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Paulus Sugianto
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Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya
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AKSONA
Published by Universitas Airlangga
ISSN : -     EISSN : 28077970     DOI : https://doi.org/10.20473/aksona.v2i1.170
Core Subject : Health, Science,
Medicine & Pharmacology Neuroscience
AKSONA is a scientific journal published by the Department of Neurology, Faculty of Medicine, Universitas Airlangga; Dr. Soetomo General Academic Hospital. AKSONA focuses on original research, case reports, and review articles on all aspects of neuroscience: Neurosurgery, Neuropsychology, Movement Disorder, Sleep Disorder, Pain and pain intervention, Neuro infection, etc. This journal is a peer-reviewed journal established to improve understanding of all things in neurology and neurosciences.
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 83 Documents
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Komorbiditas Pasien Demensia di RSUD Dr. Soetomo Periode Januari–Desember 2017 Nabilah Hasna Imami; Yudha Haryono; Anggraini Dwi Sensusiati; Muhammad Hamdan; Hanik Badriyah Hidayati
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.436 KB) | DOI: 10.20473/aksona.v1i1.95

Abstract

Pendahuluan: Demensia merupakan proses hilangnya fungsi kognitif seperti berpikir, mengingat, dan bernalar sehingga penderita demensia terganggu dalam melakukan kehidupan dan aktivitas sehari-hari pada seseorang. WHO menyebutkan bahwa jumlah pasien demensia di dunia terus meningkat. Pada tahun 2015, pasien demensia diprediksi mencapai 47,47 juta pasien dan dapat mencapai 75,63 juta pada 2030. Semakin meningkat usia lansia, faktor komorbiditas yang menyerang lansia juga semakin meningkat. Faktor komorbiditas dapat berupa penyakit kronik seperti stroke, hipertensi, DM, juga penyakit jantung. Tujuan: Untuk mengetahui prevalensi komorbiditas pada pasien lansia demensia di RSUD Dr. Soetomo Surabaya. Metode: Data diambil dari rekam medis pasien pada periode Januari hingga Desember 2017 di RSUD Dr. Soetomo Surabaya berdasarkan kriteria inklusi dan eksklusi yang telah ditetapkan. Hasil: Faktor komorbiditas yang paling banyak terjadi pada pasien demensia adalah stroke (57,3%), diikuti oleh hipertensi (50,6%), DM (30,3%), penyakit Parkinson (24,7%), dan penyakit Jantung (19,1%). Kesimpulan: Stroke merupakan komorbiditas paling banyak terjadi pada pasien dengan demensia. Hipertensi berada di tempat kedua paling banyak diderita lansia demensia. Pengendalian komorbiditas pada lansia sangat penting untuk dilaksanakan untuk mengendalikan risiko terjadinya penurunan fungsi kognitif.
Efikasi dan Tolerabilitas Karbamazepin untuk Nyeri Neuropati Diabetik Hanik Badriyah Hidayati
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (337.202 KB) | DOI: 10.20473/aksona.v1i1.91

Abstract

Neuropati perifer merupakan salah satu alasan paling sering pasien dirujuk ke klinik neurologi. Neuropati diabetik, salah satu neuropati perifer, merupakan penyebab neuropati tersering di dunia sehingga masih merupakan masalah besar dunia. Nyeri neuropati diabetik (NND) merupakan komplikasi umum dari diabetes baik diabetes tipe 1 maupun tipe 2. NND mempengaruhi kualitas hidup pasien secara substansial akibat dari kurang tidur, kelelahan konstan, kesulitan mempertahankan konsentrasi secara penuh, gangguan melakukan aktivitas harian, gangguan mood, depresi dan ansietas. Karbamazepin merupakan salah satu terapi nyeri neuropati. Artikel ini menjelaskan efikasi dan tolerabilitas karbamazepin untuk nyeri neuropati diabetik.
Korelasi Usia dan Jenis Kelamin dengan Angka Kejadian Meningioma Arlia Ayu Damayanti; Viskasari Pintoko Kalanjati; Joni Wahyuhadi
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.656 KB) | DOI: 10.20473/aksona.v1i1.99

Abstract

Pendahuluan: Meningioma merupakan tumor otak primer yang berasal dari jaringan arakhnoid. Angka kejadian meningioma di Indonesia menunjukkan peningkatan dari tahun ke tahun. Selain mutasi gen supresor tumor, meningioma dapat dipengaruhi oleh faktor eksternal diantaranya usia dan jenis kelamin. Tujuan: Mengetahui hubungan antara usia dan jenis kelamin dengan angka kejadian meningioma pada pasien di RSUD Dr. Soetomo, Surabaya, Indonesia tahun 2018 berdasarkan derajat keganasannya. Metode: Penelitian ini merupakan studi observasional analitik cross-sectional retrospektif dari data sekunder lembar hasil pemeriksaan patologi anatomi pasien yang dirawat inap melalui SMF. Ilmu Bedah Saraf, RSUD Dr. Soetomo tahun 2018; data yang tidak lengkap akan dieksklusi. Analisis data dilakukan menggunakan uji Chi squre (SPSS 25) dengan tingkat signifikansi p <0,05. Hasil: Didapatkan 45 pasien meningioma yang sesuai dengan kriteria inklusi, dengan mayoritas perempuan (71%) pada kelompok usia 45 – 49 tahun (22,2%), WHO grade I (82%) dengan tipe histopatologi transisional (49%). Terdapat hubungan yang signifikan antara angka kejadian meningioma dengan kelompok usia tertentu (r = 0,718, p = 0,025), dan dengan jenis kelamin (r = 0,441, p = 0,002). Rasio perempuan dibanding laki- laki sebesar 1:2,36. Kesimpulan: Usia dan jenis kelamin berkorelasi erat dengan angka kejadianmeningioma.
Hubungan antara Kadar HBA1C dengan Hasil Sural Radial Amplitude Ratio (SRAR) pada Pasien DM Tipe 1 dengan Neuropati Diabetik Perifer Anny Hanifah; Mudjiani Basuki; Muhammad Faizi
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (288.887 KB) | DOI: 10.20473/aksona.v1i1.98

Abstract

Pendahuluan: Neuropati diabetik perifer merupakan salah satu komplikasi mikroangiopati pada penderita diabetes mellitus. Manifestasi neuropati diabetik perifer paling banyak adalah polineuropati simetris distal, yang menunjukkan gangguan sensorik, motorik, serta penurunan refleks tendon dengan pola length-dependent. Diabetes Mellitus tipe 1 terbanyak diderita pada penderita usia muda, dimana saraf tepi memiliki amplitudo yang relatif masih tinggi, sehingga penurunan amplitudo yang relatif kecil, masih dianggap normal. Perbandingan amplitudo saraf sural dan radial dapat mendeteksi adanya neuropati subklinis. Penderita diabetes mellitus tipe 1 dengan kadar glukosa darah yang tidak teregulasi dengan baik mempunyai risiko 25.6% terkena neuropati diabetik perifer. Tujuan: untuk mengetahui hubungan antara kadar HbA1C dengan kejadian neuropati diabetik perifer pada penderita Diabetes Mellitus tipe 1. Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan cross sectional dengan teknik pengambilan subjek penelitian menggunakan consecutive sampling admission yang memenuhi kriteria inklusi dan eksklusi. Subjek penelitian dilakukan pengukuran terhadap kadar HbA1C, amplitudo saraf sural dan radial dan dihitung perbandingan diantara keduanya. Hasil: Pada 38 subjek penelitian didapatkan 31 subjek penelitian dengan Sural Radial Amplitude Ratio (SRAR) rendah dan 7 subjek penelitian dengan nilai SRAR normal. Hasil analisis penelitian didapatkan bahwa pada subjek dengan nilai SRAR rendah lebih besar pada kelompok HbA1C tinggi yaitu 26 subjek (83.87%) dibandingkan dengan kelompok HbA1C normal yaitu 5 subjek (16.13%). Perbedaan tersebut bermakna secara statistik dengan p= 0.021, rasio odd 6.933 (IK 95% 1.173-40.981). Kesimpulan: Terdapat hubungan negatif antara kadar HbA1C dengan kejadian neuropati diabetik perifer pada penderita Diabetes Mellitus Tipe 1.
Intractable Headache Akibat Fistula Karotis-Kavernosus Indirek Bilateral: Suatu Laporan Kasus Rizky Hartono; Achmad Firdaus Sani
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (635.642 KB) | DOI: 10.20473/aksona.v1i1.92

Abstract

Pendahuluan: Nyeri kepala hemikrania dengan presentasi menyerupai nyeri kepala primer namun tidak membaik dengan medikamentosa (intractable headache), perlu dicurigai suatu nyeri kepala sekunder. Etiologi nyeri kepala sekunder, ditegakan dengan melakukan pemeriksaan penunjang diagnostik lebih lanjut. Adanya kelainan yang ditemukan, akan menuntun pada terapi definitif. Kami melaporkan seorang pasien dengan intractable headache dan ditemukan etiologi berupa fistula karotiskavernosus indirek dan membaik dengan tindakan embolisasi. Kasus: Laki-laki 29 tahun dengan nyeri kepala selama 2 bulan terakhir dan tidak membaik dengan medikamentosa. Nyeri kepala berdenyut pada sisi kiri menyerupai nyeri kepala primer dan makin lama makin memberat. Skala NRS 9-10. Keluhan disusul dengan pandangan mata dobel dan ptosis mata kiri. Dari MRI kepala sekuen TOF didapatkan gambaran hiperintensitas area sinus kavernosus. Dilakukan konfirmasi dengan serebral DSA didapatkan fistula indirek dari cabang arteri karotis eksterna dan intra bilateral menuju ke sinus kavernosus. Dilakukan embolisasi pada cabang arteri karotis eksterna kiri. Post embolisasi nyeri kepala menghilang tanpa obat-obatan. Kesimpulan: Adanya anomali vaskuler, pada kasus ini fistula karotis kavernosus, perlu dipertimbangkan pada kasus nyeri kepala intraktabel. Tindakan embolisasi merupakan terapi kuratif yang dapat menghilangkan keluhan nyeri kepala
Electroencephalogram in Children who Experienced First Unprovoked Seizure Arinda Putri Auna Vanadia; Prastiya Indra Gunawan; Abdurachman Abdurachman; Martono Tri Utomo; Hanik Badriyah Hidayati
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (670.869 KB)

Abstract

Highlight: Epiletiform abnormalities on the EEG provide additional clinical infromation about seizures The majority of patients who have a first unprovoked seizure have an abnormal EEG (Abnormal II). Using EEG as a supporting diagnostic tool in patients experiencing their first unprovoked seizures may provide more information to improve treatment   ABSTRACT Introduction: The first unprovoked seizure is defined as a series of seizures that occur within 24 hours and are followed by recovery of consciousness with unknown triggering causes such as head trauma, central nervous system infections, tumors, or hypoglycemia. The first unprovoked seizure is a thing that cannot be underestimated. According to a previous study, less than half of those who experience their first unprovoked seizure will have another. An electroencephalogram (EEG) is one of the supporting examinations for the first unprovoked seizure. Objective: This study aims to determine the EEG as the first unprovoked seizure supporting examination. Methods: This is a retrospective, descriptive, observational study with sampling from the patient's medical record at Dr. Soetomo General Hospital Surabaya from January 2017 to December 2018 based on predetermined inclusion and exclusion criteria. Results: The EEG results in children who experienced their first unprovoked seizure were more abnormal (52.9%) than normal (47.1%), with an abnormal EEG breakdown of abnormal II (17.6%) and abnormal III (35.3%). There were no patients in this study who had EEG abnormal I. All patients with EEG abnormal II (17.6%) had an intermittent slow EEG waveform, while all patients with EEG abnormal III (35.3%) had a sharp waveform. The most common location of EEG wave abnormalities was temporal (55.6%). Conclusion: In the first unprovoked seizure, an EEG examination can assist clinicians as a seizure diagnostic assistant tool. It is hoped that the results of the EEG can provide better management of the first unprovoked seizure.
Stress Levels Determine Migraine Incidence in Medical Students of Duta Wacana Christian University Jonathan Dave; Esdras Ardi Pramudita; Rizaldy Taslim Pinzon
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (371.815 KB)

Abstract

Highlight: Stress can trigger migraine. There is a significant relationship between stress levels and the occurence of migraine The higher the stress level, the higher the risk of migraine   ABSTRACT Introduction: Migraine is the second most common primary headache after tension-type headache. Stress is one of the factors that can contribute to migraine occurrence. Medical students are subjected to a high-stress level due to their educational program, which increases their risk of migraine. Objective: To measure the relationship between stress levels and migraine occurrence in medical students of Duta Wacana Christian University, batch 2020. Methods: This study used an observational analytical design with a cross-sectional method and involved 61 respondents from the medical students of Duta Wacana Christian University, batch 2020, who met the inclusion and exclusion criteria. Respondents were required to approve informed consent and complete the Perceived Stress Scale and Migraine Screen Questionnaire before conducting the research. Results: The Chi-Square for Trend statistical analysis for trends showed that stress levels were related to migraine (p < 0.05), age variables revealed no association with migraine (p > 0.05), and gender revealed that the sexes had a relationship with migraine (p < 0.05). Using Fisher's statistical technique, this study found that menstrual status has no association with migraine (p > 0.05). Conclusion: Stress levels and migraine frequency were significantly correlated, meaning that high-stress levels can trigger migraines.
An Overview of the Quality of Life of Post Severe Brain Injury Patients within 2018-2020 Period of Time in Dr. Soetomo General Academic Hospital based on Short Form-36 Agus Turchan; Alivery Raihanada Armando; Meisy Andriana; Martha Kurnia Kusumawardani
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1300.511 KB) | DOI: 10.20473/aksona.v2i2.35816

Abstract

Highlight: Until today, Traumatic Brain Injury is still a major cause of death, disability, and a serious health issue Traumatic Brain Injury patients have a good quality of life if they get adequate therapy and on time interventions   ABSTRACT Introduction: Approximately 90 million traumatic brain injury (TBI) cases worldwide exist yearly. TBI pathophysiology varies, which may cause diverse complications. These complications may decrease the patients’ quality of life. Objective: Describing the quality of life of traumatic brain-injured patients after being treated at Dr. Soetomo General Academic Hospital Period 2018-2020. Methods: This research is a descriptive cross-sectional study using SF-36 questionnaire data from patients with post-severe brain injury at Dr. Soetomo General Academic Hospital in 2018-2020. Results: The value of the physical component (59.9) and mental component (68.6) in patients with severe brain injury at Dr. Soetomo General Academic Hospital showed a good quality of life, with values ​​in the SF-36 domains, namely physical function (58.2), physical limitations (46.7), body pain (73.6), general health (61.3), vitality (65.3), social functioning (72.5), emotional limitations (60), and mental health (76.5) is above the threshold value (50) except for physical limitations (46.7).Conclusion: Patients with severe brain injury had a good quality of life after receiving treatment in Dr. Soetomo General Academic Hospital.
Description of Stroke Patients with History of Smoking Activities Paulus Sugianto; Fatih Nugraha Abdillah; Isnin Anang Marhana; Fidiana Fidiana
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (351.451 KB)

Abstract

Highlight: Smoking raises the risk of cardiovascular disease, which can lead to stroke. A total of 33 stroke patients were selected from 579 samples. The results show some tendencies. The tendency of stroke patients with a history of activity to smoke can be explained for a number of reasons.   ABSTRACT Introduction: Smoking is a habit of Indonesian society and can be found in many places. Smoking increases the risk of cardiovascular problems, which can lead to stroke. Objective: Provides an overview of stroke patients who smoke from January to December 2020. Methods: This retrospective, descriptive research used medical records and extra data from telephone interviews with patients. A non-probability purposive sampling strategy with a total sampling method is used in this investigation. The observed variables include age, gender, number of cigarettes consumed per day, length of smoking history, type of stroke, and comorbidity. Results: The sample consisted of 33 participants chosen among 579 stroke patients. The age range of 56–65 (39.4%) was found to be the most prevalent in the 33 samples, and the sex group was dominated by men (100%). Then, for the smoking habit, the highest number of cigarettes consumed per day was dominated by the group of 9-16 cigarettes per day (45.46%). The group dominates the long smoking history with a smoking history of 30-50 years (42.43%). Ischemic stroke, also known as cerebral infarction, was the most common type (78.79%) among the samples. Of the 33 samples of stroke patients who smoked, 4 (12.12%) experienced comorbidities, including coronary heart disease, diabetes mellitus, and essential thrombocytosis. Conclusion: Several factors describe the tendency of stroke patients with a smoking history.
Thrombosis Mechanisms in Obese and Ischemic Stroke COVID-19 Patients: A Literature Review Putri Winanda; Natasya Putri
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (296.557 KB) | DOI: 10.20473/aksona.v2i2.36216

Abstract

Highlight: The ongoing Coronavirus disease 2019 also affects multiorgan, including cardiovascular disease with several factors. Mechanism of thrombus in the patient that induces the subject such as obesity with increased BMI, thrombotic pathway modulator and pathophysiologist. An increase in acute CVD incidence, including ischemic stroke in COVID-19 patients, has been a new concern in the ongoing pandemic.   ABSTRACT Coronavirus disease 2019 (COVID-19), despite being a respiratory infection, also causes neurological manifestations such as stroke due to thrombosis formation. Prior investigations have examined the correlation between COVID-19 and ischemic stroke, as well as COVID-19 and obesity. However, the mechanism of thrombosis in obese COVID-19 patients remains elusive. This review aims to examine the mechanism of thrombosis in COVID-19 patients with ischemic stroke and obesity. Chronic inflammation and impaired fibrinolysis are two major pathways responsible for thrombosis in people with obesity. Chronic inflammation activates prothrombic signaling pathways in vascular cells, resulting in procoagulant factors and adhesion molecules upregulation, anticoagulant proteins downregulation, platelet activation enhancement, and increased thrombin generation. SARS-CoV-2 enters human cells utilizing the angiotensin-converting enzyme 2 (ACE-2) receptors, which results in inflammation, which has been suggested as one of the factors contributing to thrombotic complications in COVID-19 patients. The infection also causes cytokine storm that induces atherosclerosis, plaque rupture, and superimposed thrombosis leading to brain damage. Together with endothelial injury, the cytokine storm might increase the expression of tissue factors and further promote a prothrombic state. In conclusion, the mechanisms of thrombosis in COVID-19 patients are related to direct infection of SARS-CoV-2 into the ACE-2 receptor and the cytokine storm that results in chronic inflammation and thrombosis formation. Obesity will further boost the inflammation process that leads to the formation of thrombosis and increase the risk of ischemic stroke among individuals with COVID-19 with obesity.

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