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Rahmatisa, Dimas
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Biochemistry, Genetics & Molecular Biology Education Medicine & Pharmacology Neuroscience Public Health

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Prognosis of Surgical Management for Intracerebral Hemorrhage: Insights from Indonesia's National Brain Center Hospital Rahmatisa, Dimas; Lasanudin, Joshua Eldad Frederich
Jurnal Neuroanestesi Indonesia Vol 13, No 1 (2024)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v13i1.588

Abstract

Background and Objective: Intracerebral hemorrhage (ICH), a stroke subtype that can be managed surgically, exhibits varying prognoses amongst countries. However, data for the Indonesian population are currently lacking. Subject and Methods: In a retrospective cohort study, medical records of post-surgical ICH cases in Rumah Sakit Pusat Otak Nasional from January 2021 to April 2023 were obtained. Prognostic data includes hospitalization duration, in-hospital mortality, and dependency upon discharge. Multivariate analysis was performed on sociodemographic and medical data to determine prognostic factors.Results: A total of 157 cases were obtained. Procedures performed include hemorrhage evacuation craniotomies (58.6%), burr holes (29.9%), ventriculoperitoneal shunts (24.2%), and decompressive craniectomies (5,1%), with 15.9% patients undergoing multiple surgical sessions. In-hospital mortality and total dependency occurred in 31.2% and 54.6% of patients, respectively. Average hospitalization is 16.32 days. Predictors for in-hospital mortality are age ? 50 years (p=0.002), male (p=0.014), hematoma volume 40mL (p=0.012), multiple surgical sessions (p=0.034), and presenting Glasgow Coma Scale (GCS) 9 (p=0.015). Predictors for total dependency are supratentorial lesions (p=0.025) and presenting GCS 9-12 (p=0.008) and 9 (p=0.002). Predictors for hospitalization 2 weeks are stroke onset 3.5 hours (p=0.008) and multiple surgical sessions (p=0.001). Conclusion: Surgical management of ICH in Indonesia reveals similar outcomes to other countries. However, differences in prognostic factors indicate potential variations between countries.
Tatalaksana Jalan Napas pada Pasien dengan Fraktur Listesis Servikal Tidak Stabil Rahmatisa, Dimas; Sudadi, Sudadi; Suryono, Bambang
Jurnal Neuroanestesi Indonesia Vol 8, No 1 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (479.268 KB) | DOI: 10.24244/jni.v8i1.210

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Cedera tulang belakang leher/cervical spine injury (CSI) tetap menjadi penyebab utama morbiditas dan mortalitas di negara maju. Sekitar 12.000 kasus baru cedera tulang belakang terjadi di Amerika Serikat setiap tahunnya. Kebanyakan dari cedera tersebut (55%) merupakan cedera servikal, sedangkan 15% merupakan cedera yang berhubungan dengan torakolumbal. Studi epidemiologis baru, menunjukkan bahwa cedera tulang belakang leher terjadi sekitar 1,8% hingga 4% pada kasus cedera trauma tumpul dan menyebabkan sekitar 6.000 kematian dan 5.000 kasus baru quadriplegia per tahun. Kasus laki-laki usia 55 tahun dengan riwayat trauma leher 5 bulan sebelum masuk rumah sakit. Pemeriksaan fisik didapatkan adanya tetraparese dan nyeri hebat pada daerah leher, terutama saat ekstensi kepala. Dari pemeriksaan laboratorium tidak didapatkan kelainan, dari pemeriksaan magnetic resonance imaging (MRI) leher didapatkan spondilolisthesis C6-7 berat sehingga korpus C6 di anterior C7. Dilakukan anestesia umum, dengan manajemen jalan napas intubasi manual in-line, serta menggunakan video laringoskop. Intubasi dilakukan 2 kali percobaan karena kesulitan visualisasi pita suara. Operasi berlangsung 10 jam, pasien kemudian dirawat di ICU selama 1 hari sebelum pindah ruang rawat biasa.Airway Management in Patient with Unstable Listhesis Cervical FractureCervical spine injury (CSI) remains a major cause of morbidity and mortality in developed countries. About 12,000 new cases of spinal cord injury occur in the United States each year. Most of these injuries (55%) are cervical injuries, while 15% are torakoumbal-related injuries. New epidemiological studies show that cervical spine injuries occur in about 1.8% to 4% in blunt trauma cases and cause around 6,000 deaths and 5,000 new cases of quadriplegia per year. The case of a 55-year-old male with a history of neck trauma 5 months before being hospitalized. Physical examination is found for tetraparese and severe pain in the neck area, especially during head extension. From the laboratory examination no abnormalities were found, from the magnetic resonance imaging (MRI) examination of the neck obtained severe C6-7 spondylolisthesis so that corpus C6 was anterior to C7. General anesthesia, with manual in-line intubation airway management with using a video laryngoscope. Intubation was carried out 2 times because of difficulty in visualizing the vocal cords. The operation lasted 10 hours, the patient was then admitted to the ICU for one day, then moved to ward.
Co-Authors Bambang Suryono, Bambang Lasanudin, Joshua Eldad Frederich SATRIYAS ILYAS