ajid risdianto - Academia.edu (original) (raw)

Papers by ajid risdianto

International Journal of General Medicine, Feb 1, 2023

Bali Medical Journal

Background: Degenerative spinal disease increases in proportion to life expectancy. Surgical trea... more Background: Degenerative spinal disease increases in proportion to life expectancy. Surgical treatments that play an essential role in the management of degenerative spinal disease have evolved from open surgery to minimally invasive surgery as well as endoscopic spinal surgery. Advanced pathological understanding, diagnostic imaging, and instrument progress have support for endoscopic spinal surgery. The study aims to report the current situation of endoscopic spinal surgery to treat degenerative spinal diseases in the Department of Neurosurgery of Kariadi Hospital.Method: Review the Endoscopy Spine Surgery case in the Department of Neurosurgery of Kariadi Hospital with degenerative spinal diseases including canal stenosis and disc herniation at all levels.Results: A total of 123 degenerative spinal diseases have been treated with endoscopic spinal surgery. Most of patients comes with HNP (89 patients, 72.4%) and operated in lumbal segment (87 patients, 70,7%). Estimated blood loss...

International Journal of General Medicine, 2020

Introduction: Corpus callosotomy (CCT) is a palliative procedure to treat injurious drop attacks ... more Introduction: Corpus callosotomy (CCT) is a palliative procedure to treat injurious drop attacks or multifocal/generalized seizures in which resection of the epileptogenic focus is not feasible. We are presenting our experience in treating intractable epilepsy patients by CCT procedures. Methods: We observed 16 patients who underwent callosotomy (male to female ratio 7:9; adult to pediatric ratio 3:13). Initial seizure frequency was reported ranged from 1 to 2 attacks daily to very often (more than 20 episodes daily). Results: Our observation showed that among patients with drop attacks, complete and >90% seizure freedom was reported by 4 and 6 of 13 patients, respectively (76.9% combined). Conclusion: Our observation showed that corpus callosotomy yielded good outcome in patients with intractable epilepsy in Indonesia. Our observation showed total callosotomy achieved complete seizure freedom better compared to partial callosotomy patients.

Current Nutrition & Food Science, 2021

Background: Meningioma is a pathological condition in the central nervous system (CNS), while obe... more Background: Meningioma is a pathological condition in the central nervous system (CNS), while obesity is defined as excess fat accumulation in the body, which is associated with adverse effects on health. Obesity is characterized by an increase in the Body Mass Index (BMI) and Waist Hip Ratio (WHR). Research on the relationship of BMI, and WHR with meningioma has been widely carried out in various countries of Europe, however, it has not been done much in the Asian countries, especially in Indonesia. Objective: To prove BMI and WHR as risk factors for the incidence of meningioma after being controlled by confounding variables of age and sex. Methods: This is a case-control research involving 44 meningioma patients and 44 family members as controls. The study was conducted at the outpatient clinic at Kariadi Doctors Hospital from May 2019 to June 2019. We collected data including age, sex, BMI, and WHR. Bivariate analysis using the Chi-square test and multivariate analysis with logis...

International Journal of Surgery Case Reports, 2020

INTRODUCTION: Penetrating cervical spinal cord injury (SCI) is a rare clinical entity that requir... more INTRODUCTION: Penetrating cervical spinal cord injury (SCI) is a rare clinical entity that requires a multitude of health care specialists for proper management. The unpredictable nature of penetrating SCI and complex systemic sequela contribute to the high mortality rates of penetrating SCI. PRESENTATION OF CASE: An 18-year-old-male patient was admitted to the emergency department with tetraparesis following a penetrating injury to the neck. Radiological examination revealed fractures of C4 and C5 spinous processes and extensive intradural pneumorrhachis. The patient was managed operatively with laminectomy, vertebral augmentation, and duroplasty. An acute decreased level of consciousness was observed four days after the operation. Laboratory investigation revealed critically low plasma sodium level. The patient remained decerebrated despite electrolyte correction and pronounced brain dead on the seventh postoperative day. DISCUSSION: Metabolic derangements and pulmonary physiologic changes following trauma are lethal complications. Hyponatremic encephalopathy and disrupted pulmonary function caused by high cervical compression by the extensive pneumorrhachis contributes to the morality in this case report. CONCLUSION: This case report presents a rare clinical entity along with its' complications. Prompt clinical stabilization, strict biochemical monitoring, and multidisciplinary care from health care specialists are mandatory for SCI patients.

Bali Medical Journal, 2020

Introduction: The main objective of the surgical procedure is to achieve maximum resections with ... more Introduction: The main objective of the surgical procedure is to achieve maximum resections with minimal functional neurological deficits for the patient with intrinsic tumors near the eloquent cortical area. The awake craniotomy procedure is currently the key option for achieving optimum safe resection. We report our two years of experience in establishing an awake craniotomy in the Kariadi General Hospital, evaluating the adoption of the technique and the outcome of the surgery.Methods: This is a retrospective study analyzed data from all patient's medical records, who have performed an awake craniotomy from January 2018 to January 2020 at Dr Kariadi General Hospital, Semarang, Indonesia. The specific anesthesia technique designated for this procedure was adopted. Sonography was introduced to determine the border of the tumor before and after surgery. Phase reversal using the cortical grid was used to recognize the central sulcus, motor and sensory cortex. Cortical stimulati...

Scientific Reports, 2020

Approximately 26–30% of temporal lobe epilepsy (TLE) cases display a normal-appearing magnetic re... more Approximately 26–30% of temporal lobe epilepsy (TLE) cases display a normal-appearing magnetic resonance image (MRI) leading to difficulty in determining the epileptogenic focus. This causes challenges in surgical management, especially in countries with limited resources. The medical records of 154 patients with normal-appearing MRI TLE who underwent epilepsy surgery between July 1999 and July 2019 in our epilepsy centre in Indonesia were examined. The primary outcome was the Engel classification of seizures. Anterior temporal lobectomy was performed in 85.1% of the 154 patients, followed by selective amygdalo-hippocampectomy and resection surgery. Of 82 patients (53.2%), Engel Class I result was reported in 69.5% and Class II in 25.6%. The median seizure-free period was 13 (95% CI,12.550–13.450) years, while the seizure-free rate at 5 and 12 years follow-up was 96.3% and 69.0%, respectively. Patients with a sensory aura had better seizure-free outcome 15 (11.575–18.425) years. Ant...

Bali Medical Journal, 2019

Background: Even with optimized anti-epileptic medications, 30% of epilepsy patients will be refr... more Background: Even with optimized anti-epileptic medications, 30% of epilepsy patients will be refractory and this condition leads to cognitive and psychosocial decline, resulting in worse quality of life and higher mortality. With 0,75% prevalence, there are more than 2.0 million epileptic in Indonesia, about 360.000 will be refractory, and half of them are potential candidates for epilepsy surgery (ES). After 17 years since the first ES on July 1999, number of ES increases every year reaching around 50 cases per year. By the end of 2017, the total number reached 615 and most was temporal lobe epilepsy (TLE) cases. Pre-surgical investigations were compared in relation to the seizure free results between the first five-year and the recent twelve-year. Despite the excellent result shown, all of these ES were still performed in Semarang (Diponegoro University), and demographic analysis showed that 80% patients came from Java-Bali area. So that new basic centers capable of performing ES for simple TLE cases are desperately needed to improve treatment for refractory epilepsy cases elsewhere. Material and methods: Until the end of 2017, there were 615 ES cases, including 514 Temporal Lobe Epilepsies (TLEs). Pre-surgical investigations were grouped as Simple (MRI with specific protocol and routine EEG), Difficult (needs long-term ictal EEG, and /or PET CT), and Complex (needs invasive or intracranial/ subdural grid EEG, and or Electrocorticography/ ECoG during the surgery). For the first five year-period, besides seizure semiology, decision to operate were based on MRI and routine EEG (Simple) in 54 out of 56 (96,4%) TLE cases. One patient had long-term ictal EEG and another had subdural grid EEG implanted, both patients showed visually normal MRI. But for the recent twelve-year, Simple TLEs occupy only 234 out of 458 (51%) TLE cases. Long-term ictal EEG were performed in 161 patients (35,2%), PET study in 39 patients (8,5%), subdural grid EEG in 30 patients (6,5%), and ECoG in 61 patients (13,3%). Results: As a new ES center performing only simple TLE cases, our surgical results were Class I: 82%, Class II: 11%, and Class III: 7% (9). As a semi advance ES center (after more than 5 years, and only half were simple ES cases), the Class I or seizure free results were 78,7% for simple TLEs, 73,4% for Difficult TLEs, and 65,2% for Complex TLEs. Demographic distribution showed that almost 80% of ES patients came from Java-Bali area, and half of them were from Central Java Province with Semarang as its capital. Patients from other parts of the country were scarce, especially from remotely located islands of East Indonesia. Conclusion: For the first five year,-as a basic ES center-we relay most on good MRI besides detailed study on seizure semiology and routine EEG. The Class I or Seizure Free result was best in the Simple TLEs with MRI showing discrete unilateral lesion in the temporal lobe. With 17 years experience, and a structured ES program including those patients needed invasive pre-surgical investigations, Semarang is a semi-advance center capable for research and training. This fact should encourage hospitals with micro-neurosurgical capabilities to initiate a new Basic ES Center by sending their neurologist and neurosurgeon to Semarang, so that ES services may become available to PWEs in all part of Indonesia.

Bali Medical Journal, 2019

Background: Exposure of the shunt is a rare but severe complication after ventriculoperitoneal (V... more Background: Exposure of the shunt is a rare but severe complication after ventriculoperitoneal (VP) shunt placement. It is unclear whether particular levels of cerebrospinal fluids (CSF) protein, glucose, or polymorphonuclears (PMNs) may influence the shunt exposure in high-risk individuals. This study aims to find the relation between CSF parameters and shunt exposure. Methods: Examined preoperative CSF characteristics included CSF colour, protein, glucose, and PMNs content in 513 patients with hydrocephalus. Mann-Whitney test was used to determine the correlation between CSF parameters and shunt exposure. Results: Shunt exposure was detected in 25 cases (4.87%). There was a significant relationship between distal tip exposure with preoperative glucose (p=0.000), protein level (p=0.007), or PMNs count (p=0.043). Conclusion: Preoperative CSF contents had a significant correlation with shunt exposure in hydrocephalus patients.

Bangladesh Journal of Medical Science, 2020

Objective: Among imaging modalities, ultrasonography (US) is one of the most versatilechoice, wit... more Objective: Among imaging modalities, ultrasonography (US) is one of the most versatilechoice, with its low cost, lack of radiation exposure, and minimally disrupted surgery flow.We described the use and characteristics of intraoperative ultrasonography (US) in selectedcases in our center to assist the intracranial tumor resection. Methods :Seventy patients wereoperated from 2011 to 2018 at Kariadi Hospital with the help of intraoperative US. Fifty sixpercents of cases were cystic tumors, 25% were abscess and 19% were metastatic tumors Weused seven parameters to measure the utility of intraoperative US and a utility score was devised(0 minimum, 7 maximum). Results: The utility score for intraoperative US was 7 in 3 cases(4%), 6 in 28 cases (54%), 5 in 21 cases (31%), 4 in 8 cases (11%), while no case had score ≤3. Conclusion: Intraoperative US is not only helpful in localizing lesions but also it can be usedin determining the morphology of the lesion for some cases, which was glioma ...

Epilepsy & Behavior Reports, 2019

Hemispherotomy is a surgical treatment indicated in patients with drug-resistant epilepsy due to ... more Hemispherotomy is a surgical treatment indicated in patients with drug-resistant epilepsy due to unilateral hemispheric pathology. Hemispherotomy is less invasive compared with hemispherectomy. We reviewed our experience performing 24 hemispherotomy and report the results of 16 patients with prolonged follow-up of this relatively uncommon procedure in two centers in Indonesia. This is a retrospective observational study conducted from 1999 to July 2019 in two epilepsy neurosurgical centers in Semarang, Indonesia. Surgical techniques included vertical parasagittal hemispherotomy (VPH), peri-insular hemispherotomy (PIH), and modified PIH called the Shimizu approach (SA). The postoperative assessment was carried out using the Engel classification system of seizure outcome. Seizure freedom (Engel class I) outcome was achieved in 10 patients (62.5%), class II in 3 patients (18.7%), class III in 2 patients (12.5%), and class IV in 1 patient (6.3%) with follow-up duration spanning from 24 to 160 months. To the best of our knowledge, this series is the most extensive documentation of hemispherotomy in an Indonesian population.

Majalah Kedokteran Bandung, 2012

Peningkatan tekanan intrakranial masih menjadi penyebab utama kematian pada penderita cedera kepa... more Peningkatan tekanan intrakranial masih menjadi penyebab utama kematian pada penderita cedera kepala. Penggunaan obat baru sebagai terapi osmosis diharapkan mampu menurunkan tekanan intrakranial. Penelitian prospektif, samar ganda, acak dilakukan terhadap 20 penderita cedera kepala berat di Unit Gawat Darurat (UGD) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Februari-Juli 2009. Penderita dikelompokkan dalam 2 kelompok yang mendapat terapi manitol atau natrium laktat. Dilakukan pengukuran tekanan intrakranial, kadar laktat, kadar natrium, serta kalium sebelum dan sesudah terapi osmosis dengan uji Shapiro-Wilk untuk analisis distribusi dan uji t berpasangan atau uji Wilcoxon untuk perbandingan rata-rata mempergunakan program statistical products and solution services (SPSS). Kelompok natrium laktat mengalami penurunan tekanan intrakranial (p<0,001) serta kenaikan kadar laktat (p=0,035). Kelompok manitol mengalami penurunan tekanan intrakranial (p=0,005) dan perubahan kadar laktat (p=0,135). Kadar natrium dan kalium pada kedua kelompok tidak terdapat perubahan yang bermakna. Penurunan tekanan intrakranial kelompok manitol dan natrium laktat tidak berbeda bermakna (p=0,417). Kadar laktat antara kelompok natrium laktat dan manitol berbeda bermakna (p=0,016), yaitu kenaikan kadar laktat yang lebih tinggi pada kelompok natrium laktat. Simpulan, pemberian natrium laktat dan manitol sama efektifnya menurunkan tekanan intrakranial pada penderita cedera kepala berat. Pemberian natrium laktat meningkatkan kadar laktat secara bermakna dibandingkan dengan pemberian manitol. Tidak terdapat perbedaan bermakna kadar natrium dan kalium pada kedua kelompok penelitian. [MKB. 2012;44(1):26-31].

Bali Medical Journal, 2021

Introduction: Spinal tumors are rare lesions. The incidence of spinal tumors is about 0.5-2.5 cas... more Introduction: Spinal tumors are rare lesions. The incidence of spinal tumors is about 0.5-2.5 cases per 100,000 population per year.1 Thirty percent of spinal tumors are located intradural. Twenty to thirty percent of intradural tumors are schwannoma and spinal neurofibroma.2 Surgery is the leading choice for schwannomas and neurofibromas that grow progressively or cause neurological deficits.2,3,4 Currently, minimally invasive surgery is developing rapidly, including minimally invasive surgery on spine surgery.Better outcomes are expected in endoscopic spine surgery compared to conventional spine surgery techniques.This paper aims to provide an overview of endoscopic procedures for the surgical removal of spinal tumors.Case description: A 59-year-old man presented paraplegia of both lower limbs. The patient complained difficulty walking for nine months before admitted to the hospital. The patient also complained of difficulty moving both of his legs, burning pain sensation, pain an...

Cedera kepala masih menjadi kasus yang banyak di hadapi oleh dokter dalam praktek sehari-hari. Ti... more Cedera kepala masih menjadi kasus yang banyak di hadapi oleh dokter dalam praktek sehari-hari. Tingkat morbiditas dan mortalitas karena cedera kepala masih tinggi, karena itu penanganan yang baik diperlukan agar pendrita cedera kepala dapat terselamatkan. Selama ini buku yang memberikan cara penanganan penderita cedera kepala masih jarang ditemui. Kehadiran buku ini di harapkan mampu mengisi kekosongan buku pegangan yang dapat di jadikan acuan untuk penanganan penderita cedera kepala.

International Journal of General Medicine, Feb 1, 2023

Bali Medical Journal

Background: Degenerative spinal disease increases in proportion to life expectancy. Surgical trea... more Background: Degenerative spinal disease increases in proportion to life expectancy. Surgical treatments that play an essential role in the management of degenerative spinal disease have evolved from open surgery to minimally invasive surgery as well as endoscopic spinal surgery. Advanced pathological understanding, diagnostic imaging, and instrument progress have support for endoscopic spinal surgery. The study aims to report the current situation of endoscopic spinal surgery to treat degenerative spinal diseases in the Department of Neurosurgery of Kariadi Hospital.Method: Review the Endoscopy Spine Surgery case in the Department of Neurosurgery of Kariadi Hospital with degenerative spinal diseases including canal stenosis and disc herniation at all levels.Results: A total of 123 degenerative spinal diseases have been treated with endoscopic spinal surgery. Most of patients comes with HNP (89 patients, 72.4%) and operated in lumbal segment (87 patients, 70,7%). Estimated blood loss...

International Journal of General Medicine, 2020

Introduction: Corpus callosotomy (CCT) is a palliative procedure to treat injurious drop attacks ... more Introduction: Corpus callosotomy (CCT) is a palliative procedure to treat injurious drop attacks or multifocal/generalized seizures in which resection of the epileptogenic focus is not feasible. We are presenting our experience in treating intractable epilepsy patients by CCT procedures. Methods: We observed 16 patients who underwent callosotomy (male to female ratio 7:9; adult to pediatric ratio 3:13). Initial seizure frequency was reported ranged from 1 to 2 attacks daily to very often (more than 20 episodes daily). Results: Our observation showed that among patients with drop attacks, complete and >90% seizure freedom was reported by 4 and 6 of 13 patients, respectively (76.9% combined). Conclusion: Our observation showed that corpus callosotomy yielded good outcome in patients with intractable epilepsy in Indonesia. Our observation showed total callosotomy achieved complete seizure freedom better compared to partial callosotomy patients.

Current Nutrition & Food Science, 2021

Background: Meningioma is a pathological condition in the central nervous system (CNS), while obe... more Background: Meningioma is a pathological condition in the central nervous system (CNS), while obesity is defined as excess fat accumulation in the body, which is associated with adverse effects on health. Obesity is characterized by an increase in the Body Mass Index (BMI) and Waist Hip Ratio (WHR). Research on the relationship of BMI, and WHR with meningioma has been widely carried out in various countries of Europe, however, it has not been done much in the Asian countries, especially in Indonesia. Objective: To prove BMI and WHR as risk factors for the incidence of meningioma after being controlled by confounding variables of age and sex. Methods: This is a case-control research involving 44 meningioma patients and 44 family members as controls. The study was conducted at the outpatient clinic at Kariadi Doctors Hospital from May 2019 to June 2019. We collected data including age, sex, BMI, and WHR. Bivariate analysis using the Chi-square test and multivariate analysis with logis...

International Journal of Surgery Case Reports, 2020

INTRODUCTION: Penetrating cervical spinal cord injury (SCI) is a rare clinical entity that requir... more INTRODUCTION: Penetrating cervical spinal cord injury (SCI) is a rare clinical entity that requires a multitude of health care specialists for proper management. The unpredictable nature of penetrating SCI and complex systemic sequela contribute to the high mortality rates of penetrating SCI. PRESENTATION OF CASE: An 18-year-old-male patient was admitted to the emergency department with tetraparesis following a penetrating injury to the neck. Radiological examination revealed fractures of C4 and C5 spinous processes and extensive intradural pneumorrhachis. The patient was managed operatively with laminectomy, vertebral augmentation, and duroplasty. An acute decreased level of consciousness was observed four days after the operation. Laboratory investigation revealed critically low plasma sodium level. The patient remained decerebrated despite electrolyte correction and pronounced brain dead on the seventh postoperative day. DISCUSSION: Metabolic derangements and pulmonary physiologic changes following trauma are lethal complications. Hyponatremic encephalopathy and disrupted pulmonary function caused by high cervical compression by the extensive pneumorrhachis contributes to the morality in this case report. CONCLUSION: This case report presents a rare clinical entity along with its' complications. Prompt clinical stabilization, strict biochemical monitoring, and multidisciplinary care from health care specialists are mandatory for SCI patients.

Bali Medical Journal, 2020

Introduction: The main objective of the surgical procedure is to achieve maximum resections with ... more Introduction: The main objective of the surgical procedure is to achieve maximum resections with minimal functional neurological deficits for the patient with intrinsic tumors near the eloquent cortical area. The awake craniotomy procedure is currently the key option for achieving optimum safe resection. We report our two years of experience in establishing an awake craniotomy in the Kariadi General Hospital, evaluating the adoption of the technique and the outcome of the surgery.Methods: This is a retrospective study analyzed data from all patient's medical records, who have performed an awake craniotomy from January 2018 to January 2020 at Dr Kariadi General Hospital, Semarang, Indonesia. The specific anesthesia technique designated for this procedure was adopted. Sonography was introduced to determine the border of the tumor before and after surgery. Phase reversal using the cortical grid was used to recognize the central sulcus, motor and sensory cortex. Cortical stimulati...

Scientific Reports, 2020

Approximately 26–30% of temporal lobe epilepsy (TLE) cases display a normal-appearing magnetic re... more Approximately 26–30% of temporal lobe epilepsy (TLE) cases display a normal-appearing magnetic resonance image (MRI) leading to difficulty in determining the epileptogenic focus. This causes challenges in surgical management, especially in countries with limited resources. The medical records of 154 patients with normal-appearing MRI TLE who underwent epilepsy surgery between July 1999 and July 2019 in our epilepsy centre in Indonesia were examined. The primary outcome was the Engel classification of seizures. Anterior temporal lobectomy was performed in 85.1% of the 154 patients, followed by selective amygdalo-hippocampectomy and resection surgery. Of 82 patients (53.2%), Engel Class I result was reported in 69.5% and Class II in 25.6%. The median seizure-free period was 13 (95% CI,12.550–13.450) years, while the seizure-free rate at 5 and 12 years follow-up was 96.3% and 69.0%, respectively. Patients with a sensory aura had better seizure-free outcome 15 (11.575–18.425) years. Ant...

Bali Medical Journal, 2019

Background: Even with optimized anti-epileptic medications, 30% of epilepsy patients will be refr... more Background: Even with optimized anti-epileptic medications, 30% of epilepsy patients will be refractory and this condition leads to cognitive and psychosocial decline, resulting in worse quality of life and higher mortality. With 0,75% prevalence, there are more than 2.0 million epileptic in Indonesia, about 360.000 will be refractory, and half of them are potential candidates for epilepsy surgery (ES). After 17 years since the first ES on July 1999, number of ES increases every year reaching around 50 cases per year. By the end of 2017, the total number reached 615 and most was temporal lobe epilepsy (TLE) cases. Pre-surgical investigations were compared in relation to the seizure free results between the first five-year and the recent twelve-year. Despite the excellent result shown, all of these ES were still performed in Semarang (Diponegoro University), and demographic analysis showed that 80% patients came from Java-Bali area. So that new basic centers capable of performing ES for simple TLE cases are desperately needed to improve treatment for refractory epilepsy cases elsewhere. Material and methods: Until the end of 2017, there were 615 ES cases, including 514 Temporal Lobe Epilepsies (TLEs). Pre-surgical investigations were grouped as Simple (MRI with specific protocol and routine EEG), Difficult (needs long-term ictal EEG, and /or PET CT), and Complex (needs invasive or intracranial/ subdural grid EEG, and or Electrocorticography/ ECoG during the surgery). For the first five year-period, besides seizure semiology, decision to operate were based on MRI and routine EEG (Simple) in 54 out of 56 (96,4%) TLE cases. One patient had long-term ictal EEG and another had subdural grid EEG implanted, both patients showed visually normal MRI. But for the recent twelve-year, Simple TLEs occupy only 234 out of 458 (51%) TLE cases. Long-term ictal EEG were performed in 161 patients (35,2%), PET study in 39 patients (8,5%), subdural grid EEG in 30 patients (6,5%), and ECoG in 61 patients (13,3%). Results: As a new ES center performing only simple TLE cases, our surgical results were Class I: 82%, Class II: 11%, and Class III: 7% (9). As a semi advance ES center (after more than 5 years, and only half were simple ES cases), the Class I or seizure free results were 78,7% for simple TLEs, 73,4% for Difficult TLEs, and 65,2% for Complex TLEs. Demographic distribution showed that almost 80% of ES patients came from Java-Bali area, and half of them were from Central Java Province with Semarang as its capital. Patients from other parts of the country were scarce, especially from remotely located islands of East Indonesia. Conclusion: For the first five year,-as a basic ES center-we relay most on good MRI besides detailed study on seizure semiology and routine EEG. The Class I or Seizure Free result was best in the Simple TLEs with MRI showing discrete unilateral lesion in the temporal lobe. With 17 years experience, and a structured ES program including those patients needed invasive pre-surgical investigations, Semarang is a semi-advance center capable for research and training. This fact should encourage hospitals with micro-neurosurgical capabilities to initiate a new Basic ES Center by sending their neurologist and neurosurgeon to Semarang, so that ES services may become available to PWEs in all part of Indonesia.

Bali Medical Journal, 2019

Background: Exposure of the shunt is a rare but severe complication after ventriculoperitoneal (V... more Background: Exposure of the shunt is a rare but severe complication after ventriculoperitoneal (VP) shunt placement. It is unclear whether particular levels of cerebrospinal fluids (CSF) protein, glucose, or polymorphonuclears (PMNs) may influence the shunt exposure in high-risk individuals. This study aims to find the relation between CSF parameters and shunt exposure. Methods: Examined preoperative CSF characteristics included CSF colour, protein, glucose, and PMNs content in 513 patients with hydrocephalus. Mann-Whitney test was used to determine the correlation between CSF parameters and shunt exposure. Results: Shunt exposure was detected in 25 cases (4.87%). There was a significant relationship between distal tip exposure with preoperative glucose (p=0.000), protein level (p=0.007), or PMNs count (p=0.043). Conclusion: Preoperative CSF contents had a significant correlation with shunt exposure in hydrocephalus patients.

Bangladesh Journal of Medical Science, 2020

Objective: Among imaging modalities, ultrasonography (US) is one of the most versatilechoice, wit... more Objective: Among imaging modalities, ultrasonography (US) is one of the most versatilechoice, with its low cost, lack of radiation exposure, and minimally disrupted surgery flow.We described the use and characteristics of intraoperative ultrasonography (US) in selectedcases in our center to assist the intracranial tumor resection. Methods :Seventy patients wereoperated from 2011 to 2018 at Kariadi Hospital with the help of intraoperative US. Fifty sixpercents of cases were cystic tumors, 25% were abscess and 19% were metastatic tumors Weused seven parameters to measure the utility of intraoperative US and a utility score was devised(0 minimum, 7 maximum). Results: The utility score for intraoperative US was 7 in 3 cases(4%), 6 in 28 cases (54%), 5 in 21 cases (31%), 4 in 8 cases (11%), while no case had score ≤3. Conclusion: Intraoperative US is not only helpful in localizing lesions but also it can be usedin determining the morphology of the lesion for some cases, which was glioma ...

Epilepsy & Behavior Reports, 2019

Hemispherotomy is a surgical treatment indicated in patients with drug-resistant epilepsy due to ... more Hemispherotomy is a surgical treatment indicated in patients with drug-resistant epilepsy due to unilateral hemispheric pathology. Hemispherotomy is less invasive compared with hemispherectomy. We reviewed our experience performing 24 hemispherotomy and report the results of 16 patients with prolonged follow-up of this relatively uncommon procedure in two centers in Indonesia. This is a retrospective observational study conducted from 1999 to July 2019 in two epilepsy neurosurgical centers in Semarang, Indonesia. Surgical techniques included vertical parasagittal hemispherotomy (VPH), peri-insular hemispherotomy (PIH), and modified PIH called the Shimizu approach (SA). The postoperative assessment was carried out using the Engel classification system of seizure outcome. Seizure freedom (Engel class I) outcome was achieved in 10 patients (62.5%), class II in 3 patients (18.7%), class III in 2 patients (12.5%), and class IV in 1 patient (6.3%) with follow-up duration spanning from 24 to 160 months. To the best of our knowledge, this series is the most extensive documentation of hemispherotomy in an Indonesian population.

Majalah Kedokteran Bandung, 2012

Peningkatan tekanan intrakranial masih menjadi penyebab utama kematian pada penderita cedera kepa... more Peningkatan tekanan intrakranial masih menjadi penyebab utama kematian pada penderita cedera kepala. Penggunaan obat baru sebagai terapi osmosis diharapkan mampu menurunkan tekanan intrakranial. Penelitian prospektif, samar ganda, acak dilakukan terhadap 20 penderita cedera kepala berat di Unit Gawat Darurat (UGD) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Februari-Juli 2009. Penderita dikelompokkan dalam 2 kelompok yang mendapat terapi manitol atau natrium laktat. Dilakukan pengukuran tekanan intrakranial, kadar laktat, kadar natrium, serta kalium sebelum dan sesudah terapi osmosis dengan uji Shapiro-Wilk untuk analisis distribusi dan uji t berpasangan atau uji Wilcoxon untuk perbandingan rata-rata mempergunakan program statistical products and solution services (SPSS). Kelompok natrium laktat mengalami penurunan tekanan intrakranial (p<0,001) serta kenaikan kadar laktat (p=0,035). Kelompok manitol mengalami penurunan tekanan intrakranial (p=0,005) dan perubahan kadar laktat (p=0,135). Kadar natrium dan kalium pada kedua kelompok tidak terdapat perubahan yang bermakna. Penurunan tekanan intrakranial kelompok manitol dan natrium laktat tidak berbeda bermakna (p=0,417). Kadar laktat antara kelompok natrium laktat dan manitol berbeda bermakna (p=0,016), yaitu kenaikan kadar laktat yang lebih tinggi pada kelompok natrium laktat. Simpulan, pemberian natrium laktat dan manitol sama efektifnya menurunkan tekanan intrakranial pada penderita cedera kepala berat. Pemberian natrium laktat meningkatkan kadar laktat secara bermakna dibandingkan dengan pemberian manitol. Tidak terdapat perbedaan bermakna kadar natrium dan kalium pada kedua kelompok penelitian. [MKB. 2012;44(1):26-31].

Bali Medical Journal, 2021

Introduction: Spinal tumors are rare lesions. The incidence of spinal tumors is about 0.5-2.5 cas... more Introduction: Spinal tumors are rare lesions. The incidence of spinal tumors is about 0.5-2.5 cases per 100,000 population per year.1 Thirty percent of spinal tumors are located intradural. Twenty to thirty percent of intradural tumors are schwannoma and spinal neurofibroma.2 Surgery is the leading choice for schwannomas and neurofibromas that grow progressively or cause neurological deficits.2,3,4 Currently, minimally invasive surgery is developing rapidly, including minimally invasive surgery on spine surgery.Better outcomes are expected in endoscopic spine surgery compared to conventional spine surgery techniques.This paper aims to provide an overview of endoscopic procedures for the surgical removal of spinal tumors.Case description: A 59-year-old man presented paraplegia of both lower limbs. The patient complained difficulty walking for nine months before admitted to the hospital. The patient also complained of difficulty moving both of his legs, burning pain sensation, pain an...

Cedera kepala masih menjadi kasus yang banyak di hadapi oleh dokter dalam praktek sehari-hari. Ti... more Cedera kepala masih menjadi kasus yang banyak di hadapi oleh dokter dalam praktek sehari-hari. Tingkat morbiditas dan mortalitas karena cedera kepala masih tinggi, karena itu penanganan yang baik diperlukan agar pendrita cedera kepala dapat terselamatkan. Selama ini buku yang memberikan cara penanganan penderita cedera kepala masih jarang ditemui. Kehadiran buku ini di harapkan mampu mengisi kekosongan buku pegangan yang dapat di jadikan acuan untuk penanganan penderita cedera kepala.