Garuda - Garba Rujukan Digital

Hemifacial Spasm Due to Contralateral Supratentorial Tumor: A Case Report Nugraha, Priya; Puti, Nazla Ananda Rachmi; Hamdan, Muhammad
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i1.56523

Highlight: A rare case of hemifacial spasm due to contralateral supratentorial tumor. Improvement of hemifacial spasm after tumor removal treatment. A comprehensive patient examination can establish the correct diagnosis and treatment. ABSTRACT Introduction: A rare neurological disorder known as hemifacial spasm (HFS) is characterized by involuntary, unilateral facial muscle contractions, typically caused by facial nerve irritation. In this report, we looked at a rare and fascinating case of hemifacial spasm (HFS) caused by a large contralateral supratentorial meningioma. The HFS went away amazingly after the tumor was removed and the patient was treated with corticosteroids. The complex connection between neurological disorders and intracranial tumors is highlighted in this case, along with potential treatment approaches for the patient. Cases: A 48-year-old woman complained of uncontrolled movements and spasms in her right eyelid and right lip corner for the past two years. The symptoms were accompanied by headaches, cognitive impairment, and a history of syncope. A neurological examination revealed right-sided central facial palsy. An MRI revealed a large atypical meningioma in the left frontal lobe. This resulted in significant brain displacement and perifocal edema, but no neurovascular contact with the 7th cranial nerve. Her hemifacial spasms significantly decreased following surgical resection, even with medication reduction. Conclusion:As an uncommon manifestation of contralateral supratentorial tumors, HFS requires careful evaluation of the patient’s history, physical examination, and radiological findings, as well as consideration of a wide range of potential causes. Accurate diagnosis and effective management can help reduce the risk of poor prognosis.

Neuroimaging and Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke beyond 4.5 Hours: A Systematic Review Ghifari, Muhammad Ramadhan; Deskianditya, Resa Budi; Oviyanti, Pradana Nur; Maatisya, Yuki Fitria; Putri, Vega Pratiwi
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i1.62758

Highlight: Ischemic stroke is a major cause of disability and death globally, emphasizing the urgent need for timely and effective thrombolytic interventions within a narrow treatment window. Neuroimaging has the potential to extend the therapeutic window for IV rt-PA beyond 4.5 hours, allowing clinicians to identify patients with salvageable brain tissue for treatment. Extending the IV rt-PA treatment window with neuroimaging support can significantly improve outcomes in stroke patients, although careful risk assessment is crucial. ABSTRACT Introduction: Current guidelines suggest giving intravenous recombinant tissue plasminogen activator (rt-PA) within 4.5 hours after acute ischemic stroke onset or the time the patient was last-seen-well. Patients often arrive at the hospital after 4.5 hours, making thrombolysis treatment challenging. It is crucial to examine expanding this timeframe beyond 4.5 hours of onset or last-seen-well. Objective: This systematic review intended to examine the effectiveness and safety of IV rt-PA in patients presenting to the hospital beyond 4.5 hours of onset or last-seen-well. Methods: We searched PubMed, Scopus, and ScienceDirect for studies on acute ischemic stroke patients treated with IV rt-PA alteplase beyond 4.5 hours of onset or last-seen-well. Outcomes comprised the Modified Rankin Scale (mRS) score, intracranial hemorrhage (ICH), symptomatic ICH, and mortality. We assessed the risk of bias using Cochrane Risk of Bias Vol 2 and ROBINS-I. Results: Eleven randomized controlled trials and observational studies were selected. Most subjects were above 65 years, and their baseline mean or median NIHSS scores were 6–12. Seven studies had specific neuroimaging criteria for eligibility, such as DWI/FLAIR or T2WI mismatch, PWI/DWI mismatch, or CT/MR perfusion. In RCTs, alteplase group had 47.1% to 53.3% favourable results (mRS 0-1) compared to 41.3% to 48.3% in placebo/controls group and 23% to 85% in observational studies. Compared to the placebp/control group and onset within 4.5 hours, alteplase typically had better ourcomes. However, ICH, symptomatic ICH, and mortality were numerically higher, albeit not statistically significant. Conclusion: IV rt-PA alteplase can be given for up to 9-12 hours from onset or last-seen-well with neuroimaging evidence of salvageable tissue, such as the perfusion imaging RAPID criteria or DWI/FLAIR or T2WI mismatch, taking consideration of hemorrhage and mortality concerns.

Epidemiological Study of Stroke Disease in the Southeast Maluku Islands Region in 2023 Paliyama, Febryn Prisiliya; Rinaldi, Fransiskus Xaverius; Silalahi, Parningotan Yosi; Nari, Janti Pare
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i1.62824

Highlight: The prevalence of stroke in Southeast Maluku is 14.1 per 1,000 population for 2023. Ischemic stroke is the most common type of stroke in the Southeast Maluku Islands. The most prevalent chronic disease among stroke patients in Southeast Maluku Islands is hypertension. ABSTRACT Introduction: Stroke is a serious health problem with a high mortality rate and incidence, especially in low- and middle-income regions like Southeast Maluku, Indonesia. Inadequate facilities and risk factors causing high stroke rates in this region provide major healthcare challenges. Epidemiological data highlight the pressing need for healthcare development. Objective: This epidemiological study aimed to provide insight on the prevalence of stroke in the Southeast Maluku Islands in 2023, with the goal of enhancing the urgency of measures to reduce stroke incidences there. Methods: This study used a descriptive methodology with a cross-sectional design. Data were collected by obtaining thorough medical records from stroke patients at Karel Sadsuitubun Regional General Hospital. Demographic information, stroke type, and comorbidities were analyzed, as well as the prevalence rate calculated from the entire patient population of 8,436 as reported in 2023, while also classifying patients by age and gender. Results: In the Southeast Maluku Islands, 107 stroke cases were reported, equal to a stroke prevalence rate of 12.6 per 1,000 people. The most common type was ischemic stroke (95.33%), followed by hemorrhagic stroke (4.67%). Hypertension, which affected 67.2% of patients, was the most common comorbidity, followed by type II diabetes mellitus and coronary artery disease. Conclusion:Stroke rates have increased in the Southeast Maluku Islands due to a variety of factors, including socioeconomic conditions and unhealthy lifestyles. The study’s findings emphasize the urgent need for interventions to reduce stroke rates.

Epidemiologic Profile of Ischemic Stroke Patients with Dyslipidemia in Dr. Soetomo General Academic Hospital Patient Prakoso, Raditya Ardra Putra; Ardhi, Mohammad Saiful; Thamrin, Husin; Setyowatie, Sita
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i1.64275

Highlight: This study provides insights into the epidemiologic profile of ischemic stroke patients with dyslipidemia in Dr. Soetomo General Academic Hospital. The majority of patients had hypertension, the most common comorbidity with low HDL-C levels Most patients showed moderate stroke severity and high levels of consciousness, with a majority proportion demonstrating recovery. ABSTRACT Introduction: Ischemic stroke is a major medical issue, especially in individuals with dyslipidemia, as it can elevate both the likelihood and severity of stroke incidents. This study is essential due to the rising prevalence of stroke and limited data regarding ischemic stroke patients with dyslipidemia in Indonesia. Understanding these traits is important for enhancing preventative and treatment strategies. Objective: This study intended to assess the epidemiologic profile of ischemic stroke patients with dyslipidemia in a tertiary hospital in Indonesia. Methods: This descriptive study assessed 116 medical records of ischemic stroke patients with dyslipidemia admitted to Dr. Soetomo General Academic Hospital in Surabaya, Indonesia, from January to June 2023. The collected data encompassed demographics, comorbidities, lipid profiles, and clinical outcomes. Dyslipidemia was defined based on the PERKENI guidelines, and stroke severity was assessed using the GCS and NIHSS scales. Results: The majority of ischemic stroke patients with dyslipidemia (77.6%) had low HDL-C levels. There were 64 males and 52 females; most of them were between the ages of 56 and 65. Hypertension was the most common comorbidity (64.7%), followed by diabetes (39.7%), heart disease (12.9%), and obesity (11.2%). Of 40 NIHSS-assessed patients, 26 had moderate, 8 mild, 2 moderate-to-severe, and 4 severe strokes. The majority of patients (70.7%) recovered. Conclusion:The majority of dyslipidemia-related ischemic stroke patients, aged 56 to 65, had low HDL-C levels. Hypertension was the main comorbidity, with many experiencing their first stroke. Most patients had high consciousness, moderate stroke severity, and showed improvements.

Headache in Preeclampsia: Review Article Sumbawati, Mulia Dian; Hidayati, Hanik Badriyah; Ernawati, Ernawati
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.53273

Highlight: Headache in preeclampsia is classified as a type of secodary headache. Pregnant women with high blood pressure have a 17-fold increased risk of developing secondary headaches. Typical preeclampsia-related headaches are progressive, bilateral (frontal or occipital), throbbing, associated with visual abnormalities, getting worse with elevated blood pressure or exercise, and resistant to over-the-counter drugs.. ABSTRACT Preeclampsia is a multisystem vascular disease characterized by systemic disturbances in maternal endothelial function and symptoms such as arterial hypertension and organ dysfunction, including the kidneys, liver, and brain. A headache is defined as pain or discomfort localized in the head region. Pregnancy-related headaches may have primary causes, such as migraines, but they can also indicate potentially life-threatening secondary causes, including preeclampsia. Pregnant women with high blood pressure have a 17-fold increased risk of developing secondary headaches. Headaches associated with preeclampsia can adversely affect pregnancy and labor, increasing the risk of complications. Preeclampsia headaches can predict eclampsia or seizures 56% sensitivity and 83% specificity. According to research conducted in Indonesia, the majority of preeclampsia patients experienced severe headaches (65.2%), followed by moderate (19.6%), mild (13%), and no headaches (2.2%). Therefore, based on the existing literature, this article intends to compile scientific data on headache pain in preeclampsia patients.

Clinical Improvement of Chronic Spinal Cord Injury and Immune Thrombocytopenia (ITP) with Corticosteroids Administration: A Case Report Talaway, Athalia Anastasia; Machin, Abdulloh; Kurniawan, Dedy
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.53453

Highlight: Understanding the causes and associated factors of of spinal cord injury (SCI) is important. Immune thrombocytopenia may contribute to spinal cord injury. Corticosteroid therapy for ITP, has shown improved clinical outcomes. ABSTRACT Introduction: Spinal cord injury (SCI) is a significant medical condition caused by either traumatic events or pathological diseases, which leads to neurological deficits and various levels of motor, sensory, and autonomic dysfunction. Several treatments, including corticosteroids, have been proposed to reduce secondary neuronal damage, but they are still controversial. Meanwhile, immune thrombocytopenia (ITP) can be treated with corticosteroids. The lack of research necessitates a review of steroids as a therapy for ITP and spinal cord trauma. Case: A 76-year-old woman complained of weakness in both legs for 15 days before being admitted to the hospital.The weakness was noticed after experiencing a fall. Additionally, the patient complained about having difficulty with both defecating and urinating. On examination, muscle strength in the lower limbs was graded 4 on both sides according to the Medical Research Council (MRC) scale. The classification of the American Spinal Injury Association (ASIA) score was D, with neurological level injury (NLI) at the 6th thoracic level with immune thrombocytopenia (ITP). Considering the patient's condition, steroids were administered as a treatment option. Fortunately, the patient showed clinical improvements, with the ASIA score improving from D to E, suggesting a positive response to steroids and potential for neurological recovery. Conclusion: Steroids may be regarded as a possible treatment alternative for individuals suffering from spinal cord injuries and immune thrombocytopenic purpura (ITP).

Analysis of Socioeconomic Status Among Risk Factors of Pediatric Abusive Head Trauma: A Systematic Review Felice, Calista; Parenrengi, Muhammad Arifin; Gunawan, Prastiya Indra; Suryaningtyas, Wihasto
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.53600

Highlight: Most studies agreed that socioeconomic status (SES) influences the prevalence of pediatric abusive head trauma. SES is associated with other AHT risk factors and contributes to varied clinical outcomes. AHT incidence can be reduced by prevention strategies that focus on education and enhanced healthcare access. ABSTRACT Introduction: Previous studies have shown that children from low socioeconomic status (SES) families are more likely to experience abusive head trauma (AHT). However, research on this topic remains limited. Some argue that clinicians may demonstrate diagnostic bias, tending to overidentify AHT in lower-SES children, regardless of actual risk. Is low SES truly a risk factor for AHT? If so, how does it affect AHT occurrence and its relationship with other risk factors? Objective: This review was to observe the relationship of SES as one of the risk factors of pediatric AHT. Methods: A systematic review was conducted on pediatric AHT using household SES data. Children with AHT were compared to non-abusive head trauma (non-AHT) controls. Articles published between 2002 and 2022 were searched from Scopus, PubMed, and Google Scholar, following PRISMA guidelines. Exlusion criteria included duplicates, inaccessible or non-English/Indonesia articles, and studies not meeting PECO criteria. Data on child age, sex, type of head trauma, and SES were collected. Demographic characterisctics, SES, risk factors, outcome, and preventive measures were analyzed. Results: A total of 19,700 articles were found after searching Scopus, PubMed, and Google Scholar. After several screenings, 18 articles were included. Of the 18 articles, 17 included data on patients with AHT, and 6 included data on control patients. In total, there were 21,451 patients with AHT and 411,185 controls. The control group consisted of children with non-AHT and children without trauma. The mean, median , and standard deviation of the percentage of low SES patients with AHT were relatively higher than controls. A higher amount of articles agreed that SES had a significant impact. Conclusion: SES may influence pediatric AHT prevalence, but it should not be used as a determinant in diagnostic decision-making.

Todd’s Paresis as a Postictal Phenomenon in Post-Traumatic Epilepsy: A Case Report Yusari, I Gusti Agung Ayu Andra; Susilawathi, Ni Made; Mahadewi, Ni Putu Ayu Putri
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.54758

Highlight: Todd’s paresis presented as transient hemiparesis in a case of untreated post-traumatic epilepsy. Proposed pathomechanisms of Todd’s paresis include neuronal exhaustion, active inhibition, and postictal hypoperfusion. Todd’s paresis was commonly misdiagnosed as acute ischemic stroke due to the similar clinical presentation ABSTRACT Introduction: Todd’s paresis is defined as a paralysis state after an epileptic seizure that lasts for several hours to days and recovers completely afterwards. It usually manifests as a transient hemiparesis after a focal or generalized seizure. Todd’s paresis cases and its mechanisms were still widely discussed. Case: A 48-year-old man with history of post-traumatic epilepsy presented with right-sided hemiparesis and facial weakness after a general motor tonic-clonic seizure. The location of the hemiparesis was contralateral to the post-trauma lesion in left frontal lobe which was suspected to be the focus of the seizure. The postictal weakness resolved completely after 30 hours without any specific intervention. It was revealed that the patient had been having several seizures beforehand after the epidural and subdural hematoma due to head trauma. The patient was diagnosed as Todd’s paresis following a post ictal condition in patient with post-traumatic epilepsy. Conclusion: Todd’s paresis should be considered as a diagnosis in patients with seizure and stroke-like syndrome such as hemiparesis due to its similar manifestations, especially if it resolves within hours. Several mechanisms were suggested to be the pathophysiology of Todd’s paresis including neuronal exhaustion, active inhibition, and postictal hypoperfusion.

Profile of Stroke Patients in John Piet Wanane General Hospital Sorong: A Descriptive Study Ardiansyah, Djohan; Ruma, Agustinus; Luhur, Lu Jordy
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.56139

Highlight: Hypertension is the leading risk factor for cardiovascular disease and stroke. Blood pressure variability, including early morning surge, increases stroke risk. Low education is associated with an increased risk of stroke due to limited health literact and lifestyle challenges. ABSTRACT Introduction: Stroke has become the major cause of physical disability in adults and the second leading cause of death in middle- to high-income countries. Indonesia has the second-highest mortality rate and stroke burden in Southeast Asia. Furthermore, there is limited study on stroke in eastern Indonesia, especially in Papua. Objective: This study aimed to evaluate the clinical profile of stroke patients treated in John Piet Wanane General Hospital. Methods: This descriptive, hospital-based study was conducted at John Piet Wanane General Hospital, Sorong, Southwest Papua, from August 1, 2023, to January 31, 2024. Data were collected through interviews and the identification of subjects’ medical records based on inclusion and exclusion criteria. Results: This study involved a total of 143 patients, with an average age of 58.17 ± 10.516 years. The gender distribution was nearly equal, with 52.4% women and 47.6% men. The subjects mainly had an overweight Body Mass Index (BMI) (39,2%) or a normal BMI (36.4%). Obesity and underweight were the least common with percentage of 18.9%% and 5.6% of subjects, respectively. Hypertension (75.5%), prior stroke (33.6%), and hyperlipidemia (33.6%) were the most frequently found among subjects. Diabetes mellitus was found in 29.4% of subects, followed by smoking (28.7%), a history of heart disease (21%), and alcohol consumption (14.7%). Ischemic stroke was the most prevalent type of stroke (65.7%), followed by intracerebral hemorrhage (23,8%), transient ishcemic attack (TIA) (5.6%), subarachnoid hemorrhage (2.8%), and pontine hemorrhage (2.1%). Conclusion:This study revealed that ischemic stroke was the predominant subtype, while pontine hemorrhage was rare. Hypertension emerged as the most common risk factor, followed by prior stroke, hyperlipidemia, and diabetes mellitus, highlighting the substantial burden of modifiable vascular risk factors.

Profile of Motoric and Non-Motoric Symptoms Using the Indonesian Version of the Wearing-Off Questionnaire-19 in Parkinson’s Patients Muktiarini, Bernadetha; Pinzon, Rizaldy Taslim; Prasetyo, Yacobus Christian
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.60459

Highlight: Tremors are the most common motor symptom in patients with Parkinson's disease. Abdominal discomfort is a prevalent non-motor symptom of Parkinson's disease. Comprehensive symptom management is essential for patients with Parkinson's disease. ABSTRACT Introduction: Parkinson's disease is a neurodegenerative disorder characterized by motor and non-motor symptoms. The prolonged administration of levodopa in patients may induce the wearing-off phenomenon, where symptoms recur before the next dose. Studies on the symptom profile of Parkinson's disease, especially in wearing-off conditions, are crucial for further management. Objective: This study aimed to determine the motor and non-motor symptom profile of patients with Parkinson's disease. Methods: conducted. The Indonesian version of the Wearing-Off Questionnaire-19 (WOQ-19) was used to identify motor and non-motor symptoms. Data were collected from 30 Parkinson’s patients at Bethesda Yogyakarta Hospital from October to December 2023 using a purposive sampling technique. The sample size was calculated using OpenEpi V3.01. Results: The most prevalent motor symptom among patients with Parkinson's disease was tremor (100%), followed by bradykinesia (93.33%) and rigidity (86.67%). The most common non-motor symptoms reported were abdominal discomfort (56.67%) and body aches (50%). Conclusion:Patients have a variety of Parkinson's disease symptoms. Parkinson's patients most commonly experienced motor symptoms such as tremors, bradykinesia, and rigidity, along with non-motor symptoms like abdominal discomfort and body aches. The significant percentage of wearing-off seen in this study underscores its common occurrence and highlights the importance of early identification and management.

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name
Paulus Sugianto

Contact Email
aksona@fk.unair.ac.id

Phone
+628989359888

Journal Mail Official
paulus.sugianto@fk.unair.ac.id

Editorial Address
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya

Location
Kota surabaya,

Jawa timur

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Paulus Sugianto

Contact Email aksona@fk.unair.ac.id

Phone +628989359888

Journal Mail Official paulus.sugianto@fk.unair.ac.id

Editorial Address Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya

Location Kota surabaya, Jawa timur INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Paulus Sugianto

Contact Email
aksona@fk.unair.ac.id

Phone
+628989359888

Journal Mail Official
paulus.sugianto@fk.unair.ac.id

Editorial Address
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya

Location
Kota surabaya,

Jawa timur

INDONESIA