Cognitive and Functional Outcome among Hospitalized Intracerebral Haemorrhage Patients in West Java’s Top Referral Hospital

Background: Stroke is the highest cause of disability in adults. Disability and cognitive function impairment cause dependency and decreasing quality of life. The objectives of this study was to describe the outcome of functional and cognitive function among intracerebral haemorrhage patients admitted to Dr. Hasan Sadikin General Hospital Bandung in 2013. Methods: This study was a quantitative descriptive study, conducted from October 2016 to August 2017. Data were collected retrospectively with total sampling method from medical records of intracerebral haemorrhage patients admitted to Dr. Hasan Sadikin General Hospital in 2013 assessed with the Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) and Barthel Index. Patients with incomplete medical records , severe aphasia, severe sensoric-motoric impairment, and decreased consciousness were excluded in this study. Data were analyzed using Microsoft Office Excel 2010 and presented in percentage. Results: Out of the 26 subjects, 11 were men and 15 women , who were in the age range of 45–54 years (42.3%), with low education level (61.5%), and unemployed (61.5%) had the highest prevalence on subjects studied. Hypertension was the most common risk factor (78%). Most subjects had cognitive function impairment (69.2%) with delayed memory function as the most common impairment domain found (84.6%), followed by visuospatial/executive function (69.2%). Most subjects had a high score of dependence according to the Barthel test (61.5%). Conclusions: Two third of intracerebral haemorrhage patients have cognitive function impairment and functional dependence. Memory function is the most common impaired cognitive functional domain

Assessment of Intratumoral Heterogeneity in Isolated Human Primary High-Grade Glioma: Cluster of Differentiation 133 and Cluster of Differentiation 15 Double Staining of Glioblastoma Subpopulations

BACKGROUND: Gliomas are the most common primary brain tumors, representing 50–60% of malignant primary brain tumors. Gliomas are highly heterogeneous with marked inter- and intratumoral diversity. Gliomas heterogeneity is a challenging issue in the development of personalized treatment. The simplest method for studying heterogeneity is using ex vivo cell cultures; in our case, the cell lines were isolated from patient with glioblastomas. AIM: Here, we reported distinct cell subpopulations heterogeneity in glioblastoma cells. METHODS: Human glioblastoma cells isolation is conducted by enzymatic method with combination of collagenase I, hyaluronidase, and trypsin enzyme in proportional amount from patient. Immunostaining was performed to assess glial fibrillary acidic protein (GFAP), Ki-67, isocitrate dehydrogenase-1 (IDH-1) status, and program death ligand-1 (PD-L1) expression. Primary glioblastoma cell line was characterized by flow cytometry (fluorescence-activated cell sorting) analysis based on cluster of differentiation (CD) 133 and CD15 marker expression. U87MG and CGNH-89 cell lines were used as control. Distinct subpopulation analysis was performed by double staining of CD133 and CD15 in isolated primary glioblastoma cell line and its comparative control cells. RESULTS: Our isolated glioblastoma cells morphology was adherent cells which were able to form spheres depending on environment. Immunostaining confirmed GFAP, Ki-67, IDH-1 mutants, and PD-L1 expression. Our isolated glioblastoma cells expressed CD133 and CD15, coexpressed CD133/CD15 in different patterns. The highest subpopulation in primary glioblastoma was CD133+/CD15+. CONCLUSION: Glioblastoma cells can be isolated using enzymatic methods. Isolated glioblastoma cells consist of four different subpopulations distinguished by CD133/CD15 double staining. Intratumoral heterogeneity exists and directly or indirectly depends on their microenvironment

Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management

Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management. Cervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in the United States of America (2008), sixty seven percent involve cervical spine injury. American Spinal Cord Injury Association (ASIA) impairment score is used as an initial assessment but not enough attention prognostic outcome of these patients was paid to. The objective of this study is to analyze the value of functional independence measure (FIM) cervical spine injury patients with conservative management and its correlation with age, sex, type of trauma, onset of trauma, cervical abnormalities, type of cervical spine lesion and ASIA impairment score. A prospective cohort study was performed to all patients with cervical spine injury treated inNeurosurgery Department of Dr. Hasan Sadikin Hospital Bandung that fullfiled the inclusion criteria. The subjects were classified based on age, sex, single/multiple trauma, acute /chronic, cervical abnormalities, complete/incomplete lesion and ASIA impairment score. The FIM examination was performed in Outpatient clinic of Neurosurgery. T-test and chi-square test was done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital during April 2009–April 2010. The average FIM value of cervical spine injury in those patients is 4+ 1.63 by cohort prospective study. There were no correlation between FIM value with age, sex, type of trauma, onset of trauma and cervical abnormalities. Significant correlations were found between FIM value with type of cervical spine lesion and ASIA impairment score in cervical spine patients. Type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 6 months after cervical injury

Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management

Cervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in  the United States of America (2008), sixty seven percent involve cervical spine injury. American Spinal Cord Injury Association (ASIA) impairment score is used as an initial assessment but not enough attention prognostic outcome of these patients was paid to. The objective of this study is to analyze the value of functional independence measure (FIM) cervical spine injury patients with conservative management and its correlation with age, sex, type of trauma, onset of trauma, cervical abnormalities, type of cervical spine lesion and ASIA impairment score. A prospective cohort study was performed to all patients with cervical spine injury treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung that fullfiled the inclusion criteria. The subjects were classified based on age, sex, single/multiple trauma, acute/chronic, cervical abnormalities, complete/incomplete lesion and ASIA impairment score. The FIM examination was performed in Outpatient clinic of Neurosurgery. T-test and chi-square test was done to analyze the data. There were 17  cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital during April 2009–April 2010. The average FIM value of cervical spine injury in those patients is 4+1.63 by cohort prospective study. There were no correlation between FIM value with age, sex, type of trauma, onset of trauma and cervical abnormalities. Significant correlations were found between FIM value with type of cervical spine lesion and ASIA impairment score in cervical spine patients. Type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 6 months after cervical injury

High-Voltage Electrically Head Injury Presenting underlying Calvarial Osteomyelitis: Single Indonesian Tertiary Hospital Experience

Objective: To demonstrate the characteristic of high-voltage electrically head injury patients presenting underlying calvarial osteomyelitis.Methods: Retrospectively report of patients high-voltage electrically head injured with calvarial osteomyelitis from January 1st 2011 to December 31st 2013. The demographic variable namely age, sex, place of accident, present of calvarial osteomyelitis, Glasgow coma scale, surgical treatment type, grading of burn injury and total body surface area of burn (TBSA).Results: Eleven high-voltage electrically injured patients presenting with calvarial osteomyelitis, who admitted to the Emergency Unit Department of Neurosurgery Hasan Sadikin Hospital, All patients were males (100%). Their ages ranged between 24 and 51 years (average 23,7 years old) All patient (100%) suffered from calvarial osteomyelitis. Eight patient (77,7%) were high building worker at the time of incident, two patients were electric installation worker (18,18%). Entry point of electric wave 11 patients (100%) from head and outlet 11 patients (100%) from leg.Conclusion: Bone debridement in calvarial osteomyelitis is a difficult to treat infectious disease with a high relapse risk, cure is possible with appropriate treatment choices. Antibiotic treatment will provide more benefit if it is combined with appropriate and timely surgical treatment for both scalp and calvarial.</p

Cedera Kepala Berat Pada Pasien Hamil

Latar Belakang dan Tujuan: Cedera kepala pada wanita dengan kehamilan dapat meningkatkan resiko morbiditas dan mortalitas bagi ibu dan janinnya. Komplikasi yang dapat terjadi antara lain kematian ibu, syok, perdarahan intrauterin, kematian janin intrauterin, trauma janin, abruptio placenta, ruptur uterin. Penyebab tersering dari trauma tersebut antara lain kecelakaan lalulintas, terjatuh dari ketinggian, kekerasan dalam rumah tangga, dan luka tembak. Banyak penilaian dan penanganan yang unik untuk kasus ini, meskipun evaluasi awal dan resusitasi sasaran utama untuk menyelamatkan ibu. Setelah keadaan ibu stabil baru dilakukan evaluasi dan penilaian dari janin. Monitoring tokokardiografi, pemeriksaan ultrasound, CT-Scan kepala dapat dilakukan disertai dengan tindakan kraniotomi dan atau seksio sesarea. Subjek dan Metode: Penelitian observasional dari tahun 2008-2012, serial kasus, pada wanita hamil yang mengalami cedera kepala berat dan dilakukan operasi untuk evakuasi hematoma. Hasil: Selama 3 tahun terakhir telah dilakukan tindakan pembedahan untuk penderita cedera kepala dengan kehamilan sebanyak 3 kasus, dua diantaranya disertai dengan seksio sesarea. Simpulan: Kasus cedera kepala pada wanita dengan kehamilan tergolong jarang dan penanganan dini multidisiplin pada cedera kepala berat pada kehamilan dapat menurunkan risiko morbiditas dan mortalitas untuk ibu dan janin Severe Head Injury in Pregnant Patients Background and Objective: Head injury in pregnancy can increase the risks of mortality and morbidity, both for the mother and fetus. Common complications are including death, shock, intrauterine bleeding, intrauterine fetal death, fetal trauma, placental abruptio and, uterine rupture. Motor vehicle accident, falls, assault and gun shot wound are the primary cause of injury. Treatment and recognition of this cases are unique, even though the main target are early evaluation and resuscitation of the mother and afterward, the fetus. Tococardiography monitoring, ultrasound, and head CT Scan can be perform with or without craniotomy and caesarean section. Subject and Method: An observasional study taken from the year of 2008-2012, a serial case report in pregnant women with severe head injury undergoing operation for evacuation of hematoma. Result: During the last 3 years, three patients had underwent surgery for head injury with two of them underwent a sectio caesarean procedure. Conclusion: The incidence of head injury in pregnant women is considered very rare and an early multidiciplinary management for head injury in pregnancy can decrease the risk of morbidity and mortality for both the mother and the fetus

Atlas operasi ilmu bedah saraf: perdarahan epidural dan fraktur kompresi tengkorak

vii, 119 hlm. : ilus. ; 21 cm

Memahami gambaran mikroanatomi pada operasi bedah saraf

vii, 92 hal; 21 c