Neurologico Spinale Medico Chirurgico
Neurologico Spinale Medico Chirurgico (NSMC) is an open-access, single-blind peer-reviewed journal, published by Indonesian Neurospine Society (INSS) under the flag of Indonesian Neurosurgery Society (INS) and Faculty of Medicine, Udayana University. NSMC publishes articles which encompass all aspects of basic research/clinical studies. The journal facilitates, bridge and integrate the intellectual, methodological, and substantive diversity of medical knowledge, especially in the field of surgery, neurology, neurosurgery, spine, neuroanesthesia, medicine, and health. The journal appreciates any contributions which promote the exchange of ideas between practising educators and medical researchers all over the world.
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<![CDATA[Tuberculosis transverse myelitis in pediatric patient ]]>
<![CDATA[Robert Sinurat]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
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DOI: 10.36444/nsmc.v4i3.168
<![CDATA[Tuberculosis myelitis usually impact adult patients and associated with tuberculous meningitis, miliary tuberculosis, or human immunodeficiency virus infection. Pediatric tuberculosis myelitis cases without any associated diseases have never been reported. The author reported a case of a pediatric patient with tuberculosis myelitis without any other organ involvement and the outcome after treatment. Girl 13 years old suffered from paraplegia of her lower extremities. Two months before paraplegia she felt weakness in her left leg and followed by the right side. The legs were spastic and ankle clonus was positive. She lost sensation from epigastrium level to her both of legs and difficult to bowel. Laboratories result was normal but spinal magnetic resonance imaging showed hyperintense lesion of spinal cord thoracic vertebrae 5-8. During the laminectomy procedure, there was no any tumor, abscess, or tuberculoma, but the spinal cord looked brown. A biopsy was performed, and the histopathology results showed the granuloma containing lymphocytes, epithelioid macrophages, and datia langhans cells. The patient was treated with anti-tuberculosis chemotherapy for twelve months. Clinical symptoms improved gradually and the patient was able to walk slowly. Tuberculosis myelitis is an inflammatory spinal cord disease and it can cause paralyzed, sensory and autonomic disturbance. Magnetic resonance imaging can differentiate between spinal tuberculosis and spinal tumors, but it will be difficult if there are no signs of vertebral body and discs inflammation. Tuberculosis myelitis should be considered as a differential diagnosis of spinal cord lesions in children and its response to anti-tuberculosis chemotherapy is excellent.]]>
<![CDATA[Rupture of the recurrent thoracic intramedullary spinal cord cavernoma ]]>
<![CDATA[Galih Indra Permana]]>;
<![CDATA[Eko Agus Subagio]]>;
<![CDATA[Muhammad Faris]]>;
<![CDATA[Abdul Hafid Bajamal]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
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DOI: 10.36444/nsmc.v4i3.169
<![CDATA[The intramedullary spinal cord cavernoma is a rare vascular disease that occur within spinal cord or intramedullary and account for about 5%-12% of all pathology in the spinal vascular disease. We report a clinical progression of disease and evolution of the haemorrhage every years until patient underwent surgical procedure. A 63-years old male with progressive weakness of the lower extremity since 1 month before admission, worse in the left side He also complained loss of sensation at the level of the T4 and below it. Patient suffer three times rebleeding before underwent surgery. MR imaging showing intramedullary spinal cord cavernoma and a histology examination exhibited the characteristics of a cavernoma. Intramedullary spinal cord cavernoma is a rare disease that should be treated before rebleeding occur and enlargement of the lesion. Postoperative neurological function in intramedullary spinal cord cavernoma patient is determined by the preoperative neurological status.]]>
<![CDATA[A devastating complication “white cord syndrome” following posterior cervical decompression for ossification of the posterior longitudinal ligament stenosis ]]>
<![CDATA[Christian Permana]]>;
<![CDATA[Yoga Arif Syah Hidayat]]>;
<![CDATA[Fadhil]]>;
<![CDATA[Muhammad Sinatrya Caropeboka]]>;
<![CDATA[Mardjono Tjahjadi]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
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DOI: 10.36444/nsmc.v4i3.171
<![CDATA[Reperfusion injury of the spinal cord or “white cord syndrome” (WCS) refers to the sudden onset of neurological deterioration after spinal decompressive surgery. It is thought to be caused by reperfusion injury of the spinal cord. The risk of WCS might be increased in elderly and patients with chronic hypertension as commorbidities. A 50-year-old male suggestive a continuous ossified posterior longitudinal ligament (OPLL) with cervical spinal stenosis from C2-C4 underwent posterior decompression and posterior fixation from C2 to C4. After the patient recover from anesthesia, he developed hemiparesis on right side with motor strength 1/5. Immediate postoperative CT scan imaging revealed no malpositioned screw, on cervical MRI disclosed a hyperintense signal in T2-weighted sequences at C3-C4 levels and the diagnosis of WCS was suspected. A high dose methylprednisolone according to NASCIS II, mannitol, and methylcobalamin were given. On post-operative day (POD)-1 the patient's muscle strength improved to grade 3/5 in the upper extremity and to grade 4/5 in the lower extremity but the elbow flexion muscle strength still 1/5. Two weeks after surgery the patient able to walk normally but the upper extremity still no improvement. There are still no class I, II, and III evidence backing specific treatment of WCS. However, there are several prevention strategies to decrease the risk of WCS such as CSF pressure management, remote ischemic preconditioning (RIPC), intraoperative monitoring, and technique switch to laminoplasty. We recommend that the importance of early recognition and prompt treatment of white cord syndrome to minimize the complication.]]>
<![CDATA[Bidara leaf extract (Ziziphus mauritiana) inhibits MMP-1 increase and collagen decrease in female Wistar rat skin exposed to UVB and cigarette smoke ]]>
<![CDATA[Citra Anggraeny]]>;
<![CDATA[Anak Agung Gde Putra Wiraguna]]>;
<![CDATA[Gde Ngurah Indraguna Pinatih]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
Publisher : <![CDATA[Indoscholar ]]>
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DOI: 10.36444/nsmc.v4i3.178
<![CDATA[Background: Exposure to cigarette smoke and UV-B, can activate enzymes that degrade collagen and inhibit its production through increased levels of MMP-1. Bidara leaves with high content of flavonoids and tannins may prevent damage caused by free radicals. This study aimed to prove the effect of bidara leaf extract in inhibiting the increase in MMP-1 levels and collagen reduction in female Wistar rats skin exposed to UV-B and cigarette smoke. Methods: A randomized posttest-only control group design study was conducted on 30 female Wistar rats, aged 8-10 weeks, weighing 130-150 grams. The rats were divided into three groups: the group without treatment, the base cream, and the 7.5% bidara leaves extract groups. The last two groups were exposed to UV-B light and cigarette smoke. After four weeks of intervention, the back skin tissue was taken to assess collagen amount and MMP-1 levels. Comparative analysis was performed to see the difference between groups. Results: The results showed that the mean levels of MMP-1 in the untreated group were lowest, followed by the bidara leaf extract cream and the base cream group. The mean of collagen amount of bidara leaf extract group was the highest, followed by the base cream and the untreated group. The analysis showed a significant difference in the mean levels of MMP-1 and collagen amount between groups (p<0.05). Conclusion: The 7.5% bidara leaf extract cream inhibited the increase in MMP-1 levels and the decrease in collagen in female Wistar rats exposed to UV-B light and cigarette smoke.]]>
<![CDATA[The administration 3% Tamarind (Tamarindus indica) leaves ethanol extract cream inhibited the increase of tyrosinase expression and the amount of skin melanin in male Guinea pigs (Cavia porcellus) skin exposed to UV B ]]>
<![CDATA[Angelia Ongko Prabowo]]>;
<![CDATA[Wimpie Pangkahila]]>;
<![CDATA[Ni Putu Sriwidyani]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
Publisher : <![CDATA[Indoscholar ]]>
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DOI: 10.36444/nsmc.v4i3.181
<![CDATA[Background: The main factor of skin aging is exposure to sunlight, especially UV B rays. Tamarind leaves extract known containing tannins, flavonoids, and polyphenols as anti-aging agents. This study was aimed to prove the protective effect of 3% Tamarind leaves (Tamarindus indica) ethanol extract cream in inhibiting the skin aging due to exposure to UV B by evaluate the tyrosinase expression and the amount of melanin. Methods: This was a randomized post-test only control group design involving 36 subjects of male Guinea pigs, that divided into 2 groups. The control group received placebo cream and the treatment group received 3% Tamarind leaves ethanol extract cream. Cream application was given twice a day for 2 weeks. UV B were given 3 times a week for 2 weeks with a total dose of 390 mJ/cm2. Tyrosinase expression was examined by calculating the cell percentage that express the enzyme using the immunohistochemical method. The amount of melanin was examined digitally by calculating the pixel percentage of melanin in Masson Fontana staining slides. Statistical analysis by the Independent T-test to compare the mean between two groups with p=0.05 significance. Results: The mean tyrosinase expression and the mean amount of melanin in the control group was higher than treatment group. 20.650±4.911% vs 16.067±3.451%, p=0.003 and 10.461±4.916 pixel% vs 7.300±3.111 pixel%, p=0.029, respectively. Conclusion: Administration of 3% Tamarind leaves (Tamarindus indica) etanol extract cream inhibited the increase in tyrosinase expression and the amount of skin melanin in male guinea pigs (Cavia porcellus) exposed to UV B.]]>
<![CDATA[Supratentorial and spine metastatic medulloblastoma in adults ]]>
<![CDATA[Satriya Ranuwibawa]]>;
<![CDATA[Nyoman Wahyudana]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
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DOI: 10.36444/nsmc.v4i3.182
<![CDATA[Medulloblastoma is an infratentorial primitive neuroectodermal tumor that is predominantly found in children. The incidence of medulloblastoma fluctuates between 20-35% in kids and is extraordinarily uncommon to be found in adults. A twenty-four-year-old man presented with a chief complaint of weakness of the lower extremity. Physical examination revealed myelopathy sign at the 12th thoracic level. Past medical history revealed that he had undergone total resection of a medulloblastoma of the cerebellum three years prior to the weakness. A thoracolumbar MRI with gadolinium contrast injection was performed which revealed a solid mass at thoracic vertebra 12 – lumbar 1. Four months after the total resection of the spinal mass, the patient presented again with a chief complaint of vomiting and a severe headache. A head CT scan was done followed by a head MRI with gadolinium contrast injection. A mass was found at the right temporoparietal region and craniotomy for tumor removal was immediately done to resolve the intracranial pressure problem. Pathological anatomy revealed the spinal and intracranial mass as medulloblastoma. This case report presents an adult with primary medulloblastoma of the cerebellum who presented with metastases of the spine and supratentorial regions. However, the incidence of medulloblastoma is very rare in adults and the 5-year survival rate is between 60% - 80% for all adult medulloblastoma patients. Surgeons must be careful in choosing the first management for better prognosis such as surgical management only, surgical management followed by adjuvant therapy, or just a chemotherapeutic-only approach.]]>
<![CDATA[Clitoria ternatea L. extract cream 5% inhibited the increase of MMP-1 levels and decrease of collagen amount in wistar rats (Rattus norvegicus) dermic skin exposed to ultraviolet B ]]>
<![CDATA[Ayunda Tamara Barito Saritani]]>;
<![CDATA[Anak Agung Gde Putra Wiraguna]]>;
<![CDATA[Luh Putu Iin Indrayani Maker]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
Publisher : <![CDATA[Indoscholar ]]>
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DOI: 10.36444/nsmc.v4i3.183
<![CDATA[Background: Photoaging increases MMP-1 and damage collagen by forming ROS. The antioxidant compounds in Clitoria ternatea L. have been studied to lower ROS, thus inhibiting the emergence of MMP-1 and preserving the collagen. The study initiated to analyze the Clitoria ternatea L. extract cream 5% effect on inhibiting MMP-1 increase and collagen decrease in female Wistar rat's skin exposed to UV-B. Methods: A randomized post-test-only control group design was conducted on 30 female Wistar rats, aged 8-10 weeks old with 130-150 grams bodyweight. They were assigned to three groups: the untreated group, placebo group, and the Clitoria ternatea L. extract cream 5% group. The last two groups were exposed to UV-B. After four weeks their skin was examined for MMP-1 levels using ELISA and collagen amount using Picro Sirius Red staining. Results: A comparative analysis showed that the lowest mean levels of MMP-1 was seen in the untreated group (4.64 ± 0.14 ng/ml), followed by the Clitoria ternatea L. extract cream group 5% (5.54 ± 0.21 ng/ml) and placebo group (8.68 ± 0.78 ng/ml). The highest mean of collagen amount was seen in the Clitoria ternatea L. extract cream group 5% (76.12 ± 5.09 %pixel), followed by the untreated group (69.38 ± 3.96 %pixel) and placebo group (30.31±8.06 %pixel). The comparative analysis shows a significant difference between groups (p < 0.05). Conclusion: The Clitoria ternatea L. extract cream 5% has proven to inhibited the increase of MMP-1 levels and decrease of collagen amount in Wistar rats skin exposed to UV-B.]]>
<![CDATA[Topical administration of Tamanu Oil (Calophyllum inophyllum) inhibited the increase of matrix metalloproteinase-1 (MMP-1) expressions and decrease of collagen dermis amount in male wistar rats exposed to ultraviolet B ]]>
<![CDATA[Yoselyn Gunawan]]>;
<![CDATA[Alex Pangkahila]]>;
<![CDATA[Agus Eka Darwinata]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
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DOI: 10.36444/nsmc.v4i3.186
<![CDATA[Background: UV-B irradiation is the major causative factor in photoaging. Photoaging increases MMP-1 significantly and cause damage to collagen by forming ROS. The monounsaturated free fatty acids and antioxidant compounds in Tamanu oil have been studied to inhibit the emergence of MMP-1 and maintain collagen amount. The study aimed to investigate topical Tamanu oil in inhibiting MMP-1 expressions and collagen decrease in male Wistar rats’ skin exposed to UV-B. Methods: A randomized post-test-only control group design was performed on 36 male Wistar rats, aged 2-3 months old with 180-220 grams body weight. They were assigned to two groups: the placebo group and the Tamanu oil group. Both groups were given the same amount of UV-B exposure for four weeks totalling in 840 mJ/cm2 of dosage radiation. Their dermis was examined for MMP-1 using Immunohistochemistry and collagen amount using Picro Sirius Red staining. Results: A comparative analysis was done to show the difference between groups. The mean expression of MMP-1 in the control group was 34,03±2.97 cell/HPF and the Tamanu oil group was lower at 22.73±2.68 cell/HPF. The mean amount of collagen dermis in the control group was 38.90±11.64 % and the Tamanu oil group was higher at 65.66±8.13 %. A significant difference was shown in the two groups (p<0.05). Conclusion: Topical Tamanu oil has proven to hinder the increase of MMP-1 expressions and collagen amount in male Wistar rats’ skin exposed to UV-B.]]>
<![CDATA[Eucalyptus globulus essential oil increased neovascularization and vascular endothelial growth factor expression in male wistar rats exposed to UVB ]]>
<![CDATA[Noviana Indrawati]]>;
<![CDATA[Ida Sri Iswari]]>;
<![CDATA[Ni Wayan Winarti]]>
<![CDATA[ Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021) ]]>
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DOI: 10.36444/nsmc.v4i3.187
<![CDATA[Background: Eucalyptus globulus essential oil contained 1,8-cineol, which may accelerate wound healing. This study aimed to prove Eucalyptus globulus essential oil's effect on increasing neovascularization and Vascular Endothelial Growth Factor (VEGF) expression in Wistar rats skin exposed to ultraviolet B (UVB). Methods: A Post-test only controls group study design was applied on 36 male Wistar rats, aged 3-4 months old, weighing 150-200 grams. The animal subject was exposed to UVB (65 mJ/cm2, 65 seconds for seven days), injured on their back using a punch biopsy with a diameter of 10 mm, and divided into two groups. For seven days, on the wound, the control group was given 2 cc of 0.9% NaCl twice a day, while the treatment group was given Eucalyptus globulus essential oil (2 cc). Both groups were given oral Amoxicillin three times a day. The skin tissue was taken on day eight to assess neovascularization and VEGF expression. Results: The results show that neovascularization in the treatment group was higher than in the control group (p < 0.05). Meanwhile, the median VEGF expression in the treatment group was also higher than in the control group (p < 0.05). Conclusions: Topical administration of Eucalyptus globulus essential oil increased neovascularization and VEGF expression in the skin of male Wistar rats injured and exposed to UVB. Further research is needed to assess the effectiveness of the essential oil in enhancing neovascularization and VEGF expression in humans with multiple exposures at different doses to optimize the wound-healing effect.]]>
