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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 299 Documents
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HUBUNGAN NEUTROPHIL TO LYMPHOCYTE RATIO SEBAGAI FAKTOR PREDIKTIF DEFISIT NEUROLOGIS PADA PASIEN STROKE ISKEMIK AKUT Adrian Djatikusumo; Poppy Kristina Sasmita; Bryany Titi Santi
NEURONA Vol 38 No 2 (2021)
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Abstract

Introduction: Stroke is defined as a neurological deficit with sudden onset associated with focal and global vascular causes, which leads to morbidity and mortality. In all stages of acute ischemic stroke, an inflammatory process occurs, which is mediated by neutrophils or lymphocytes. Aim: To determine the correlation between neutrophil to lymphocyte ratio (NLR) with neurological deficits or functional outcomes in acute ischemic stroke patients. Methods: This study was conducted using a systematic review method. The studies, filtered through various databases, were assessed for quality and risk of bias using the Newcastle-Ottawa Scale (NOS). Stroke severity and neurological deficits were assessed using the National Institutes of Health Stroke Scale (NIHSS), Scandinavian Stroke Scale (SSS) and modified Rankin Scale (mRS). Results: There were seven studies that met the criteria for the literature search and were assessed as having high quality based on NOS. All included studies stated that there was a significant relationship between NLR and poor stroke functional outcomes in acute ischemic stroke patients (p-value <0.05). The cutoff value of the NLR on the neurological deficits of acute ischemic stroke patients ranged from 2.39 to 4.58 with varying sensitivity and specificity. Discussion: The variations of cutoff, sensitivity and specificity of NLR in predicting neurological deficits could be influenced by the number and characteristics of the sample, race, comorbidity and inclusion and exclusion criteria in the included articles. The significant relationship between NLR and neurological deficits is based on an inflammatory process that occurs at all stages of acute ischemic stroke. Keywords: acute ischemic stroke, functional outcomes, neurological deficits, NLR.
TERAPI PREDNISON MEMBERIKAN LUARAN KLINIS YANG BAIK PADA MIOSITIS POST VAKSINASI Ivan Santosa; Yudy Goysal; Andi Kurnia Bintang; Cahyono Kaelan
NEURONA Vol 38 No 2 (2021)
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Abstract

A six-year-old girl was consulted from the Pediatrics department to the Neurology outpatient clinic at Wahidin Sudirohusodo Hospital in Makassar with an initial diagnosis of neuropathy. She complained of weakness on both legs suffered a month before treatment, she had difficulty reaching a standing position from sitting or squatting. She walked quite normally when standing, there was no disturbance in gait, but she had difficulty on climbing stairs, and had myalgia in the leg area. There was a history of intramuscular injection of diphtheria tetanus (Td) vaccine in the right upper arm. She got the vaccine according to the vaccination program. On physical examination, vital signs were within normal limits, there was slight paraparesis, decreased patellar reflex and no pathological reflexes. Sensory and autonomic physical examination were normal. There was Gower’s sign noted. Laboratory investigations findings: SGOT 134, SGPT 49, LDH 1584, CK 1922.80. Biopsy finding shows inflammatory changes consistent with myositis. Prednisone therapy provides significant clinical improvement. Keywords: Myositis, prednisone, vaccination
KEJADIAN STROKE ISKEMIK PADA PASIEN POSITIF COVID-19 TERKONFIRMASI DI RUMAH SAKIT UNIVERSITAS INDONESIA Rakhmad Hidayat; Gemia Clarisa Fathi; Ramdinal Aviesena Zairinal; Raden Rara Diah Handayani; Mohammad Kurniawan; Taufik Mesiano; Al Rasyid; Salim Harris
NEURONA Vol 38 No 2 (2021)
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Abstract

Coronavirus disease 2019 (COVID-19) is not only disrupts the respiratory system, it can disrupt various organ systems, one of which is the central nervous system. Indonesia still has a little literature that discusses COVID-19 and its relation to ischemic stroke. This study aims to report the course of ischemic stroke cases in patients who have been confirmed positive for COVID-19. A 56 year old man presented with confirmed COVID-19, the patient had a history of type 2 diabetes mellitus and also a history of dyslipidemia. At initial presentation the patient did not complain of neurological symptoms, but after 12 days of treatment the patient complained of weakness in the left side of the upper leg. The CT scan of the head with contrast revealed an infarction in the peripheral area, perfusion CT found that the patient was hypoperfused in the right cerebral hemisphere area without the presence of a large core infarction or a clear perfusion mismatch defect. CT angiography did not reveal stenosis or occlusion of the large vessels. It can be concluded that ischemic stroke in COVID-19 patients can occur due to various underlying factors, one of which is hypercoagulability. Keywords: COVID-19, Stroke, Universitas Indonesia Hospital
POTENSI VITAMIN D SEBAGAI OBAT PREVENTIF UNTUK MENGHAMBAT PROGRESIVITAS TENSION TYPE HEADACHE Elvan Wiyarta; Stefen Weliadi Ali
NEURONA Vol 38 No 2 (2021)
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Abstract

Tension type headache (TTH) is one of the most common primary headaches. The prevalence of this headache is very high in Indonesia. Even so, many people still ignore this disease and eventually come when it has progressed to chronic. Several drugs have been developed to inhibit the progression of TTH, but they have some drawbacks. As an alternative, vitamin D is alleged to be able to act as an inhibiting drug for TTH progression through its mechanism of muscle spasm. The role of vitamin D is mainly found in the system of muscle contractility disorders that occur in TTH. Several clinical studies also support this theory. Vitamin D also has high applicability as a preventive drug for the progression of TTH, in terms of effectiveness, compliance, safety, and cost. Therefore, vitamin D has the potential to act as an inhibiting drug for TTH progression. However, further studies still need to be done. Keyword: , tension type headache, vitamin D
PRESERVASI FUNGSI NEUROKOGNITIF PADA PASIEN METASTASIS OTAK YANG MENJALANI RADIOTERAPI Ayu Santika Santaningrum; Henry Kodrat
NEURONA Vol 38 No 2 (2021)
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Abstract

Brain metastasis is a major factor of mortality and morbidity in cancer patients, leading to poor prognosis in patient survival. Whole-brain radiotherapy (WBRT) has remained preferred therapy to prolong survival in patients with brain metastases. Neurocognitive decline due to WBRT affects the quality of life of patients, thus encouraging development of techniques and strategies in radiation therapy for brain metastatic patients. Stereotactic radiosurgery (SRS) shows its ability to preserve cognitive function and improve quality of life in patients with limited number of intracranial metastatic lesions, with better survival at age ≤50 years. For patients who undergo WBRT, hippocampal avoidance (HA)-WBRT technique, addition of memantine, or combination of both showed significantly better neurocognitive preservation, without affecting toxicity and survival in patients with brain metastases. Keywords: brain metastases, hippocampal avoidance, memantine, stereotactic radiosurgery, whole-brain radiotherapy
Faktor Risiko Stroke pada Pasien Penyakit Ginjal Kronik di RSUP dr. Sitanala Tangerang Delarosa, Dinda Olinda
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 3 (2022): Vol 39 No 3 (2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i3.234

Abstract

Introduction: Chronic Kidney Disease (CKD) is an independent risk factor in cardiovascular disease, leading to stroke incidence. The risk of stroke increased three to seven times in CKD stage 3 to 5 compared with the general population. Risk of stroke increases when the glomerulus filtration rate (GFR) decreases. Aim: This study is to know stroke risk factors in chronic kidney disease patients, especially at RSUP Dr Sitanala. Methods: This study was descriptive-analytic, a case-control study. Data were collected from the medical record from January 2021 to November 2021 at RSUP Dr Sitanala with purposive sampling based on inclusion and exclusion criteria. Data used univariate analysis, bivariate analysis with Chi-square, and logistic regression test. Results: From 100 samples showed that ten patients experienced a stroke. Woman (6%) was higher than man (4%). Hypertension was a higher risk factor (8%). CKD stage 5 was higher (9%) than other stages. Dyslipidemia and hyperuricemia had a significant relation statistically with stroke incidents in CKD patients. Hyperuricemia increased stroke 14 times in CKD patients. Conclusion: CKD is related to stroke by considering its severity based on CKD stages, hemodialysis, and underlying risk factors management.
Kadar Homosistein Plasma Berhubungan dengan Derajat Keparahan Stroke Iskemik Akut Bintang, Andi Kurnia
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 3 (2022): Vol 39 No 3 (2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i3.237

Abstract

Introduction: Stroke is a major health problem globally, as well as Indonesia. It has high mortality and morbidity rate. Most patients have disability that impacts their quality of life. Recent studies reported the role of homocysteine in neurotoxicity, disruption of the blood-brain barrier, and oxidative stress. However, evidences regarding stroke severity and clinical outcome are still not consistent. Aim: Analyze correlation between serum homocysteine levels and severity index and clinical outcome the acute ischemic stroke. Methods: Subjects in this cross-sectional study were first-attack acute ischemic stroke patients with an onset less than 96 hours were recruited. Venous blood was collected within the first 24 hours of admission for serum homocysteine measurement. Severity index was assessed with National Institute of Health Stroke Scale (NIHSS) score. Clinical outcome was determined using the modified Rankin scale (mRS) score on the 14th day after stroke onset. Spearman’s coefficient was used to analyze correlation. Results: As many as 52 subjects were recruited, with female predominance (n=28, 53,8%). Serum homocysteine levels were higher in males (p=0,006) and had positive correlation with NIHSS score (r=0,029, p=0,036). No correlation was observed with mRS score (r=0,17, p=0,24). Subgroup analysis on homocysteine <15µmol/L showed correlation with stroke severity index (r=0,35, p=0,01). Discussion: This study supports previous ones regarding correlation between serum homocysteine levels and severity index in acute phase of ischemic stroke. No correlation was observed between serum homocysteine level and early clinical outcome. Correlation was found at serum homocysteine levels <15µmol/L. Keywords: acute ischemic stroke, homocysteine, NIHSS
HUBUNGAN ANEMIA DENGAN TINGKAT KEPARAHAN DAN PERJALANAN PENYAKIT STROKE ISKEMIK AKUT Eugenia Isadora; Budi Riyanto Wreksoatmodjo; Tara Puspitarini Sani
NEURONA Vol 38 No 3 (2021)
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Introduction: Stroke is the second leading cause of death and the third leading cause of disability throughout theworld. Anemia or reduced hemoglobin level can worsen the tissue damage caused by ischemia; including ischemic braintissue caused by ischemic stroke. Aim: This research aims to determine the association between anemia and stroke severity and clinical course basedon the NIHSS score among acute ischemic stroke patients in Atma Jaya Hospital during 2014-2019 Methods: A cross-sectional study using secondary data from Atma Jaya Stroke Registry from 2014-2019. A totalsampling method obtained 347 samples with complete pertinent data. Anemia was defined as Hb level <12 g/dL for womenand <13 g/dL for men. Stroke severity was measured by NIHSS score. Association between variables was calculated withthe chi-square test. Results: The risk factor associated with the severity of stroke was hypertension (p=0.013). There was no significantassociation between anemia and stroke severity on admission (p=0.895) and hospital discharge (p=0.773). There was nosignificant association between anemia and the clinical course of acute ischemic stroke (p=0.09). Discussion: Factors that may contribute to the various results of similar studies were differences in study design,anemia as a comorbid condition, genetic factors, sample size, and differences in measurement methods of stroke outcomeor severity. Keywords: Anemia, ischemic stroke, NIHSS, severity
HUBUNGAN APOE-4 DAN JENIS KELAMIN DENGAN FUNGSI BAHASA DAN MEMORI PADA LANSIA Abigail Madeline; Yuda Turana; Yvonne Suzy Handajani
NEURONA Vol 38 No 3 (2021)
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Abstract

Background: The APOE-4 allele, which globally has an estimated prevalence of 3-41%, is one of the strongestgenetic risk factors for Alzheimer’s disease dementia which generally has an early symptom of decreased memory functionAim: To determine the relationship between the APOE-4 gene and gender on cognitive function, especially languageand memory domains. Methods: This research is a descriptive-analytic study with a cross-sectional study design. Data collection was carriedout in September 2019. Respondents in this study were 97 elderly (aged ≥ 60 years). Data collection was carried outby filling out questionnaires and assessing cognitive function (using the Boston Naming Test with a cut-off value of <13 anddelayed free recall with a cut-off of <6, which shows impairment) and laboratory examination of the APOE-4 genotype.The data analysis test was performed using the Chi-square test. Results: It was found that the average age of the respondents was 66.78 years???? and most of them were female(72.2%). A total of 27.8% of respondents were found to have a positive APOE-4 gene. The percentage of impaired languageand memory functions was 24.7% and 46.4%. respectively. Based on data analysis, it was found that there was arelationship between the APOE-4 gene with language function (p = 0.004) and gender with language function (p = 0.014)and memory function (p = 0.042). Discussion: There is a significant relationship between the APOE-4 gene with language function and gender withlanguageand memory functions.
PROFIL KLINIS DAN LUARAN STROKE ISKEMIK AKUT DENGAN TROMBEKTOMI MEKANIK BERDASARKAN LOKASI OKLUSI DI RSUPN DR. CIPTO MANGUNKUSUMO Kevin Kevin; Taufik Mesiano; Mohammad Kurniawan; Rakhmad Hidayat; Affan P. Permana; Al Rasyid; Salim Harris
NEURONA Vol 38 No 3 (2021)
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Abstract

Introduction: Occlusion in anterior circulation gives variable clinical manifestations. Mechanical thrombectomy promises almost two times higher recanalization rate as opposed to thrombolysis. Aim: To evaluate the clinical and outcome profile of acute ischemic stroke patients who underwent mechanical thrombectomy based on the occlusion site. Methods: This was a retrospective cohort conducted at Cipto Mangunkusumo National Referral Hospital from May 2017 to January 2020. All acute ischemic stroke patients in anterior circulation who underwent mechanical thrombectomy with or without bridging intravenous thrombolysis were analyzed. Occlusion site and recanalization rate were scored based on arteriogram. Results: Sixteen patients had occlusion in ICA-M1 segment, while ten others were in the M2 segment. NIHSS value was two points higher in ICA-M1 occlusion (p>0.05), which further analysis found that the proportion of aphasia manifestation was higher in the ICA-M1 segment (50.0% vs 20.0%; p=0.218). Demographical and clinical characteristics were similar between the two groups. Thrombolysis did not modify the occlusion site on thrombectomy (p>0.05). Despite statistical insignificancy, ICA-M1 occlusion showed an earlier time trend from admission to recanalization. The M2 segment had a higher proportion of mTICI 2b/3 recanali????ation (50.0% vs 70.0%; p=0.428) and mRS 0-2 on discharge (12.5% vs 50.0%; p=0.053). Discussion: Aphasia was more common in proximal occlusion???? which drove family members to bring patients earlier to the hospital. The functional outcome on discharge was lower in proximal occlusion due to more extensive and permanent brain tissue loss. Future coordination is warranted to improve the therapeutic time from admission to recanalization. Keywords: functional outcome, ischemic stroke, mechanical thrombectomy, occlusion site

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