Anatomy Variation of Ruptured Anterior Communicating Artery (AcoA) Aneurysm : Serial Cases

Introduction : Intracranial aneurysms (IA) is an acquired disease characterized by dilatation of intracranial arteries, and is usually found at the location of arterial branches in the cranii base region. The selection of management and anatomic variations is quite interesting to be discussed in the case of aneurysms. Cases Report : Four cases of AcoA aneurysm were reported with variations in clinical manifestations, A1 segment anatomy, fundal projections and management considerations (Coiling vs. Clipping). This case series illustrates the compatibility with previous case studies that have existed. Discussion : The author concludes that the actions taken in cases I, II and III are in the form of coiling due to age, dome and neck ratio and access to perform such difficult surgical procedures. In case IV , it was considered to be performed surgical clipping action due to the presence of intracerebal hemoraghic, and the approach can be done from a non dominant hemisphere, proximal control only through the right carotid and the location of the posterior dome which was favorable for surgical clipping Conclusion : Aneurysms from the ACA-anterior communicating artery (ACoA) complex are some of the most complex lesions in the field of vascular neurosurgery. This location is where most rupture aneurysms occured with high mortalities due to complications of vasospasm and SAH. The choice of management in aneurysm cases which involved many factors such as age and anatomic variations.

Early Postoperative Serum Sodium Level and Urine Output Volume Profile after Endoscopic Endonasal Transsphenoidal Surgery in Macroadenoma Pituitary Tumor

Introduction: Surgery is still the initial treatment of choice to for the majority of date with pituitary tumors. One of the most commonly performed minimally invasive neurosurgical procedures is transsphenoidal endoscopic endonasal surgery (ETS) and microscopic transsphenoidal surgery (MTS), used commonly for the resection of pituitary tumors. Neurosurgical operations for pituitary and suprasellar tumors may result in postoperative complications due to the crucial anatomical location of these tumors. The resulting postoperative complications can manifest as anterior or posterior pituitary dysfunction, particularly sodium disturbances, due to the changes in antidiuretic hormone (ADH) secretion, which remains one of the most frequent postoperative reasons for hospital readmission. Method: The aim of this study is to describe and determine the frequency distribution of patient characteristics who underwent endoscopic endonasal transsphenoidal resection of pituitary adenoma at Universitas Sumatera Utara Hospital between 2021 and 2022. Result: The findings of this study showed the frequency distribution of patient characteristics who underwent endoscopic endonasal transsphenoidal resection and postoperative sodium serum level profile as well as postoperative urine output profile. Discussion: The discussion section briefly discusses the findings and their implications. It mentions the high prevalence of headache and visual deficits among the patients, which aligns with previous studies. It also provides an overview of normal water balance and the pathophysiology of water balance disorders after pituitary surgery.

Prevalence and Demographic of Spontaneous Intracerebral Hemorrhage Cases In Haji Adam Malik Hospital From 2018-2019

Introduction: Spontaneous intracerebral hemorrhage (ICH) represents as cerebral parenchymal bleeding that may also extend into ventricular (IVH). ICH, as a stroke subtype, is associated with poor neurological outcome as well as high mortality in 40% cases. Hypertension is the main and the most common risk factor in the development of ICH, particularly in the basal ganglia, thalamus, pons and deep cerebellar white matter. Hypertensive ICH in these localizations are particularly common in patients with chronic hypertension and they are not in compliance with blood pressure management. Other risk factor such as smoking and diabetes meilitus. Case Report: This retrospective study reviewed patient who were diagnosed with spontaneous intracerebral hemorrhage from January 2018 until December 2019 at the Haji Adam Malik General Hospital  Medan,Indonesia. The patient’s demographic data and number of cases are collected. There were 163 cases of pure spontaneous ICH  and 159 cases of Spontaneous ICH with IVH were among the total cases of ICH from 2018 to 2019. Discussion: Based on data at the Haji Adam Malik General Hospital Medan from 2018 to 2019,there are differences in the number of men and women proportion in the incident of  pure ICH , for men who are 110 people around 67% while in women it is 53 people or about 32%. The incidence also higher in diabetes meilitus and smoking patient. Conclusion: We reported 163 cases of  pure ICH and 159 cases of ICH with IVH. Based on demographic examination, male are dominant about 67% of total cases. Based on the biggest risk factors in patients with spontaneous ICH are hypertension, in the case of spontaneous ICH with IVH the biggest risk factor was smoking

Experimental Study on Flow Characters of Salt Hydrate Slurry in Phase Change Temperature Range

One of the efforts in minimizing energy consumption chiller type air conditioning system is the use of phase changing material in secondary refrigerant. Secondary refrigerant functions to obtain heat from the air to cool a room and to release heat in chiller evaporator. Based on working temperature of secondary refrigerant, the fluid can flow in liquid form, and can also be in fluid solid form or slurry at the temperature of its phase change. This research studies the effect of temperature toward flow characteristics, with the parameter analyzed being the pressure decrease and friction coefficient. Besides that, in order to support data analysis, it was initiated by viscosity testing, density and concentration of solid mass. Data taken were viscosity, density, solid mass concentrate, and pressure difference found in copper pipe. Data were taken for several fluid temperatures, and at pressure decrease was added by variation of flow speed. Hydrate salt tested were CaCl2 and Na2HPO4. Viscosity and density increased with the decrease in temperature. The formation of solid particles within phase change temperature range also gave an impact on the increase in the value of viscosity and density. Pressure drop increased when using hydrate salt fluid. The use of CaCl2 solution resulted in the highest pressure decrease. This salt hydrate has far higher viscosity and density compared to water. This has an effect toward an increase in pressure drop. This increase started to be significant in the phase change temperature area in which solid particle started to form. The same thing happened in the friction coefficient value

Microsurgical Resection of Cerebral Arteriovenous Malformation: Our Precious Experience

Introduction : Intracranial ateriovenous malformation (AVM) is a non-neoplastic congenital vascular abnormality which appears as a mass lesion composed of tangled blood vessels connecting arteries and veins in the brain. Case Report : Twenty seven years old male was present in our emergency department (ED) with decreased of conciousness and reccurent generalized seizure. The physical examination reveal the patient Glasgow coma scale (GCS) of 12 points (E4M5V3). Head CT scan with contrast shows contrast enhancing lesion on the frontoparietal region with extension to right lateral ventricle which suggest vascular lesion. We performed surgical resection of the AVM using the temporary clip on M2 branch which supply the nidus to reduce the risk of bleeding on operation. Discussion : Patients with grade I or II AVM tolerate resection with acceptable morbidity, whereas those with a grade IV or V AVM may be considered for conservative management because of the high anticipated risk of surgical morbidity Conclusion : AVMs are abnormalities of the intracranial vessels that constitute a connection between the arterial and venous systems and lack an intervening capillary bed. Microsurgical excision of the AVM involves a craniotomy, careful dural opening with circumferential nidus dissection until complete AVM resection is achieved

Cerebral Abscess In A Child With Unknown Origin Of Infection: A Case Report

Introduction: The incidence of brain abscesses is higher in developing countries. The classic triad of fever, headache, and focal neurological signs was seen in 9–28% of the pediatric cases. Brain abscesses occur infrequently with potentially life-threatening conditions. Case Report: The patient was a child 1 year 8 months old with a main complaint of weakness in the left arm and leg progressively for one month. She had a local seizure on her left arm and leg one month before admission with a duration of 30 minutes. She was irritable for the last two weeks. The strength of the upper and lower extremities was 3 respectively. The physiology reflex was hyper-reflex on the upper and lower extremities. A Head non-contrast CT scan showed a hypodense lesion on the right parietal with a perifocal edema lesion. A head contrast CT scan showed a hypodense lesion on the right parietal with ring enhancement measuring approximately 6,2 cm x 4,5 cm. Craniotomy evacuation abscess with near total capsulectomy was done on initial and capsule resection was done. Discussion: Brain abscess is a focal pyogenic infection of the brain parenchyma, and the frontotemporal lobe is the most common site of brain abscess, followed by frontal-parietal, parietal, occipital lobes, and cerebellar. The most common risk factors that predispose a child to the formation of a brain abscess include congenital heart disease, sinus and otogenic infections, and poor dental hygiene. The triad of brain abscess, including headache, fever, and neurological symptoms is only present in (15%) of the cases reported. Medical treatment is recommended in patients without increased intracranial pressure, with symptoms of less than 1 week long and abscess of less than 2 cm seen in tomography. The suggested time of treatment is between 6 and 8 weeks with intravenously administered antibiotics. A full recovery rate from the infection of about 60–70% is reported in the case of early diagnosis and proper therapy Conclusion: Cerebral abscess in pediatrics with unknown origin of infection may happen in 12%. Early diagnosis and treatment of pediatric cerebral abscesses can reduce morbidity and mortality rates. A broadspectrum antibiotic is an optimal treatment in the postoperative evacuation of cerebral abscess cases with unknown origin infection

Transsphenoid surgery outcomes in pituitary adenoma patients at Sumatera Utara University Hospital in 2022–2023: A prospective study

Background: Adenomas are common pituitary tumors, accounting for 10–15 % of all intracranial tumors. They are non-metastatic and benign, originating in the pituitary gland. The exact genetic mutations causing adenomas are not fully understood, but they involve tumor suppressor inactivator genes and protooncogene activator mutations. Transsphenoidal surgery is the preferred treatment for patients with neuro-ophthalmological symptoms to relieve pressure on the optic tract, resulting in visual improvement for around 80 % of patients. Surgery is recommended for patients with such symptoms or when the tumor invades the optic nerve. Risks of transsphenoidal surgery include diabetes insipidus, electrolyte imbalances, neurological deficits, and CSF rhinorrhea. Materials and methods: This is a clinical trial study with a prospective cohort design to evaluate outcomes of pituitary adenoma patients who were undergone transsphenoid surgery at USU Hospital in 2022–2023. Total of 13 patients were included in the study. Preoperative and postoperative Na+, K+, and Cl− were measured to assess outcomes of transsphenoid surgery in pituitary adenoma patients. Result: Various postoperative complications can be seen and be anticipated in transsphenoidal pituitary surgery. Conclusion: Water and electrolyte imbalance is one of the most common complication found in patient who undergone transsphenoid surgery for pituitary adenoma. It can lead to secondary hospital admission and may be life-threatening if not treated adequately and immediately. Preoperative and postoperative laboratory Na+, K+, Cl− and urinary output are important parameters to be monitored in pituitary adenoma patient who undergone transsphenoid surgery

Penerapan Semantic Text Analysis Dan String Filter Matching Menggunakan Algoritma Boyer Moore Pada Aplikasi Chat Online

Penggunaan media sosial saat ini menjadi suatu kebutuhan sehari-hari yang tidak bisa dihindari. Berbagi pesan teks satu sama lain yang dikirmkan kepada penerima bisa saja menimbulkan suatu masalah yaitu adanya kata atau kalimat yang mengandung makna kotor ataupun tidak pantas yang ditulis oleh pengirim kepada penerima. Hal ini perlu adanya penyaringan teks untuk memberikan interaksi yang baik diantara pengguna dalam berbagi teks sebagai kebutuhan berbagi informasi. Semantic Text Analysis dalam penyaringan teks ini membandingkan kata-kata yang sama antara kata yang kotor, jika kata yang dikirim memiliki pesan yang mengandung makna tidak sopan atau kotor maka pesan teks yang dikirim kepada penerima disensor. Di dunia ilmu komputer perbandingan teks bisa diatasi dengan dengan pencarian teks. Proses pencarian pada kata yang akan dicari salah satu nya dengan menggunakan algoritma Boyer-Moore yang merupakan suatu solusi yang cukup baik untuk menyelesaikan pencarian teks secara cepat dan tepat dengan susunan karakter di dalam string yang dicocokkan memiliki jumlah atau urutan karakter di dalam string yang sama. sehingga perbandingan menjadi efisien, setelah dilakukan uji coba yang telah di lakukan masalah di atas dapat teratasi dengan baik merubah kalimat kata-kata yang tidak pantas menjadi symbol atau karakter yang di sandikan sehingga percakapan dapat berjalan dengan baik