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All Journal Indonesian Journal of Cancer Acta Neurologica Indonesia
Madjid, Irma Savitri
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Educating General Practitioners about Medication-overuse Headache: Importance and Call to Action Sofyan, Henry Riyanto; Madjid, Irma Savitri; Faiq, Ahmad Rafi; Indrapriambada, Ery Riady; Humaira, Sarah; Aninditha, Tiara
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.49

Abstract

Medication overuse headache (MOH) is a secondary headache that frequently accompanied chronic primary headaches which poses a great burden in an individual and systemic level. Globally, it is recognized as one of the relevant headaches for primary care. However, in Indonesia, it has not been included in the standard competence for doctors, and therefore has been underrecognized by general practitioners who encountered headache patients in primary care. In this policy brief, we mapped the problems regarding MOH and proposed several action plans, including educating GPs, as the recommendations.
Headache Characteristic in Brain Tumor Patients Sembiring, Saulina; Sofyan, Henry Riyanto; Madjid, Irma Savitri; Alvonsius Silalahi, Raymond Aris Nimrod; Albertin, Elizabeth; Aninditha, Tiara
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1197

Abstract

Background: Headache is an alarm for structural abnormalities, and it frequently manifests as an initial symptom of brain tumors, with an occurrence rate ranging between 36-80%, depending on the type and location of the tumorMethods: We conducted a retrospective cross-sectional study to observe hospitalized brain tumor patients at Dr. Cipto Mangunkusumo Hospital from January 2022 to March 2023. This study described the prevalence and the percentages of baseline characteristics.Results: Our study revealed that out of 101 brain tumor patients, predominated by females (60.4%) with a mean age of 46.2 years. Secondary brain tumors originating from breast cancer were more prevalent (13.9%). Frontal lobe location was frequent (32.3%), displaying rapid growth (66.3%), focal deficits (82.2%), and headaches (79.2%). Atypical headache was the most common phenotype (40%), often occurring either before the onset of neurological deficits (prechronous) or concurrently with them (synchronous). Discussion: The study revealed that high-grade, rapidly growing brain tumors tend to induce focal neurological deficits and headaches due to the tumor’s progressivity and mass effect. Brain tumor lesions were primarily found in the frontal lobe of the supratentorial region, displaying a mainly atypical headache phenotype. The absence of pain receptors in the parenchyma suggested that pain resulted from mechanical stimulation of other pain-sensitive structures.Conclusion: Atypical headaches occurring within 30 days before neurological deficits could indicate potential malignancy.
Rare Case of Solitary Brain Metastasis from Colorectal Cancer Ririhena, Fiorentina C; Aninditha, Tiara; Sofyan, Henry Riyanto; Madjid, Irma Savitri
Acta Neurologica Indonesia Vol. 4 No. 02 (2026): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v4i02.94

Abstract

Introduction: Solitary brain metastasis (BM) from colorectal cancer (CRC) is rare (0.6–3.2%) and presents management challenges, especially in eloquent brain regions where surgical resection carries high risk. Stereotactic radiotherapy (SRT) is often preferred when surgery is not feasible, particularly in patients with good functional status. Case Illustration: A 49-year-old male with a KPS of 90 presented with worsening right-sided pulsating headaches for five days, accompanied by left-sided facial nerve palsy. MRI revealed a solitary intra-axial metastasis in the right temporal lobe, an eloquent region, with microbleeds and surrounding edema, suggestive of BM from rectal adenocarcinoma. Given the lesion's eloquent location, where surgery posed high risks, SRT was selected as the primary treatment modality, alongside corticosteroids for edema control and psychiatric support for depression Discussion: Solitary CRC BM in eloquent regions is a clinical dilemma. While surgery is standard for accessible lesions, SRT offers effective tumor control while reducing neurological complications, making it preferable for patients with high KPS (≥90) as it preserves cognitive function and improves survival outcomes. A multidisciplinary and holistic treatment approach, addressing both oncological and psychological aspects, is essential. Conclusion: Managing solitary CRC BM in eloquent brain regions requires special strategies. SRT was favored to reduce the risk of neurological impairment while maintaining tumor control, especially when surgery was not viable. A multidisciplinary approach is crucial to optimizing care and improving quality of life. Keywords: solitary brain metastasis, colorectal cancer, stereotactic radiotherapy, eloquent brain region
Co-Authors Albertin, Elizabeth Alvonsius Silalahi, Raymond Aris Nimrod Aninditha, Tiara Faiq, Ahmad Rafi Humaira, Sarah Indrapriambada, Ery Riady Ririhena, Fiorentina C Sembiring, Saulina Sofyan, Henry Riyanto