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Journal : Neurona

PREDIKTOR SYMPTOMATIC INTRACEREBRAL HEMORRHAGE PASCATROMBOLISIS INTRAVENA PADA STROKE ISKEMIK AKUT Al Rasyid; Salim Harris; Mohammad Kurniawan; Rakhmad Hidayat; Taufik Mesiano
NEURONA Vol 35 No 3 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i3.12

Abstract

PREDICTORS OF SYMPTOMATIC INTRACEREBRAL HEMORRHAGE FOLLOWING INTRAVENOUS THROMBOLYSIS IN ACUTE ISCHEMIC STROKEABSTRACTDespite its effectiveness, the percentage of ischemic stroke patients who received definitive treatment, thrombolysis, never went above 10%, due to one of the reason is the occurrence of severe, post-therapeutic complications, such as symptomatic intracerebral hemorrhage (sICH). Several factors contribute to sICH occurrence are age, severity of stroke, early changes of ischemic sign, hyperglycemia, blood pressure, antiplatelet use and its interval. Patients with highest risk of sICH has been shown to have the greatest benefits from thrombolysis among other subgroup patients, therefore withholding therapy is not a choice. Compliance to the stroke’s guidelines could reduce the risk of complications as well as boost effectiveness of treatment.Keywords: Safety predictors, acute ischemic stroke, thrombolysis, sICH ABSTRAK Walau terbukti efektif, persentase pasien yang dapat dilakukan tindakan definitif stroke iskemik akut berupa trombolisis  tidak  pernah  mencapai  angka  10%,  salah  satunya  disebabkan  pertimbangan  terhadap  komplikasi  berat, seperti symptomatic intracerebral hemorrhage (sICH). Beberapa faktor yang berpengaruh terhadap kejadian sICH antara lain usia, derajat stroke, perubahan tanda iskemik dini, hiperglikemia dan diabetes melitus, tekanan darah, penggunaan antiplatelet, serta waktu pemberian. Pasien dengan risiko sICH tertinggi memiliki keuntungan terbesar dari trombolisis sehingga menunda tindakan bukanlah suatu opsi. Kepatuhan terhadap panduan tindakan dapat mengurangi angka kejadian komplikasi berat.Kata kunci: Prediktor keamanan, stroke iskemik akut, trombolisis, sICH
PERDARAHAN INTRASEREBRAL SEBAGAI KOMPLIKASI NEUROLOGI EMBOLI SEPTIK PADA ENDOKARDITIS INFEKTIF: SEBUAH LAPORAN KASUS Mohammad Kurniawan; Salim Harris; Al Rasyid; Taufik Mesiano; Rakhmad Hidayat; Yesi Astri
NEURONA Vol 36 No 4 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i4.93

Abstract

      INTRACEREBRAL HEMORRHAGE AS A NEUROLOGICAL COMPLICATION OF SEPTIC EMBOLISM IN INFECTIVE ENDOCARDITIS: A CASE REPORTABSTRACTInfective endocarditis (IE) is a life-threatening disease. The incidence of IE in developing countries is reported at 1.7-6.2 per 100,000 individuals per year. IE is also known as a potential condition for embolization, especially septic embolism to the brain. Septic embolism results in various neurological complications and manifestations due to vascular occlusion, aneurysm formation and rupture of the aneurysm. We report a case of 34-year-old male with definitive IE based on Duke criteria who experienced neurological complications of intracerebral bleeding. Patient was given pharmacological treatment according to the guidelines of the American Heart Association (AHA)with improvement in clinical symptoms.Keywords: Infective endocarditis, intracerebral hemorrhage, septic embolismABSTRAKEndokarditis infektif (EI) merupakan penyakit yang mengancam nyawa, walaupun angka kejadiannya kecil, yaitu 1,7-6,2 per 100.000 individu per tahun di negara berkembang. EI juga sangat potensial menyebabkan embolisasi, khususnya emboli septik ke otak. Emboli ini mengakibatkan manifestasi gangguan neurologis yang disebabkan karena oklusi pembuluh pembentukan dan ruptur aneurisma. Dilaporkan kasus seorang laki-laki 34 tahun dengan EI definitif berdasarkan kriteria Duke yang mengalami komplikasi neurologis perdarahan intraserebral. Pasien ditatalaksana sesuai panduan American Heart Association (AHA) dengan perbaikan gejala klinis.Kata kunci: Endokarditis infektif, emboli septik, perdarahan intrakranial  
MEMBANGUN SISTEM CODE STROKE PADA DUA RUMAH SAKIT PENDIDIKAN DI INDONESIA Rakhmad Hidayat; Hirari Fattah Yasfi; Dinda Diafiri; Reyhan Eddy Yunus; Andi Ade Wijaya Ramlan; Taufik Mesiano; Mohammad Kurniawan; Al Rasyid; Salim Harris
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.165

Abstract

Code stroke system is rapid respond system for ischemic stroke patient’s care to have immediate therapy in order to increase effectiveness and achieve maximum outcome. Cipto Mangunkusumo Hospital and Universitas Indonesia Hospital are educational hospitals with different background, resources, facilities, and conditions in code stroke system implementation. This paper compares the code stroke system between both hospitals from some aspects, such as emergency unit health care providers, cost and facility, diagnostic imaging, initiator of code stroke system, observation room, availability of catherization lab, and communication within code stroke team. Code stroke system can be implemented in many hospitals correspondingly adjusting each of hospital conditions by maximizing advantages to cover the hospital’s shortcomings. Keywords: Code stroke, hospital, ischemic stroke, thrombectomy, thrombolysis
KEJADIAN STROKE ISKEMIK PADA PASIEN POSITIF COVID-19 TERKONFIRMASI DI RUMAH SAKIT UNIVERSITAS INDONESIA Rakhmad Hidayat; Gemia Clarisa Fathi; Ramdinal Aviesena Zairinal; Raden Rara Diah Handayani; Mohammad Kurniawan; Taufik Mesiano; Al Rasyid; Salim Harris
NEURONA Vol 38 No 2 (2021)
Publisher : PERDOSNI

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Abstract

Coronavirus disease 2019 (COVID-19) is not only disrupts the respiratory system, it can disrupt various organ systems, one of which is the central nervous system. Indonesia still has a little literature that discusses COVID-19 and its relation to ischemic stroke. This study aims to report the course of ischemic stroke cases in patients who have been confirmed positive for COVID-19. A 56 year old man presented with confirmed COVID-19, the patient had a history of type 2 diabetes mellitus and also a history of dyslipidemia. At initial presentation the patient did not complain of neurological symptoms, but after 12 days of treatment the patient complained of weakness in the left side of the upper leg. The CT scan of the head with contrast revealed an infarction in the peripheral area, perfusion CT found that the patient was hypoperfused in the right cerebral hemisphere area without the presence of a large core infarction or a clear perfusion mismatch defect. CT angiography did not reveal stenosis or occlusion of the large vessels. It can be concluded that ischemic stroke in COVID-19 patients can occur due to various underlying factors, one of which is hypercoagulability. Keywords: COVID-19, Stroke, Universitas Indonesia Hospital
PROFIL KLINIS DAN LUARAN STROKE ISKEMIK AKUT DENGAN TROMBEKTOMI MEKANIK BERDASARKAN LOKASI OKLUSI DI RSUPN DR. CIPTO MANGUNKUSUMO Kevin Kevin; Taufik Mesiano; Mohammad Kurniawan; Rakhmad Hidayat; Affan P. Permana; Al Rasyid; Salim Harris
NEURONA Vol 38 No 3 (2021)
Publisher : PERDOSNI

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Abstract

Introduction: Occlusion in anterior circulation gives variable clinical manifestations. Mechanical thrombectomy promises almost two times higher recanalization rate as opposed to thrombolysis. Aim: To evaluate the clinical and outcome profile of acute ischemic stroke patients who underwent mechanical thrombectomy based on the occlusion site. Methods: This was a retrospective cohort conducted at Cipto Mangunkusumo National Referral Hospital from May 2017 to January 2020. All acute ischemic stroke patients in anterior circulation who underwent mechanical thrombectomy with or without bridging intravenous thrombolysis were analyzed. Occlusion site and recanalization rate were scored based on arteriogram. Results: Sixteen patients had occlusion in ICA-M1 segment, while ten others were in the M2 segment. NIHSS value was two points higher in ICA-M1 occlusion (p>0.05), which further analysis found that the proportion of aphasia manifestation was higher in the ICA-M1 segment (50.0% vs 20.0%; p=0.218). Demographical and clinical characteristics were similar between the two groups. Thrombolysis did not modify the occlusion site on thrombectomy (p>0.05). Despite statistical insignificancy, ICA-M1 occlusion showed an earlier time trend from admission to recanalization. The M2 segment had a higher proportion of mTICI 2b/3 recanali????ation (50.0% vs 70.0%; p=0.428) and mRS 0-2 on discharge (12.5% vs 50.0%; p=0.053). Discussion: Aphasia was more common in proximal occlusion???? which drove family members to bring patients earlier to the hospital. The functional outcome on discharge was lower in proximal occlusion due to more extensive and permanent brain tissue loss. Future coordination is warranted to improve the therapeutic time from admission to recanalization. Keywords: functional outcome, ischemic stroke, mechanical thrombectomy, occlusion site
Perbandingan Keputusan Rujuk Pasien Stroke Baru Dengan Pasien yang Pernah Didiagnosis Sebelumnya Pada Layanan Telemedis Prawiroharjo, Pukovisa; Kurniawan, Mohammad; Alexander, Fooann
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.665

Abstract

ABSTRACT Introduction: Stroke is the third leading cause of death worldwide. Unfortunately, the high incidence of stroke in Indonesia is not matched by prompt and effective treatment, resulting in a high disability rate. These limitations make decision-making in telemedicine services challenging. Objective: This study aims to compare decision-making related to stroke management between newly diagnosed patients and those previously diagnosed. Methods: This study employed a cross-sectional retrospective design. The data consisted of 256 secondary data obtained from telemedicine company conversations during March and April 2020. Patients were categorized into newly diagnosed stroke patients and previously diagnosed stroke patients. Results: Among the 256 subjects, a significant relationship was found between patient status and decisions regarding referral and pharmacological management. Newly diagnosed stroke patients more frequently received referral decisions, while previously diagnosed patients more often received pharmacological management. Discussion: This study indicates a significant association between patient status and decisions on referral and pharmacological management in telemedicine services. Further studies with larger sample sizes and longer time periods are needed for better representation of conditions in Indonesia. Keywords: patient status, pharmacological treatment, referral, stroke, telemedicine.
Co-Authors Affan P. Permana Afif, M. Bariq Naufal Afriyani, Fauziah Agiska, Bella Putri Ahmad Sulaiman Alwahdy Ainul Yaqin Al Rasyid Al Rasyid Aldina, Rizky Alexander, Fooann Alwahdy, Ahmad S. Amanda, Cahya Gita Andi Ade Wijaya Ramlan ANDUN SUDIJANDOKO Anna Mira Lubis Aris Munandar Badriyah, Nur Farihah Berry Juliandi Budi Setiawan Dinda Diafiri Eka Agustina, Eka Emilda, Emilda Febriansyah, Pebi Fritz Sumantri Usman, Fritz Sumantri Gemia Clarisa Fathi Herqutanto Hirari Fattah Yasfi Intan, Amelia Nur Karolina Margareta Kevin Gunawan Kevin Kevin Khalily, Muhammad Naufal Lazuarni, Shafiera Lestari, Dhara Ayu M.H, Nisyah Audya Marnisah, Luis Masawir, Bambang Maslina, Maslina Maulana, Rizki Dimas Mesiano, Taufik Moh Hasan Machfoed, Moh Hasan Mohamad Saekhu Mohammad Hasan Machfoed Nurdin, Ilham Pangeran, David Prayoga, M. Panca Pukovisa Prawiroharjo, Pukovisa Puspita E. Wuyung Puspita Eka Wuyung Putri Putri, Putri Putri, Stefanie Karina Raden Rara Diah Handayani Rahmana, Arizari Haj Rakhmad Hidayat Rakhmad Hidayat Ramadianti Ramdinal Aviesena Zairinal Ramli, Yetty Reyhan Eddy Yunus Rika Wulandari Rima, Siti Pujiwati Permata Roswaty Salim Harris Salim Harris Salim Harris Salim Harris Salim Harris, Salim Saputri, Efrillia Missel Siti Komariah Hildayanti, Siti Komariah Susanto, Yayi D.B. Susi Handayani Taufik Mesiano Taufik Mesiano Taufik Mesiano Taufik Mesiano Tiara Anindhita Veronica, Meilin Winnugroho Wiratman, Manfaluthy Hakim, Tiara Aninditha, Aru W. Sudoyo, Joedo Prihartono Wiranto, Muhammad Dimas Putra Yayi Dwina Bilianti Susanto Yesi Astri