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Agni Susanti
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Jurnal Neuroanestesi Indonesia
Published by Indonesian Society of Neuroanesthesia & Critical Care
ISSN : 20889674     EISSN : 24602302     DOI : https://doi.org/10.24244/jni
Core Subject : Health, Science, Education,
Biochemistry, Genetics & Molecular Biology Education Medicine & Pharmacology Neuroscience Public Health
Editor of the magazine Journal of Neuroanestesi Indonesia receives neuroscientific articles in the form of research reports, case reports, literature review, either clinically or to the biomolecular level, as well as letters to the editor. Manuscript under consideration that may be uploaded is a full text of article which has not been published in other national magazines. The manuscript which has been published in proceedings of scientific meetings is acceptable with written permission from the organizers. Our motto as written in orphanet: www.orpha.net is that medicine in progress, perhaps new knowledge, every patient is unique, perhaps the diagnostic is wrong, so that by reading JNI we will be faced with appropriate knowledge of the above motto. This journal is published every 4 months with 8-10 articles (February, June, October) by Indonesian Society of Neuroanesthesia & Critical Care (INA-SNACC). INA-SNACC is associtation of Neuroanesthesia Consultant Anesthesiology and Critical Care (SpAnKNA) and trainees who are following the NACC education. After becoming a Specialist Anesthesiology (SpAn), a SpAn will take another (two) years for NACC education and training in addition to learning from teachers in Indonesia KNA trainee receive education of teachers/ experts in the field of NACC from Singapore.
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 354 Documents
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Diagnosis and Management of Cerebral Vasospasm Following Aneurysmal SAH Oktavian, Mirza; Bisri, Dewi Yulianti; Rachman, Iwan Abdul
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.657

Abstract

Cerebral Vasospasm, characterized by the progressive constriction of cerebral arteries, often occurs following a subarachnoid hemorrhage (SAH) and is a leading cause of morbidity and mortality in affected patients. This condition can be resulted in cerebral ischemia, the severity of which correlates with the degree of vasospasm. The underlying pathophysiology involves the encasement of arteries by blood clots, although the intricate interactions between the hematoma and adjacent structures remain incompletely understood. The delayed onset of vasospasm offers a potential window for preventive interventions. However, recent randomized controlled trials have been discouraging, as they failed to demonstrate any significant improvement in patient outcomes with the use of clazosentan (an endothelin antagonist), simvastatin (a cholesterol-lowering agent), or magnesium sulfate (a vasodilator). Current best practices for managing vasospasm include minimizing ischemia by maintaining adequate blood volume and pressure, administering nimodipine (a calcium channel blocker), and, when necessary, performing balloon angioplasty. Over the past two decades, advancements in the management of vasospasm have significantly reduced associated morbidity and mortality rates. Nevertheless, vasospasm remains a critical determinant of clinical outcomes following aneurysmal rupture.
Multiple Large Cerebral Infactions in Tuberculous Meningitis: A Rare Case Kustila, Ela; Dian, Sofiati
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.688

Abstract

Cerebral infarction is well known as a consequence arising from tuberculous meningitis (TBM), which generally involves the small and medium-sized intracranial arteries. These infarcts are usually located in regions termed the “TB zone,” perfused by the medial striate and thalamo-perforating arteries, and in the “ischemic zone,” supplied by the lateral striate, anterior choroidal, and thalamogeniculate arteries. In contrast, the involvement of larger arteries is an uncommon feature of tuberculous vasculitis. We report the case of a 24-year-old man with TBM and pulmonary tuberculosis, without HIV infection, who developed loss of consciousness after undergoing a ventriculoperitoneal (VP) shunt procedure. Neuroimaging with computed tomography (CT) revealed extensive cerebral edema accompanied by massive infarctions involving the cerebellum, cerebral hemispheres, and brainstem. These findings illustrate an unusual presentation of multiple large cerebral infarctions associated with TBM. Such extensive infarcts represent severe complications that can be resulted in profound neurological deficits. This case underscores the importance of early recognition and management of TBM-related complications. Prompt initiation of antituberculosis therapy is essential to reduce the risk of fatal outcomes. Moreover, further investigations are warranted to establish more effective therapeutic approach and optimize patient prognosis
Pediatric Spinal Cord Contusion: A Case Report Highlighting Clinical Symptoms and Management Strategies in a 2-Year-Old Patient Chriswidarma, Dewa Gede; Adityawarma, Anak Agung Ngurah Agung Harawikrama; Lauren, Christopher; Satyarsa, Agung Bagus Sista; Suarjaya, I Putu Pramana; Mahadewa, Tjokorda Gde Bagus
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.692

Abstract

Spinal cord injuries (SCI) can be resulted in permanent disability, often caused by high-intensity incidents such as car accidents, falls, and violent crimes. Although relatively rare in children, they can have profound effects. This case report was aimed to elucidate the clinical symptoms of Th1-Th3 spinal contusion in a 2-year-old patient. A 2-year-old boy presented to a private peripheral hospital with complaints of back pain following a traffic accident. The examination revealed complete motor weakness (0/5) in both lower extremities, with preserved sacral sparing. Thoracolumbar MRI demonstrated spinal cord contusion and edema at the level of Th1-Th3. Based on history, physical examination, and supporting tests, the patient was diagnosed with SCI ASIA Impairment Scale B and upper thoracic spinal cord contusion, leading to the decision to perform laminectomy at the Th2-Th3 level. This case underscores the importance of recognizing initial symptoms in spinal cord injury cases and being vigilant for red flags in spinal trauma cases. Prompt initial trauma treatment, such as patient immobilization, is crucial. In this instance, laminectomy decompression was undertaken to address the contusion. A high level of vigilance was required as neurological symptoms could evolve or be initially obscured. Spinal cord injuries often manifest within days of an accident, although they can remain undetected for extended periods. Cord contusions may present with neurological symptoms, necessitating prompt diagnosis via spinal magnetic resonance imaging (MRI) and potential emergency surgical intervention, such as laminectomy.
The Management of Peritumoral Brain Bisri, Dewi Yulianti; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.586

Abstract

Brain edema is classified into four main types: vasogenic, cellular, osmotic, and interstitial. These types may be triggered by various conditions, such as head injuries, vascular ischemia, intracranial lesions, and obstructive hydrocephalus. Several factors are associated with the development of (the swelling of the brain including tumors, physical injuries, insufficient oxygen supply (hypoxia), infections, disruption in metabolism, or acute hypertension. Vasogenic brain edema, the most prevalent form of brain edema, is characterized by a blood- brain barrier (BBB) disorder. When the BBB is compromised, ions and proteins move more easily into the extravascular space, creating an osmotic effect that fluid into the brain’s interstitium. In brain tumors, cerebral edema occurs due to leakage of plasma into the parenchyma caused by impaired function of cerebral capillaries. Management of brain edema focuses on two key strategies: preventing further damage caused by the increased fluid in the brain, and addressing the underlying cause of the edema. Corticosteroids are frequently used as a primary therapy for this condition. While low-dose corticosteroids are preferred to minimize serious adverse effects such as myopathy or diabetes, higher doses of dexamethasone-sometimes along with osmotherapy (e.g. mannitol) or surgical interventions- may be necessary in emergency situations. Careful tapering of corticosteroids is essential to prevent dependence or withdrawal symptoms. New therapies, such as vascular endothelial growth factor receptor inhibitors and corticotropin-releasing factor, require additional clinical evaluation. A thorough understanding of pathophysiology of brain edema is crucial for optimizing the treatment strategies both before and after surgical procedures.

Page 36 of 36 | Total Record : 354

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