kata kunci: Fibrinogen, luaran, mRS, perdarahan intraserebral spontan
INTENSITAS MIELUM PADA GAMBARAN MRI SERVIKAL SEBAGAI FAKTOR PROGNOSTIK LUARAN CERVICAL SPONDYLOSIS MYELOPATHY PASCAOPERASI Mohamad Saekhu; Jeremia Prastya Pardede; Renindra Ananda Aman; Hanif Gordang Tobing; Samsul Ashari; David Tandian; Syaiful Ichwan; Wismaji Sadewo; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 35 No 4 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i4.30

Abstract

         MYELUM INTENSITY ON MRI CERVICAL AS PROGNOSTIC FACTORS IN CERVICAL SPONDYLOSIS MYELOPATHY PATIENTSABSTRACTIntroduction: Cervical spondylosis myelopathy (CSM) is a stenosis condition in cervical canal due to the cervical structural changes that compress the myelum, thus causing spinal medulla ischemia. Other than clinical factors, myelum intensity changes on MRI T1-weighted images (T1W1) and T2W1 might be useful to predict the pos-operative outcome.Aims: Identify prognostic factors in post-operative patients with CSM based on clinical symptoms and myelum intensity on cervical MRI.Methods: Retrospective study on CSM patients who underwent surgery in Neurosurgery Department, Cipto Mangunkusumo hospital, Jakarta, from January 2013 to December 2016. Magnetic resonance imaging data was obtained before the surgery, while clinical symptoms were assessed by Nurick scale before and 1 year after the surgery to evaluate outcome.Results: There were 50 subjects included in this study with mean age 51.98±9.64 years, majority male (76%), have moderate myelopathy (Nurick scale pre-operative ≤2), and time between onset and surgery mostly ≤1 year (80%). Most subject (88%) had improvement clinically, but mostly without hypointensity on cervical T1W1 MRI.Discussion: Myelum hypointensity in cervical MRI is associated with poor outcome in CSM post-surgery patients.Keywords: Cervical spondylosis myelopathy, MRI, myelum hypointensity, Nurick scaleABSTRAKPendahuluan: Cervical spondylosis myelopathy (CSM) merupakan suatu kondisi stenosis kanal servikal akibat adanya perubahan struktur servikal yang menyebabkan kompresi mielum, sehingga timbul iskemia medula spinalis. Selain faktor-faktor klinis, perubahan intensitas mielum pada MRI T1-weighted images (T1W1) dan T2W1 dapat dijadikan modalitas untuk memprediksi luaran pascaoperasi.Tujuan: Mengidentifikasi faktor prognosis luaran pasien CSM pascaoperasi berdasarkan gejala klinis dan intensitas mielum pada gambaran MRI servikal.Metode: Penelitian retrospektif terhadap penderita CSM yang dilakukan operasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Januari 2013 hingga Desember 2016. Dilakukan penilaian klinis dan gambaran MRI awal, serta luaran 1 tahun pascaoperasi menggunakan skor Nurick.Hasil: Terdapat 50 subjek dengan rerata usia 51,98±9,64 tahun, terutama laki-laki (76%), memiliki derajat mielopati ringan (skor Nurick preoperasi ≤2), dan jarak antara onset dengan waktu operasi ≤1 tahun (80%). Sebagian besar subjek (88%) mengalami perbaikan skor pascaoperasi yang mayoritas (95,4%) tidak didapatkan gambaran hipointesintas pada T1W1 MRI servikal.Diskusi: Hipointensitas mielum pada MRI servikal merupakan faktor prognosis luaran buruk pascaoperasi pada pasien CSM.Kata kunci: Cervical spondylosis myelopathy, hipointens, mielum, MRI, skala Nurick
PERBEDAAN NILAI LEUKOSIT PRA- DAN PASCAOPERASI SEBAGAI PREDIKTOR LUARAN FUNGSIONAL PERDARAHAN INTRASEREBRAL SPONTAN Hanif Gordang Tobing; Bismo Nugroho PPR; Mohamad Saekhu; Setyo Widi Nugroho; Affan Priyambodo; Wismaji Sadewo; Syaiful Ichwan; Renindra Ananda Aman; David Tandian; Samsul Ashari
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.68

Abstract

          DIFFERENCES BETWEEN PRE- AND POST-SURGERY LEUKOCYTE COUNTS AS FUNCTIONAL OUTCOME PREDICTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Hematoma in spontaneous intra-cerebral  hemorrhage (SICH) results inflammation due to secondary brain injury. Leukocyte, an inflammation indicator which is routinely examined, known as an outcome predictor in non- operated SICH. The role of inflammation in operated SICH is still unknown, however, pre- and post-surgery leukocyte counts can be a marker of brain tissue damage (brain injury).Aim: This study investigated the characteristics of leucocyte parameters in operated SICH patients and its correlation to functional outcome based on Glasgow Outcome Scale (GOS).Methods: This was a retrospective cohort study for SICH patients who underwent surgery at Department of Neurosurgery in Dr. Cipto Mangunkusumo National General Hospital from January 2012–March 2017. This study analyzed the association between pre-operative leucocyte level with age, pre-operative GCS, hemorrhage volume, length of hospitalization, and  six-month post-operative GOS. The correlation of differences of pre-operative and one-day post- operative leucocyte counts with six-month post-operative GOS and hematoma evacuation percentage were analyzed. The analysis was done using Pearson correlation test, Spearman, Chi-square χ2 test, Fisher exact test, and Anova test.Results: There was a significant correlation  between differences of leukocyte counts in pre- and post-surgery with GOS. A higher post-surgery leukocyte difference would lower GOS; there was a significant correlation between the leukocytes counts in pre-operative leucocyte and GCS. A higher pre-operative leukocytes counts would lower the GCS.Discussion: The differences of pre-operative and post-operative leucocyte counts is a functional outcome predictors within 6 months in operated SICH patients.Keywords: Leukocyte, outcome, spontaneous intracerebral hemorrage, surgeryABSTRAKPendahuluan: Hematoma pada perdarahan intraserebral spontan (PISS) menyebabkan inflamasi akibat cedera otak sekunder. Leukosit sebagai indikator inflamasi yang rutin diperiksa, diketahui memiliki peranan sebagai prediktor luaran pada PISS yang tidak dioperasi. Sejauh ini belum diketahui peranan inflamasi pada PISS yang dioperasi, namun kadar leukosit pra- dan pascaoperasi dapat menjadi penanda adanya kerusakan jaringan otak (brain injury).Tujuan: Untuk mengetahui karakteristik parameter leukosit pasien PISS yang dioperasi dan kaitannya dengan luaran fungsional berdasarkan skor Glasgow Outcome Scale (GOS).Metode: Studi kohort retrospektif pada pasien PISS yang dioperasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2012-Maret 2017. Dilakukan analisis antara nilai leukosit praoperasi dengan usia, GCS praoperasi, volume perdarahan, lama rawat inap, dan skor GOS 6 bulan pascaoperasi. Dilakukan analisis perbedaan nilai leukosit praoperasi dibandingkan hari pertama pascaoperasi dengan skor GOS 6 bulan pascaoperasi dan persentase evakuasi hematoma. Analisis dilakukan menggunakan korelasi Pearson, Spearman, uji Chi-square χ2  test, Uji Fisher exact test, dan Anova.Hasil: Pada uji statistik didapatkan korelasi bermakna antara perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi dengan skor GOS. Semakin tinggi nilai perbedaan leukosit pascaoperasi akan menurunkan skor GOS; didapatkan korelasi bermakna antara leukosit praoperasi dengan GCS praoperasi. Semakin tinggi leukosit praoperasi, semakin rendah GCS.Diskusi: Perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi merupakan prediktor luaran fungsional dalam 6 bulan pada pasien perdarahan intraserebral spontan yang dioperasi.Kata kunci: Leukosit, luaran, operasi, perdarahan intraserebral spontan 
Kadar Neuroglobin dan Sitoglobin dalam Plasma, Cairan Serebro Spinalis, dan Jaringan Otak Pasien Strok Hemoragik Mudjihartini, Ninik; Saekhu, Mohamad; Jusman, Sri Widia A.; Sadikin, Mohamad
Muhammadiyah Journal of Geriatric Vol 3, No 1 (2022): Muhammadiyah Journal of Geriatric
Publisher : Faculty of Medicine and Health Universitas Muhammadiyah Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24853/mujg.3.1.1-8

Abstract

Latar belakang: Otak memerlukan oksigen yang banyak selain glukosa. Hipoksia iskemik karena strok hemoragik atau Spontaneous intracerebral hemorrhage (sICH) dapat mengganggu suplai oksigen dan nutrisi ke otak berakibat produksi energi di otak akan menurun. Deplesi energi ini menyebabkan kerusakan dan kematian sel otak terjadi lebih cepat. Neuroglobin (Ngb) dan sitoglobin (Cygb) merupakan protein golongan globin yang terdapat di otak dan berperan sebagai protein pengikat oksigen di mitokondria. Tujuan: Penelitian ini bertujuan mendapatkan gambaran/profil kadar Ngb dan Cygb, di plasma, cairan serebro spinal (CSS), dan jaringan otak pasien strok hemoragik. Metode: Penelitian ini merupakan penelitian lanjutan menggunakan sampel plasma, CSS, dan jaringan otak yang diperoleh saat kraniotomi evakuasi hematoma pasien strok hemoragik sICH di rumah sakit Cipto Mangunkusumo dan rumah sakit lainnya di Jakarta. Kadar protein Ngb dan Cygb dari plasma, CSS, dan jaringan otak diukur dengan metode ELISA. Hasil: Rerata kadar Ngb otak adalah 0,058 ng/mg protein otak, sedangkan di plasma dan CSS masing-masing adalah 0,017 ng/mg protein otak dan 0,013 ng/mg protein otak atau 29,31% dan 22,41% dari rerata kadar Ngb otak. Rerata kadar Cygb otak adalah 4,943 ng/mg protein otak, di CSS adalah 1,685 ng/mg protein otak, atau 25,26% dari rerata Cygb otak, sedangkan di dalam plasma hampir tidak terdeteksi. Simpulan: Pada keadaan hipoksia oleh karena strok hemoragik sICH, protein Ngb dan Cygb dapat diukur di plasma, CSS, dan jaringan otaknya.
Luaran Pendekatan Operasi Mikroskopis dan Endoskopik pada Pasien Kraniofaringioma di RSUPN Dr. Cipto Mangunkusumo Ashari, Samsul; Saekhu, Mohamad; Tandian, David; Ray, Laode Maly; Nugroho, Setyo Widi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 4 (2023): Vol 39 No 4 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i4.286

Abstract

ABSTRACTIntroduction: Advances in neurosurgery technology are rising quickly. The Neurosurgery Department RSCM is currently developing minimally invasive surgical technique using transcranial endoscopy. This minimally invasive procedure have been carried out to date. However, the patient's outcome after surgery is not yet known.Aim: Acknowledging the outcome of microscopic and endoscopic surgical approaches in craniopharyngioma patients at dr. Cipto Mangunkusumo Hospital.Methods: This was a retrospective cohort study of craniopharyngioma patients who underwent either endoscopic or microscopic surgery. This study used a consecutive sampling technique, using samples from 2012 to 2021 at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The inclusion criteria were craniopharyngioma patients who were admitted to the hospital for craniotomy tumor removal procedure with an endoscopic or microscopic approach, never had surgery, had diagnosis of craniopharyngioma confirmed by clinical findings and supporting investigation. Exclusion criteria were patients with extracranial problems and endoscopic patients with extensive craniotomy. Demographic data such as age, gender, tumor location, consistency, anatomical pathology results, and history of radiotherapy were recorded. Clinical outcomes were pre- and postoperative complaints, intraoperative bleeding, postoperative complications, and recurrence. Resectability is the size of the tumor pre- and 1-month after surgery. The data were analyzed using SPSS 25.0.Results: Thirty patients were enrolled in this study. A total of 22 subjects (73%) underwent microscopic surgery and 8 subjects (27%) underwent endoscopic surgery. Intraoperative bleeding was found to be significantly smaller on the endoscopic approach than on the microscopic approach (p=0.002). The operation time of endoscopic approach was significantly shorter than microscopic approach (p=0.002). There was no significant difference in pre- and postoperative complaints, postoperative complications, recurrence, resectability and duration of hospitalization in the endoscopic approach compared to the microscopic approach in the management of craniopharyngioma patients.Conclusion: Transcranial endoscopic approach in craniopharyngioma patients has good potential as an option for surgical management of craniopharyngioma patients.Keywords: Craniopharyngioma, Transcranial Endoscopy, Microscopy
Spinal Cord Compression Due to Intradural Extramedullary Hematopoiesis in a Young Adult with Cooley’s Anemia Mesiano, Taufik; Rasyid, Al; Kurniawan, Mohammad; Hidayat, Rakhmad; Pangeran, David; Lubis, Anna Mira; Saekhu, Mohamad; Gunawan, Kevin; Putri, Stefanie Karina; Rahmana, Arizari Haj; Harris, Salim
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.4

Abstract

Cooley's anemia, also known as beta thalassemia major, is an inherited multisystemic disorder characterized by skeletal and non-skeletal complications resulting from hemoglobinopathies. Extramedullary Hematopoiesis (EMH) is a complication of thalassemia major due to insufficient erythropoiesis expansion. The incidence rate of paraspinal EMH in beta-thalassemia is rare but tends to be on the rise. We present a case of spinal cord compression due to intradural EMH in a 21-year-old man with Beta Thalassemia major, who exhibited acute lower motor, sensory, and autonomic disorder, along with severe anemia, and electrolyte imbalance. Patients were treated with corticosteroids, blood transfusions, electrolyte correction and pain medications. Several days later, the patient experienced clinical improvement in reduced pain and motor improvement. The patient was planned to undergo elective surgery and radiotherapy after reaching the stabilized condition. Management options of spinal cord compression due to EMH include corticosteroids, adequate blood transfusion, hydroxyurea, radiotherapy, surgical decompression, exchange transfusion, or a combination of these approaches. The choice of therapy should be based on the patient's clinical condition, diagnostic evaluations, and the size of the mass exerting pressure on the spinal cord. The optimal management of EMH remains uncertain. We need further research to establish effective treatment strategies of spinal cord compression due to EMH in Cooley’s Anemia.
Co-Authors A.A. Ketut Agung Cahyawan W Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Al Rasyid Aman, Renindra Ananda Amelia, Ria Amir S. Madjid, Amir S. Anna Mira Lubis Aryandhito Widhi Nugroho Bismo Nugroho Bismo Nugroho PPR David Tandian David Tandian David Tandian David Tandian David Tandian David Tandian David Tandian,* Muhammad Harisyah,* Hanif Gordang Tobing,* Samsul Ashari,* Renindra Ananda Aman,* Sy Eka Susanto Eka Susanto Hilman Mahyuddin Ina S. Timan Ina S. Timan, Ina S. Jeremia Prasetya Pardede Jeremia Prastya Pardede Jusman, Sri Widia Azraki Kevin Gunawan Kurniawan, Azhar Farisyabdi Kurniawan, Mohammad Mahyuddin, Hilman Martin Susanto Mesiano, Taufik Mohamad Sadikin Muhammad Harisyah Ninik Mudjihartini Nugroho, Setyo Widi Nurhadi Ibrahim Padmo Santjojo Pangeran, David Putri, Stefanie Karina Rahmana, Arizari Haj Rakhmad Hidayat Ray, Laode Maly Renindra A Aman Renindra A. Aman Renindra A. Aman Renindra Ananda Aman Renindra Ananda Aman Renindra Ananda Aman Renindra Ananda Aman Renindra Ananda Aman Ronokusumo, Teguh A.S. Ronokusumo, Tegus A.S. Salim Harris, Salim Samsul Ashari Samsul Ashari Samsul Ashari Samsul Ashari SAMSUL ASHARI, SAMSUL Setyo Handryastuti Setyo W. Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Sudigdo Sastroasmoro Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Wismaji Sadewo Wismaji Sadewo Wismaji Sadewo Wismaji Sadewo Yulius Seno Nugroho