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Asian Australasian Neuro and Health Science Journal (AANHS-J)
Published by TALENTA PUBLISHER
ISSN : 26860848     EISSN : 26860848     DOI : https://doi.org/10.32734
Core Subject : Health, Science,
Focus and Scope Asian Australasian Neuro and Health Science Journal (AANHSJ) provides a forum for publishing the full research articles in the area of Neurosurgery and Health related to topics from the following subject areas: Neuro-Anatomy Neuro-Physiology Neuro-oncology Neuro-Spine Neuro-Pediatric Neuro-Trauma Neuro-Vascular Neuro-Fungsional Basic Science Biomoleculer in Neurology Radiology in Neurosurgery
Articles 5 Documents
Search results for , issue "Vol. 3 No. 3 (2021): AANHS Journal" : 5 Documents clear
Traumatic Brain Injury Cases Through Emergency Department During Covid-19 Pandemic Era 2020 In Adam Malik General Hospital Medan Mahyudanil Mahyudanil; Patrice LWY Sinaga; M. Ari Irsyad; Faisal Faisal; Tommy Rizky Hutagalung
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.v3i3.7567

Abstract

Abstract Introduction: Coronavirus disease 2019 (COVID-19) has been infecting nearly 800.000 individuals of all ages in 31 March 2020. Based on Harvard Medical school experience, almost over 80% of patients have switched to telemedicine services. In Indonesia, there are almost 1,22 million cases with recovery of 1 million case and the death of 33.183 cases. In North Sumatera, the COVID-19 cases occurred in 22.999 cases and the recovery of 19.758 cases with death of 786 cases. Here, we report the trend of traumatic brain injury (TBI) cases in pandemic era 2020 in our institution in Adam Malik General Hospital, Medan, North Sumatera. Method: This retrospective observational study reported 343 TBI cases from January 2020 to December 2020. January 2020 to March 2020 regarded as pre pandemic and April 2020 to December 2020 as the pandemic era. Results: There is significant decrease of traumatic brain injury patients from March 2020 to April 2020. It was 61% decrease in patients admission to our Emergency Department (ED). Demographically, male patients in productive age group and mild TBI has the most common presentation to our ED. Discussion: There is significant decrease of patients with TBI in our institution. The number of cases was declining from 55 patients on January to 21 patients on April. This also occurred concurrently with the start of social distancing in Indonesia on April 2020 and the civilian suggested to stay at home during this period. This decline was also found in other countries, like Massachusetts, USA and India. Conclusion: We reported significant decrease in traumatic brain injury cases in Adam Malik General Hospital during COVID-19 pandemic era in 2020. Neurosurgeons and Residents of Neurosurgery have to be cautious in assessing the TBI patients to limit the spread of COVID-19 in ED.
Overview of Patients with Metastatic Brain Tumors from Breast Cancer at H. Adam Malik Hospital, Medan in 2017-2021 Fahmi Rasyid; Dhyka Alloyna; Kamal Basri
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.v3i3.7581

Abstract

Abstract Introduction: The incidence of breast cancer based on Globocan in 2018, reached 2,088,849 cases (11.6%), with a mortality rate of 626,679 cases (6.6%). Breast cancer is one of the most common causes of a metastatic brain tumor. Approximately 10%-16% of patients with breast cancer develop brain metastases during the course of their disease. Current case management guidelines for patients with metastatic brain tumors from breast cancer are radiotherapy to the entire brain, with or without surgical resection, or stereotactic radiosurgery. Hormone receptor ([HR]; estrogen receptor [ER], progesterone receptor [PR]) and HER2 expression serve as predictors of response to hormone-targeted therapy and HER2, respectively. Method: The study was a descriptive study with a retrospective cohort design in which the researchers identified 78 patients with breast cancer brain metastases (either for diagnostic purposes or for therapeutic purposes at RSUP HAM Medan between 2017 and 2021. Data were collected from SIRS RSUP HAM Medan. Data related to clinicopathology were collected from medical records, including demographic characteristics, tumor characteristics, biomarker status, recurrence of metastatic brain tumors based on Magnetic Resonance Imaging (MRI) examination, and data on therapeutic regimens in cases of brain metastases of breast cancer. ER and PR status were determined by immunohistochemical examination. the intensity of the HER2 3+ immunohistochemical staining was considered positive Result: The mean age at breast cancer diagnosis was 46 years (range: 24-73 years). Most patients had invasive ductal histology (n=73, 94%). In addition, 56% of patients had T3 (n=34) T4 disease in 56% of patients (n=44) and 68% of patients (n=53) had positive axillary lymph nodes. Among patients with known HR and HER2 status, a total of 56% of tumors were ER negative (ER-; n=44), 62% were PR negative (n=48), and 44% were HER2-positive (HER2+; n= 34). With regard to the four subtypes formed by the combined values of HR and HER2 status, 21% (n=16) of tumors were HR+HER2+, 27% (n=21) were HR+HER2-, 23% (n=18) were HR+/ HER2-, and 28% (n=23) were triple negative (TN). Discussion: In the current study, investigators found that apart from patient age and number of brain metastases, HER2 status was a strong predictor of survival outcome after brain metastases. Patients with HER2-positive characteristics had a longer life expectancy than patients with HER2-negative disease. Considering the intracranial antitumor effect of anti-HER2 therapy, it is important to establish HER2 status not only in primary tumors but also in brain metastases to aid in consideration of the choice of therapeutic modality Conclusion: This study showed that younger age, brain metastases from solitary breast cancer, and HER2 positive from breast tumors were independent predictors of better survival in patients with breast cancer brain metastases
Our Experience Of Pediatric Brain Tumour In Medan: Demographic Study In Adam Malik General Hospital 2019-2020 Abdurrahman Mouza; Fahmi Rasyid
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

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.
Intradural Extramedullary Spinal En-Plaque Meningioma With Calcification: A Case Report And Literature Review rais siregar; Sabri Ibrahim
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.v3i3.7607

Abstract

Abstract Introduction: Intradural extramedullary (IDEM) tumors are benign neoplasms arising in the spinal canal about two-thirds of primary spinal tumors and 15% of tumors affecting the Central Nervous System. Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like, and incidence in the literature only ranging from 0.1% to 3.1%. Pain is the most clinical symptom, weakness and sensory changes also occur frequently. Magnetic resonance imaging (MRI) is the standard modality for the radiologic diagnosis of meningioma. Case Report: A patient, 35 years old man with a diagnosis of intradural extramedullary spinal meningioma (IDEM) en-plaque with calcification, confirmed by the symptoms, workups such as spinal MRI, and intra-operative findings. The patient was successfully treated surgically with laminectomy and total tumor resection with a posterior approach. Discussion: Spinal en-plaque meningioma is a type that grows in a sheet-like or collar-like manner around the spinal cord can involve dura extensively with significant neurological deficits. Patient was with lower limb weakness, and had a history of back pain radiating to the right limb for the last 1 year. Spinal meningiomas are primarily found in the Intradural Extramedullary, and the tumor diagnosis is typically fairly straight forward based on radiologic findings. Meningiomas are most commonly found in the thoracic region of the spine. In this case from MRI Imaging was revealed a mass in thoracic region of the spine pressing the spinal cord anteriorly. The management of spinal en-plaque meningioma is tumor resection surgery. A retrospective study suggested a significant improvement in neurological deficit post-tumor resection on patients with spinal IDEM tumor. Conclusion: Spinal meningioma is a reasonably frequently found case of a spinal tumor but spinal en-plaque meningiomas are rarely found. MRI scan is the radiological gold standar diagnose spinal en-plaque meningiomas. Patient was successfully treated by total tumor resection using the laminectomy method and tumor resection with a posterior approach without any postoperative complications observed.
Trend of Improvement in Visual Field Deficits after Transsphenoidal Endoscopic Surgery in Pituitary Tumour Patients: A Case Series Syekh Ahmad Arafat Husain; Tommy Rizky Hutagalung; Muhammad Deni Nasution
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.v3i3.7608

Abstract

Abstract Introduction: Pituitary tumours account for approximately 15% of all brain tumours, and the growing tumours press against the optic chiasm, resulting in impairment of visual function manifested as visual field defects, decreased visual acuity, and decreased color vision . Compression of the optic chiasm by pituitary tumours generally results in selective loss of the temporal VFs, or bitemporal hemianopia, implying that the nasal retinal fibers are preferentially damaged. The reason for this preferential damage is not fully understood. Transsphenoidal surgery has been reported to safely reduce the pressure on the anterior visual pathway in most patients. Improvement in visual function may occur after transsphenoidal decompression of the chiasm. Because improvement in visual function may occur from a variety of proposed biologic processes. Case Series : The number of patients according to gender was 71% male (10 people) while 29% female (4 people). The age distribution was found mostly at the age of 40-50 years 36% (5 people). The most common clinical symptoms were field disturbances 85% (12 people). Patients complained of visual field disturbances for 1-2 years as many as 58% (7 people). Vision before surgery is /6 as much as 45% (4 people). Improvements in vision were found for 1 month postoperatively as much as 22% (2 people). Discussion : Compression of the optic chiasm by pituitary tumours generally results in selective loss of the temporal VFs, or bitemporal hemianopia, implying that the nasal retinal fibers are preferentially damaged. The minimally invasive transsphenoidal approach can be used effectively for 95% of pituitary tumours. Exceptions are those large tumours with significant temporal or anterior cranial fossa extension. In such circumstances, transcranial approaches are often more appropriate. Occasionally, combined transsphenoidal and transcranial approaches are used. Nevertheless, some surgeons extend the basic transsphenoidal exposure in order to remove some of these tumours and avoid a craniotomy . Potential mechanisms of axonal injury from a compressive lesion include direct disruption of conduction along the axon, impaired axoplasmic flow, demyelination with impaired signal conduction, and ischemia from compression or stretching of the blood supply of the chiasm by the tumour. An early fast phase of improvement is consistent with restoration of signal conduction along retinal ganglion cell axons after removal of a compressive lesion.In some individuals, we observed the rapid restoration of normal vision, which would be consistent with this hypothesis. In these individuals, a physiologic conduction block is presumably the main mechanism of injury. Conclusion: The pattern of improvement of visual function after decompression of the anterior visual pathways suggests three phases of improvement. Improvement in visual function may occur after transsphenoidal decompression of the chiasm. Because improvement in visual function may occur from a variety of proposed biologic processes, we sought to better define this potential for improvement.

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