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All Journal Althea Medical Journal MNJ (Malang Neurology Journal) Universa Medicina Majalah Kedokteran Neurosains Biomolecular and Health Science Journal Indian Journal of Forensic Medicine & Toxicology AKSONA
Achmad Firdaus Sani, Achmad Firdaus
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga; RSUD Dr. Soetomo, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Safety of cerebral digital subtraction angiography : complication rate analysis Usman, Fritz Sumantri; Sani, Achmad Firdaus; Husain, Shakir
Universa Medicina Vol 31, No 1 (2012)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2012.v31.27-33

Abstract

Background Cerebral digital subtraction angiography (DSA) continues to be used for the examination of patients with cerebrovascular diseases. In the past decade, safer contrast agents have been used and there have been important technical advances including smaller catheters, hydrophylic guide wires, and digital imaging systems. The objective of this study was to determine the neurological complication rates of cerebral angiography performed for inpatients. MethodsA prospective study was conducted from January 2009 until December 2011. The patient’s demographic characteristics, the procedural details as well as complications appearing during and after the procedure were documented. Neurological complications are classified based on the international classification: (a) transient, disappearing within 24 hours; (b) reversible, lasting more than 24 hours but less than 7 days; (c) permanent, if the complication last for more than 7 days. The complications were examined by a neurologist.ResultsThe patients comprised 82 (41%) women and 118 (59%) men, ranging from 11 to 86 years of age. From 200 patients who underwent the procedure, permanent neurological complications were found in 1 (0.50 %) patient. Neither reversible nor transient neurological complications were found. ConclusionThe cerebral digital subtraction angiography procedure, when conducted by a neuro interventionist, is relatively save, both from the aspect of neurological and non-neurological complications, and from the number of deaths. The overall neurological complication rate fell within the limits recommended by quality improvement and safe practice guidelines.
Higher mean arterial pressure increases risk of in-hospital mortality in aneurysmal subarachnoid hemorrhage Ramadhania, Nadya Noor; Darmawan, Ahmad Faisal; Sani, Achmad Firdaus
Universa Medicina Vol. 39 No. 3 (2020)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2020.v39.153-161

Abstract

Background The majority (80%) of spontaneous subarachnoid hemorrhage (SAH) cases are caused by cerebral aneurysm rupture. The reported case fatality rate of aneurysmal SAH is still as high as 25 to 50%. Even though studies on aneurysmal SAH have been conducted, the mechanism and factors contributing to its mortality have not yet been clearly understood. The present study aimed to determine the predictors of mortality in aneurysmal SAH.Methods This was an observational analytic cross-sectional study. Data of 264 patients with aneurysmal SAH was obtained retrospectively from the medical records. Age, degree of consciousness, blood pressure, absence of aneurysmal treatment and mortality were collected. The simple and multiple logistic regression were used to analyze the data.Results The in-hospital mortality rate of aneurysmal SAH was still very high, with 140 (53.1%) patients dying during hospitalization. Simple logic regression analysis showed that patients with older age, lower Glasgow Coma Scale (GCS) score, higher mean arterial pressure (MAP) and no aneurysm treatment had higher in-hospital mortality risk. However, multivariate logistic regression showed that the strongest in-hospital mortality predictor was higher MAP (aOR 2.29; p=0.025), while younger age (aOR 0.39; p=0.006) and aneurysm treatment (aOR 0.34; p=0.006) were independent protective factors against in-hospital death.Conclusion Patients with higher mean arterial pressure on initial measurement had higher risks of mortality. More endovascular neurointervention facilities are needed to decrease the mortality rate of aneurysmal SAH.
A RARE CASE OF RUPTURED ANEURYSM AT THE ORIGIN OF INFERIOR PART OF DUPLICATED MIDDLE CEREBRAL ARTERY Sani, Achmad Firdaus; Kurniawan, Dedy
Malang Neurology Journal Vol 7, No 2 (2021): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.02.13

Abstract

Duplicated middle cerebral artery (DMCA) is an anomalous vessel arises from the internal carotid artery (ICA). This anatomical variation is rare. Aneurysm with this anatomical variation and unusual form was very rare. Even though this kind of aneurysm is rare, it was often ruptured. In this paper, we report a case of  40-years old female with abrupt decreased of consciousness as a chief complaint, along with severe headache one day earlier, no history of head trauma, and there was nuchal rigidity. She didn’t had history of hypertension before. Head computed tomography showed subarachnoid hemmorrhage (SAH) mostly on the left sylvian fissure with Hunt and Hess scale was 3 and Fisher scale was 2, while the cerebral angiography showed duplication of the left middle cerebral artery in which the inferior part of the MCA duplication has ruptured aneurysm at the origin. Treatment option for this aneurysm is endovascular coiling with preserved of the inferior part of duplicated MCA. Result of this treatment shows a good outcome.
TINGKAT KEAMANAN CEREBRAL DIGITAL SUBSTRACTION ANGIOGRAPHY PADA ANAK DI BEBERAPA RUMAH SAKIT DI INDONESIA Fritz Sumantri Usman, Achmad Firdaus Sani, Yuwono, Ashari Bahar, Tommy Rachmat Setyawan, Iskandar Na
NEURONA Vol 32 No. 1 Desember 2014
Publisher : Neurona Majalah Kedokteran Neuro Sains

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

INTRODUCTIONTHE PREVALENCE OF STROKE IN CHILDREN BETWEEN 611 PER 100000 CHILDREN CEREBRAL DIGITAL SUBSTRACTION ANGIOGRAPHY CEREBRAL DSA IS THE GOLD STANDARD PROCEDURE FOR ASSESSING VASCULAR ABNORMALITIES OF THE BRAIN HOWEVER IT IS AN INVASIVE PROCEDURE AND IS RELATIVELY EXPENSIVE UNTIL NOW THERE HAVE BEEN NO REPORTS OF COMPLICATIONS OF CEREBRAL DSA IN CHILDREN
Bleeding Volume, Blood Pressure, and Consciousness Level in Association with the Mortality Rate among Patients with Intracerebral Hemorrhage at Dr. Soetomo General Hospital, Surabaya Mohammad Pratama Jauhar Putra; Achmad Firdaus Sani; Puji Lestari; Mohammad Saiful Ardhi
Althea Medical Journal Vol 7, No 2 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v7n2.1751

Abstract

Background: Intracerebral hemorrhage is one of the deadliest acute conditions. The volume of bleeding and its location are factors that alter consciousness level, leading to death. This study aimed to explore the association between bleeding volume, blood pressure, and consciousness level with the mortality rate among patients with intracerebral hemorrhage, so proper treatment and diagnosis can be conducted efficiently.Methods: This was an observational retrospective study conducted from October 2018–July 2019. Bleeding volume, blood pressure, consciousness level, and mortality as the outcomes of the patients with intracerebral hemorrhage were evaluated. Consciousness level was determined by using the Glasgow Coma Scale score. Data were collected from the medical record of intracerebral hemorrhage patients of the Neurologic Department in Dr. Soetomo General Academic Hospital Surabaya in the period of 2016. The Chi-square analysis method was used to determine the correlation between variables.Results: In total, 51 medical records were retrieved, and the majority of the patients were in the 45–60 years old group (54.9%). The mortality during hospitalization was 17.6% with most of them (82.4%) had bleeding volume less than 30 cc. Interestingly, the bleeding volume correlated with the consciousness level (p=0.001) and the outcome of the patients (p=0.02). The blood pressure shows a correlation with the volume of bleeding (p=0.009).Conclusions: Bleeding volume and consciousness level as determined by the Glasgow Coma Scale score show significant correlations with the mortality rate in patients with intracerebral hemorrhage. 
Journal of Forensic Medicine & Toxicology, April-June 2020, Vol. 14, No. 2 1633 The Impact of High Cortisol Level in Increasing Incidence of Infection Cases among Acute Stroke Patients Indah Ari Handaayani1, Joseph Eko Wahono Rahardjo1, Muhammad Hamdan1, Paulus Sugianto1, Achmad Firda
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3159

Abstract

Background: Infection in the stroke was a treatment major problem, because it determines the prognosis. In the acute phase of stroke, high level cortisol may lead to a decreased immune system and patients tend to be more susceptible to infection. The correlation of serum cortisol level among acute stroke patients with incidence of infection was not fully investigated. Objective: The aim of this study was to determine the relationship between initial serum cortisol levels and the incidence of infection in acute stroke patients. Method: A prospective cohort study was conducted on 32 of acute stroke patients who admitted in RSUD Dr. Soetomo Surabaya during the period December 2015 to February 2016. Total of 2 cc to the venous blood within 48 hours in onset of stroke being examined of serum cortisol. During the 7 days of hospitalization, the patient was observed for signs of infection, both clinically and the investigation in accordance with the operational definition. Results: In the infected group there were 8 people (50%) with high cortisol levels (p = 0.015; RR 15,000; 95% IK 1.583-143,171); 6 people were (50%) using urine catheter (p = 0.049; RR 6,667; 95% IK 1.067-30.085); And 6 people were (54.5%) using NGT (p = 0,035; RR 7,200; 95% IK 1.311 - 39,557). In multivariate analysis obtained that Odds Ratio (OR) 15,468 based on high cortisol and OR 7,469 based on NGT usage. Conclusion: High cortisol levels and the use of NGT had the effect on the incidence of infection in acute stroke
Poor Glycemic Control is Correlated with Reduced Cognitive Function in Type 2 Diabetes Mellitus Patients Archangela Olivia Eugenia; Achmad Firdaus Sani; Hermawan Susanto; Jongky Hendro Prajitno
Biomolecular and Health Science Journal Vol. 5 No. 1 (2022): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bhsj.v5i1.31880

Abstract

Introduction: The prevalence of type 2 Diabetes Mellitus (T2DM) in Indonesia is increasing and is known to cause several complications related to the patient’s glycemic control. A chronic hyperglycemic state will lead to microvascular injury of the brain resulting in cognitive impairment as one of the complications of T2DM. Therefore, our present study observed the correlation between glycemic control and cognitive impairment in patients with T2DM.Methods: This was an observational study with a cross-sectional design of T2DM patients in endocrine outpatient clinics of Dr. Soetomo General Academic Hospital from October 2020 to March 2021. The subjects were recruited consecutively then categorized into groups with controlled (HbA1c < 7%) and uncontrolled (HbA1c ≥ 7%) blood glucose. The cognitive function was evaluated using the AD8 informant-based questionnaire.Results: A total of 43 adult T2DM patients aged < 65 years were recruited. The incidence of cognitive impairment was not significantly different (p=0.127) between controlled and uncontrolled blood glucose groups. However, HbA1c levels were positively and significantly correlated with AD8 scores (p=0.031, R=0.330). Moreover, the duration of T2DM was found to significantly affect cognitive abnormalities in these patients. (p=0.021).Conclusion: Poor glycemic control in T2DM patients increased the risk of developing reduced cognitive function.
Hubungan Antara Rasio H/M pada Stroke Akut dengan Derajad Spastisitas Pascastroke Achmad Firdaus Sani; Yudhi Adrianto; Fadil; Mudjiani Basuki; Fidiana
AKSONA Vol. 1 No. 2 (2021): JULY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (167.944 KB) | DOI: 10.20473/aksona.v1i2.150

Abstract

Pendahuluan: Spastisitas adalah gangguan motorik yang sering dijumpai dan muncul setelah stroke. Spastisitas dapat menyebabkan nyeri dan disabililitas pada bagian tubuh yang mengalaminya. Tujuan: mencari hubungan antara rasio H/M yang diukur dengan elektromiografi dengan derajad spastisitas yang terjadi setelah fase akut stroke. Metode: Penelitian ini adalah studi analisis korelatif observasional, dengan 26 sampel. Pasien diukur rasio H/M pada saat stroke akut dan diukur derajad spastisitasnya dengan menggunakan Modified Ashworth Scale setelah 3 bulan. Hasil yang didapatkan dilakukan analisa statistik dengan menggunakan tes korelatif kategorik dari Spearman. Hasil: Pasien yang mengikuti penelitian ini sebanyak 26 orang. Terdapat perbedaaan antara nilai H/M rasio antara sisi parese dengan sisi sehat dan tidak didapatkan hubungan yang bermakna antara nilai rasio H/M yang diukur saat fase akut stroke dengan derajad spastisitas yang diukur dengan Modified Ashworth Scale (MAS) setelah 3 bulan (p = 0,06 ; r = 0, 37). Kesimpulan: Rasio H/M pada pasien stroke akut meningkat pada sisi parese dibanding pada sisi sehat, namun peningkatan ini tidak memiliki hubungan yang signifikan dengan derajad spastisitas pasca stroke yang diukur dengan MAS, sehingga rasio H/M tidak dapat digunakan sebagai prediktor munculnya spastisitas pasca stroke
Intractable Headache Akibat Fistula Karotis-Kavernosus Indirek Bilateral: Suatu Laporan Kasus Rizky Hartono; Achmad Firdaus Sani
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (635.642 KB) | DOI: 10.20473/aksona.v1i1.92

Abstract

Pendahuluan: Nyeri kepala hemikrania dengan presentasi menyerupai nyeri kepala primer namun tidak membaik dengan medikamentosa (intractable headache), perlu dicurigai suatu nyeri kepala sekunder. Etiologi nyeri kepala sekunder, ditegakan dengan melakukan pemeriksaan penunjang diagnostik lebih lanjut. Adanya kelainan yang ditemukan, akan menuntun pada terapi definitif. Kami melaporkan seorang pasien dengan intractable headache dan ditemukan etiologi berupa fistula karotiskavernosus indirek dan membaik dengan tindakan embolisasi. Kasus: Laki-laki 29 tahun dengan nyeri kepala selama 2 bulan terakhir dan tidak membaik dengan medikamentosa. Nyeri kepala berdenyut pada sisi kiri menyerupai nyeri kepala primer dan makin lama makin memberat. Skala NRS 9-10. Keluhan disusul dengan pandangan mata dobel dan ptosis mata kiri. Dari MRI kepala sekuen TOF didapatkan gambaran hiperintensitas area sinus kavernosus. Dilakukan konfirmasi dengan serebral DSA didapatkan fistula indirek dari cabang arteri karotis eksterna dan intra bilateral menuju ke sinus kavernosus. Dilakukan embolisasi pada cabang arteri karotis eksterna kiri. Post embolisasi nyeri kepala menghilang tanpa obat-obatan. Kesimpulan: Adanya anomali vaskuler, pada kasus ini fistula karotis kavernosus, perlu dipertimbangkan pada kasus nyeri kepala intraktabel. Tindakan embolisasi merupakan terapi kuratif yang dapat menghilangkan keluhan nyeri kepala
Partial Transvenous Coil Embolization with Significant Clinical Improvement in Patient with Indirect Carotid Cavernous Fistula Muh. Wildan Yahya; Achmad Firdaus Sani; Dedy Kurniawan; Mohammad Saiful Ardhi
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (476.891 KB) | DOI: 10.20473/aksona.v2i2.36633

Abstract

Highlight: CCF is a rare vascular malformation with challenging management. Partial transvenous embolization is quite effective as an alternative therapy for indirect CCF type D.   ABSTRACT Introduction: An indirect carotid-cavernous fistula (CCF) is an abnormal connection between the internal or external carotid artery and the cavernous sinus. The optic, trochlear, abducens, and trigeminal nerves are located in the cavernous sinus. Head Computed Tomography (CT) scan, Magnetic Resonance Imaging (MRI), and Cerebral Angiography are some imaging modalities used to establish and diagnose carotid-cavernous fistula. Endovascular intervention can be performed with trans-arterial or trans-venous access. In some cases, complete embolization by endovascular treatment is not possible because of difficult angioarchitecture. Case: A 61-year-old female reported having pain in her left eye (numerical rating scale was 6). The left eye was bulging, reddish, ptosis, and unable to move. The patient felt double vision when opening both eyes, complained of intermittent stabbing headaches on the left side, and heard a bruit from the left side of the head. The cerebral angiography showed bilateral indirect CCF Barrow type D. The procedure involved partial transvenous embolization with coiling. The angiographic evaluation showed partial occlusion, and residual flow from the fistula was still visible on angiography. There was a significant clinical improvement several days after the procedure and a five-month follow-up.  Conclusion: This case report showed that partial targeted transvenous embolization is quite effective in indirect CCF when complete embolization is impossible.
Co-Authors Adrianto, Yudhi Archangela Olivia Eugenia Basuki, Mudjiani Chandrawati Widya Hartati Darmawan, Ahmad Faisal Dedy Kurniawan Dedy Kurniawan Fadil Fadil Fidiana Fidiana, Fidiana Fritz Sumantri Usman, Fritz Sumantri Hermawan Susanto Jongky Hendro Prajitno Mohammad Pratama Jauhar Putra Mohammad Saiful Ardhi Muh. Wildan Yahya Puji Lestari Ramadhania, Nadya Noor Rizky Hartono Rizky Hartono, Rizky Shakir Husain, Shakir Sita Setyowatie Taurus Laisari Yusak Maryunianta