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All Journal Medical Journal of Indonesia Asian Australasian Neuro and Health Science Journal (AANHS-J)
Satyanegara
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Temporary Visual Hallucinations in a 31-year-old Female Patient Post Falcotentorial Meningioma Resection with No History of Psychosis: A Case Report Sipayung, Sebastian; Janitra, Raka; Hassan, Roslan; Satyanegara
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 6 No. 2 (2024): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v6i2.17699

Abstract

Introduction: Falcotentorial meningiomas are rare, comprising 1%–2% of all intracranial meningiomas, arising at the junction of the falx cerebri and tentorium. These tumors may compress the quadrigeminal plate and/or splenium, leading to peduncular hallucinosis—vivid, colorful visual hallucinations of people and animals, which can persist even after tumor removal. Case Description: A 31-year-old woman with no psychosis history presented with a bilateral visual field deficit and left extremity weakness. Brain MR imaging revealed a lobulated mass attached to the right cerebellar tentorium, posterior falx cerebri, and adjacent venous sinuses. Visual field analysis showed homonym superior quadranopsia. Following craniotomy and tumor removal, histology confirmed a mixed-type meningioma. Post-surgery, the patient experienced vivid visual hallucinations that resolved in two weeks, but bilateral visual field deficits remained. A post-op CT showed reduced structural compression around the lesion with slight narrowing of the quadrigeminal cistern. Discussion : Visual hallucinations in falcotentorial meningioma patients, often as peduncular hallucinosis, occur due to compression of the quadrigeminal plate and/or splenium and may persist post-surgery if lesions are present in the cerebral peduncles or nearby midbrain areas. Conclusion: The patient's temporary hallucinations may have resulted from post-resection tissue edema causing quadrigeminal cistern narrowing or indicate lesions in the cerebral peduncles or adjacent midbrain regions.
Intracranial dural arteriovenous fistula presenting like longitudinally extensive transverse myelitis Yuliatri, Nia; Widjaya, Ingrid Ayke; Wibawa, Gibran Aditiara; Harlyjoy, Alphadenti; Satyanegara
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.cr.247543

Abstract

Intracranial dural arteriovenous fistula (DAVF) that drains into spinal perimedullary veins can generate longitudinally extensive transverse myelitis (LETM)-like lesion, which often represents a significant diagnostic and therapeutic challenge. This is a case report of a 50-year-old male referred with all extremity weaknesses. Despite receiving high-dose intravenous steroids for suspected myelitis, no improvement was recorded. Spinal imaging showed abnormal hyperintensity extending from the T6 vertebral level to the medulla, and a flow void lesion from the cervicomedullary junction up to the L3 level. Angiography confirmed a Cognard type V spinal DAVF, which was treated with transarterial embolization of the feeding vessel. Follow-up angiography showed complete occlusion of the fistula without any backflow. Flow voids are no longer visible on MRI conducted 3 weeks post-procedure. Unfamiliarity with these disorders often leads to delays in diagnosis and treatment. Therefore, it is essential to consider intracranial DAVF as a differential diagnosis for LETM-like lesions.
Transventricular transforaminal endoscopic fenestration with cysto-ventriculoperitoneal shunt to manage a third ventricular arachnoid cyst: a case report Yuliatri, Nia; Widjaya, Ingrid Ayke; Harlyjoy, Alphadenti; Wibawa, Gibran Aditiara; Satyanegara
Medical Journal of Indonesia Vol. 32 No. 3 (2023): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.236856

Abstract

Regular ventriculoperitoneal (VP) shunt is commonly used as the first option to manage a third ventricular arachnoid cyst due to the lack of facilities, unfamiliarity with endoscopic techniques, or misdiagnosis as purely obstructive hydrocephalus. A 9-year-old girl with obstructive hydrocephalus due to a third ventricular arachnoid cyst was treated with a VP shunt. 2 months later, the previous shunt device was removed due to an infection. Following a sterile cerebrospinal fluid analysis culture, we conducted a navigation-assisted transventricular transforaminal endoscopic fenestration and cysto-VP programmable shunt placement. A decrease in ventricular dilatation was seen on follow-up. This approach was justified due to the possibility of establishing communication with normal cisterns, the high rate of cyst elimination, and the potential for achieving shunt independence. Performing an endoscopic fenestration followed by cysto-VP shunt placement could be an optimal option for managing this condition.
Co-Authors Harlyjoy, Alphadenti Hassan, Roslan Janitra, Raka Nia Yuliatri Sipayung, Sebastian Wibawa, Gibran Aditiara Widjaya, Ingrid Ayke