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All Journal JBN (Jurnal Bedah Nasional) Journal of International Surgery and Clinical Medicine
Wirdayanto, Ade
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Health Professions Medicine & Pharmacology

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Giant Cavernoma Wirdayanto, Ade; Lestari, Enny; Randa, Said Rafly Okta; Puteri, Sherly Aprilia Perel
JBN (Jurnal Bedah Nasional) Vol 8 No 2 (2024): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2024.v08.i02.p05

Abstract

Latar belakang: Cerebral Cavernous Malformation (CCM) adalah suatu kondisi langka yang disebabkan oleh malformasi vena, ditandai dengan kemunculan pembuluh darah menyerupai-sinusoid dengan sirkulasi yang sangat lambat di otak. CCM memiliki dinding yang sangat lunak, sehingga mudah pecah dan menimbulkan perdarahan. Rata-rata CCM berukuran 1,5 cm, namun terdapat beberapa kasus di dunia dengan ukuran lebih dari 4 cm dan disebut sebagai giant cavernoma. Gejala klinis giant cavernoma adalah kejang epileptik, defisit neurologis fokal, serta gejala peningkatan tekanan intrakranial (TIK). Giant cavernoma diidentifikasi dengan baik melalui pemeriksaan MRI. Pemeriksaan histopatologi diperlukan untuk memastikan diagnosis serta menentukan terapi dan prognosis. Kasus: Laki-laki berusia 39 tahun diantar ke IGD oleh keluarganya dengan keluhan penurunan kesadaran sejak 12 jam sebelumnya. Pasien sebelumnya mengalami kejang berulang diseluruh tubuh dengan durasi kejang 1 menit. Pasien memiliki riwayat nyeri kepala yang tidak khas selama satu tahun terakhir. Pemeriksaan fisik didapatkan GCS 13 (E3M6V4), tekanan darah 184/110 mmHg, frekuensi napas 20x/menit, nadi 98x/menit, suhu 36,5­­oC, dan lainnya dalam batas normal. CT scan kepala menunjukkan massa pada lobus frontal dekstra. Pasien didiagnosis dengan tumor cerebri frontal dekstra dan direncanakan craniotomy removal tumor. Simpulan: Giant cavernoma adalah kasus dengan insiden yang sangat langka di seluruh dunia. MRI merupakan modalitas utama untuk mendeteksi kondisi ini. Belum ada rekomendasi prosedur untuk menangani giant cavernoma, namun reseksi total adalah tindakan yang paling sering dilakukan.
Understanding Trigeminal Neuralgia: A Comprehensive Review of Symtoms, Diagnosis, and Management Valentino, Andrea; Mardhiyah, Farah; Maspian Tjili, Tondi; Hadisi, Anthar; Aji Prihartomo, Gatot; Prastya Pardede, Jeremia; Wirdayanto, Ade
Journal of International Surgery and Clinical Medicine Vol. 4 No. 2 (2024): (Available online: 1 December 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i2.62

Abstract

Trigeminal neuralgia (tic douloureux) is a rare and debilitating facial pain condition affecting one or more branches of the trigeminal nerve. It is frequently misdiagnosed as a dental issue or temporomandibular disorder due to overlapping symptoms, delaying appropriate treatment. Diagnosis is primarily clinical, often requiring the expertise of a neurologist to distinguish it from other causes of facial pain. Imaging studies such as MRI or CT scans are not diagnostic but play a crucial role in ruling out secondary causes and identifying pathological changes in the affected nerve root. Although not life-threatening, trigeminal neuralgia significantly impacts the quality of life, causing severe, recurrent pain episodes that can be challenging to manage. Timely and accurate diagnosis, along with the implementation of effective therapeutic strategies, is essential to alleviate symptoms and improve patient outcomes. This review highlights the clinical presentation, diagnostic approach, and current treatment modalities for trigeminal neuralgia, emphasizing the importance of a multidisciplinary approach to care.
Intraventricular Meningioma: A Case Series Valentino, Andrea; Wahyudi; Prastya Pardede, Jeremia; Maspian Tjili , Tondi; Hadisi, Anthar; Aji Prihartomo, Gatot; Wirdayanto, Ade; Rangkuti, Ina Farida
Journal of International Surgery and Clinical Medicine Vol. 4 No. 2 (2024): (Available online: 1 December 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i2.61

Abstract

Introduction: Intraventricular meningiomas account for approximately 1.5% of meningiomas, 80% of these were localized in the lateral ventricles, 15% in the third ventricle (mostly in the ventricle trigone), and the remaining 5% in the fourth ventricle. This case report aims to highlight clinical findings and difficulty on removal of the tumor intraoperatively. Case description: We presented 2 cases of Intraventricular Meningioma. Both patient have a chief complaint of chronic headache since 2 years ago. Through the magnetic resonance imaging examination, we found a  solid mass at right ventricle trigone with enhance homogenously 7.3 x 5.5 x 6.5 cm  on the first patient and 6.8 x 8.4 x 3.2 cm on the second patient. Both patients went through craniotomy tumor removal. The pathology showed a Transitional Meningioma who grade I and KI-67 immunohistochemical staining result: 1-2 % on the first patien and angiomatous meningioma (WHO grade 1) on the second patient. Both patients showed improvement post-surgery Conclusion: We  have  successfully  performed  a  total  craniotomy  tumor  removal  on  the  right  trigone  intraventricular  meningioma.  However, the primary challenge lies in excising intraventricular meningiomas located in the trigone without causing injury to the geniculocalcarine tracts. Therefore, the surgical approach must be carefully planned based on the tumor's location and intraoperative monitoring as well as surgical strategy to avoid the neurological deficits.
Co-Authors Aji Prihartomo, Gatot Enny Lestari Hadisi, Anthar Mardhiyah, Farah Maspian Tjili , Tondi Maspian Tjili, Tondi Prastya Pardede, Jeremia Puteri, Sherly Aprilia Perel Randa, Said Rafly Okta Rangkuti, Ina Farida Valentino, Andrea WAHYUDI