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All Journal Magna Neurologica Neurona Indonesian Journal of Biomedicine and Clinical Sciences
Setyawan, Tommy Rachmat
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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C-reactive protein (CRP) and lactate dehydrogenase (LDH) as functional outcome predictors in stroke patients Nadhilla, Nyimas Farisa; Gofir, Abdul; Setyawan, Tommy Rachmat; Farida, Siti; Ar Rochmah, Mawaddah
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 3 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i3.15893

Abstract

Stroke is a neurologic disorder with high mortality and disability. Its pathophysiology is associated with vascular inflammation. However, studies between vascular inflammatory markers and stroke outcomes are still limited. This study aimed to investigate the association between inflammatory markers and functional outcomes of stroke. This was a retrospective cohort study involving all stroke patients at the Dr. Sardjito General Hospital, Yogyakarta from October 2020 to August 2021 who meet the inclusion and exclusion criteria. Mann-Whitney was used for bivariate analysis, followed by multivariate analysis. A total of 269 subjects, with 213 infarcts (79.2%) and 56 hemorrhagic (20.8%) strokes. There were 83 subjects deceased (30.9%), with 66 infarct (31%) and 17 hemorrhagic (30.4%) strokes. High CRP levels had significant and independent associations with worse GCS, ADL, IADL, NIHSS, BI, SSGM, MRS, and higher mortality rates (p < 0.05). High LDH levels had a significant and independent association with worse GCS scores and higher mortality rates (p < 0.05). Sub-analysis showed high CRP and LDH had associations with high mortality rates in infarct (p < 0.001), but only CRP (p = 0.029) had associations with high mortality rates in hemorrhagic. There was no significant association between fibrinogen and procalcitonin with stroke outcomes (p > 0.05). Cox-regression analysis showed CRP>24.5 mg/dL and LDH >300U/L associated with hazard ratios of 3.2 (p < 0.001) and 1.65 (p = 0.026). In conclusion. high CRP and LDH levels are associated with mortality rates in stroke patients.
TROMBEKTOMI MEKANIS DAN TROMBOLISIS INTRAARTERI PADA STROKE ISKEMIK: FOKUS PADA LUARAN KLINIS Listyawan, Rakhian; Setyawan, Tommy Rachmat
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i5.864

Abstract

Mechanical thrombectomy has become the standard recommended therapy for acute ischemic stroke due to large vessel occlusion. A series of fundamental clinical trials have demonstrated the superiority of mechanical thrombectomy in achieving functional independence (modified Rankin Scale [mRS] score 0-2) at 90 days compared to medical therapy alone. The therapeutic window for mechanical thrombectomy has even been extended to 24 hours for selected patients based on perfusion imaging. Meanwhile, the role of intraarterial thrombolysis has evolved from primary therapy to an adjunctive or rescue strategy, used in cases of incomplete recanalization or distal embolism after mechanical thrombectomy. Both treatment modalities continue to evolve to improve clinical outcomes in patients. Keywords: Ischemic stroke, mechanical thrombectomy, intraarterial thrombolysis, large vessel occlusion, clinical outcome.
Outcome of Aneurysmal Subarachnoid Haemorrhage at Posterior Communicating Artery with Obstructive Hydrocephalus Post Successful Surgical Clipping and External Ventricular Drainage: A Case Report Fiharjatin, Dyah; Setyawan, Tommy Rachmat; Listyawan, Rakhian; Maskuri, Fajar
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2204

Abstract

Background: Approximately 25% of patients with SAH die before hospital admission. Proper posterior communicating artery (PCoA) aneurysm-related SAH is rare, with an incidence of about 1%. It is typically treated with coil embolization via digital subtraction angiography (DSA). In this case, decompressive craniectomy and external ventricular drainage (EVD) were performed, followed by aneurysm clipping, resulting in an excellent outcome. Case: A 63-year-old woman presented with a sudden severe headache, vomiting, somnolence, and right-sided limb weakness. Head CT angiography revealed SAH from a ruptured saccular aneurysm with a daughter aneurysm on the PcoA, Modified Fisher scale 2, and intraventricular hemorrhage (IVH) with a modified Graeb score of 3. The patient underwent decompressive craniectomy, EVD placement, and aneurysm clipping. On postoperative day two, she was alert but had left oculomotor nerve palsy and global aphasia. Head CT showed an acute infarction. Nicardipine was administered for a hypertensive emergency. Intravenous ceftazidime and gentamicin were used to treat nosocomial pneumonia. Nutritional support, physiotherapy, and speech therapy were provided. Discussion: Clipping was chosen for higher aneurysm obliteration rates and better oculomotor nerve recovery, despite a higher risk of postoperative cerebral ischemia than coiling. Due to high Modified Fisher and Graeb scores, EVD was necessary. Hemodynamic management and pneumonia treatment were critical. Early intervention, multidisciplinary care, and close postoperative monitoring are essential to reduce mortality and improve outcomes in PcoA aneurysm-related SAH. Conclusion: Decompressive craniectomy, EVD, and clipping combined with optimal hemodynamic management and complication control resulted in satisfactory outcomes in this rare PcoA aneurysm SAH case.
Co-Authors Abdul Gofir Fiharjatin, Dyah Listyawan, Rakhian Maskuri, Fajar Mawaddah Ar-Rochmah Nadhilla, Nyimas Farisa Siti Farida