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Magna Neurologica
Published by Universitas Sebelas Maret
ISSN : 29636027     EISSN : 29853729     DOI : https://doi.org/10.20961/magnaneurologica.v1i2.647
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
Magna Neurologica is a peer-reviewed and open access journal that focuses on promoting neurological sciences generated from basic neurosciences and clinical neurology. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short features of medicine, latest developments in diagnostic procedures of neurology disease, treatment, or other health issues related to neurology that is important also acceptable. Letters and commentaries of our published articles are welcomed.
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 15 Documents
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Search results for , issue "Vol. 4 No. 1 (2026): January" : 15 Documents clear
The Impact of Additional Ginkgo Biloba Extract on Cognitive Function in Acute Ischemic Stroke: A Systematic Review and Meta Analysis Mohammad Sandhia Mahardhika Putra; Mutiyas Nadia Ulfa; Krisninda Anggonowati
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.1990

Abstract

Background: Stroke is the primary cause of mortality and disability among patients worldwide, and can cause cognitive impairment among these patients. Ginkgo Biloba Extract is an organic compound made from G. Biloba. The active ingredients in Ginkgo biloba extract have demonstrated some clinical benefits for cognitive impairment. Objective: We aim to investigate whether the addition of Ginkgo Biloba Extract to patients with acute ischemic stroke improves their cognitive function after follow-up. Methods: A literature search was conducted on PubMed, Google Scholar, and the Cochrane Database, without publication date limits, to identify studies investigating the effect of Ginkgo Biloba Extract on the cognitive function of patients with Acute Ischemic Stroke. The study's primary outcome is a change in cognitive status compared with the baseline, which was assessed with the Montreal Cognitive Assessment (MoCA) after follow-up. Results: Four randomized controlled trials with 3824 patients were identified. Based on the analysis, the addition of Ginkgo Biloba Extract had a significant impact on improving the MoCA score of acute ischemic stroke patients (MD = 0.47 [0.45-0.49], I2 = 76%, p < 0.00001). Conclusion: Additional Ginkgo biloba extract may improve cognitive function in patients with acute ischemic stroke.
Unknown Risk Factor in Pediatric Ischemic Stroke: Challenges in A Developing Country Samudra, Edeline; Ketaren, Retno Jayantri
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2101

Abstract

Background: Stroke is a sudden neurological disturbance with high mortality rates in both children and older people. Pediatric stroke is rare but can lead to lifelong disability due to the immaturity of the brain, and its management can be challenging. Case: A 23-year-old female presented with a history of right-sided weakness and spasticity that began 11 years ago and improved over the past two years. Risk factors that could be excluded were ruled out, while congenital disorders could not be investigated due to financial constraints. Diagnosed with non-hemorrhagic stroke at age 12, an MRI revealed an old infarct in the left internal capsule. The absence of known risk factors underlying her ischemic stroke made a congenital disorder a plausible diagnosis. She was given botulinum toxin type A (BoNT-A) injections to manage spasticity, and her symptoms improved. In the past year, she developed mood disturbances and sleep difficulties, which were treated with quetiapine. Discussion: The pediatric brain is metabolically more active with higher cerebral blood flow demands, making it more susceptible to focal neurological injuries. Most pediatric strokes are ischemic, with numerous potential risk factors including cardiac issues, vasculopathy, coagulopathies, infections, and congenital disorders with vascular complications. Treatment for pediatric ischemic stroke is similar to that in adult cases. In this patient, BoNT-A injections reduced acetylcholine release, effectively treating the patient’s spasticity. Conclusion: Stroke can occur at any age, with pediatric strokes potentially resulting in worse outcomes. Therefore, thoroughly evaluating diverse potential etiologies, including congenital disorders, is crucial.
A Case Report: Intracerebral and Intraventricular Hemorrhage Due to Rupture of Aneurysm in the Middle Cerebral Artery Aglen, Siti Setya Sari; Lidia Chara Tania Ginting; Hendra Irawan
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2165

Abstract

Background: Intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) caused by aneurysm rupture without subarachnoid hemorrhage (SAH) is a rare condition, with a prevalence of 1.6%. Case: A 40-year-old male presented with a sudden headache, vomiting, and generalized seizures lasting one day. Initially conscious, he later developed recurrent seizures and transient decreased consciousness. He had a history of smoking and uncontrolled hypertension. Neurological examination showed normal motor function and positive neck stiffness. Head CT revealed ICH and IVH without SAH. The patient underwent ventriculoperitoneal (VP) shunt placement. Six months later, follow-up CT showed a hyperdense lesion in the inferolateral right frontal lobe. Digital subtraction angiography (DSA) identified a saccular aneurysm in the right middle cerebral artery (MCA), M1 segment. Endovascular coiling was performed. Discussion: The patient’s symptoms resembled SAHs, including thunderclap headache, vomiting, and decreased consciousness. However, initial CT showed only ICH and IVH without SAH, possibly due to the timing of imaging. Secondary ICH and IVH can result from aneurysm rupture and parenchymal hemorrhage near the ventricles. Seizures may contribute to aneurysm rupture and consciousness loss. Risk factors such as hypertension, smoking, and age were present. DSA confirmed the aneurysm as the bleeding source. Endovascular coiling was done to prevent rebleeding. Conclusion: Prompt diagnosis using CT and DSA is critical to identify aneurysm-related hemorrhage and guide effective treatment, improving patient outcomes.
Paraplegia due to A Rare Spinal Metastasis of Hepatocellular Carcinoma: A Case Report Nerissa Arviana; Hendra Gunawan; Nilna Nur Faizah; William Luth
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2192

Abstract

Background: Paraplegia caused by spinal cord compression is a rare but serious condition that can occur in cancer patients, including metastasis from hepatocellular carcinoma (HCC). Hepatocellular carcinoma metastasis to the spine can compress the spinal cord, disrupt nerve function, and lead to motor and sensory impairment in the lower limbs, ultimately resulting in paraplegia. Case: An 86-year-old man presented with progressive weakness in both lower limbs. He had not previously complained of weakness; his family attributed it to the natural effects of old age. However, the patient frequently complained of low back pain that did not improve with analgesics. Further investigation of the lesion revealed sensory impairment equivalent to the T8 dermatome. A complete physical examination showed an enlarged liver without stigmata of liver disease. CT scan revealed an extradural lesion at the T4 region and a compression fracture at the T8 region. The patient then underwent ultrasonography (USG), which identified a hepatoma suggestive of hepatocellular carcinoma (HCC). Discussion: Spinal cord compression as an initial presentation of HCC is uncommon and often delays diagnosis, especially in the absence of typical liver symptoms. MRI played a key role in identifying the extradural mass. Early recognition and management are crucial in preventing irreversible neurological damage. Treatment may include corticosteroids, radiotherapy, or surgery to relieve symptoms and improve quality of life; however, the prognosis remains poor without prompt intervention. Conclusion: These findings highlight the importance of early detection and comprehensive management in cases of paraplegia due to HCC metastasis to minimize neurological complications and improve patient survival.
Haemorrhagic Transformation in Ischemic Stroke Induced by Polycythemia Vera: A Case Report Zalafi Kartika Azka; Irfan Pranowo
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2195

Abstract

Background: Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by the overproduction of red blood cells. This can lead to hyperviscosity, which significantly increases the risk of thrombosis, which in turn increases the risk of ischemic stroke. There is currently no reported case of haemorrhagic transformation of PV-induced acute ischemic stroke in Indonesia. Case: A 62-year-old female was admitted to the emergency department after a sudden onset of left-sided weakness one hour before admission. She has a history of polycythemia vera, with prior hemoglobin levels reaching 22 g/dL, and had a previous ischemic stroke one year prior. On physical examination, the patient was alert, with a GCS of 15, blood pressure of 168/94 mmHg, left-sided hemiparesis, dysarthria, and facial drooping. Laboratory tests revealed elevated hemoglobin 16.8 g/dL, hematocrit 56%, platelets 466,000/µL, and leukocytes 20.4 x 10³/µL. A non-contrast head CT showed a hypodense lesion in the right temporoparietal lobe with a hyperdense spot, consistent with hemorrhagic transformation of a thromboembolic infarction in the right middle cerebral artery (MCA) region, an infarct in the left thalamus, and cerebral atrophy. Discussion: PV-induced ischemic strokes involve a confluence of hyperviscosity, endothelial activation, and platelet aggregation. The thickened blood compromises microcirculatory flow, particularly in the cerebral vascular, increasing embolic risks. HT occurs due to the reperfusion of ischemic tissues following the breakdown of the blood-brain barrier (BBB). Conclusion: Hemorrhagic transformation can develop in PV-induced acute ischemic stroke. Effective management requires a multidisciplinary approach, integrating acute stroke care, rigorous hematologic control, antihypertensive therapy, lifestyle modifications, and antiplatelet treatment.
New-Onset Intracranial Hemorrhage in A Patient with Glioblastoma Multiforme: A Case Report Adam Arya Pratama; Meritania Ridianti Putri; Hanis Setyono
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2201

Abstract

Background: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults. GBM is a high-grade glioma of the central nervous system associated with high morbidity and/or mortality, often accompanied by Intracranial Hemorrhage (ICH).  Case: This study reports a 62-year-old male patient presenting with sudden-onset weakness in the left extremities, which worsened over the past week, without any history of trauma. A non-contrast computed tomography (CT) scan of the head revealed the presence of ICH. Laboratory findings showed leukocytosis and mild hyponatremia. The patient had previously been diagnosed with glioblastoma in the right parietal region, confirmed through magnetic resonance imaging (MRI), which revealed multiple lesions with solid-cystic components. The patient had undergone tumor removal surgery via craniotomy for further histopathological examination. A repeat craniotomy was performed to evacuate the ICH. Following the evacuation of the hemorrhage, clinical improvement was observed. Discussion: GBM classically presents with symptoms of increased intracranial pressure and gradually progressive neurological deficits. GBM also enhances vascular endothelial growth factor (VEGF) activity, contributing to the increased incidence of ICH. Acute presentation with ICH and rapid clinical deterioration is rare. The current treatment options for GBM are multimodal, including surgical resection, radiation therapy, and chemotherapy.  Conclusion: GBM presenting with ICH is uncommon but life-threatening. This case underscores the need for high clinical suspicion and immediate neuroimaging in patients with known or suspected GBM presenting with acute neurological decline. Timely surgical intervention can improve outcomes.
Outcome of Aneurysmal Subarachnoid Haemorrhage at Posterior Communicating Artery with Obstructive Hydrocephalus Post Successful Surgical Clipping and External Ventricular Drainage: A Case Report Fiharjatin, Dyah; Setyawan, Tommy Rachmat; Listyawan, Rakhian; Maskuri, Fajar
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2204

Abstract

Background: Approximately 25% of patients with SAH die before hospital admission. Proper posterior communicating artery (PCoA) aneurysm-related SAH is rare, with an incidence of about 1%. It is typically treated with coil embolization via digital subtraction angiography (DSA). In this case, decompressive craniectomy and external ventricular drainage (EVD) were performed, followed by aneurysm clipping, resulting in an excellent outcome. Case: A 63-year-old woman presented with a sudden severe headache, vomiting, somnolence, and right-sided limb weakness. Head CT angiography revealed SAH from a ruptured saccular aneurysm with a daughter aneurysm on the PcoA, Modified Fisher scale 2, and intraventricular hemorrhage (IVH) with a modified Graeb score of 3. The patient underwent decompressive craniectomy, EVD placement, and aneurysm clipping. On postoperative day two, she was alert but had left oculomotor nerve palsy and global aphasia. Head CT showed an acute infarction. Nicardipine was administered for a hypertensive emergency. Intravenous ceftazidime and gentamicin were used to treat nosocomial pneumonia. Nutritional support, physiotherapy, and speech therapy were provided. Discussion: Clipping was chosen for higher aneurysm obliteration rates and better oculomotor nerve recovery, despite a higher risk of postoperative cerebral ischemia than coiling. Due to high Modified Fisher and Graeb scores, EVD was necessary. Hemodynamic management and pneumonia treatment were critical. Early intervention, multidisciplinary care, and close postoperative monitoring are essential to reduce mortality and improve outcomes in PcoA aneurysm-related SAH. Conclusion: Decompressive craniectomy, EVD, and clipping combined with optimal hemodynamic management and complication control resulted in satisfactory outcomes in this rare PcoA aneurysm SAH case.
Civamide Nasal Spray: A Breath of Fresh Air in Migraine and Cluster Headache Therapy? Insights from A Systematic Review Cyntia Arum; Danar Dwi Anandhika; Nabil Hajar; Moh. Iqbal Setiawan; Fatima Khiarun Nisa; Suwandhi; Firza Yoga Baskoro; Hera Dwi Priharti
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2208

Abstract

Background: Migraines and cluster headaches are severe neurological disorders characterized by complex pathophysiological mechanisms, particularly involving the trigeminal nerve and vascular inflammatory responses. Both conditions primarily affect the trigeminal nerve, a key pathway in pain transmission, and are closely associated with vascular inflammation. Migraines are typically characterized by recurrent, unilateral, and intense headaches, whereas cluster headaches are marked by excruciating pain, often localized around the eye. These disorders are multifactorial, with various mechanisms contributing to their initiation and persistence. Civamide nasal spray, which modulates neural pathways, has emerged as a promising therapeutic option for targeted pain relief. This study aims to evaluate the effectiveness of Civamide nasal spray in managing these debilitating headaches. Objective: To assess the efficacy of civamide nasal spray in treating migraine and cluster headache attacks. Methods: This study followed the Synthesis without Meta-analysis (SWiM) guideline. A systematic search was conducted using a predefined query in Medline, Google Scholar, and Cochrane Central Library. Eight independent reviewers screened studies for eligibility based inclusion criteria and assessed the risk of bias using the Cochrane RoB 2.0 tool. Results: Two eligible studies were analyzed. Participants receiving civamide demonstrated a greater reduction in weekly headache frequency compared with those receiving a placebo. Additionally, civamide treatment was associated with decrease in pain intensity. Conclusion: The findings suggest that civamide nasal spray effectively reduces both the frequency and severity of headaches. Nonetheless, further investigations, particularly evaluating its long-term preventive use, are required to establish its clinical role in migraine and cluster headache management.
Successful Pudendal Nerve Block and Radiofrequency in 4 Years Scrotal Pain Resistant to Treatment and Three Varicocelectomies: A Case Report Arjuna, Yang Yang Endro; Pradhana, Tasya Meidy; Siahaan, Yusak Mangara Tua
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2259

Abstract

Background: Only a small percentage of patients (2-10%) report pain symptoms during varicocele or post-varicocelectomy. The cause of the pain remains unclear and is still a matter of debate. Neither conservative nor surgical treatments provide a conclusive solution for pain. Nerve blocks can serve as a diagnostic and therapeutic tool in cases where the origin of pain is unknown. Case: A 30-year-old male presented with 4 year history of chronic scrotal pain, worsening over the past three weeks. The pain, rated 6/10 on the Numeric Rating Scale (NRS), was unrelieved by rest or analgesics and worsened at night and with prolonged sitting (NRS 7/10), significantly impacting daily activities. He had bilateral recurrent varicocele and underwent three varicocelectomies and ureteroscopy. Oral analgesics and neuropathic pain medications provided only temporary relief. The neurological examination revealed hyperalgesia in the distribution of the pudendal nerve. The imaging results were expected. Discussion: A notable reduction in pain was observed following an ultrasound-guided diagnostic pudendal nerve block with 2 mL of 2% lidocaine, confirming pudendal neuralgia related to varicocele or post-varicocelectomy. The pain is likely due to compression of the pudendal nerve branch by an enlarged pampiniform plexus.  Pulsed radiofrequency is utilized to provide longer-lasting pain relief. No complications were reported after the treatment.      Conclusion: Pudendal nerve blocks can alleviate scrotal pain and may be an alternative to genitofemoral and ilioinguinal nerve blocks. This is the first report of a successful pudendal nerve block for scrotal pain associated with varicocele or varicocelectomy.
Non-Traumatic Subarachnoid Hemorrhage with Brain Abscess due to Eisenmenger Syndrome: A Rare Case Report Muhammad Ikhlas Muttaqin Aditiarman; Dhesty Fadhilah Faatin; Ni Nyoman Ayu Susilawati
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2274

Abstract

Background: Non-traumatic subarachnoid hemorrhage in patients with congenital heart disease, such as Eisenmenger syndrome, may involve multiple organs and carries a risk of cerebral abscess due to multiorgan mechanisms. Case: A 20-year-old male with untreated congenital heart disease since childhood was admitted with severe headache, neck stiffness, projectile vomiting, fatigue, lip curling, slurred speech, and stroke-like symptoms. Neurological deficits included right-dominant tetraparesis, accompanied by cyanosis and clubbing of fingers. CT scan revealed a subarachnoid hemorrhage extending into the perimesencephalic cistern with a thick-walled hypodense lesion, suspected to be a brain abscess. Laboratory findings revealed secondary erythrocytosis, characterized by elevated hematocrit and erythrocyte levels. Discussion: In this case, the subarachnoid hemorrhage was non-traumatic and perimesencephalic, likely caused by a mycotic aneurysm associated with Eisenmenger syndrome. The brain is a frequent target of septic emboli linked to mycotic aneurysms that trigger hemorrhage. Hemodynamic instability contributes to arterial endothelial degeneration, while hyperviscosity from congenital heart disease and septic embolism facilitates aneurysm formation. Rupture of such aneurysms leads to a sudden rise in intracranial pressure, worsening neurological outcomes. Conclusion: Subarachnoid hemorrhage in Eisenmenger syndrome is strongly associated with mycotic aneurysms from septic emboli, which may progress to cerebral abscess due to diffuse hypoxia from impaired cardiac output. Early diagnostic evaluation is crucial to establish the etiology, and heightened vigilance is needed in Eisenmenger cases, given the elevated risk of subarachnoid hemorrhage through septic emboli and aneurysm rupture.

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