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All Journal Asian Australasian Neuro and Health Science Journal (AANHS-J)
Lizen, Nindi
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Journal : Asian Australasian Neuro and Health Science Journal (AANHS-J)

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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

Abstract

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.
Improving Motoric Outcome after Early Craniectomy in Patient with Open Depressed Fracture Involving Motoric Cortex Area : A Case Report Husain, Syekh Ahmad Arafat; Hutagalung, Tommy Rizky; Lizen, Nindi; Mahyudanil
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.v3i1.5946

Abstract

Introduction : Traumatic brain injury  (TBI) remains a major public health problem worldwide. It is a leading cause of mortality and disability across the globe. Brain swelling and intracranial hypertension are well-recognized secondary insults associated with increased mortality and poorer outcomes. In majority of head injury cases, the incidence of depressed skull fracture is also increasing. When this situation involving in motoric cortex area, it can cause limb weakness and devastating effect. Case Report : We reported a 21 year old male patient came with complaints of decreased consciousness due to a motorcycle accident. On motoric examination, hemiplegia was found in the left limb. There was a open wound in the right fronto-parietal region, Head CT Scan revealed a depressed fracture in the right fronto-parietal region and  multiple contusions on the right frontal. Craniectomy procedures was performed. Post operatively there is an improvement in patient consciousness and motoric outcome. Discussion : Open depressed fracture is one of the most common traumatic brain injury (TBI). Prevent infection and saving traumatic penumbra is the main target of surgery in this case. The pathophysiological changes in the traumatic penumbra are dynamic processes, the development and outcome of TBI depends greatly on the progression of tissue damage in the traumatic penumbras. Early clinical treatment can effectively rescue the tissue which has the potential to recover and hinder the progression of secondary injury Conclusion : Traumatic brain injury (TBI) has high morbidity and mortality in worldwide. Time dependent progression has provided a window of opportunity to take interventional action and reduce secondary injury after TBI. Motoric outcome can improve with early management.
Co-Authors Husain, Syekh Ahmad Arafat Hutagalung, Tommy Rizky Mahyudanil Mouza, Abdurrahman