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Dedy Kurniawan
Department of Neurology, Faculty of Medicine, Universitas Airlangga; Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

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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.
Stroke Risk Factor Profile in an Urban Population: A Community-Based Descriptive Study in Mojo Sub-District, Surabaya, Indonesia Ilham Ikhtiar; Muhammad Wijdan Rosyich; Muhammad Arief Ardhanu; Dewi Setyaning Bastiana; Dedy Kurniawan; Sita Setyowatie
AKSONA Vol. 3 No. 1 (2023): JANUARY 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v3i1.40764

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Highlight: The stroke risk of the urban population in Mojo sub-district, Surabaya, was high (more than 10% risk for 36.3% of the population) . The risk factor for stroke is highly prevalent in Indonesia's urban communities, such as Surabaya. The Indonesian version of the Cardiovascular Disease Risk Index chart aids in determining stroke risk factors. The development of a stroke-spesific index chart has been done before but requires validation for the Indonesian population   ABSTRACT Introduction: Stroke is still a major cardiovascular disease in Indonesia. Locally published data regarding stroke risk factors is still rarely reported. This condition complicates the regulation, policy-making, and community empowerment efforts to reduce modifiable stroke risk factors. Thus, a study is necessary to provide an overview of stroke risk factors and risks in cities in Indonesia, such as Surabaya. Objective: This study aimed to describe stroke risk factors in an urban Indonesian community, such as the Mojo sub-district in Surabaya. Methods: This was a descriptive study to describe stroke risk factors like age, gender, history of comorbidities, and history of cardiovascular disease, as well as patient clinical data like neurological symptoms, cardiovascular symptoms, anthropometry, vital signs, simple laboratory values, and cardiovascular risk categorization in the next ten years based on the Cardiovascular Disease Risk Index chart, Indonesian version. Results: In this study, 33 participants were included. Risk factors showed that many participants had histories of active smoking (18.2%), hypertension (45.5%), and diabetes (24.2%). One-third of the participants had a history of dyslipidemia. Based on the risk chart for cardiovascular disease, 36.3% of participants were at >10% risk of developing cardiovascular disease in the next ten years. Conclusion: The risk index of cardiovascular disease in the Mojo sub-district, Surabaya, was still high. A combination of government policies, public awareness improvement, and community empowerment are urgently required to manage these risk factors epidemiologically.