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All Journal Medical Journal of Indonesia MNJ (Malang Neurology Journal) Jurnal Keperawatan Padjadjaran Magna Neurologica Neurona
Tejomukti, Teddy
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing 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.
Olfactory Neuroblastoma with Intracranial Extension Nurwahyu Putra Romadhani, Andry; Imanuddin, Iqbal; Tejomukti, Teddy; Watanabe, Yasuhiro; Murakami, Takenobu; Tajiri, Yuki
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.v2i2.1164

Abstract

Background: Olfactory Neuroblastoma (ONB), so called esthesioneuroblastoma, is a rare malignant tumor of the sinonasal tract. ONB represents 6.3% of all sinonasal tract malignancies, with a prevalence of 0.4 cases per million population. These tumors are slow-growing and there may be intracranial extension of the tumor. Nasal obstruction, anosmia, recurrent epistaxis and pain are typical early manifestations. Imaging studies are essential in determining tumor extension and surgical planning of ONB. Endonasal biopsy is required to confirm the diagnosis of ONB. The case provides a basis for discussion of ONB and highlights the possibility of extension of this tumor. Case: A 45-year-old male presented with a generalized clonic seizure, conjugate eye deviation, and pre-seizure headache. Post-seizure, the patient was unconscious and incontinent, later appearing conscious but confused. The patient had a history of seizures at home and in the ER, along with occasional headaches over the past year. The patient described nasal congestion, decreased smell, and recurrent nosebleeds, having undergone ethmoidectomy in 2020 for papilloma. Discussion: The patient experienced symptoms of seizures, headache, and nasal disturbances. Olfactory neuroblastoma (ONB) tumor was detected after comprehensive examination. Treatment involves multimodal therapy, including surgery, chemotherapy, and radiotherapy, with prognosis depending on tumor stage and grade. Conclusion: Early diagnosis of ONB is necessary to prevent further tumor progression. Intracranial extension of the ONB should be carefully investigated. Imaging as well as histopathological and immunohistochemical examinations are very helpful in identifying the location, metastasis and degree of malignancy of the tumor.
Comparison of Seizure-Free Rates Between Levetiracetam and Phenytoin Administration in Seizure Patients with Brain Metastases Tumor (BM) During Period January 2023-December 2024 Hapsari, Dhiandra Dwi; Tejomukti, Teddy; Nastiti, Ranum Anggun
Magna Neurologica Vol. 3 No. 1 (2025): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i1.1726

Abstract

Background: Brain metastase tumor (BM) is the most frequently found intracranial tumor. The prevalence of seizures in BM ranges from 30%-50%. One of the treatments for seizure patients with BM is the administration of Anti-Epileptic Drugs (AED). The latest neuropharmacology now makes Levetiracetam (LEV) the first-line choice in BM cases compared to phenytoin (PHT), which was previously often used in BM cases. Objective: This study aims to compare seizure-free rates in patients with seizures on BM who received PHT or LEV treatment at Regional General Hospital Dr. Moewardi Surakarta from January 2023 – December 2024. Methods: An observational study using a cross-sectional method with a retrospective approach. Patients included were patients with BM who experienced seizures and received AEDs, either PHT 2x100 mg or LEV 2x500 mg, for a minimum duration of 6 months during the period January 2023–December 2024. Results: There were 50 research subjects with an age range of 38-67 years. The independent T-Test showed a significance value of 0.007 < value (0.05). In the group of patients given PHT, the seizure-free rate was 6.83±1.26 a (7 months), while in the LEV group, it was 9.02±0.85 b (9 months). Conclusion: A longer seizure-free rate in research subjects with LEV than PHT was found. This result is to previous research regarding the effectiveness of LEV as the leading choice in seizure patients with BM.
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.
Posterior communicating artery aneurysm presenting as isolated oculomotor palsy: The role of rapid identification, intervention, and multidisciplinary care - A case study Tedjo, Raden Andi Ario; Subandi, Subandi; Tejomukti, Teddy; Hamidi, Baarid Luqman; Tristan, Christopher Daniel; Hamka, Muhammad Farid; Rahman, Awalil Rifqi Kurnia; Putra, Stefanus Erdana; Hafizhan, Muhammad
Jurnal Keperawatan Padjadjaran Vol. 13 No. 1 (2025): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v13i1.2587

Abstract

Background: Posterior communicating artery (PCOM) aneurysms are the prevalent type of aneurysm with high rupture risks. Isolated oculomotor nerve (CN III) palsy is a key symptom warranting heightened awareness in primary care. Given the need for advanced imaging, early referral is paramount. This study highlights the significance of prompt identification, targeted intervention, and comprehensive management in optimizing patient outcomes. Case: A 58-year-old woman presented with isolated CN III palsy. The patient underwent rapid referral to tertiary care with magnetic resonance angiography (MRA) and digital subtraction angiography (DSA), revealing an aneurysm in the PCOM. Subsequently, coiling was performed to achieve complete occlusion. The procedure resulted in significant neurological recovery, with restoration of CN III function. Post-coiling, the patient receives close nurse monitoring, incorporating fall management and comprehensive education before discharge. CN III palsy is one of the unique-noticeable presentations of PCOM aneurysms, though symptoms may include facial pain, occasional headaches, and migraines. Coiling was chosen due to its less invasiveness and was recommended for posterior circulation aneurysms. Blood pressure control is essential to prevent aneurysm formation, rupture, and recurrence. Regular imaging follow-ups were needed to ensure long-term outcomes. Conclusion: PCOM aneurysm care involves a multidisciplinary approach. Rapid identification, early referral, immediate occlusion, and comprehensive rehabilitative programs were mandatory to improve patient outcomes.
PROFIL PEMERIKSAAN EVOKED POTENTIAL PADA KASUS NEUROONKOLOGI DI RSUPN DR. CIPTO MANGUNKUSUMO Tejomukti, Teddy; Aninditha, Tiara
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.476

Abstract

ABSTRACT Introduction: Functional integrity of specified cortical areas and pathways in the central nervous system can be assessed by recording electrical potency such as Evoked Potential (EP) related to sensory or motoric events. Neoplasm can disturb functional integrity in the nervous system. Methods: This was an analytic cross-sectional research with the categorical approach in patients who underwent EP in Neurological Clinic RSUPN dr. Cipto Mangunkusumo Jakarta since 2022. Data were taken from medical records from December 2022 to March 2023. Demographic data, clinical data, neoplasm data, and EP examination data were recorded. The relation between neoplasm (type, location, number of lesions) and symptoms to EP results were analysed with Chi Square test Result: There were 660 evoked potential examinations consisting of 363 SSEP, 242 VEP and 55 BAEP examinations for various neurological clinical indications, however EP examinations indicated for neurooncology cases were 45 subjects or 6.8% of all examinations. A significant relation was found between sensory (p=0.03), motor (p=0.04), and autonomic (p=0.004) symptoms with abnormal SSEP examination results. Pain was not associated with abnormal SSEPs. No significant relationship was found between the number and location of tumors with the SSEP examination. All of the study subjects (100%) had visual disturbances and abnormal features of VEP. The BAEP examination was not analyzed because the sample size was too small. Conclusion: EP may be indicated in neurooncology cases in assessing functional lesions due to tumors, both intracranial and spinal. Keywords: Evoked Potential, nervous system neoplasm
Co-Authors Aninditha, Tiara Bambang Purwanto Budianto, Pepi Dhiandra Dwi Hapsari Diah Kurnia Mirawati Dono Indarto Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Luqman Hamka, Muhammad Farid Hutabarat, Ervina Arta Jayanti Iqbal Imanuddin Muhammad, Faizal Murakami, Takenobu Nastiti, Ranum Anggun Novian Anindito Santosa Nurwahyu Putra Romadhani, Andry Prabaningtyas, Hanindia Riani Rahman, Awalil Rifqi Kurnia Ristinawati, Ira Rivan Danuaji Soetrisno Stefanus Erdana Putra Subandi Subandi SUROTO Suroto Suroto Tajiri, Yuki Tedjo, Raden Andi Ario Tristan, Christopher Daniel Vitri Widyaningsih Watanabe, Yasuhiro