{"title":"Silicone hypersensitivity necessitating removal of ventriculoperitoneal shunt in schizencephaly patient complicated with hydrocephalus: A case report","authors":"Zainy Hamzah, Cut Vanessa Rachmadian Muly","doi":"10.15562/ijn.v4i3.207","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.207","url":null,"abstract":"Introduction: Allergic reaction to shunt material is rarely encountered. We report a case of hypersensitivity to silicone-based shunt material that did not subside with corticosteroid which required shunt removal. Case presentation: A 5 years old child with spastic quadriplegic cerebral palsy was brought to our ER due to loss of consciousness. Physical examination revealed anisocoria of the pupils (2 mm / 7 mm) and Glasgow Coma Scale score of E2VxM3. Head computed tomography (CT) scan showed a fluid collection in the frontotemporal region and the appearance of schizencephaly. Conclusion: Allergic reaction to silicone in ventriculoperitoneal shunt material is extremely rare. Polyurethane-based tubes are usually used as a substitution for silicone tubes. However, these tubes were not available and were not covered by insurance in Indonesia. Ventriculostomy is another option for selected cases.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128859401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Putu Ananta Wijaya Sabudi, M. Arifianto, W. Suryaningtyas, Muhammad Arifin Parenrengi
{"title":"Agreement between assessor in using shunt algorithm for frontoethmoidal encephalocele with cerebrospinal fluid circulation disorder","authors":"Putu Ananta Wijaya Sabudi, M. Arifianto, W. Suryaningtyas, Muhammad Arifin Parenrengi","doi":"10.15562/ijn.v4i3.151","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.151","url":null,"abstract":"Introduction: Frontoethmoidal encephalocele (FEE) is a type of neural tube formation disorder. Hydrocephalus and intracranial cysts are the most common accompanying abnormalities in FEE. A high rate of shunt complications led to the development of the shunt algorithm for frontoethmoidal encephalocele (SAFE) to assess whether the shunt is needed. Method: This was a cross-sectional study with 10 cases assessed using the SAFE algorithm. Each case was assessed by two assessors in three experience groups (neurosurgical residents who have passed the neuropediatric division, chief of neurological resident, and neurosurgeon) with a double-blind sampling method. Results: The median age was ten months with 60% of the samples were female and 50% of the samples were not having shunt insertion, while 90% of the samples had FEE reconstruction. The agreement value with Fleiss Kappa showed low interrater agreement (κ = 0.037; 95% CI 0.035 to 0.039; p = 0.254) with moderate κ values of the six SAFE components where statistically significant for the cerebrospinal fluid (CSF) accumulation (κ = 0.460; 95 % CI 0.456 to 0.463; p = 0.001) and the FEE volume (κ = 0.450; 95% CI 0.447 to 0.454; p = 0.001). Agreement value in shunt insertion was adequate, with a value of κ = 0.250 (95% CI 0.245 to 0.255), p = 0.002. The agreement value in patients who had shunts was moderate with a value of κ = 0.411 (95% CI 0.403 to 0.418 p = 0.000. The agreement value in patients who were not shunted was low with a value of κ = 0.089 (95% CI 0.082 to 0.97 p = 0.439. Conclusion: The assessors’ agreement using SAFE in FEE patients with circulatory CSF abnormality was low and not statistically significant. All components did not have an optimal agreement value. The components that were closest to the moderate agreement value were the CSF accumulation and FEE volume. Both of them were statistically significant.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133987602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. A. Akbar, Muhammad Kamil, F. Moinuddin, Shingo Fujio, H. Hirano, A. Ibrahim, Y. Bakhtiar, Thohar Arifin, Z. Muttaqin, K. Arita
{"title":"Variety in magnetic resonance imaging of enlarged perivascular space: Case reports","authors":"M. A. Akbar, Muhammad Kamil, F. Moinuddin, Shingo Fujio, H. Hirano, A. Ibrahim, Y. Bakhtiar, Thohar Arifin, Z. Muttaqin, K. Arita","doi":"10.15562/ijn.v4i3.85","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.85","url":null,"abstract":"Introduction: Expansion of perivascular spaces leads to tissue damage in the surrounding parenchyma. Enlarged perivascular spaces (EPS) have been long regarded as benign and normal variants, and have been subject to little investigation. We report three cases of EPS in unusual locations with their typical findings and clinical symptoms as consideration to differentiate them from other brain lesions. Case presentation: The first case was a 64-year-old woman presenting with vertigo, vomiting, and shoulder stiffness. The second case was a 25-year-old woman who worked as an agricultural trainee who complained of intermittent headaches 3 years before admission. The third case was a 42-year-old woman with dizziness and recurring headache. The MRI finding in T1 flair was a hypointense, which was surrounded by a hyperintensity wall. T2WI revealed a hyperintensity in the superior temporal lobe, with no pathological finding to prove an ischemic or infarction process in Diffuse Weighted Imaged (DWI) and Apparent Diffusion Coefficient (ADC) images. Conclusion: These 3 locations in our case reports should be one of consideration for diagnosing an EPS with its typical feature. A routine MRI study is needed to follow up progressivity of EPS.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"207 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134324645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. P. Vinodh, Sivakumaran Rajandran, Theepan Sellamuthu Pulivendhan, P. Sellamuthu
{"title":"Decision making in cranioplasty: A case report","authors":"V. P. Vinodh, Sivakumaran Rajandran, Theepan Sellamuthu Pulivendhan, P. Sellamuthu","doi":"10.15562/ijn.v4i3.202","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.202","url":null,"abstract":"Introduction: Decompressive craniectomy (DC) is the treatment for intractable high intracranial pressure (ICP). Patients are left with a skull defect after the surgery which necessitates the need to close the defect. Case presentation: We report a classic traumatic case that required DC and was followed by cranioplasty later. We explained in detail surgical steps which are considered paramount in avoiding complications. We also reviewed the relevant literature which aids surgeons in ideal decision making. Despite all the recent advances, there is no clear guideline on the ideal cranioplasty after DC. Cranioplasty is indicated to recreate the solid skull covering for protection from external injury. Cranioplasty has been proven beneficial in sunken flap syndromes that fail to respond to non-surgical treatment. Conclusion: Cranioplasty is a common procedure but involves many complications if not properly planned or done. Deliberate care must be taken during the perioperative period to prevent complications to ensure a good postoperative outcome.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126246501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk factors of mortality due to traumatic brain injury in Marsidi Judono general hospital, Belitung, Indonesia","authors":"Jeffrey Chandra, Widodo L. Tobing","doi":"10.15562/ijn.v4i3.163","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.163","url":null,"abstract":"Introduction: Traumatic brain injury (TBI) is a global problem and the biggest cause of mortality and disability of all trauma cases. This study aimed to determine the characteristics and relationship between risk factors for TBI and its impact on mortality and also to provide epidemiological data related to TBI in Belitung regency. Methods: A retrospective study was conducted using secondary data from the medical records of participants who met the inclusion and exclusion criteria at dr. H. Marsidi Judono General Hospital Belitung from January to December 2019. Data were analyzed as univariate, bivariate, and multivariate using binary logistic regression. Results: Two hundred and seventy patients were included in this study. Men were more likely to have a TBI than women in all categories (65.9%). The adolescent age group (33.7%) followed by adults (31.5%) were the largest contributors to TBI. Road traffic accident cases (86.7%) dominated the incidence of TBI. The use of headgear was still lacking (36.7%) while cases of road traffic accidents were high. The use of ambulances was lacking (10.4%) compared to other vehicles. A total of 119 patients (44%) were hospitalized in either the general ward or ICU with an average length of hospitalization was 3 days. Of all TBI cases, the mortality rate was 11.9%. People with older age have a higher mortality rate compared to other age categories (OR 1.052; 95% CI: 1.001 – 1.106). Conclusion: The mortality rate due to TBI reaches 11.9% in this region, with age as a statistically significant predictor of mortality due to TBI. Older patients tend to have a higher likelihood of death due to TBI. The data obtained can be used by general practitioners, disease preventative planners, and policymakers to reduce mortality due to TBI in Belitung regency.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133338484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ditto Darlan, Abrar Arham, Muhammad Arief Rachman Kemal
{"title":"Profile of the brain arteriovenous malformation at National Brain Center hospital in 2015 – 2016: Epidemiological study","authors":"Ditto Darlan, Abrar Arham, Muhammad Arief Rachman Kemal","doi":"10.15562/ijn.v4i3.186","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.186","url":null,"abstract":"Introduction: Brain arteriovenous malformation (AVM) is a congenital vascular lesion in which arterial blood flows directly into draining veins without capillary networking. The estimated incidence rate is approximately 1 case for 100,000 people a year. Clinical presentations are headache, seizure, neurological deficit, and others that are caused by space-occupying lesions. The treatment of brain AVM consists of microsurgery resection, embolization, stereotactic radiosurgery to conservative treatment. Methods: The design of the study was a descriptive non-analytical study. Data were taken from patients’ medical records, radiological records, and catheter lab data records at National Brain Center Hospital in 2015 – 2016. Results: There were 32 patients with AVM. The characteristics of brain AVM in our study were mostly men (62.5%), productive age ranging from 20 – 29 years (31.25%), manifested as seizure (43.75%), presence with Glasgow Coma Scale (GCS) score 15 (87.5%), and rupture of brain AVM nidus (59.38%). Conclusion: Brain AVM predominantly occurred at a young age and the management varied on the Spetzler-Martin grading. In addition, the likelihood of rupture was influenced by the characteristics of the lesion, such as size, age, location of the nidus, and history of rupture of brain AVM nidus.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122724374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Characteristics and clinical findings of traumatic brain injury patients in single referral hospital dr. Hasan Sadikin hospital, Bandung, West Java, Indonesia","authors":"M. Arifin, A. B. Sutiono, Rendy Febrian Badri","doi":"10.15562/ijn.v4i3.183","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.183","url":null,"abstract":"Introduction: Traumatic brain injury (TBI) is the leading cause of mortality and morbidity in children and young adults globally. Knowledge of TBI characteristics holds importance on the treatment improvement of and scientific progression. Thus, this study aimed to evaluate the characteristics of TBI in Hasan Sadikin Hospital. Methods: Analysis of data obtained from a retrospective review of medical records and from a systematic database pertaining to diagnostic criteria of TBI treated in the Department of Neurosurgery at Dr. Hasan Sadikin Hospital, Bandung, Indonesia from January 1st 2012 to December 31st 2018. Results: This study included 10,234 cases over the described time period. Men had a higher prevalence of TBI (7,539 patients or 73.7%) compared to women (2,695 patients or 26.7%). The majority of the cases were mild TBI (68.3%). The most common skull fracture was linear fracture (68.6%), while the majority of skull base fracture was anterior skull base fracture (66.7%). The majority of intracranial lesions were cerebral contusion (26.4%). Intracranial lesions were commonly observed in patients with moderate or severe than mild TBI. Conclusion: The incidence of accompanying intracranial lesions and skull fracture were commonly observed in patients with moderate or severe TBI than patients with mild TBI.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120901449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Agrawal, Harold E. Vasquez, William Andres Florez Perdomo, L. Moscote-Salazar
{"title":"Occipital dural fistula presenting with hydrocephalus: A case report","authors":"A. Agrawal, Harold E. Vasquez, William Andres Florez Perdomo, L. Moscote-Salazar","doi":"10.15562/ijn.v4i3.134","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.134","url":null,"abstract":"Introduction: Dural arteriovenous fistula (DAVF) is an abnormal vascular communication between branches of dural arteries and dural veins or venous sinuses. These fistulas are associated with hydrocephalus in 35% of cases in the pediatric population. However, the presence of hydrocephalus in adults is rare in DAVF. We presented a case report of DAFV accompany by hydrocephalus and was managed with endovascular therapy. Case presentation: A 15-year-old school girl presented with nausea and vomiting for two weeks. She had spastic paraparesis and cognitive impairment. Her mother had a history of cerebral arteriovenous malformation that was associated with hydrocephalus. Magnetic resonance imaging was further examined and revealed dilation of both lateral ventricular and hyperintensity on the periventricular area. Diagnostic angiography was performed which showed the presence of a dural fistula between occipital sinus and multi-side of Galen vein. Embolization with onyx was performed successfully. Conclusion: DAVF in our case was a rare condition with an atypical localization. Further study will be needed to describe this rare entity and to establish its true prevalence.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128219136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ponticulus posticus upon routine evaluation of cervical spine x-ray in head injury patient: Case reports","authors":"F. Yudoyono, C. Ade","doi":"10.15562/ijn.v4i3.162","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.162","url":null,"abstract":"Introduction: Ponticulus posticus or known as foramen arcuate is an anatomic variation of the first cervical vertebra origin from calcification of the posterior atlantooccipital membrane. The vertebral artery passes through this canal. This canal can be complete or incomplete and can also be unilateral or bilateral. Often related to symptoms of headaches, vertebrobasilar insufficiency, or acute hearing loss. Whereas, imaging studies show the presence of a partial osseous bridge on the upper surface of the atlas. This study aimed to present two cases of ponticulus posticus in head injury patients. Case presentation: We reported 2 cases of ponticulus posticus found incidentally in head injury patients at our institution. The patients were managed conservatively for 5 days and sent home with no neurological deficit and complication. Conclusion: Ponticulus posticus is often ruled out in pre-admission screening. Neurosurgeons should consider this to predict the neurological deficit.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132021604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation of vestibular schwannoma tumor with facial nerve weakness, hypoesthesia of face, and disequilibrium","authors":"A. B. Sutiono, Selfy Oswari, Centery Centery","doi":"10.15562/ijn.v4i3.149","DOIUrl":"https://doi.org/10.15562/ijn.v4i3.149","url":null,"abstract":"Introduction: Vestibular schwannoma is the most common lesion in the cerebellopontine angle. Some of the most common symptoms arise as the tumor grows bigger such as disequilibrium, hypoesthesia of the face, and facial nerve paresis. Based on the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Consensus Meeting on Systems for Reporting Results in Acoustic Neuroma, there is still no clarity of a single method used to measure the tumor itself. Methods: This was a retrospective study to analyze the correlation between the size (anteroposterior and mediolateral) of the vestibular schwannoma with disequilibrium, hypoesthesia of the face, and facial nerve paresis among the patients in the Neurosurgery Department of Hasan Sadikin Hospital Bandung from January 2014 to December 2019. The data was analyzed using Spearman and Binary Logistic Regression. Results: A total of 58 patients were included in this study with median age was 43 years, ranging from 21 – 72 years. The most common symptoms were disequilibrium (48.27%), followed by facial nerve paresis (39.65%) and hypoesthesia of face (20.68%). The mean anteroposterior size was 3.8 ± 1.17 cm and the mean mediolateral size was 3.0 ± 1.01 cm. There were significant correlation between disequilibrium with anteroposterior size (r = 0.385; p = 0.003) and mediolateral size (r = 0.409; p = 0.001). There were also significant correlation between facial nerve paresis with anteroposterior size (r = 0.458; p= 0.000) and mediolateral size (r = 0.321, p = 0.014). Conclusion: There were significant correlations between the anteroposterior and mediolateral size of the tumor with the occurrence of disequilibrium and facial nerve paresis in patients with vestibular schwannoma.","PeriodicalId":206128,"journal":{"name":"Indonesian Journal of Neurosurgery","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133425667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}