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Isolated Abducens Nerve Palsy: A Case Report of Cerebral Pseudocyst of Dorello’s Canal Puspitasari, Vivien; Japutri, Josephine; Solansa, Tracy; Cenweikiawan, Anderson
Medicinus Vol 13, No 2 (2024): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i2.8108

Background: Abducens nerve is the second longest intracranial path out of all of the cranial nerves. Abducens nerve pasly had a prevalence 11.3/100.000 and mostly seen in adults. Isolated abducens nerve palsy due to neoplastic lesion are rare and mostly related to skull base tumor.Case Presentation: We present a case of 57 years old woman with complaints of red right eye and worsening headache associates with diplopia on the right lateral gaze for three days prior admission. She was later diagnosed with isolated abducens nerve palsy associated to neoplasm cause in Dorello’s canal. Patient was then discharged with symptomatic therapy and educated for head posturing and avoid triggers.Conclusions: Abducens nerve palsy is the most common isolated ocular nerve palsy. The incidence of mass formation such as neoplastic lesion or cyst are rare.

Comparison of 2009 and 2011 WHO Guidelines, and Scoring Models for Adult Hospitalized Dengue Infection: A Single Observation in Tangerang, Indonesia Wiwing, Veronica; Japutri, Josephine; Suryadinata, Neneng
Medicinus Vol 13, No 2 (2024): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i2.8104

Background: World Health Organization (WHO) published a dengue guideline in 2009 and in 2011 by WHO-SEARO. However, many of dengue cases in early phase do not meet all the criteria by WHO classification. Because of this condition there is a scoring model that was published in 2015, that might help in primary health care. Therefore, a study to compare those diagnostic tools especially in adult dengue patients in Banten is needed.Aims: This study is to know the comparison between 2009 version and 2011 version of dengue diagnostic guidelines by WHO and scoring model version.Methods and Material: This study used a descriptive method with a cross-sectional design at 60 adult dengue patients. Each patient is grouped according to diagnostic tools’ classification and will be analyzed using Chi-square.Results: Results are grouped according to the WHO diagnosis from 2009 and 2011, presumptive model and probable models where there are 46 (77%), 48 (78%), 31(52%), and 15 (25%) of patients diagnosed with dengue infection. Overall, the diagnosis made by the 2009 WHO and the probable models has the most superior sensitivity and specificity values of 84,6% and 25%, and 82,4% and 97,7% respectively compared to other diagnostic tools. However, from the results of positive predictive values, probable models have a higher percentage than the 2009 WHO diagnosis.Conclusions: The probable model is more sensitive and specific than other diagnostic results. These conclude that probable model is best tool for dengue infection screening in early phase of infection.

The Heart-Shaped Sign Infarct: A Rare Case of Bilateral Medial Medullary Infarction Japutri, Josephine; Puspitasari , Vivien
Acta Neurologica Indonesia Vol. 3 No. 02 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i02.63

Introduction Medullary infarction is a life-threatening condition with an incidence rate of 0.5-1.5% of all ischemic strokes. It seldom occurs bilaterally and might cause fatal respiratory complications. Here, we present a rare case of Bilateral Medial Medullary Infarct (BMMI) with unique Magnetic Resonance Imaging (MRI) findings and discuss its anatomical involvement. Case Report a 67-year-old man with poorly controlled hypertension and diabetes presented with acute visual impairment, dysphagia, dysarthria, and left hemiparesis since one day before. On the third day post-stroke, the patient developed quadriparesis along with worsening bulbar symptoms. Brain MRI revealed a heart-shaped infarct in the medial medulla, confirming the rare diagnosis of BMMI. The patient was treated with antiplatelet, and there were no further complications. Discussion Although rare, clinical findings of bulbar symptoms, quadriparesis, and respiratory involvement may aid early identification of BMMI. Brain MRI is recommended as they reveal the radiological hallmark of a heart-shaped infarct associated with the anteromedial and anterolateral branch of the vertebrobasilar artery that suplies the medullary. MRI is useful in differentiating BMMI from other neurological disorders and determining proper course of treatment. Conclusion BMMI early identification with a typical heart-shaped infarct is essential to prevent fatal respiratory failure. Risk factors management is crucial to prevent recurring infarcts.

Comparison of 2009 and 2011 WHO Guidelines, and Scoring Models for Adult Hospitalized Dengue Infection: A Single Observation in Tangerang, Indonesia Wiwing, Veronica; Japutri, Josephine; Suryadinata, Neneng
Medicinus Vol. 13 No. 2 (2024): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i2.8104

Background: World Health Organization (WHO) published a dengue guideline in 2009 and in 2011 by WHO-SEARO. However, many of dengue cases in early phase do not meet all the criteria by WHO classification. Because of this condition there is a scoring model that was published in 2015, that might help in primary health care. Therefore, a study to compare those diagnostic tools especially in adult dengue patients in Banten is needed.Aims: This study is to know the comparison between 2009 version and 2011 version of dengue diagnostic guidelines by WHO and scoring model version.Methods and Material: This study used a descriptive method with a cross-sectional design at 60 adult dengue patients. Each patient is grouped according to diagnostic tools’ classification and will be analyzed using Chi-square.Results: Results are grouped according to the WHO diagnosis from 2009 and 2011, presumptive model and probable models where there are 46 (77%), 48 (78%), 31(52%), and 15 (25%) of patients diagnosed with dengue infection. Overall, the diagnosis made by the 2009 WHO and the probable models has the most superior sensitivity and specificity values of 84,6% and 25%, and 82,4% and 97,7% respectively compared to other diagnostic tools. However, from the results of positive predictive values, probable models have a higher percentage than the 2009 WHO diagnosis.Conclusions: The probable model is more sensitive and specific than other diagnostic results. These conclude that probable model is best tool for dengue infection screening in early phase of infection.

Isolated Abducens Nerve Palsy: A Case Report of Cerebral Pseudocyst of Dorello’s Canal Puspitasari, Vivien; Japutri, Josephine; Solansa, Tracy; Cenweikiawan, Anderson
Medicinus Vol. 13 No. 2 (2024): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i2.8108

Background: Abducens nerve is the second longest intracranial path out of all of the cranial nerves. Abducens nerve pasly had a prevalence 11.3/100.000 and mostly seen in adults. Isolated abducens nerve palsy due to neoplastic lesion are rare and mostly related to skull base tumor.Case Presentation: We present a case of 57 years old woman with complaints of red right eye and worsening headache associates with diplopia on the right lateral gaze for three days prior admission. She was later diagnosed with isolated abducens nerve palsy associated to neoplasm cause in Dorello’s canal. Patient was then discharged with symptomatic therapy and educated for head posturing and avoid triggers.Conclusions: Abducens nerve palsy is the most common isolated ocular nerve palsy. The incidence of mass formation such as neoplastic lesion or cyst are rare.

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