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All Journal Medical Journal of Indonesia MNJ (Malang Neurology Journal) Jurnal Keperawatan Padjadjaran Smart Medical Journal Neurona
Tejomukti, Teddy
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Health Professions 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.
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
Intracranial and Extracranial Vertebrobasilar Artery Stenosis Patient Profile in Dr. Moewardi General Hospital Subandi, Subandi; Suroto, Suroto; Mirawati, Diah Kurnia; Danuaji, Rivan; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Tejomukti, Teddy; Ristinawati, Ira; Tedjo, Raden Andi Ario; Pretikasari, Zefania Yonisa; Hafizhan, Muhammad; Putra, Stefanus Erdana
Smart Medical Journal Vol 6, No 3 (2023): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i3.71299

Abstract

Introduction: Vertebrobasilar artery stenosis can be extracranial or intracranial, and accounts for up to 20% of posterior circulation ischemic strokes. The gold standard for diagnosing is Digital Subtraction Angiography (DSA), an invasive diagnostic method by injecting a contrast agent into the blood vessels leading to the brain through a catheter. This study aims to determine the profile of patients with intracranial and extracranial vertebrobasilar artery stenosis who underwent DSA procedures.Methods: This descriptive research was conducted in RSUD Dr. Moewardi in patients who underwent DSA procedures for the period January 2020 to March 2022 and found vertebrobasilar artery stenosis. The study samples were grouped based on the location of the stenosis; intracranial and extracranial. The data collected included age, gender, symptoms, risk factors, degree of stenosis, and angiographic findings.Results: Of 42 subjects, 33 (78.6%) patients were male. There are 23 (54.8%) patients with intracranial vertebrobasilar stenosis and 19 (45.2%) patients in extracranial. The main symptoms included hemiparesis, vertigo, hemiesthesia, loss of consiciousness, aphasia, dysartria, and dysphagia. The risk factors were 36 (85.7%) patients with hypertension, 18 (42.9%) patients with diabetes mellitus, 18 (42.9%) patients with a history of smoking, and 13 (31%) patients with hyperlipidemia. A total of 8 patients underwent stenting/angioplasty.Conclusion: The prevalence of vertebrobasilar artery stenosis increases with age, most commonly occurring at the age of 50-59 years..The most common risk factor for vertebrobasilar artery stenosis is hypertension. Management recommendations include a combination of antiplatelet and endovascular therapy.
Co-Authors Aninditha, Tiara Bambang Purwanto Budianto, Pepi Diah Kurnia Mirawati Dono Indarto Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Luqman Hamka, Muhammad Farid Hutabarat, Ervina Arta Jayanti Ira Ristinawati Muhammad, Faizal Novian Anindito Santosa Prabaningtyas, Hanindia Riani Pretikasari, Zefania Yonisa Rahman, Awalil Rifqi Kurnia Rivan Danuaji Soetrisno Stefanus Erdana Putra Subandi Subandi SUROTO Suroto Suroto Tedjo, Raden Andi Ario Tristan, Christopher Daniel Vitri Widyaningsih