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Characteristics and Survival of Patients with WHO Grade 4 Diffuse Glioma in Dharmais National Referral Cancer Hospital Tadjoedin, Hilman; Suryana, Kresna Dharma; Rosalina, Rosalina; Hartono, Bryan Arista; Widarta, Oskar Ady; Dewin, Nikrial; Andriani, Rini
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1261

Abstract

Background: The WHO grade 4 diffuse glioma are extremely aggressive and account for over 60% of adult Central Nervous System (CNS) tumors. The diagnosis and management pose significant challenges due to the need for comprehensive evaluation and holistic treatment approaches. This study aims to determine the clinical characteristics of WHO grade 4 diffuse glioma in Indonesia and the overall survival as a secondary goal. Methods: This is a retrospective cohort study of all WHO grade 4 glioma patients from 2017 to 2022 at Dharmais National Cancer Hospital, Jakarta, Indonesia. Demographic characteristics were presented descriptively. Kaplan-Meier plot was used to evaluate the median survival. Results: Twenty-eight patients were eligible for this study. The median age group is 45 years old, with equal male and female prevalence. Headache was the most prevalent primary symptom. The therapy following surgery was radiotherapy (RT) with chemosensitizer (82.1%) and RT alone (14.3%) with both followed by adjuvant chemotherapy. There was one patient (3.6%) underwent palliative therapy. The median survival of all patients was 10 months, whereas 10 months in RT with the chemo-sensitizer group and 1 month in RT only group. There was no statistically significant difference between RT with and without chemotherapy sensitizer in terms of survival rates. Conclusions: Our study reports a younger median age of WHO Grade 4 diffuse glioma. Male subjects were equivalent to females. Median OS was 10 months and were longer in RT with the chemosensitizer group. Further multicentered and at the genetic level investigation was needed, to achieve optimal outcomes.
Comprehensive Management of Pediatric Epidural and Subdural Hematomas Following Traumatic Brain Injury: A Case Report Sari, Francisca Wuri Anzaz; Widarta, Oskar Ady
Jurnal Ners Vol. 8 No. 2 (2024): OKTOBER 2024
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v8i2.25299

Abstract

This case report details the management and implications of a 13-year-old male patient who presented with Epidural Hematoma (EDH) and Subdural Hematoma (SDH) following a traumatic brain injury sustained from a fall. The patient's treatment involved decompressive craniotomy to relieve intracranial pressure and reduce the risk of further brain damage, followed by cranioplasty to reconstruct the cranial vault. The case highlights the complexities involved in pediatric neurosurgery, especially in managing EDH and SDH, which are common yet critical conditions in traumatic brain injury cases. These hematomas, while distinct in their location and nature, share a common etiology in trauma and require prompt and effective surgical intervention. The importance of decompressive craniotomy in such cases is emphasized, particularly for alleviating increased intracranial pressure and minimizing additional cerebral injury. However, the potential postoperative complications, including cerebrospinal fluid leaks, infections, and seizures, necessitate vigilant postoperative care and monitoring. The epidemiology of EDH and SDH in the context of traumatic brain injury underscores their prevalence and the significant impact they have on the pediatric population. The successful management of this case, with both immediate surgical intervention and comprehensive postoperative care, illustrates the effectiveness of current treatment protocols. This case also sheds light on the critical need for a multidisciplinary approach in the long-term rehabilitation of pediatric patients, ensuring optimal recovery and development post-injury. In conclusion, this report contributes to the understanding of the management of traumatic brain injuries in children, emphasizing the significance of timely surgical intervention, careful monitoring for complications, and the importance of a holistic approach to patient care for favorable outcomes.