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All Journal Medical Journal of Indonesia MNJ (Malang Neurology Journal) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Magna Neurologica
Hutabarat, Ervina Arta Jayanti
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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ANGIOPLASTIC STENOSIS IN SPONTANEOUS BILATERAL CAROTIC ARTERY DISSECTION: A CASE REPORT Subandi, Subandi; Danuaji, Rivan; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario; Santosa, Novian Anindito; Putra, Stefanus Erdana; Hafizhan, Muhammad
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.20

Abstract

Case: A 28-years-old woman presented with sudden right extremities weakness, right sided facial droop, and not being able to speak. On examination, the patient had upper motor neuron (UMN) hemiplegia and motor aphasia. On blood laboratory, we found D-dimer level of 1068 ng/dl. A non-contrast head CT-scan and CT-angiography showed left cerebral hemisphere infarction, and bilateral carotid artery stenosis. Further investigation with transcranial Doppler demonstrated partial stenosis of internal carotid artery (ICA). On cerebral digital subtraction angiography (DSA), we observed pseudoaneurysm on the right ICA and flame-shaped appearance on the left ICA, both are common radiological finding of ICA dissection. Then we performed stenting angioplasty on bilateral ICA to provide recanalization, and aspirin 80mg q.d. and clopidogrel 75mg q.d. was initiated. Conclusion: Spontaneous dissection of the carotid artery can occur on young adults. DSA is considered as the gold standard for vascular examination, and stenting with angioplasty was performed for recanalization to prevent the progression to severe stroke.
A 21-Years-Old Man with Mesial Temporal Lobe Epilepsy and Dystonia: A Rare Case Report Putri, Puspita Sari Sugiyarto; Mirawati, Diah Kurnia; Hutabarat, Ervina Arta Jayanti
Magna Neurologica Vol. 2 No. 2 (2024): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i2.934

Abstract

Background: Mesial temporal lobe epilepsy (MTLE) with dystonia is a rare case. Seizures and movement disorders have almost the same phenomenology, so it is often difficult to distinguish them. In this study, we report a unique case of MTLE and co-occurring dystonia. Case: A 21 years old male with complaints of seizures since 4 years ago. Seizures of one body jerking and drooling with a duration of less than 5 minutes. Prior to the seizure the patient was nauseous then vomited and followed by an empty mind, after the seizure the patient was confused. The patient also complained of unconscious movements in his right hand since 8 years ago. The movements disappeared when the patient slept. Physical examination revealed dystonic movement with a sensory trick on the right hand. Magnetic resonance imaging (MRI) of the brain with contrast showed bilateral hippocampal atrophy accompanied by left hippocampal sclerosis. Blood laboratory results, electroencephalography, and neurobehavior examination were within normal limits.. Discussion: MTLE can be caused by mutations in SCN1A, VPS13A, C90RF72, or TDP 43. Dystonia can be caused by mutations in SCN1A, TUBB4A, TOR1A, THAP1, or GNAL. SCN1A causes an increase in sodium influx, causing depolarization which causes clinical manifestations in the form of seizures and dystonia. For some disorders, although genetic causes have been identified, the molecular pathophysiology remains largely unknown, requiring further research. Conclusion: For some disorders, although genetic causes have been identified, the molecular pathophysiology remains largely unknown, requiring further research.
Association between vaspin rs2236242 gene polymorphism and atherosclerosis in ischemic stroke patients with diabetes mellitus in the Indonesian population Danuaji, Rivan; Suroto; Purwanto, Bambang; Indarto, Dono; Muhammad, Faizal; Mirawati, Diah Kurnia; Widyaningsih, Vitri; Soetrisno; Subandi; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario
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.oa.247566

Abstract

BACKGROUND Stroke is the third leading cause of morbidity and second in mortality worldwide. Diabetes mellitus (DM) is a risk factor for stroke. Vaspin and single nucleotide polymorphism (SNP) rs2236242 involved DM pathogenesis. This study aimed to explore the correlation between SNP rs2236242, serum vaspin levels, and atherosclerosis in patients with ischemic stroke and DM. METHODS This study was conducted in Dr. Moewardi Hospital from 2022 to 2023. The case group included patients with ischemic stroke and DM, while the controls were those with ischemic stroke only. Tetra-primer amplification refractory mutation system-polymerase chain reaction was used to determine the genotypes. RESULTS There were 31 cases and 33 control. SNP rs2236242 showed that odds ratio (OR) (95% confidence interval [CI]) for AA-TT was 0.273 (0.241–0.305) and for TA-TT was 0.315 (0.298–0.341). The OR (95% CI) for allele A to T was 0.789 (0.373−1.669). The mean (standard deviation) serum vaspin level in the case group compared to the control was 1,570 (2,108) ng/ml versus 1,630 (1,428) ng/ml (p = 0.064). Higher vaspin levels were found in T allele of the TT (1,523 [2,269] ng/ml, p = 0.021) and TA (1,760 [1,349] ng/ml, p = 0.004) genotype groups than the A allele of the AA genotype group (0.914 [0.329] ng/ml). CONCLUSIONS Vaspin gene polymorphism AA genotype or A allele significantly reduces vaspin levels in patients with ischemic stroke with DM.
Combination of stem cell and repetitive transcranial magnetic stimulation in acute ischaemic stroke as a promising treatment: A case report Danuaji, Rivan; Hambarsari, Yetty; Hamidi, Baarid Luqman; Hutabarat, Ervina Arta Jayanti; Tedjo, Raden Andi Ario; Fairuzya, Azmi Farah; Savitri, Martha Oktavia Dewi
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 15, No 1, (2024)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol15.Iss1.art15

Abstract

Stroke is a major contributor to long-term disability and its incidence continues to rise annually. This case report aimed to explore the promising benefits of combining stem cell therapy with repetitive transcranial magnetic stimulation (rTMS) in managing acute ischaemic stroke patients. A 62-year-old male presented with left-sided hemiparesis and hemineglect, as well as a cognitive disturbance in the attention domain. His medical history included uncontrolled hypertension over decades and diabetes mellitus for five years. A non-contrast head computed tomography (CT) scan revealed infarction in the right middle cerebral artery (MCA), with an initial National Institutes of Health Stroke Scale (NIHSS) of 13 upon admission to the Emergency Room. The infection and tumour markers were conducted to confirm no contraindication in this patient receiving stem cell therapy. Following the acute phase, the patient underwent a comprehensive treatment regimen involving both stem cell therapy and serial rTMS. Clinical assessments included NIHSS, Barthel Index, and Fugl-Meyer Assesement to evaluate neurological deficits. Additionally, the Montreal Cognitive Assessment-Indonesian version (MoCA-INA) assessment, electroencephalography examination and motor threshold were conducted. The results of this case report revealed noteworthy improvements in NIHSS, motoric strength, and cognitive function post-treatment. In this case report, improvement in clinical outcomes was obtained in the form of motor strength and higher cortical function. Stem cell therapy combined with rTMS has good potential in treating various neuroregenerative and rehabilitative aspects in ischaemic stroke patients.
Co-Authors Bambang Purwanto Budianto, Pepi Diah Kurnia Mirawati Dono Indarto Fairuzya, Azmi Farah Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Luqman Martha Oktavia Dewi Savitri Muhammad, Faizal Novian Anindito Santosa Prabaningtyas, Hanindia Riani Putri, Puspita Sari Sugiyarto Ristinawati, Ira Rivan Danuaji Soetrisno Stefanus Erdana Putra Subandi Subandi SUROTO Suroto Suroto Tedjo, Raden Andi Ario Tejomukti, Teddy Vitri Widyaningsih