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Nasofrontal Mucocele Following after Craniotomy Procedure Hutagalung, Tommy Rizky; Mouza, Abdurrahman
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 2 No. 3 (2020): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v2i3.4623

Introduction : Mucocele is a chronic, expanding, mucosa-lined lesion of the paranasal sinus characterized by mucous retention that can be infected becoming a mucopyocele. They originate from obstruction of the sinus ostium by congenital anomalies, infection, inflammation, allergy, trauma (including surgery) or a benign or malignant tumor. The frontal sinuses are most commonly affected, and subsequently ethmoidal sinuses. Case Report : A 56 years old man, presented with a lump on the left and right forehead accompanied by a protruding left eye since 6 months and is getting wors. Patient with a history of craniectomy debridement surgery indicated for open depressed fracture due to an accident 12 years ago, then underwent a titanium mesh cranioplasty 11 years ago. From examination of the head CT scan revealed a solid mass lesion filling the left and right frontal sinuses expands into the left orbital cavity. Bifrontal craniotomy was performed on the patient. Discussion : Mucoceles are mucous-secreting expansive pseudocystic formations, and capable of expansion by virtue of a dynamic process of bone resorption and new bone formation. They result from obstruction of a sinus ostium and frequently are related to a previous condition as chronic sinusitis, trauma, surgery or expansible lesion. With continued secretion and accumulation mucus, the increasing pressure causes atrophy or erosion of the bone of the sinus, allowing the mucocele to expand in the path of less resistance. This may be into the orbit, adjacent sinuses, nasal cavity, intracranial or through the skin; intracranial and orbital extension were demonstrated in this patient. Conclusion : Frontal mucoceles are benign and curable, but early diagnosis and treatment of them is important. Open surgery remains a valid procedure in frontal mucoceles with orbital and/or intracranial extension and in cases where the district anatomy is unfavourable for a purely endonasal approach.

Epidemiology of Pediatric Brain Tumor in the Center of Referral Hospital in North Sumatera from 2013 -2017 Putra, Prawira; Tala, Ihsan Z; Dharmajaya, Ridha; Mouza, Abdurrahman; Tandean, Steven
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 1 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i1.1033

Brain tumors are the most common disease group of solid tumors in childhood, and children with brain tumors have a relatively poor survival rate. Epidemiologic data from a hospital-based registry provide the necessary information to obtain a full picture of the frequency of this disease, which is a great challenge in pediatric oncology. One hundred thirty four tumors in children between 0 and 17 years of age diagnosed between 2013 to 2017 were classified according the sex, and topography. Incidence of brain tumor in boys were higher than girls. From the registry data, the prevalence for boys was higher (67%). In the whole series, 54% were supratentorial, 46% infratentorial. The most common histopathologic pattern seen in the registry were pilocytic astrocytoma which accounts for 42 cases (31%) followed by medulloblastoma and craniopharygioma with the percentage of 25% and 18% respectively. The least histopathologic pattern of pediatric tumor seen in our center are diffuse astrocytoma and choroid plexus papiloma which was only seen in 1 patient for the last 5 years of our experience.

A Case Report : Massive Subdural Empyema Following Ventriculo-Peritoneal Shunt Placement in Child Patient Lizen, Nindi; Mouza, Abdurrahman
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 2 No. 2 (2020): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v2i2.4337

Background: Subdural empyema is a critical neurosurgical condition that arise from neurosurgical procedures, trauma, meningitis, sinusitis, or otogenic infection. Reported mortality rates vary from 4.4% to 24%. Ventriculoperitoneal (VP) shunt placement is one of the most common procedures and reported rates for shunt infections are relatively high. However, their association with subdural empyema is rare. Case Report: One years old boy who presented with fever, lethargy, and inability to walk was admitted to the hospital. He was undergone Vp-shunt 1 month ago because of hydrocephalus. At the time of admission, the child was alert, had a moderate right hemiparesis, and a macrocephalic appearance. An emergency CT scan showed well-circumscribed subdural empyema. Discussion: A craniotomy was performed, then thick fibrous capsule underlying the dura mater was encountered, finally the pus was totally removed. Postoperatively, he was fully alert with a marked motoric improvement. Diplococus gram positive was found. The patient was given appropriate antibiotic treatment for 3 weeks periode. Conclusion: Subdural empyema is an unusual complication of a VP-shunt. Although rare in children, it is still a neurosurgical problem. The combination of medication and surgery treatment in Subdural empyema resulted in a good response.

Comparative between Syndromic and Nonsyndromic Craniosynostosis: A Literature Review Rasyid, Fahmi; Mouza, Abdurrahman
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 2 No. 3 (2020): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v2i3.4779

Craniosynostosis (CS) refers to the premature fusion in the perinatal stage of one or multiple skull sutures, also denominated synostoses (sagittal, metopic, uni and bilateral coronal, and lamboidal), which are commonly accompanied by facial, trunk, and limb deformities. During normal human body and head development, cranial growth achieves approximately 80% of the adult size at birth and its definitive size between 2.5 and 3 years of age. In the fetal or newborn skull, the flat bones are separated by four fontanelles and six major cranial sutures that participate in this process. Hereby presented the literature review of syndromic and non-syndromic craniosynostosis.

Efficacy Comparison of Ventriculoperitoneal Shunt and Endoscopic Third Ventriculostomy as Treatment of Hydrocephalus in Children in Developing Countries: A Meta-Analysis Rasyid, Fahmi; Mouza, Abdurrahman
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 1 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v1i1.5887

Introduction: In Indonesia, cases of hydrocephalus in children are found in 40% to 50% of medical visits or neurosurgical operations. Endoscopic third ventriculostomy was one of choices for treat the patient but efficacy and effects still unknown. Purpose of this study is to broadly assess the outcome of treatments and review evidence that one treatment may have greater efficacy than another. Method: Researchers develop PICO questions. Demographic information, detailed methods, interventions, and results were extracted from the selected manuscripts. Of the 122 articles identified using optimized search parameters, 52 were withdrawn for full-text review. In total, 6 articles were accepted for inclusion in the evidentiary table and 8 were excluded for various reasons. Result: The tabulated evidence provides sufficient data to allow our evaluation of the CSF versus ETV shunt. Conclusion: CSF shunt and endoscopic third ventriculostomy (ETV) are options in the management of hydrocephalus in children

How Well Do We Know Neonatal Stroke: A Literature Review Sebayang, Moriko Madadoni; Mouza, Abdurrahman
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 2 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i2.6281

Neonatal stroke can be characterized as a cerebrovascular injury that happens between 20 weeks of fetal life and 28 days post-pregnancy life. The assessed frequency of neonatal stroke is between one of every 1600 and one out of 3000 live births which recommends that the neonatal period is the most engaged lifetime time of hazard for stroke. Utilizing the advances in neuroimaging which have assisted with characterizing explicit neonatal stroke sickness states, several topics consisting of pathophysiology, manifestation, diagnosis, and management of neonatal stroke are systematically reviewed in this study. The results confirm several points, namely: (1) Neonatal stroke is characterized as one of six explicit sickness states based on clinical show and neuroimaging discoveries. (2) Intense indicative assortments normally present with seizures, while assumed neonatal stroke assortments typically present with hemiparetic cerebral paralysis. (3) Across all types of neonatal stroke, causative systems are ineffectively perceived, featuring the requirement for extra investigations just as an alert in allotting causation.

Prevalence, Risk Factors and Demographic of Pediatric Hydrocephalus in RSUP H. Adam Malik Medan 2019-2020 Delrizal, Sulaiman; Mouza, Abdurrahman; Hutagalung, Tommy Rizky
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 2 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i2.6501

Introduction: Hydrocephalus is a disorder of the central nervous system which manifests as excess cerebrospinal fluid found in the head either inside the ventricular system or the subarachnoid space. The prevalence and demographics of congenital hydrocephalus remain poorly defined, in part because the definition of “congenital hydrocephalus” varies between studies; depending on the clinical criteria used to define congenital hydrocephalus, the prevalence has been reported between 1 and 32 per 10,000 live births. Previously known several risk factors include infection during pregnancy (toxoplasmosis, CMV, meningitis), family history hydrocephalus (less than 2%), premature pregnancy and low birth weight (which may increase the incidence of intraventricular hemorrhage). Method and Result : This Study was a descriptive study, we collected data from 2018-2019 at Haji Adam Malik General Hospital. From the data we found 58 cases of pediatric Hydrocephalus, with hydrocephalus obstructive 24 cases (41%) and communicans hydrocephalus 34 case ( 59%). Based on age, most samples were <6 months of age in both types of hydrocephalus. Most of the gender is male. Most of the GCS conditions at admission were GCS 13-15. The most common etiology in obstructive hydrocephalus cases was aquaduct stenosis in 13 cases (54%), while the most common etiology in cases of hydrocephalus communicans was infection in 22 cases (65%). Infection during pregnancy, low birth weight and premature pregnancy are thought to be the most risk factors found Discussion : Hydrocephalus is described as non communicating when it is caused by lesions that obstruct CSF flow through the ventricular system, such as fourth ventricular tumors. Communicating hydrocephalus is present when the lesion is at the level of the subarachnoid spaces, arachnoid granulations, or the venous system. Previously known several risk factors include infection during pregnancy, family history hydrocephalus, premature pregnancy and low birth weight.

Our Experience Of Pediatric Brain Tumour In Medan: Demographic Study In Adam Malik General Hospital 2019-2020 Mouza, Abdurrahman; Rasyid, Fahmi
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 3 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i3.7606

Abstract Introduction: Primary brain and central nervous system tumors are the most prevalent and frequent neoplasm in children and adolescents aged 0 to 19 years. Brain and CNS tumors are the second leading cause of cancer-related deaths in children and adolescents aged 0 to 19 years old. Previous studies in several countries have reported the incidence rate of primary brain and CNS tumors in children and adolescent, ranged from 1.08 to 5.57 per 100,000 population. The incidence of brain tumor in pediatric patients has increased in the past decades, due to innovations in the imaging studies and the increase of benign form diagnoses. The highest occurrence of pediatric brain tumor is in the United States. Based on the study by Rictherova et al. in 2018, according to the age groups, the highest incidence is in adolescents aging 15-19 years with 6.38 per 100,000 children, followed by children aging under 1 year with 6.2 per 100,000 children. Method: A total of 58 patients were reported in this study. Data was collected from medical bank data of Neurosurgical Department of Faculty of Medicine of North Sumatera in Indonesia. The variables that we collected were as follows: gender, tumor diagnosis, Glasgow-Coma Scale (GCS) score on admission, and age group. We classified age group into <1 year, 2-4 years, 5-9 years, 10-14 years, and 15-19 years old. The data was computed using the SPSS 25th edition. Result: Out of 58 diagnosis, boys were the predominance frequency with a total of 69% and girls were 31%. most patients had medulloblastoma (27.6%) followed by glioma (24.1%), craniopharyngioma (8.6%), and meningioma (8.6%). Other types of tumor, namely cerebral abscess, cerebromalacia, choroid plexus papilloma, craniopharyngioma, ependymoma, neurofibromatosis 1, soft tissue tumor, were accounted for 1.7%, respectively Discussion: Primary brain and central nervous system tumors are the most prevalent and frequent neoplasm in children and adolescents aged 0 to 19 years. Brain and CNS tumors are the second leading cause of cancer-related deaths in children and adolescents aged 0 to 19 years old. In our study, from a total of 58 patients, most of the patients (69%) were boys with a frequency of 40. Girls were only accounted for 18 (31%). A study by Stiller et al. in 2019 regarding incidence of childhood CNS tumors in Britain also reported similar result, with 2275 boys and 1891 girls out of 4166 tumor patients. The most common diagnosis was medulloblastoma (27.6%), in line with the study by Stiller et al. and Suresh et al. The most common age group with brain tumor was 10-14 years old (34.5%). Conclusion: Based on our study, from the total of 58 patients, most of the patients were boys (69%). The most common tumor diagnosis in our study was medulloblastoma (27.6%) followed by glioma (24.1%). The results in our study had been in line with other literatures. However, the age group distribution was not in line with other literatures as our study reported the age group of 10-14 years old having the highest percentage of brain tumors. Overall, this study had reported the demographic result of pediatric brain tumor in Adam Malik General Hospital from 2019-2020.

Giant Size Pilocytic Astrocytoma in Pediatric Patient : A Case Report Vegi, Oktama; Mouza, Abdurrahman; Kausar, T Akmal; Fadhlan, Rais; Arafat Husain, Syekh Ahmad
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 4 No. 2 (2022): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v4i2.8937

Introduction: Pilocytic astrocytomas are the most common primary tumor in children and adolescents, accounting for approximately 15.6% of all brain tumors and 5.4% of all gliomas. The incidence of tumors substantially decreases with age and diagnosis in patients older than 50 years is less common. According to the Central Brain Tumor Registry of the United States (CBTRUS), its development is more common in the first two decades of life and there are few reports in the age group over 18 years. Case Report: An 8-year-old girl was brought by her parents with complaints of loss of consciousness. This happened 2 days before admission to the hospital. The patient was prepared for craniotomy tumor removal. During the operation, the tumor specimen was sent to Anatomical Pathology for histopathological examination. The examination revealed calcified Rosenthal Fibers and eosinophilic granular bodies. Discussion : Astrocytic tumors originate from neuroepithelial tissue and are grade I because of their well-defined and slow-growing nature. They are mostly found in infratentorial structures such as the cerebellum and in the midline of brain structures such as the optic nerve, hypothalamus, and brainstem. However, it can be found anywhere on the neuroaxis. Considered relatively rare in adults, there are few publications on the most efficient treatment methods and subsequent patient outcomes. Conclusion: Pilocytic astrocytoma (PA) treated with complete or near complete tumor resection tends to have a better prognosis, recent studies recommend aggressive tumor resection without neurologic deficits.

Cisternostomy In Lipomyelomeningocele Without Hydrocephalus: A Case Report Mouza, Abdurrahman; Farhan, Luthfy; Sembiring, Arya Sadewa; Rasyid, Fahmi
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 4 No. 3 (2022): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v4i3.10380

Introduction: Spinal dysraphisms can be classified as either open or closed dysraphisms. Closed spinal dysraphisms such as lipomyelomeningocele, diastematomyelia, and spina bifida occulta have no exposed neural tissue and are accompanied by cutaneous markers in 43%–95% of cases, and include lesions such as subcutaneous masses, capillary hemangioma, dimples, and hairy nevus. These cutaneous markers can be used to recognize cases in an asymptomatic neonate. LMMC can be associated with additional pathologies, including Chiari malformation type 1 (13%), spina bifida (14.4%), split cord malformations (3.1%), associated dermal sinuses (3.1%), dermoid or epidermoid cysts (3.1%), diastematomyelia (3.1%), terminal hydromyelia (3.1%), anal stenosis (1.0%), and Down syndrome (1.0%). Case Report: A year old girl, came to our department with chief complaint of lump on the back since the patient was born. No history of increased intracranial pressure was complained. On physical examination, there is no maceration on the lump, and there is no sign of ruptured lump on the back. Patient also has active motoric on all extremity. We diagnosed the patient with spina bifida. We did CT scan of the head to rule out hydrocephalus and MRI for the confirmation of spina bifida. Excision of cele was done. Postoperatively, there is an increased of csf leak of the patient from the excised cele and we decided to do cisternostomy. After cisternotomy, there is no increased of leakage and patient also have good motoric function. Patient was treated in our outpatient clinic and has good recovery after surgery. Discussion: Lipomyelomeningocele is a rare but complicated defect, lying in the spectrum of occult neural tube defects. It is actually a form of occult spinal dysraphism in which a subcutaneous fibrofatty mass traverses the lumbodorsal fascia, causes a spinal laminar defect, displaces the dura, and infiltrates and tethers the spinal cord. Spinal lipomas and LMMCs are frequently associated with cutaneous and musculoskeletal abnormalities in addition to sensorimotor deficits and urological dysfunction. Cutaneous lesions include subcutaneous lipomas, capillary hemangiomas, complex dimples, and hypertrichosis, whereas complex malformations, such as dermal appendages, are rare. Magnetic resonance imaging is useful in demonstrating the presence of a fatty mass and cord tethering. Surgical objectives in a lipomyelomeningocele repair include removal of the adipose mass, identification of the defect in the lumbosacral fascia for release of the tether, possible release of the filum terminale, preservation of neural elements, and prevention of retethering of the spinal cord. After operation for lipomyelomeningocele, the cord may not be completely untethered, or after a short period may retether Discussion: Cisternostomy may be done in cases of spina bifida without hydrocephalus in our experience

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