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All Journal Medical Journal of Indonesia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia AKSONA
Kurniawan, Ricky Gusanto
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Challenging Endovascular Treatment of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm: A Case Report Prasetyo, Bambang Tri; Kurniawan, Ricky Gusanto; Rilianto, Beny; Windiani, Pratiwi Raissa; Kelvin, Kelvin Theandro
AKSONA Vol. 4 No. 1 (2024): JANUARY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i1.44640

Abstract

Highlight: Posterior inferior cerebellar artery (PICA) aneurysms are rare in occurence. The endovascular management of PICA aneursysms is challenging due to anatomical difficulties in accessing the site. The rebleeding of PICA aneurysms, although rare than other intracranial anurysms, may still happen and must be considered in their management   ABSTRACT Introduction Aneurysms of the posterior inferior cerebellar artery (PICA) are rare clinical entities with a lower risk of rupture than other intracranial locations. This makes managing PICA aneurysms challenging and important for neurointerventionists to understand. In this case report, we looked at a rare case of PICA aneurysm with post-coiling rebleeding.  Case: We reported a 51-year-old female with complaints of dizziness and vomiting. The patient was found to be hypertensive and a neurologic assessment revealed neck stiffness and left hemiparesis. A computed tomography (CT) scan of the head indicated subarachnoid hemorrhage. CT angiography (CTA) showed an aneurysm at the right proximal PICA. Although endovascular coiling was performed, the patient rebleed one month later. Following the insertion of the second coil, successful embolization was achieved, and the patient showed clinical improvement. Conclusion: PICA aneurysms require careful endovascular management, considering the difficulty of access due to their anatomical location. An understanding of its proper management is of paramount importance to reducing mortality.  
Stand-alone middle meningeal artery embolization in chronic subdural hematoma patient presenting cognitive decline: a case report Galindra, Yusmahenry; Rilianto, Beny; Kurniawan, Ricky Gusanto; Prasetyo, Bambang Tri
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.247366

Abstract

Chronic subdural hematoma (cSDH) is a neurological disorder that commonly occurs in the elderly with high morbidity and mortality. Current treatment for cSDH consists of conservative therapy, surgical evacuation, and endovascular therapy, or a combination of all the methods. Endovascular therapy for cSDH management involving middle meningeal artery embolization (MMAE) has become a promising therapeutic option for clinicians as it offers a minimally invasive, safe, and effective choice with a low recurrence rate. MMAE using particles can also be performed in frail elderly patients who cannot undergo large craniotomy procedures. We presented a case of a subdural hematoma patient with cognitive decline using a therapeutic strategy of stand-alone MMAE, which resulted in cognitive function improvement
Carotid-Cavernous Fistula: Manifestasi Klinis dan Tatalaksana Putri, Nadira Deanda; Prasetyo, Bambang Tri; Kurniawan, Ricky Gusanto; Rilianto, Beny; Windiani, Pratiwi Raissa; Arham, Abrar
Majalah Kedokteran Indonesia Vol 73 No 2 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.2-2023-880

Abstract

Carotid-cavernous fistula (CCF) is a vascular abnormality that occurs between the internal or external carotid artery and veins within the cavernous sinus. CCFs can be classified as direct (Barrow type A) or indirect CCFs (Barrow types B, C, and D). The causes of direct CCFs are trauma and vascular rupture, whereas indirect CCFs are commonly found in patients with hypertension, connective tissue disorders, pregnancy, and dissection of the internal carotid artery. Signs and symptoms of CCF vary widely, ranging from acute-onset headache, proptosis, diplopia, ophthalmoplegia, conjunctival chemosis, orbital bruit, and blindness, but it can solely manifest as conjunctival redness. Patients with suspected CCF should undergo neuroradiology imaging, followed by endovascular intervention to close the fistula and keep the carotid artery open. With appropriate treatment, complete resolution is expected to occur in all patients.
Co-Authors Arham, Abrar Galindra, Yusmahenry Kelvin, Kelvin Theandro Prasetyo, Bambang Tri Putri, Nadira Deanda Rilianto, Beny Windiani, Pratiwi Raissa