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Asian Australasian Neuro and Health Science Journal (AANHS-J)
Published by TALENTA PUBLISHER
ISSN : 26860848     EISSN : 26860848     DOI : https://doi.org/10.32734
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Focus and Scope Asian Australasian Neuro and Health Science Journal (AANHSJ) provides a forum for publishing the full research articles in the area of Neurosurgery and Health related to topics from the following subject areas: Neuro-Anatomy Neuro-Physiology Neuro-oncology Neuro-Spine Neuro-Pediatric Neuro-Trauma Neuro-Vascular Neuro-Fungsional Basic Science Biomoleculer in Neurology Radiology in Neurosurgery
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 95 Documents
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Improving Motoric Outcome after Early Craniectomy in Patient with Open Depressed Fracture Involving Motoric Cortex Area : A Case Report Husain, Syekh Ahmad Arafat; Hutagalung, Tommy Rizky; Lizen, Nindi; Mahyudanil
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 1 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i1.5946

Abstract

Introduction : Traumatic brain injury  (TBI) remains a major public health problem worldwide. It is a leading cause of mortality and disability across the globe. Brain swelling and intracranial hypertension are well-recognized secondary insults associated with increased mortality and poorer outcomes. In majority of head injury cases, the incidence of depressed skull fracture is also increasing. When this situation involving in motoric cortex area, it can cause limb weakness and devastating effect. Case Report : We reported a 21 year old male patient came with complaints of decreased consciousness due to a motorcycle accident. On motoric examination, hemiplegia was found in the left limb. There was a open wound in the right fronto-parietal region, Head CT Scan revealed a depressed fracture in the right fronto-parietal region and  multiple contusions on the right frontal. Craniectomy procedures was performed. Post operatively there is an improvement in patient consciousness and motoric outcome. Discussion : Open depressed fracture is one of the most common traumatic brain injury (TBI). Prevent infection and saving traumatic penumbra is the main target of surgery in this case. The pathophysiological changes in the traumatic penumbra are dynamic processes, the development and outcome of TBI depends greatly on the progression of tissue damage in the traumatic penumbras. Early clinical treatment can effectively rescue the tissue which has the potential to recover and hinder the progression of secondary injury Conclusion : Traumatic brain injury (TBI) has high morbidity and mortality in worldwide. Time dependent progression has provided a window of opportunity to take interventional action and reduce secondary injury after TBI. Motoric outcome can improve with early management.
Frontoorbital Advancement (FOA) using surgical suture. Our experience : single institution Kemas, K M A Halim Habibi
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 2 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i2.5704

Abstract

Frontoorbital advancement (FOA) was mainstay treatment of coronal and metopic craniosynostosis. There are several techniques and materials such as absorpable plate, surgical suture fixation, and osteogenesis distraction. Each techniques and materials has advantages to clinical outcome. This study describe our experience in FOA using surgical suture in our Institution.
Recent Updates on Experience, Treatment and Prevalence of Adult Brain Tumor : Single Center Study Tommy Rizky Hutagalung; Ridha Dharmajaya
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 2 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i2.6218

Abstract

Introduction : Brain tumor is a disease with high morbidity and mortality rates. Treating brain tumors requiring medical providers to have basic understanding of brain tumor diagnosis and management. The most common brain tumors are meningiomas, gliomas, pituitary adenomas and brain metastasis. The treatment of each type of brain tumor is different and multidisciplinary involving other scientific fields besides neurosurgery. Case Series : We reported 131 cases of brain tumors at the Haji Adam Malik Hospital in the period January 2018-December 2019, consisting of 52 cases (40%) of meningioma, 34 cases (26%) of Glioma , 12 cases (9%) of pituitary adenomas and 33 cases (25%) of brain metastasis. Meningiomas were mostly treated with surgery alone in 38% of cases, gliomas with surgery followed by chemo-radiation in 41% of cases, all of pituitary adenomas were treated with endonasal transfenoid surgery, while brain metastasis in 70% of cases required whole brain radiation with controlled primary tumors. Discussion : The modalities for treating brain tumor patients has been increasing recently. Meningiomas are mostly benign and managed by surgical resection only, chemo-radiation reserved for high risk or refractory case of meningiomas. Glioblastoma is the most common glioma and aggressive malignant primary brain tumor, limited response to gross surgical tumor and chemo-radiation. Pituitary adenomas mostly treated with endonasal transfenoid surgery, radiotherapy use in recurrent case. Brain metastasis may require complex multidisciplinary care with neurosurgery, radiation oncology, and medical oncology. Conclusion: The treatment of brain tumors is influenced by various considerations such as age, patient condition,neurological deficits, location of the tumor, comorbidities, experience of the neurosurgeon and available modalities. Treatment methods for brain tumors continue to evolve.
How Well Do We Know Neonatal Stroke: A Literature Review Sebayang, Moriko Madadoni; Mouza, Abdurrahman
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 2 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i2.6281

Abstract

Neonatal stroke can be characterized as a cerebrovascular injury that happens between 20 weeks of fetal life and 28 days post-pregnancy life. The assessed frequency of neonatal stroke is between one of every 1600 and one out of 3000 live births which recommends that the neonatal period is the most engaged lifetime time of hazard for stroke. Utilizing the advances in neuroimaging which have assisted with characterizing explicit neonatal stroke sickness states, several topics consisting of pathophysiology, manifestation, diagnosis, and management of neonatal stroke are systematically reviewed in this study. The results confirm several points, namely: (1) Neonatal stroke is characterized as one of six explicit sickness states based on clinical show and neuroimaging discoveries. (2) Intense indicative assortments normally present with seizures, while assumed neonatal stroke assortments typically present with hemiparetic cerebral paralysis. (3) Across all types of neonatal stroke, causative systems are ineffectively perceived, featuring the requirement for extra investigations just as an alert in allotting causation.
Prevalence, Risk Factors and Demographic of Pediatric Hydrocephalus in RSUP H. Adam Malik Medan 2019-2020 Delrizal, Sulaiman; Mouza, Abdurrahman; Hutagalung, Tommy Rizky
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 2 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i2.6501

Abstract

Introduction: Hydrocephalus is a disorder of the central nervous system which manifests as excess cerebrospinal fluid found in the head either inside the ventricular system or the subarachnoid space. The prevalence and demographics of congenital hydrocephalus remain poorly defined, in part because the definition of “congenital hydrocephalus” varies between studies; depending on the clinical criteria used to define congenital hydrocephalus, the prevalence has been reported between 1 and 32 per 10,000 live births. Previously known several risk factors include infection during pregnancy (toxoplasmosis, CMV, meningitis), family history hydrocephalus (less than 2%), premature pregnancy and low birth weight (which may increase the incidence of intraventricular hemorrhage). Method and Result : This Study was a descriptive study, we collected data from 2018-2019 at Haji Adam Malik General Hospital. From the data we found 58 cases of pediatric Hydrocephalus, with hydrocephalus obstructive 24 cases (41%) and communicans hydrocephalus 34 case ( 59%). Based on age, most samples were <6 months of age in both types of hydrocephalus. Most of the gender is male. Most of the GCS conditions at admission were GCS 13-15. The most common etiology in obstructive hydrocephalus cases was aquaduct stenosis in 13 cases (54%), while the most common etiology in cases of hydrocephalus communicans was infection in 22 cases (65%). Infection during pregnancy, low birth weight and premature pregnancy are thought to be the most risk factors found Discussion : Hydrocephalus is described as non communicating when it is caused by lesions that obstruct CSF flow through the ventricular system, such as fourth ventricular tumors. Communicating hydrocephalus is present when the lesion is at the level of the subarachnoid spaces, arachnoid granulations, or the venous system. Previously known several risk factors include infection during pregnancy, family history hydrocephalus, premature pregnancy and low birth weight.
Microsurgical Resection of Cerebral Arteriovenous Malformation: Our Precious Experience Irsyad, Muhammad Ari; Hutagalung, Tommy Rizky; Putra, Prawira Buntara; Tala, Muhammad Ihsan Zulkarnain
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 2 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i2.6569

Abstract

Introduction : Intracranial ateriovenous malformation (AVM) is a non-neoplastic congenital vascular abnormality which appears as a mass lesion composed of tangled blood vessels connecting arteries and veins in the brain. Case Report : Twenty seven years old male was present in our emergency department (ED) with decreased of conciousness and reccurent generalized seizure. The physical examination reveal the patient Glasgow coma scale (GCS) of 12 points (E4M5V3). Head CT scan with contrast shows contrast enhancing lesion on the frontoparietal region with extension to right lateral ventricle which suggest vascular lesion. We performed surgical resection of the AVM using the temporary clip on M2 branch which supply the nidus to reduce the risk of bleeding on operation. Discussion : Patients with grade I or II AVM tolerate resection with acceptable morbidity, whereas those with a grade IV or V AVM may be considered for conservative management because of the high anticipated risk of surgical morbidity Conclusion : AVMs are abnormalities of the intracranial vessels that constitute a connection between the arterial and venous systems and lack an intervening capillary bed. Microsurgical excision of the AVM involves a craniotomy, careful dural opening with circumferential nidus dissection until complete AVM resection is achieved.
Traumatic Brain Injury Cases Through Emergency Department During Covid-19 Pandemic Era 2020 In Adam Malik General Hospital Medan Mahyudanil, Mahyudanil; Sinaga, Patrice LWY; Irsyad, M. Ari; Faisal, Faisal; Hutagalung, Tommy Rizky
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 3 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i3.7567

Abstract

Abstract Introduction: Coronavirus disease 2019 (COVID-19) has been infecting nearly 800.000 individuals of all ages in 31 March 2020. Based on Harvard Medical school experience, almost over 80% of patients have switched to telemedicine services. In Indonesia, there are almost 1,22 million cases with recovery of 1 million case and the death of 33.183 cases. In North Sumatera, the COVID-19 cases occurred in 22.999 cases and the recovery of 19.758 cases with death of 786 cases. Here, we report the trend of traumatic brain injury (TBI) cases in pandemic era 2020 in our institution in Adam Malik General Hospital, Medan, North Sumatera. Method: This retrospective observational study reported 343 TBI cases from January 2020 to December 2020. January 2020 to March 2020 regarded as pre pandemic and April 2020 to December 2020 as the pandemic era. Results: There is significant decrease of traumatic brain injury patients from March 2020 to April 2020. It was 61% decrease in patients admission to our Emergency Department (ED). Demographically, male patients in productive age group and mild TBI has the most common presentation to our ED. Discussion: There is significant decrease of patients with TBI in our institution. The number of cases was declining from 55 patients on January to 21 patients on April. This also occurred concurrently with the start of social distancing in Indonesia on April 2020 and the civilian suggested to stay at home during this period. This decline was also found in other countries, like Massachusetts, USA and India. Conclusion: We reported significant decrease in traumatic brain injury cases in Adam Malik General Hospital during COVID-19 pandemic era in 2020. Neurosurgeons and Residents of Neurosurgery have to be cautious in assessing the TBI patients to limit the spread of COVID-19 in ED.
Overview of Patients with Metastatic Brain Tumors from Breast Cancer at H. Adam Malik Hospital, Medan in 2017-2021 Rasyid, Fahmi; Alloyna, Dhyka; Basri, Kamal
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 3 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i3.7581

Abstract

Abstract Introduction: The incidence of breast cancer based on Globocan in 2018, reached 2,088,849 cases (11.6%), with a mortality rate of 626,679 cases (6.6%). Breast cancer is one of the most common causes of a metastatic brain tumor. Approximately 10%-16% of patients with breast cancer develop brain metastases during the course of their disease. Current case management guidelines for patients with metastatic brain tumors from breast cancer are radiotherapy to the entire brain, with or without surgical resection, or stereotactic radiosurgery. Hormone receptor ([HR]; estrogen receptor [ER], progesterone receptor [PR]) and HER2 expression serve as predictors of response to hormone-targeted therapy and HER2, respectively. Method: The study was a descriptive study with a retrospective cohort design in which the researchers identified 78 patients with breast cancer brain metastases (either for diagnostic purposes or for therapeutic purposes at RSUP HAM Medan between 2017 and 2021. Data were collected from SIRS RSUP HAM Medan. Data related to clinicopathology were collected from medical records, including demographic characteristics, tumor characteristics, biomarker status, recurrence of metastatic brain tumors based on Magnetic Resonance Imaging (MRI) examination, and data on therapeutic regimens in cases of brain metastases of breast cancer. ER and PR status were determined by immunohistochemical examination. the intensity of the HER2 3+ immunohistochemical staining was considered positive Result: The mean age at breast cancer diagnosis was 46 years (range: 24-73 years). Most patients had invasive ductal histology (n=73, 94%). In addition, 56% of patients had T3 (n=34) T4 disease in 56% of patients (n=44) and 68% of patients (n=53) had positive axillary lymph nodes. Among patients with known HR and HER2 status, a total of 56% of tumors were ER negative (ER-; n=44), 62% were PR negative (n=48), and 44% were HER2-positive (HER2+; n= 34). With regard to the four subtypes formed by the combined values of HR and HER2 status, 21% (n=16) of tumors were HR+HER2+, 27% (n=21) were HR+HER2-, 23% (n=18) were HR+/ HER2-, and 28% (n=23) were triple negative (TN). Discussion: In the current study, investigators found that apart from patient age and number of brain metastases, HER2 status was a strong predictor of survival outcome after brain metastases. Patients with HER2-positive characteristics had a longer life expectancy than patients with HER2-negative disease. Considering the intracranial antitumor effect of anti-HER2 therapy, it is important to establish HER2 status not only in primary tumors but also in brain metastases to aid in consideration of the choice of therapeutic modality Conclusion: This study showed that younger age, brain metastases from solitary breast cancer, and HER2 positive from breast tumors were independent predictors of better survival in patients with breast cancer brain metastases
Our Experience Of Pediatric Brain Tumour In Medan: Demographic Study In Adam Malik General Hospital 2019-2020 Mouza, Abdurrahman; Rasyid, Fahmi
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 3 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i3.7606

Abstract

Abstract Introduction: Primary brain and central nervous system tumors are the most prevalent and frequent neoplasm in children and adolescents aged 0 to 19 years. Brain and CNS tumors are the second leading cause of cancer-related deaths in children and adolescents aged 0 to 19 years old. Previous studies in several countries have reported the incidence rate of primary brain and CNS tumors in children and adolescent, ranged from 1.08 to 5.57 per 100,000 population. The incidence of brain tumor in pediatric patients has increased in the past decades, due to innovations in the imaging studies and the increase of benign form diagnoses. The highest occurrence of pediatric brain tumor is in the United States. Based on the study by Rictherova et al. in 2018, according to the age groups, the highest incidence is in adolescents aging 15-19 years with 6.38 per 100,000 children, followed by children aging under 1 year with 6.2 per 100,000 children. Method: A total of 58 patients were reported in this study. Data was collected from medical bank data of Neurosurgical Department of Faculty of Medicine of North Sumatera in Indonesia. The variables that we collected were as follows: gender, tumor diagnosis, Glasgow-Coma Scale (GCS) score on admission, and age group. We classified age group into <1 year, 2-4 years, 5-9 years, 10-14 years, and 15-19 years old. The data was computed using the SPSS 25th edition. Result: Out of 58 diagnosis, boys were the predominance frequency with a total of 69% and girls were 31%. most patients had medulloblastoma (27.6%) followed by glioma (24.1%), craniopharyngioma (8.6%), and meningioma (8.6%). Other types of tumor, namely cerebral abscess, cerebromalacia, choroid plexus papilloma, craniopharyngioma, ependymoma, neurofibromatosis 1, soft tissue tumor, were accounted for 1.7%, respectively Discussion: Primary brain and central nervous system tumors are the most prevalent and frequent neoplasm in children and adolescents aged 0 to 19 years. Brain and CNS tumors are the second leading cause of cancer-related deaths in children and adolescents aged 0 to 19 years old. In our study, from a total of 58 patients, most of the patients (69%) were boys with a frequency of 40. Girls were only accounted for 18 (31%). A study by Stiller et al. in 2019 regarding incidence of childhood CNS tumors in Britain also reported similar result, with 2275 boys and 1891 girls out of 4166 tumor patients. The most common diagnosis was medulloblastoma (27.6%), in line with the study by Stiller et al. and Suresh et al. The most common age group with brain tumor was 10-14 years old (34.5%). Conclusion: Based on our study, from the total of 58 patients, most of the patients were boys (69%). The most common tumor diagnosis in our study was medulloblastoma (27.6%) followed by glioma (24.1%). The results in our study had been in line with other literatures. However, the age group distribution was not in line with other literatures as our study reported the age group of 10-14 years old having the highest percentage of brain tumors. Overall, this study had reported the demographic result of pediatric brain tumor in Adam Malik General Hospital from 2019-2020.
Intradural Extramedullary Spinal En-Plaque Meningioma With Calcification: A Case Report And Literature Review siregar, rais; Ibrahim, Sabri
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 3 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i3.7607

Abstract

Abstract Introduction: Intradural extramedullary (IDEM) tumors are benign neoplasms arising in the spinal canal about two-thirds of primary spinal tumors and 15% of tumors affecting the Central Nervous System. Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like, and incidence in the literature only ranging from 0.1% to 3.1%. Pain is the most clinical symptom, weakness and sensory changes also occur frequently. Magnetic resonance imaging (MRI) is the standard modality for the radiologic diagnosis of meningioma. Case Report: A patient, 35 years old man with a diagnosis of intradural extramedullary spinal meningioma (IDEM) en-plaque with calcification, confirmed by the symptoms, workups such as spinal MRI, and intra-operative findings. The patient was successfully treated surgically with laminectomy and total tumor resection with a posterior approach. Discussion: Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like manner around the spinal cord can involve dura extensively with significant neurological deficits. Patient was with lower limb weakness, and had a history of back pain radiating to the right limb for the last 1 year. Spinal meningiomas are primarily found in the Intradural Extramedullary, and the tumor diagnosis is typically fairly straight forward based on radiologic findings. Meningiomas are most commonly found in the thoracic region of the spine. In this case from MRI Imaging was revealed a mass in thoracic region of the spine pressing the spinal cord anteriorly. The management of spinal en-plaque meningioma is tumor resection surgery. A retrospective study suggested a significant improvement in neurological deficit post-tumor resection on patients with spinal IDEM tumor. Conclusion: Spinal meningioma is a reasonably frequently found case of a spinal tumor but spinal en-plaque meningiomas are rarely found. MRI scan is the radiological gold standar diagnose spinal en-plaque meningiomas. Patient was successfully treated by total tumor resection using the laminectomy method and tumor resection with a posterior approach without any postoperative complications observed.

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