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Neurona
Published by Perhimpunan Dokter Spesialis Neurologi Indonesia
ISSN : 02166402     EISSN : 25023748     DOI : https://doi.org/10.52386/neurona
Core Subject : Health, Science,
Health Professions Medicine & Pharmacology Neuroscience
Neurona merupakan satu-satunya jurnal yang memuat perkembangan penelitian dan kasus terbaru bidang neurosains oleh Perhimpunan Dokter Spesialis Saraf (PERDOSSI) Pusat di Indonesia. Jurnal ini diterbitkan bulan Maret, Juni, September dan Desember. Bidang studi cakupan NEURONA meliputi: Stroke dan Pembuluh darah Neurotrauma Neuroonkologi Neuro Infeksi Neuro Behavior Neurorestorasi Neuropediatri Gangguan Tidur Nyeri Kepala Neurootologi Neuro Intervensi Neuro Intensif Neurogeriatri Gangguan Gerak Epilepsi Neuro Epidemiologi
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 39 Documents
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Search results for , issue "2024" : 39 Documents clear
PROFIL KLINIS DAN NEUROIMAGING PASIEN CAROTID CAVERNOUS FISTULA DI RUMAH SAKIT WAHIDIN SUDIROHUSODO MAKASSAR Ardhany, Andri; GOYSAL, YUDY
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.596

Abstract

Introduction: Carotid cavernous fistula (CCF) is a rare abnormal connection between the carotid artery and the cavernous sinus. Based on its etiology, CCF is divided into traumatic and spontaneous types. CCF presents with varied clinical findings and neuroimaging features. Diagnosis is established based on clinical findings and neuroimaging characteristics. Objective: This study aims to provide a descriptive overview of clinical profile and neuroimaging of CCF patients at Wahidin Sudirohusodo Hospital, Makassar. Method: This descriptive study retrospectively collected data from medical records of Wahidin Sudirohusodo Hospital, Makassar, from January 2023 to March 2024, using total sampling method. Results: A total of 25 subjects meeting the criteria were obtained. The mean age was 33.08±15.37 years, predominantly male (76%). The duration of symptoms was mostly >1 month (88%). Trauma was the most common etiology (76%). Unilateral lateralization was most frequent (84%). The most common symptoms and signs were proptosis (80%), conjunctival injection (60%), and headache (52%). Cranial nerve VI involvement was most frequent (52%). All subjects had direct CCF anatomical characteristics. Imaging features included dilated superior ophthalmic vein (92%), proptosis (76%), and cavernous sinus enlargement (36%). Discussion: Traumatic etiology was more common than spontaneous in CCF, consistent with other studies finding traumatic etiology most prevalent in direct CCF patients. Symptoms and signs such as proptosis, conjunctival injection, headache, and imaging features like dilated superior ophthalmic vein, proptosis, and cavernous sinus enlargement on CT scan or MRI suggest CCF. Keywords: Carotid-Cavernous Fistula, Proptosis, Cavernous Sinus
Pengaruh Pemberian Terapi rTMS dengan Kualitas Tidur Pasien Post Stroke Iskemik Desfarina, Desfarina
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.602

Abstract

ABSTRACT Background: Stroke is the second leading cause of death and disability in the world. One of the complications of stroke is sleep disorders. Apart from medication, repetitive Transcranial Magnetic Stimulation (rTMS) is an alternative therapy for managing sleep disorders. Objective: This study aimed to assess the effect of rTMS therapy on the sleep quality of post ischemic stroke patients at RS Dr. M. Djamil Padang. Method: This analytical observational study utilized a cross sectional design conducted at the Neurological Polyclinic of RS Dr. M. Djamil Padang from August 2023 to February 2024. Samples were taken using consecutive sampling techniques based on inclusion and exclusion criteria. High frequency rTMS stimulation was administered to the left DLPFC (dorsolateral prefrontal cortex) 10 times. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The influence between research variables was tested bivariate using the T test, Mann-Whitney test, Fisher test, and McNemar test. Results: The average PSQI score in patients before rTMS therapy was 9.83±3.996, and after rTMS therapy was 4.13±3.327. Based on the results of bivariate analysis, there is a significant effect between giving rTMS therapy and improving sleep quality in post ischemic stroke patients with a value of p<0.001. Discussion: Post ischemic stroke patients who underwent rTMS therapy experienced a decrease in average PSQI score with a mean difference of 5.70, and most patients had good sleep quality after undergoing rTMS therapy in this study (75%). Giving high frequency rTMS to the left DLPFC enhances cortical and subcortical stimulation, thereby improving sleep quality. Keywords: rTMS, sleep quality, stroke, PSQI.
Perbandingan Keputusan Rujuk Pasien Stroke Baru Dengan Pasien yang Pernah Didiagnosis Sebelumnya Pada Layanan Telemedis Prawiroharjo, Pukovisa; Kurniawan, Mohammad; Alexander, Fooann
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.665

Abstract

ABSTRACT Introduction: Stroke is the third leading cause of death worldwide. Unfortunately, the high incidence of stroke in Indonesia is not matched by prompt and effective treatment, resulting in a high disability rate. These limitations make decision-making in telemedicine services challenging. Objective: This study aims to compare decision-making related to stroke management between newly diagnosed patients and those previously diagnosed. Methods: This study employed a cross-sectional retrospective design. The data consisted of 256 secondary data obtained from telemedicine company conversations during March and April 2020. Patients were categorized into newly diagnosed stroke patients and previously diagnosed stroke patients. Results: Among the 256 subjects, a significant relationship was found between patient status and decisions regarding referral and pharmacological management. Newly diagnosed stroke patients more frequently received referral decisions, while previously diagnosed patients more often received pharmacological management. Discussion: This study indicates a significant association between patient status and decisions on referral and pharmacological management in telemedicine services. Further studies with larger sample sizes and longer time periods are needed for better representation of conditions in Indonesia. Keywords: patient status, pharmacological treatment, referral, stroke, telemedicine.
PROFIL KLINIS DAN LUARAN PASIEN STROKE-ASSOCIATED PNEUMONIA (SAP) DI RSUD ARIFIN ACHMAD PROVINSI RIAU Juananda, Desby; Sukiandra, Riki; Maryanti, Yossi; Sucipto, Sucipto; Rahmata Illahi, Annisa; Luo Putra Fau, Joyada; Muslimah Syahrianti, Ukhty
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction: Stroke-associated pneumonia (SAP) is a post-stroke complication that increases morbidity and mortality. Aim: This study aims to examine the clinical characteristics and outcomes to facilitate appropriate clinical decision-making for the treatment and prevention of post-stroke complications. Methods: This cohort retrospective study utilizes medical records of SAP patients at RSUD Arifin Achmad from July 2019 to June 2024. The populations were patients who have developed pneumonia within 48 hours to 7 days after stroke onset. Results: Out of 1,040 stroke patients, 108 (10.4%) developed SAP, with 66.7% classified as definite cases and 33.3% as probable cases. Patients in the ≥60 age group accounted for the highest number of cases (54.6%), with a male-to-female predominance of 64.8%. SAP occurred more frequently in ischemic stroke (68.5%) compared to hemorrhagic stroke (31.5%). Most SAP patients required mechanical ventilation (52.8%). SAP patients required hospitalization, with 45.4% staying for ≤14 days and 53.7% for >14 days. Regarding comorbidities, SAP patients also suffered from hypertension (54.1%), followed by other comorbidities such as diabetes mellitus, chronic obstructive pulmonary disease (COPD), and atrial fibrillation (AF). The blood glucose levels upon hospital admission indicated that SAP patients had a glucose distribution range of 80-144 mg/dl (53.7%), 145-179 mg/dl (14.8%), and ≥180 mg/dl (31.5%). The mortality rate was 57.4%, resulting in 62 deaths. Discussion: This study reveals a significant incidence of SAP in older male stroke patients, especially those with ischemic strokes. The strong association to ventilator use and mortality rates emphasizes the need for early identification and management strategies.
Neuromuscular Taping Decompression Technique in Diabetic Painful Polyneuropathy: Impact on Pain Intensity Harun Muchsin, Achmad; Blow, David; Goysal, Yudy; Wuysang, Audry Devisanty; Tammasse, Jumraini; Bahar, Ashari; Zainuddin, Andi Alfian; Walenna, Nirwana Fitriani
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.679

Abstract

Background: This study aimed to evaluate the effects of neuromuscular taping decompression technique (NMT) on modifying pain scale in diabetic patients with painful distal symmetrical polyneuropathy (DSPN) at Wahidin Sudirohusodo Hospital, Makassar, Indonesia. Using a pure experimental design with a pre-test and post-test control group method, 30 patients were included: 15 in the treatment group and 15 in the control group. The treatment group received decompression NMT on the dorsal and plantar aspects of the foot twice a week for four weeks, along with vitamin B complex supplementation. The control group received only vitamin B complex. Result: The Mann-Whitney test showed significant improvement (p <0.05) in the pain scale of the treatment group on day 28, with the Numeric Pain Rating Scale (NPRS) score being lower than that of the control group. Conclusion: This study demonstrated the significant pain-reducing effect of NMT in DSPN patients. The combination of vitamin B1, B6, and B12 supplementation with 8 NMT sessions over 28 days reduced pain to 0 on the NPRS scale. Treatment twice a week for 4 weeks, alongside vitamin B, led to near-zero pain, with pain-free results expected after 5 treatments over 17 days. NMT combined with vitamin B reduced pain approximately 2 times faster than vitamin B alone. Keywords: Diabetic Painful Distal Symmetrical Polyneuropathy, DSPN, Diabetic Neuropathic Pain, Neuromuscular Taping, NMT
Carotid Artery Stenosis as a Risk Factor for Crescendo Transient Ischemic Attack: Case Report Amry, Carissa Maharani; Imran, Yudhisman; Rahmansyah, Mulia; Rachmiyani, Irmiya; Khusfiani, Triasti
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.758

Abstract

Background A Transient Ischemic Attack (TIA) is an indicator of ischemic stroke. When the frequency, duration, and severity of TIAs increase, they are known as a Crescendo Transient Ischemic Attack (cTIA). Several risk factors, including carotid artery stenosis, can contribute to cTIA. Case Description A 49-year-old man presented to the Emergency Department (ED) after being referred from another hospital, complaining of sudden weakness on the left side of his body that started three days ago. The weakness on his left side was noted to be intermittent. The patient initially experienced sudden weakness on the left side of his body five days before his hospital admission at 2:00 PM, after which his condition improved. That evening, at 8:00 PM, the patient again experienced sudden weakness on the left side, but it improved to normal afterward. Four days before admission, at 12:00 PM, the patient experienced weakness on the left side along with slurred speech, which also improved. Before being referred, the patient underwent a non-contrast head computed tomography (NCCT), revealing no bleeding. The neurological physical examination was within normal limits. The patient was hospitalized and received dual antiplatelet therapy (Aspilet and Clopidogrel), Ranitidine, Citicoline, Mecobalamin, and Atorvastatin. He was discharged on the second day, with no neurological deficits observed during treatment. The patient was evaluated at the neurology clinic and underwent CT angiography of the carotid arteries, revealing moderate stenosis (50 - 69% NASCET Scale stenosis) in the right internal carotid artery and mild stenosis (<50% NASCET scale stenosis) in the left internal carotid artery. Conclusions Crescendo Transient Ischemic Attack (cTIA) is an important indicator of ischemic stroke requiring hospitalization. In cTIA, a supporting examination is needed, typically computed tomography angiography (CTA). This imaging technique has high sensitivity for detecting intracranial stenosis and occlusion, which are significant risk factors for recurrent TIA. In high-risk TIA patients, DAPT (aspirin and clopidogrel) should be started early to reduce the risk of recurrent ischemic stroke. Keywords: Transient Ischemic Attack, Crescendo Transient Ischemic Attack, computed tomography angiography
Luaran Klinis dan Komplikasi Terapi Endovaskular pada Pasien Stroke Iskemik Akut dengan Trombolisis Intra-Arteri dan Trombektomi Mekanik pada Setting Penanganan Kritis Retnaningsih, Retnaningsih; Tugasworo, Dodik; Kurnianto, Aditya; Tri Rahayu, Fitriani
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.774

Abstract

Introduction: Acute ischemic stroke (AIS) is a major cause of disability and death worldwide. Mechanical thrombectomy (MT) has become the standard endovascular therapy for AIS with large vessel occlusion, though incomplete reperfusion remains a concern. Intra-arterial thrombolysis (IA-T) has emerged as a potential adjunct therapy to enhance reperfusion. Aim: To evaluate clinical outcomes and complication rates between IA-T plus MT compared to MT alone in AIS patients treated in the ICU of Dr. Kariadi Hospital, Semarang. Methods: A total of 38 AIS patients with MCA occlusion who received endovascular reperfusion therapy were divided into two intervention groups: IA-T + TM (n=18) and TM alone (n=20). Outcomes according to Modified Rankin Scale (mRS) score and complication data were compared between groups. Results: Patients in both groups had similar baseline characteristics. A higher percentage of patients in the IA-T + MT group achieved favorable mRS scores (0–2) compared to the MT-only group (72.2% vs 65%), though the difference was not statistically significant (p=0.632). No significant differences in complication rates were found. Discussion: The combination of IA-T and MT showed a trend toward better functional outcomes without significantly increasing complications. This suggests potential benefit in selected cases. Keywords: ischemic stroke, intra-arterial thrombolysis, mechanical thrombectomy
TB Meningitis: Tantangan Diagnosis Dini dan Implikasi terhadap Morbiditas serta Mortalitas Gaharu, Maula Nuruddin
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.794

Abstract

Bulan Maret merupakan hari tuberkulosis (TBC) dunia yang di peringati setiap tanggal 24. Indonesia menempati urutan keduaterbanyak setelah India pada prevalensi tuberkulosis, Global TB Report 2023 mencatat sekitar 1 juta kasus baru dan kematian akibat TBCper tahun di Indonesia mencapai 100.000 kasus. Secara global, 8% kasus berasal dari Indonesia. TB meningitis (TBM) merupakanpenyebab mortalitas tersering pada kasus TB ekstrapulmonal, bahkan, dari TB pulmonal itu sendiri. TBM merupakan penyebab terseringpada kasus-kasus infeksi serebral. The Lancet Global Health Commision, melaporkan 50% mortalitas TBM disebabkan oleh buruknyalayanan kesehatan. Bermacam kendala dalam tata laksana TBM, mulai dari penegakan diagnosis, modalitas, regimen pengobatan, hinggafaktor kemampuan sarana kesehatan dalam menangani TBM.Manifestasi klinis yang kadang tidak khas terkadang tidak dikenali sebagai manifestasi TBM, seperti gangguan kognitif, manifestasiklinis menyerupai stroke, gangguan gerak bola mata, dan defisit neurologis lainnya, menyebabkan progresifitas infeksi yang semakinberat. Bahkan, tidak jarang tenaga kesehatan membuat diagnosis selain TBM pada tahap awal perjalanan penyakit. World HealthOrganization membagi keterlambatan diagnosis berdasarkan waktu, penegakan diagnostik, dan inisiasi medikamentosa antituberkulosa.Pada literatur, bahkan, disebutkan keterlambatan penegakan diagnosis dapat terjadi hingga 2 bulan. Hal-hal tersebut menjadi tantanganbagi para neurolog untuk meningkatkan kewaspadaan terhadap TBM, bahkan, pemahaman klinis TBM juga perlu diberikan pada dokterumum yang sering kali menjumpai pasien pada stadium awal. Literatur melaporkan 35% kasus pertama kali berobat pada praktek-praktekpribadi dan sisanya pada Pusat Kesehatan Masyarakat (Puskemas) bahkan fasilitas kesehatan informal seperti apotik, toko obat, dll.Jika kecepatan dan ketepatan diagnosis TBM dapat dilakukan pada tahap awal perjalanan penyakit, akan ada dampak besar padapenurunan morbiditas dan mortalitas TBM. Melengkapi sarana-sarana kesehatan mulai dari primer hingga sekunder dengan diagnostiklaboratorium hingga imajing. Selain itu tindakan lumbal pungsi juga penting dilakukan pada layanan Kesehatan sekunder, di sampingketersediaan diagnostik imajing CT scan kepala kontras. Peranan pemerintah dalam pembuatan kebijakan-kebijakan pada pembiayaanpenjaminanan nasional juga menentukan ketepatan dan kecepatan diagnosa.Kolaborasi yang baik akan memperkuat kewaspadaan dan kemampuan penanganan TBM, yang berdampak mengurangi morbiditasserta mortalitas TBM. Selamat hari tuberkulosis, bersama, kita bisa.
Gangguan Tidur Pada Lanjut Usia (Lansia) Asrini, Silvana
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.795

Abstract

Gangguan tidur pada umumnya sering kita temukan pada masyarakat awam, terutama pada orang dengan lanjut usia (lansia). Prevalensinya sekitar 76%. Kelompok lansia lebih sering mengalami sulit tidur (40%), sering terbangun malam hari (30%) dan sisanya gangguan pemenuhan kebutuhan tidur lain. Waktu tidur total harian relatif tetap stabil pada lanjut usia yang sehat, pada mereka dengan usia 60 tahun keatas yang memiliki waktu tidur rata-rata 6,5 – 7 jam per hari Siklus tidur dan bangun (irama sirkadian) berfungsi mempertahankan untuk tetap terbangun saat siang hari saat cahaya terang dan tidur sepanjang malam hari saat gelap. Jadi faktor kuncinya adalah adanya perubahan gelap dan terang. Stimulasi cahaya terang akan masuk melalui mata dan mempengaruhi suatu bagian di hipotalamus yang disebut nukleus suprakiasmatikus (NSC). NSC akan mengeluarkan neurotransmiter yang mempengaruhi sekresi berbagai hormon pengatur temperatur badan, kortisol, GH (growth hormone) dan lain-lain yang memegang peran untuk bangun dan tidur. NSC bekerja seperti jam, meregulasi segala kegiatan bangun dan tidur. Gangguan tidur pada populasi lanjut usia dihubungkan dengan beberapa faktor, termasuk gangguan tidur spesifik, perubahan dari irama sirkadian endogen, kelainan medis dan psikiatri, serta pengaruh obat-obatan Proses penuaan mempengaruhi berbagai irama fisiologis yang mempengaruhi tidur, seperti suhu tubuh, sekresi melatonin, dan fluktuasi sistem neuroendokrin (penurunan sekresi luteinizing hormone, growth hormone, dan thyroid-stimulating hormone, rendahnya kadar serotonin) Namun banyak kondisi medis yang dialami lansia yang dapat mengganggu tidur seperti diabetes, hipertensi, dan radang sendi. Hal ini meningkat seiring dengan pertambahan usia. Gangguan tidur dapat mempengaruhi kualitas hidup pada orangtua, menurunkan status imunologi, gangguan hormonal dan endokrinologi, serta penurunanfungsi kognitif. Gangguan tidur tersering pada lansia adalah kesulitan untuk mulai tidur (sleep onset problems),kesulitan mempertahankan tidur nyenyak (deep maintenance problem), bangun terlalu pagi (earlymorning awakening/EMA). Adapun penyakit gangguan tidurnya antara lain insomnia, gangguan tidur karena gangguan pernapasan (sleep-disordered breathing), gangguan gerakan tungkai yang periodik (periodic Llimb movements in sleep) atau sindrom kaki kurang tenang (restless legs syndrome), circadian rhythms sleep disorders, rapid eye movement sleep behavior disorder. Manajemen untuk gangguan tidur ini meliputi terapi non-farmakologis danfarmakologis. Perubahan perilaku dan modifikasi diet pada beberapa penyebab gangguan tidurterbukti efektif. Intervensi non-farmakologis seperti sleep hygiene dan terapi perilaku kognitif (Cognitive-Behavioral Therapy) merupakan terapi lini pertama pada berbagai gangguan. Selain itu dapat juga dengan Stimulus-Control Therapy dan Sleep-Restriction Therapy. Bila pengobatan hipnotik dibutuhkan tidur untuk pasien lanjut usia, harus mempertimbangkan beberapa hal berikut: (1) meresepkan dimulai dengan dosis terendah yang efektif, (2) mengunakan hipnotik dengan waktu paruh singkat, dan (3) evaluasi kemungkinan efek samping yang muncul

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