Rare Distal Anterior Choroidal Artery Aneurysm

Objective: To describe a rare patient with ruptur aneurysm case of distal anterior choroidal artery (AChA) and intraventricular hemorrhage. A 56-year old female came to our hospital with chief complaint sudden onset of severe headache and vomiting.Methods: Head computed tomography (CT)-scan and angiography on the lesion was performed at the Department of Radiology, Siloam Hospital, Tangerang, Indonesia.Results: Head CT-scan imaging revealed an intraventricular hemorrhage, primarily in the right lateral ventricle, with slight enlargement of both lateral, 3rd and 4th ventricles. Angiography examination revealed a round vascular lesion at the wall of the posterior cornu of the lateral ventricle and an occlusion of the M1 base segment of the left middle cerebral artery.Conclusions: The lesion, distal AChA aneurysm, at the posterior cornu was reached using an infratemporal lobe approach with the help of neuronavigation. Microsurgical clipping was successfully performed.Keywords: Aneurysm, distal anterior choroidal artery, neuronavigation DOI: 10.15850/ijihs.v4n2.83

Penatalaksanaan fraktur mandibula pada anak dengan cedera kepala sedang

Management of mandibular fracture in child with moderate head injury. Mandibular fractures in child with moderate head injuries were relatively rare, the management of child patient need special considerations regarding their age and growth. Management of mandibular fractures in child with moderate head injuries need cooperation with specialists Neurosurgery. This case report aims to explain the management of mandibular fracture in child with moderate head injury. A 7 years old boy ushered to Hasan Sadikin Hospital, with bleeding at head and fracture of the lower jaw. The patient was hit by a motorcycle high speed while crossing the street with unknown mechanism there was history of unconsciousness about 20 minutes, there was bleeding from mouth. GCS 9, asymmetrical face, post suturing in the head and fracture of the lower jaw. Then, examination support, and then diagnosed Moderate Head Injury with Open fractures more than one tabula at right parietal and right mandibular angle fracture, left mandibular parasimphysis fracture. Management according ATLS, with the primary survey, secondary survey and stabilization, then craniectomy debridement. Once a patient is stabilized performed ORIF with regard mandibular growth and development of teeth. craniectomy debridement to prevent the occurrence of intracranial infection because of their open fractures in the bones of the head. Open Reduction and Internal Fixation by installing miniplat with a screw for fixation of mandibular fractures managed to restore the aesthetic and masticatory functions. Open wounds can cause intracranial infections that can develop into meningitis and brain abscess. Management of mandibular fractures in children with head injuries being successful if there is cooperation between specialists Neurosurgery and Oral and Maxillofacial Surgery

Rare Distal Anterior Choroidal Artery Aneurysm

Objective: To describe a rare patient with ruptur aneurysm case of distal anterior choroidal artery (AChA) and intraventricular hemorrhage. A 56-year old female came to our hospital with chief complaint sudden onset of severe headache and vomiting.Methods: Head computed tomography (CT)-scan and angiography on the lesion was performed at the Department of Radiology, Siloam Hospital, Tangerang, Indonesia.Results: Head CT-scan imaging revealed an intraventricular hemorrhage, primarily in the right lateral ventricle, with slight enlargement of both lateral, 3rd and 4th ventricles. Angiography examination revealed a round vascular lesion at the wall of the posterior cornu of the lateral ventricle and an occlusion of the M1 base segment of the left middle cerebral artery.Conclusions: The lesion, distal AChA aneurysm, at the posterior cornu was reached using an infratemporal lobe approach with the help of neuronavigation. Microsurgical clipping was successfully performed.Keywords: Aneurysm, distal anterior choroidal artery, neuronavigation DOI: 10.15850/ijihs.v4n2.83

Korelasi antara Nilai S100-Beta Pre dan Post Kraniotomi Evakuasi Perdarahan Intraserebral Spontan dengan Luaran

Latar Belakang dan Tujuan: Perdarahan intraserebral/Intracerebral hemorrhage (ICH) spontan ialah penyakit luaran bervariasi yang cenderung fatal dan berbiaya tinggi. S100B ialah enzim yang dapat dinilai pada serum darah saat sel otak cedera dengan biaya lebih rendah dibanding CT-Scan kepala. Penelitian ini mencari korelasi S100B dengan luaran ICH spontan. Prediksi dini luaran buruk pada masa perawatan postoperatif akan mempermudah tenaga medis dan keluarga memutuskan terapi lebih lanjut. Subjek dan Metode: Penelitian cross sectional ini mencari korelasi dengan pengumpulan data prospektif consecutive sampling pada 40 pasien ICH spontan yang dilakukan kraniotomi evakuasi di bagian bedah saraf RSUP Hasan Sadikin Bandung periode Januari–Juli 2016. Hasil: Pasien ICH spontan menunjukkan korelasi positif signifikan S100B preoperatif dan postoperatif dengan mortalitas. Risiko relatif ICH spontan dengan S100B preoperatif 0,220 ug/L berpeluang meninggal 3,157 kali lebih besar dan S100B postoperatif 0,225 ug/L berpeluang meninggal 5,405 kali. Ada korelasi negatif signifikan antara S100B preoperatif dan postoperatif dengan Glasgow Outcome Score (GOS). Ada korelasi positif signifikan antara S100B preoperatif dan postoperatif dengan volume ICH. Tidak ada perbedaan signifikan antara nilai S100B preoperatif dan postoperatif. Simpulan: Nilai serum S100B pre dan post kraniotomi evakuasi ICH spontan berkorelasi dengan luaran mortalitas dan GOS. Nilai S100B postoperatif 0,225 ug/L dapat membantu memutuskan terapi lanjut post kraniotomi. The Correlation between S-100 Beta Level at Pre and Post Craniotomy Evacuation Spontaneous Intracerebral Hemorrhage with Outcome Background and Objective: Spontaneous intracerebral hemorrhage (ICH) is a disease with diverse outcome which tends to be fatal and costly. S100B is a measurable enzyme from the blood serum when astrocytes are damaged. S100B has less cost compared with head CT-Scan. This study used S100B to predict spontaneous ICH outcome. Early post operative prediction of poor outcome would help in deciding further therapy. Subject and Method: This is a cross sectional study to find a correlation between variables by collecting prospective data with consecutive sampling of 40 inpatient spontaneous ICH subjects and performed craniotomy evacuation at Hasan Sadikin hospital neurosurgery department during January-July 2016 period. Result: Spontaneous ICH patients demonstrated significant positive correlation between preoperative and postoperative S100B levels with mortality. Relative risk of spontaneous ICH with 0.220 ug/L preoperative S100B level had 3.157 higher death risk and 0.225 ug/L postoperative S100B level had 5.405 higher death risk. There was significant negative correlation between preoperative and postoperative S100B levels with ICH volume. There was no significant difference between preoperative and postoperative S100B levels. Conclusion: S100B serum levels of pre and post craniotomy evacuation of spontaneous ICH patients had correlations between mortality and GOS outcome. Postoperative S100B level 0.225 can deciding further therapy

Perbandingan antara Tindakan Dekompresi Hemikraniektomi Evakuasi dengan Kraniotomi Evakuasi terhadap Hasil Luaran Pasien Perdarahan Intraserebral Spontan dengan Glasgow Coma Scale < 9

Background and Objective:Indonesian stroke prevalence based upon 2013 Indonesian Health Ministry database that was diagnosed by health professionals was 12.1/mil. West Java was ranked 13 out of 33 provinces with a stroke prevalence of 6.6%. Coma patients with ICH are a special condition because of the high mortality rate and improper therapy. The aim of this study was to analyze the comparison between evacuative hemicraniectomy decompression and craniotomy evacuation upon spontaneous ICH patients with GCS < 9. Subject and Method:This research was done during February-July 2016. The research used analytical cohort study with comparative analysis design. Employed statistical analysis was unpaired t-test with normal distribution or Mann Whitney if it was abnormal using SPSS ver. 17. Result:There were 16 samples that met research inclusion criteria. The results of postoperative NIHS score comparison between decompressive hemicraniectomy and craniotomy showed significant difference with p = 0.021 (p<0.05). Meanwhile for postoperative midline shift and less than 30 days mortality didn’t demonstrate significant difference with respective were p = 0.328 and p = 1.00. Conclusion: Evacuative hemicraniectomy decompression gave better outcome compared with craniotomy evacuation upon spontaneous basal ganglia ICH patients with GCS < 9 using NIHS score assessment

Rare Distal Anterior Choroidal Artery Aneurysm

Objective: To describe a rare patient with ruptur aneurysm case of distal anterior choroidal artery (AChA) and intraventricular hemorrhage. A 56-year old female came to our hospital with chief complaint sudden onset of severe headache and vomiting. Methods: Head computed tomography (CT)-scan and angiography on the lesion was performed at the Department of Radiology, Siloam Hospital, Tangerang, Indonesia. Results: Head CT-scan imaging revealed an intraventricular hemorrhage, primarily in the right lateral ventricle, with slight enlargement of both lateral, 3rd and 4th ventricles. Angiography examination revealed a round vascular lesion at the wall of the posterior cornu of the lateral ventricle and an occlusion of the M1 base segment of the left middle cerebral artery. Conclusions: The lesion, distal AChA aneurysm, at the posterior cornu was reached using an infratemporal lobe approach with the help of neuronavigation. Microsurgical clipping was successfully performed

Endovascular treatment as a management of ruptured posterior inferior cerebellar artery: A rare case report

A 52-year-old female reported a sudden onset of severe headache, vomiting, and unconsciousness. The patient's medical history includes hypertension. A Non-Contrast Head CT scan indicated a hyperdense lesion in the bilateral lateral ventricles, third ventricle, and fourth ventricle, in addition to a hyperdense shadow in the interpeduncular cistern, bilateral sylvian cisterns, crural cistern, and ambient cistern. A 3D CT Angiography indicated the presence of a Saccular Aneurysm at the Left PICA in the Posteroinferior Projection with a Dome size of 0.50 cm, a Neck size of 0.31 cm, and a Dome neck ratio of 1.61. The patient will undergo Coiling Embolization and Digital Subtraction Angiography (DSA). Intracranial aneurysms are treated by coiling, which is a relatively new treatment procedure. Coiling requires inserting a catheter through a peripheral artery, such as the femoral, into the cerebral circulation and precisely putting a coil into the aneurysm to induce clotting, a process known as embolization