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All Journal Medicinus : Jurnal Kedokteran Journal of Neurointervention and Stroke (JNeViS)
Diafiri, Dinda
Unknown Affiliation
Medicine & Pharmacology Neuroscience Public Health

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Tuberculoma With Visual and Vestibular Symptoms in A β-Thalassemia Patient: A Case Report Suryawijaya, Evlyne Erlyana; Ariarini, Ni Nengah Rida; Diafiri, Dinda; Dewati, Eva; Sitorus, Freddy
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10163

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, which can affect the lungs (pulmonary TB) as well as other organs (extrapulmonary TB), including the central nervous system (CNS). The number of TB cases in Indonesia remains high, with 969,000 cases reported in 2021. Tuberculoma is a manifestation of TB in the CNS, presenting as an intracranial mass due to the spread of TB from other organs. It is a rare and serious form of CNS TB infection. The presence of congenital β-thalassemia adds complexity to the pathogenesis, diagnosis, and treatment of tuberculoma. Case Description: A 25-year-old female with a history of β-thalassemia HbE intermedia with a major phenotype presented with the main complaint of blurred vision in the lower right visual field. The patient also experienced vertigo, headache, and a history of seizures. Examination revealed inferior right quadrantanopia, anemia, leukopenia, and thrombocytopenia. Imaging and CSF analysis supported a diagnosis of intracranial tuberculoma. The patient was treated with anti-TB medication and intravenous dexamethasone. Discussion: Patients with thalassemia may have an increased risk of TB infection, including CNS TB. Tuberculoma involves granuloma formation in the brain, often in the meninges and cerebrum. Its manifestations vary and can include headaches and seizures. Diagnosis is based on clinical history, radiological findings, and laboratory results. The patient’s symptoms and imaging findings supported a diagnosis of tuberculoma, for which anti-TB and neurorestorative therapy was administered. Conclusions: Tuberculoma, as a manifestation of CNS TB, presents with variable and non-specific symptoms. Visual field disturbances can be one of the presenting symptoms that aid in diagnosis. Clinical, radiological, and laboratory evaluations are necessary for prompt and accurate diagnosis. Treatment involves anti-TB therapy and dexamethasone. This case highlights the importance of early diagnosis and comprehensive management of complex extrapulmonary TB infections.
Funduscopic and Transcranial Doppler Profile of the Ophthalmic Artery in Stroke Patients with Hypertensive Retinopathy Adriani, Dini; Dewati, Eva; Sitorus, Freddy; Ariani, Ni Nengah Rida; Diafiri, Dinda; Kasih, Tiara; Kurniawan, Mohammad
Journal of Neurointervention and Stroke Vol. 1 No. 2: NOVEMBER 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.12.12

Abstract

Highlight: Hypertensive retinopathy may predict stroke risk TCD may complement funduscopy in stroke with HR ABSTRACT Introduction: Hypertensive retinopathy (HR) is a manifestation of chronic vascular damage and is increasingly recognized as a predictor of stroke. Funduscopy and Transcranial Doppler (TCD) examination of the ophthalmic artery may offer non-invasive insight into cerebrovascular health. Objective: To describe the demographic, funduscopic, and ophthalmic artery hemodynamic profiles in stroke patients with hypertensive retinopathy using Transcranial Doppler. Method: A cross-sectional descriptive study was conducted from May 2022 to May 2025 at Cipto Mangunkusumo National Hospital, involving 67 ischemic stroke patients with HR. Retrospective data were collected from medical records, including sociodemographics, fundus classification based on Wong and Mitchell, and Pulsatility Index (PI) values of the ophthalmic artery from TCD. Result: Mild hypertensive retinopathy is prevalent in ischemic stroke patients, and elevated ophthalmic artery PI values are suggestive of small-vessel disease. Conclusion: Funduscopy and TCD can be complementary tools in evaluating stroke risk in hypertensive.
Co-Authors Adriani, Dini Aninditha, Tiara Ariani, Ni Nengah Rida Ariarini, Ni Nengah Rida Dewati, Eva Imran, Darma Kasih, Tiara Kurniawan, Mohammad Pukovisa Prawiroharjo, Pukovisa Sinthia, Novita Ayu Sitorus, Freddy Sofyan, Henry Riyanto Suryawijaya, Evlyne Erlyana Zairinal , Ramdinal Aviesena