1
|
Suryo AP, Meizikri R, Apriawan T, Turchan A, Hendrati LY, Bajamal AH, Parenrengi MA, Utomo B, Fauziah D, Wiratama PA. Effect of Kencur ( Kaempferia galanga L.) Ethanolic Extract Treatment on Cerebral Caspase-3 Expression in Traumatic Brain Injury Rat Models. Malays J Med Sci 2024; 31:43-51. [PMID: 38694581 PMCID: PMC11057826 DOI: 10.21315/mjms2024.31.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/21/2023] [Indexed: 05/04/2024] Open
Abstract
Background Traumatic brain injury is one of the most common forms of trauma and causes significant morbidity and mortality. Kencur (Kaempferia galanga L.) ethanolic extract is known to contain substances that could theoretically inhibit unfavourable cellular processes, including oxidative stress and inflammation. This research aimed to study Kencur's anti-apoptosis activity through the inhibition of caspase-3. Methods This is a true experimental post-test-only group design study, using male Wistar rats (Ratus novergicus) with weight-drop-induced traumatic brain injury. The subjects in this study were divided into four groups: two Control groups (Groups A and B) and two Therapy groups (Groups C and D). Groups C and D differed in the dose of Kencur ethanolic extract administered (600 mg/kgBW/day and 1,200 mg/kgBW/day, respectively). The Therapy groups were then subdivided into those receiving therapy for 24 h (C-24 and D-24) and those receiving therapy for 48 h (C-48 and D-48). Caspase-3 expression in brain tissue was evaluated at the end of the therapy using immunohistochemistry. All groups were subjected to a Kruskal-Wallis comparison test and the investigation continued with a Mann-Whitney U test to compare the two groups. Results In traumatic brain injury rat models treated with Kaempferia galanga L. ethanolic extract at doses of 1,200 mg/kgBW/day within 48 h of therapy (D-48) compared to those who were not treated, there was a significant change in the cerebral expression of caspase-3 (P = 0.016). There was also a significant difference between the two doses of intervention (C-24 at 600 mg/kgBW/day and D-48 at 1,200 mg/kgBW/day; P = 0.016). Conclusion With a minimum of 48 h of treatment split into two doses, Kencur (Kaempferia galanga L.) ethanolic extract can decrease caspase-3 expression in rats with traumatic brain injury.
Collapse
Affiliation(s)
- Army Pambudi Suryo
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Rizki Meizikri
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Tedy Apriawan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Agus Turchan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Lucia Yovita Hendrati
- Department of Epidemiology, Population, Biostatistics and Health Promotion, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Universitas Airlangga Academic Hospital, Surabaya, Indonesia
| | - Muhammad Arifin Parenrengi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Budi Utomo
- Department of Public Health Science and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dyah Fauziah
- Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Priangga Adi Wiratama
- Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| |
Collapse
|
2
|
Al Fauzi A, Rahmatullah MI, Suroto NS, Utomo B, Fahmi A, Bajamal AH, Wahid BDJ, Wisnawa IWW. Comparison of outcomes between clipping and endovascular coiling in anterior choroidal artery aneurysm: a systematic review. Neurosurg Rev 2023; 46:276. [PMID: 37861756 DOI: 10.1007/s10143-023-02179-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023]
Abstract
SAH (subarachnoid hemorrhage) caused by aneurysm rupture has the greatest mortality rate, with nearly 50% of patients unable to survive beyond 1 month after the attack. Anterior choroidal artery (AChA) aneurysms are one of the most difficult to treat among the numerous types of aneurysms. Until now, some neurosurgeons employed shearing while others employed coiling. In this trial, researchers will compare surgical clipping and endovascular coiling treatments for anterior choroidal artery aneurysms in terms of mortality, rebleeding, retreatment, and post-procedure outcomes. Using the PubMed electronic database, the Cochrane library, the Medline Database, the Directory of Open Access Journals, and EBSCHOHOST, a systematic review compared surgical clipping and endovascular coiling in all cases of choroidal artery aneurysm. There were 17 studies that met the eligibility requirements, with a total of 1486 patients divided into groups that underwent clipping (1106) or endovascular coiling (380). The mortality rate for clipping is 1.8%, while the mortality rate for endovascular coiling is 2.34%. Rebleeding occurs in 0% of patients undergoing endovascular coiling and 0.73% of patients undergoing clipping. Retreatment of clipping was 0.27%, while endovascular coiling was 3.42%. Post-complication procedures occurred in 11.12% of patients undergoing endovascular clipping and 15.78% of patients undergoing endovascular coiling. The intervention technique of clipping has a reduced rate of mortality, reoperation, and post-operative complications. Endovascular coiling results in a reduced rate of rebleeding than clipping.
Collapse
Affiliation(s)
- Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia.
| | - M Irfan Rahmatullah
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Nur Setiawan Suroto
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Budi Utomo
- Department of Public Health, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Achmad Fahmi
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Billy Dema Justia Wahid
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - I Wayan Weda Wisnawa
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| |
Collapse
|
3
|
Subagio EA, Wicaksono P, Faris M, Bajamal AH, Abdillah DS. Diagnosis and Prevalence (1975-2010) of Sudden Death due to Atlantoaxial Subluxation in Cervical Rheumatoid Arthritis: A Literature Review. ScientificWorldJournal 2023; 2023:6675489. [PMID: 37841539 PMCID: PMC10569890 DOI: 10.1155/2023/6675489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/09/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023] Open
Abstract
Rheumatoid arthritis (RA), a chronic inflammatory disease primarily affecting synovial joints and tendons, can potentially impact various organs within the body. One notable complication associated with RA is upper cervical spine instability, medically termed atlantoaxial subluxation (AAS). This condition can lead to adverse consequences, including chronic myelopathy and acute mechanical compression of the medulla oblongata, with the potential for sudden death. While AAS may often remain asymptomatic, some nonspecific symptoms, such as neck pain, have been documented. Severe atlantoaxial subluxation can trigger more distinct symptoms, including delayed occipital pain attributed to the compression of the exiting C2 nerve root. Recent studies have elucidated a spectrum of symptoms preceding sudden death, encompassing vertigo, dizziness, convulsions, dysphagia, disorientation, and seizures. Remarkably, some cases have reported sudden death occurring during sleep. Historical data reveal a fluctuating incidence of this phenomenon, with eleven cases reported between 1969 and 1975 and six cases documented between 1990 and 2010. Notably, one of the most prevalent causes of sudden mortality in individuals with RA is the acute mechanical damage inflicted upon the medulla oblongata due to atlantoaxial subluxation.
Collapse
Affiliation(s)
- Eko Agus Subagio
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Pandu Wicaksono
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Muhammad Faris
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | | |
Collapse
|
4
|
Agus Subagio E, Apriyansa Rahmadhan M, Faris M, Indarto Susilo R, Setiawan Suroto N, Utomo B, Wicaksono P, Hafid Bajamal A. Comparison of fusion outcomes of bone morphogenetics proteins-7 and bone autograft in posterolateral lumbar fusion : a systematic review. Interdisciplinary Neurosurgery 2023. [DOI: 10.1016/j.inat.2023.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
|
5
|
Al Fauzi A, Apriawan T, Ranuh IGMAR, Christi AY, Bajamal AH, Turchan A, Agus Subagio E, Suroto NS, Santoso B, Dachlan EG, Utomo B, Kasper EM. Traumatic brain injury in pregnancy: A systematic review of epidemiology, management, and outcome. J Clin Neurosci 2023; 107:106-117. [PMID: 36527810 DOI: 10.1016/j.jocn.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Traumatic brain injury (TBI) during pregnancy is an extremely rare condition in our neurosurgical emergency practices. Studies on the epidemiology and management of TBI in pregnancy are limited to case reports or serial case reports. There is no specific guidelines of management of TBI in pregnancy yet. METHODS The authors performed a structured search of all published articles on TBI in pregnancy from 1990 to 2020. We restricted search for papers in English and Bahasa. RESULTS The literature search yielded 22 articles with total 43 patients. We distinguished C-section based on its timing according to the neurosurgical treatment into primary (simultaneous or prior to neurosurgery) and secondary group (delayed C-section). The mean GOS value in primary C-section is better compared to secondary C-section in severe TBI group (3.57 ± 1.47 vs 3.0 ± 1.27, respectively) consistently in the moderate TBI group (4.33 ± 1.11 vs 3.62 ± 1.47, respectively). The fetal death rate in primary C-section is lower compared to secondary C-section in severe TBI group (14.2 % vs 33.3 %, respectively), contrary, in moderate TBI group (16.7 % vs 12.5 %, respectively). CONCLUSIONS Care of pregnant patients with TBI often requires multidisciplinary approach to optimize treatment strategy on a case-by-case basis in light of prior experience across different center. We propose management guideline for head injury in pregnancy.
Collapse
Affiliation(s)
- Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
| | - Tedy Apriawan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - I G M Aswin R Ranuh
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ayu Yoniko Christi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Agus Turchan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Eko Agus Subagio
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Nur Setiawan Suroto
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Budi Santoso
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Erry Gumilar Dachlan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Budi Utomo
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ekkehard M Kasper
- Department of Neurosurgery, St. Elizabeth's Medical Center, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Utomo SA, Bajamal AH, Yuyun Yueniwati P.W.. Spine vascular lesions from embryology to imaging findings review article with serial cases. Bali Med J 2022. [DOI: 10.15562/bmj.v11i3.3812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Spine vascular lesions like brain vascular lesions include spinal cord stroke, vascular malformation such as venous malformation or venous angioma, cavernous malformation, arteriovenous malformation or arteriovenous fistula. Embryogenesis of spinal vascular is the basic principle to understand the vascular malformation of the spine. This study aims to report serial cases with review of spinal vascular lesions. MR angiography techniques with contrast injection may reflect the direction of flow epidural veins to describe the site of arterial feeders. Serpiginous veins are commonly visible through the dorsal cord surface in MR myelography. The gold standard for diagnosing vascular malformation is Digital Subtraction Angiography (DSA). MRA helps to guide the location for DSA. Several cases are reported using MRA modalities and show the special location site of the spinal disorder.
Collapse
|
7
|
Permana GI, Meizikri R, Apriawan T, Suroto NS, Bajamal AH. The uncommon delayed neurological deficit in posterior fossa chronic epidural hematoma: A case report. Int J Surg Case Rep 2022; 99:107725. [PMID: 36261939 PMCID: PMC9568836 DOI: 10.1016/j.ijscr.2022.107725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Chronic epidural hematoma (CEDH) is uncommon and therefore, less well characterized. The incidence of CEDH ranges from 3.9 % to 30 % of all epidural hematomas. Posterior fossa epidural hematomas represent a rare clinical entity. It has been reported in only 4-7 % of all extradural hematomas. This rare condition may present with rapid clinical deterioration by quick increase in size that may cause brain stem compression. This study aims to provide a case of chronic epidural hematoma with uncommon sign of delayed neurological deficits, specifically in the posterior fossa region. CASE PRESENTATION We report a case of a 34-years-old male with left upper and lower extremities weakness for 3 days before admission. The patient had a history of falling from a height of approximately 3 m about 3 weeks ago. Craniotomy epidural hematoma evacuation was performed on the patient. CONCLUSION Chronic epidural hematoma is uncommon and therefore, less well characterized. The results of surgical care of symptomatic chronic posterior fossa EDH are often excellent. Early diagnosis and emergent evacuation provide better outcome.
Collapse
Affiliation(s)
- Galih Indra Permana
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Rizki Meizikri
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Tedy Apriawan
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia.
| | - Nur Setiawan Suroto
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| |
Collapse
|
8
|
Destiansyah RA, Subagio EA, Bajamal AH, Faris M. One-stage anterior approach for long-segment subaxial cervical spondylitis tuberculosis: A case report. Int J Surg Case Rep 2022; 99:107693. [PMID: 36162359 PMCID: PMC9568880 DOI: 10.1016/j.ijscr.2022.107693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 11/14/2022] Open
Abstract
Background Spondylitis TB on cervical region is a rare disease, that may lead to severe neurological complications. The anterior approach is considered as a gold standard for cervical spine tuberculosis. Available studies and literature have not precisely mentioned on how many levels are acceptable for this disease and still up for discussion. Case presentation A 45-year-old Asian male was brought from a rural hospital to our outpatient clinic with progressive weakness of all extremities for 3 months. Cervical x-ray and MRI showed three-levels of vertebral body destruction, suggesting a cervical spondylitis TB. Patient had debridement, corpectomy on C4, 5, 6, fusion with cage, and anterior plating from C3 to Th1 in a one-stage anterior approach. Immediately after the surgery, the patient had no complaints of pain, and he was able to walk on his own. One year follow-up after the surgery, no residual neurological impairment is detected and had no limitation in daily activities. Cervical x-ray and MRI showed good ossification and improvement of lordotic curvature. Conclusion Treatment of cervical spondylitis TB which involved three-levels of vertebrae using one-stage anterior approach provides a good rate of deformity correction along with clinical improvement and long-term well-being of the patient. Cervical TB is rare and could lead to severe neurological symptoms, thus, should be diagnosed and managed with extra care. The anterior approach is considered as a gold standard for cervical spine tuberculosis, since the disease usually involves anterior column, allowing direct access to the focus of the disease, and provide better stabilization Opinions in the literature regarding the management of cervical spondylitis TB have periodically fluctuated from completely conservative to radical surgical management. In this case the use of anterior approach for involvement of 3 levels of cervical vertebrae is to correct the kyphosis of the patient. Treatment of cervical spondylitis TB which involved three-levels of vertebrae using one-stage anterior approach provides a good rate of deformity correction along with clinical improvement of the patient.
Collapse
|
9
|
Cannizzaro D, Safa A, Bisoglio A, Jelmoni AJ, Zaed I, Tropeano MP, Al Fauzi A, Bajamal AH, Khan T, Kolias A, Hutchinson P, Servadei F. Second Footprint of Reports from Low- and Low- to Middle-Income Countries in the Neurosurgical Data: A Study from 2018–2020 Compared with Data from 2015–2017. World Neurosurg 2022; 168:e666-e674. [DOI: 10.1016/j.wneu.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
|
10
|
Balafif F, Faris M, Subagio EA, Bajamal AH, Kusumadewi A. Lumbar disc herniation in a 15-year-old girl: A case report. Int J Surg Case Rep 2022; 98:107560. [PMID: 36057249 PMCID: PMC9482986 DOI: 10.1016/j.ijscr.2022.107560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Fachriy Balafif
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Muhammad Faris
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia; Department of Neurosurgery, Adi Husada Undaan Hospital, Surabaya, East Java, Indonesia.
| | - Eko Agus Subagio
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Annie Kusumadewi
- Department of Pediatrics, Adi Husada Undaan Hospital, Surabaya, East Java, Indonesia
| |
Collapse
|
11
|
Turchan A, Fahmi A, Kurniawan A, Bajamal AH, Fauzi A, Apriawan T. The change of serum and CSF BDNF level as a prognosis predictor in traumatic brain injury cases: A systematic review. Surg Neurol Int 2022; 13:250. [PMID: 35855138 PMCID: PMC9282766 DOI: 10.25259/sni_1245_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/24/2022] [Indexed: 11/04/2022] Open
Abstract
Background: Mortality predictions following traumatic brain injury (TBI) may be improved by including genetic risk in addition to traditional prognostic variables. One promising target is the gene coding for brain-derived neurotrophic factor (BDNF), a ubiquitous neurotrophin important for neuronal survival and neurogenesis. Methods: A total of seven publications pertaining to BDNF in the study of traumatic head injury were included and reviewed. The majority of patients were male, that is, 483 (83.85%) patients, compared to 93 (16.15%) female patients. The median length of follow-up was 6 months (3 days–12 months). Measurement of the patient’s initial condition was carried out by measuring the initial GCS of the patient at the time of admission across the five studies being 6.5. The median CSF BDNF levels in the unfavorable group being 0.2365 (0.19–0.3119) ng/ml, from favorable group which was 0.20585 (0.17–0.5526) ng/ml. The median serum BDNF level in the unfavorable group being 3.9058 (0.6142–13.0) ng/ml, from favorable group which was 4.3 (0.6174–23.3) ng/ml. Results: Six studies reported on the sex distribution of patients, the majority of patients were male, that is, 483 (83.85%) patients, compared to 93 (16.15%) female patients. Six studies reported the number of patients per outcome group. The comparison of the number of patients in the two groups was quite balanced with the number of patients in the good group as many as 269 patients (55.5%) and the number of patients in the unfavorable group as many as 216 patients (44.5%). Measurement of the patient’s initial condition was carried out by measuring the patient’s initial GCS at the time of admission. It was reported in five studies, with the overall mean baseline GCS across five studies being 6.5 (3.2–8.8). Measurement of patient outcome was carried out by several methods, two studies used Glasgow Outcome Scale, Glasgow Outcome Scale Extended was used in two studies, and five studies used survival as a patient outcome measure. The patient’s BDNF level was measured in CSF and/or serum. A total of four studies measuring BDNF CSF levels and serum BDNF levels. Measurement of BDNF levels in TBI patients conducted on patients in seven literatures showed that there were differences in the trend of BDNF levels from CSF sources and serum sources. Measurement of CSF BDNF levels CSF BDNF levels was reported in two of the seven literatures, with the median CSF BDNF level in the unfavorable group being 0.2365 (0.19–0.3119) ng/ml. CSF BDNF levels were higher than the median in the preferred group, which was 0.20585 (0.17–0.5526) ng/ml. The results of the analysis from three other literatures stated that there was a tendency for lower CSF BDNF levels in the preferred group. Serum BDNF levels were reported in two of the seven literatures, with the median serum BDNF level in the unfavorable group being 3.9058 (0.6142–13.0) ng/ml. This serum BDNF level was lower than the median in the preferred group, which was 4.3 (0.6174–23.3) ng/ml. The results of the analysis of four literatures reporting serum BDNF stated that there was a tendency for lower serum BDNF levels in the poor group. A risk assessment of bias for each study was performed using ROBINS-I because all included studies were non-RCT studies. Overall the results of the risk of bias analysis were good, with the greatest risk of confounding bias and outcome bias. Conclusion: Serum BDNF levels were found to be lower in the unfavorable group than in the favorable group. This is associated with an increase in autonomic function as well as a breakdown of the blood–brain barrier which causes a decrease in serum BDNF levels. Conversely, CSF BDNF levels were found to be higher in the unfavorable group than in the favorable group. This is associated with an increase in the breakdown of the blood–brain barrier which facilitates the transfer of serum BDNF to the brain, leading to an increase in CSF BDNF levels.
Collapse
|
12
|
Permana AT, Bajamal AH, Parenrengi MA, Suroto NS, Lestari P, Fauzi AA. Clinical outcome and safety of stem cell therapy for ischemic stroke: A systematic review and meta-analysis. Surg Neurol Int 2022; 13:206. [PMID: 35673677 PMCID: PMC9168316 DOI: 10.25259/sni_1174_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Several reports on stem cell administration have emerged proving it to be an ideal therapeutic approach for improving neurological functions in ischemic stroke patients. However, some studies also show disappointing results, with some reporting no statistically significant improvements among several different parameters. Several challenges also arise relating to safety and nonscientific aspects, such as ethics. Methods: We performed a systematic review and meta-analysis to evaluate the effect of stem cell therapy on the clinical outcomes of ischemic stroke patients. A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A thorough literature search was conducted on PubMed, Scopus, and Cochrane databases. Articles were selected systematically based on the PRISMA protocol and reviewed completely. A total of 19 publications pertaining to stem cell therapy on the ischemic route were included and reviewed. Efficacy outcomes were measured with the National Institutes of Health Stroke Scale, modified Rankin Scale, or Barthel Index. Results: The results of the meta-analysis indicate that the efficacy outcomes suggest favorable results after stem cell therapy, although not all study results are statistically significant. Stem cell therapy in stroke cases showed a better outcome than standard conservative therapy alone, although our analysis shows that many factors can influence this outcome, and significant effects can only be seen after several months. Conclusion: The results of this study show promising and satisfying efficacy and a relatively low rate of serious adverse events.
Collapse
Affiliation(s)
- Andhika Tomy Permana
- Department of Neurosurgery Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Muhammad Arifin Parenrengi
- Department of Neurosurgery Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Nur Setiawan Suroto
- Department of Neurosurgery Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Pudji Lestari
- Department of Public Health, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Asra Al Fauzi
- Department of Neurosurgery Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| |
Collapse
|
13
|
Azzam M, Fahmi A, Utomo B, Faris M, Parenrengi MA, Sudiana IK, Bajamal AH, Subagio EA. The Effect of ACTH(4–10) PRO8-GLY9-PRO10 Administration on the Expression of IL-6 and IL-8 in Sprague Dawley Mice with Spinal Cord Injury. J Neurosci Rural Pract 2022; 13:370-375. [PMID: 35946003 PMCID: PMC9357503 DOI: 10.1055/s-0042-1744468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Abstract
Background Spinal cord injury (SCI) is a significant cause of morbidity since it results in the inflammation process which leads to necrosis or apoptosis. Inflammatory response to the tissue damage increases IL-6 and IL-8 levels. ACTH4–10Pro8-Gly9-Pro10 is a peptide community that has been shown to have a beneficial effect on minimizing the morbidity and increasing the recovery time.
Methods This study is a true experimental laboratory research with a totally randomized method. The subjects were animal models with light and extreme compression of spinal cord, respectively.
Results The administration of ACTH 4–10 in mild SCI in the 3-hour observation group did not show a significant difference in IL-6 expression compared with the 6-hour observation group. The administration of ACTH 4–10 in severe SCI showed a significantly lower expression level of IL-6 in the 3-hour observation group compared with the 6-hour one. The administration of ACTH 4–10 in severe SCI led to a significantly lower IL-8 expression in the 3-hour observation group compared with the 6-hour one. However, there was no significant difference in IL-8 expression in the group receiving ACTH 4–10 in 3 hours observation compared with that in 6 hours observation.
Conclusion The administration of ACTH4–10Pro8-Gly9-Pro10 can reduce the expression of IL-6 and IL-8 at 3-hour and 6-hour observation after mild and severe SCI in animal models. Future research works are recommended.
Collapse
Affiliation(s)
- Muhammad Azzam
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Achmad Fahmi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Budi Utomo
- Department of Public Health-Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Faris
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Muhammad Arifin Parenrengi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - I. Ketut Sudiana
- Department of Pathological Anatomy, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Eko Agus Subagio
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| |
Collapse
|
14
|
Faris M, Permana GI, Subagio EA, Bajamal AH. Surgical treatment approach of cervicothoracic junction spinal tuberculosis in pediatric: A case report. Int J Surg Case Rep 2022; 95:107173. [PMID: 35569313 PMCID: PMC9112014 DOI: 10.1016/j.ijscr.2022.107173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction and importance The cervicothoracic junction is prone to infection by tuberculosis bacteria, which leads to spinal instability. Meanwhile, cervicothoracic junction spinal tuberculosis is a disease that affects the C7 to T3 vertebral, and it accounts for 5% of all spinal tuberculosis cases. Surgical procedures of treating this disease vary, and the most commonly used method is the combined anterior and posterior approach. This case report presents the disease with uncommon location in pediatric, which is rarely reported, and performed with the single-stage posterior approach to treat the patient, which showed a good clinical and radiological result. Case presentation A 15-years old girl with one-month history of progressive inferior paraplegia (within a month, her muscle strength went from score 5 to 0) initially complained of neck pain, gradual weakness of the lower extremities, and hypoesthesia below T4. The spine's MRI also showed a tuberculous spondylitis in the T1 to T3 vertebral and a huge paravertebral abscess at the C5 to T3 level. Subsequently, an adequate decompression, debridement, maintenance and reinforcement of stability as well as deformity correction were carried out using the single-stage posterior approach. Conclusions The cervicothoracic junction spinal tuberculosis with huge paravertebral abscess makes surgical procedures difficult, specifically in pediatric patients. However, the single stage posterior approach produced a better clinical and radiological result with a short operation time. The selection of appropriate surgical approach management with good perioperative planning as well as effective medical management improved the patient's condition. Spinal tuberculosis cases are one of the most common infection cases that happen in the most developed country. Cervicothoracic junction spinal tuberculosis in pediatric is rarely reported, especially with a large paravertebral abscess. Surgical approaches of the spinal tuberculosis are varied and most of the cases performed with combined surgery.
Collapse
Affiliation(s)
- Muhammad Faris
- Department of Neurosurgery, Airlangga University - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia.
| | - Galih Indra Permana
- Department of Neurosurgery, Airlangga University - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Eko Agus Subagio
- Department of Neurosurgery, Airlangga University - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Airlangga University - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| |
Collapse
|
15
|
Clark D, Joannides A, Adeleye AO, Bajamal AH, Bashford T, Biluts H, Budohoski K, Ercole A, Fernández-Méndez R, Figaji A, Gupta DK, Härtl R, Iaccarino C, Khan T, Laeke T, Rubiano A, Shabani HK, Sichizya K, Tewari M, Tirsit A, Thu M, Tripathi M, Trivedi R, Devi BI, Servadei F, Menon D, Kolias A, Hutchinson P, Abdallah OI, Abdel-Lateef A, Abdifatah K, Abdullateef A, Abeygunaratne R, Aboellil M, Adam A, Adams R, Adeleye A, Adeolu A, Adji NK, Afianti N, Agarwal S, Aghadi IK, Aguilar PMM, Ahmad SR, Ahmed D, Ahmed N, Aizaz H, Aji YK, Alamri A, Alberto AJM, Alcocer LA, Alfaro LG, Al-Habib A, Alhourani A, Ali SMR, Alkherayf F, AlMenabbawy A, Alshareef A, Aminullah MAS, Amjad M, Amorim RLOD, Anbazhagan S, Andrade A, Antar W, Anyomih TT, Aoun S, Apriawan T, Armocida D, Arnold P, Arraez M, Assefa T, Asser A, Athiththan S, Attanayake D, Aung MM, Avi A, Ayala VEA, Azab M, Azam G, Azharuddin M, Badejo O, Badran M, Baig AA, Baig RA, Bajaj A, Baker P, Bala R, Balasa A, Balchin R, Balogun J, Ban VS, Bandi BKR, Bandyopadhyay S, Bank M, Barthelemy E, Bashir MT, Basso LS, Basu S, Batista A, Bauer M, Bavishi D, Beane A, Bejell S, Belachew A, Belli A, Belouaer A, Bendahane NEA, Benjamin O, Benslimane Y, Benyaiche C, Bernucci C, Berra LV, Bhebe A, Bimpis A, Blanaru D, Bonfim JC, Borba LAB, Borcek AO, Borotto E, Bouhuwaish AEM, Bourilhon F, Brachini G, Breedon J, Broger M, Brunetto GMF, Bruzzaniti P, Budohoska N, Burhan H, Calatroni ML, Camargo C, Cappai PF, Cardali SM, Castaño-Leon AM, Cederberg D, Celaya M, Cenzato M, Challa LM, Charest D, Chaurasia B, Chenna R, Cherian I, Ching'o JH, Chotai T, Choudhary A, Choudhary N, Choumin F, Cigic T, Ciro J, Conti C, Corrêa ACDS, Cossu G, Couto MP, Cruz A, D'Silva D, D'Aliberti GA, Dampha L, Daniel RT, Dapaah A, Darbar A, Dascalu G, Dauda HA, Davies O, Delgado-Babiano A, Dengl M, Despotovic M, Devi I, Dias C, Dirar M, Dissanayake M, Djimbaye H, Dockrell S, Dolachee A, Dolgopolova J, Dolgun M, Dow A, Drusiani D, Dugan A, Duong DT, Duong TK, Dziedzic T, Ebrahim A, El Fatemi N, El Helou AE, El Maaqili RE, El Mostarchid BE, El Ouahabi AE, Elbaroody M, El-Fiki A, El-Garci A, El-Ghandour NM, Elhadi M, Elleder V, Elrais S, El-shazly M, Elshenawy M, Elshitany H, El-Sobky O, Emhamed M, Enicker B, Erdogan O, Ertl S, Esene I, Espinosa OO, Fadalla T, Fadelalla M, Faleiro RM, Fatima N, Fawaz C, Fentaw A, Fernandez CE, Ferreira A, Ferri F, Figaji T, Filho ELB, Fin L, Fisher B, Fitra F, Flores AP, Florian IS, Fontana V, Ford L, Fountain D, Frade JMR, Fratto A, Freyschlag C, Gabin AS, Gallagher C, Ganau M, Gandia-Gonzalez ML, Garcia A, Garcia BH, Garusinghe S, Gebreegziabher B, Gelb A, George JS, Germanò AF, Ghetti I, Ghimire P, Giammarusti A, Gil JL, Gkolia P, Godebo Y, Gollapudi PR, Golubovic J, Gomes JF, Gonzales J, Gormley W, Gots A, Gribaudi GL, Griswold D, Gritti P, Grobler R, Gunawan R, Hailemichael B, Hakkou E, Haley M, Hamdan A, Hammed A, Hamouda W, Hamzah NA, Han NL, Hanalioglu S, Haniffa R, Hanko M, Hanrahan J, Hardcastle T, Hassani FD, Heidecke V, Helseth E, Hernández-Hernández MÁ, Hickman Z, Hoang LMC, Hollinger A, Horakova L, Hossain-Ibrahim K, Hou B, Hoz S, Hsu J, Hunn M, Hussain M, Iacopino G, Ideta MML, Iglesias I, Ilunga A, Imtiaz N, Islam R, Ivashchenko S, Izirouel K, Jabal MS, Jabal S, Jabang JN, Jamjoom A, Jan I, Jarju LBM, Javed S, Jelaca B, Jhawar SS, Jiang TT, Jimenez F, Jiris J, Jithoo R, Johnson W, Joseph M, Joshi R, Junttila E, Jusabani M, Kache SA, Kadali SP, Kalkmann GF, Kamboh U, Kandel H, Karakus AK, Kassa M, Katila A, Kato Y, Keba M, Kehoe K, Kertmen HH, Khafaji S, Khajanchi M, Khan M, Khan MM, Khan SD, Khizar A, Khriesh A, Kierońska S, Kisanga P, Kivevele B, Koczyk K, Koerling AL, Koffenberger D, Kõiv K, Kõiv L, Kolarovszki B, König M, Könü-Leblebicioglu D, Koppala SD, Korhonen T, Kostkiewicz B, Kostyra K, Kotakadira S, Kotha AR, Kottakki MNR, Krajcinovic N, Krakowiak M, Kramer A, Krishnamoorthy S, Kumar A, Kumar P, Kumar P, Kumarasinghe N, Kuncha G, Kutty RK, Laeke T, Lafta G, Lammy S, Lapolla P, Lardani J, Lasica N, Lastrucci G, Launey Y, Lavalle L, Lawrence T, Lazaro A, Lebed V, Leinonen V, Lemeri L, Levi L, Lim JY, Lim XY, Linares-Torres J, Lippa L, Lisboa L, Liu J, Liu Z, Lo WB, Lodin J, Loi F, Londono D, Lopez PAG, López CB, Lotbiniere-Bassett MD, Lulens R, Luna FH, Luoto T, M.V. VS, Mabovula N, MacAllister M, Macie AA, Maduri R, Mahfoud M, Mahmood A, Mahmoud F, Mahoney D, Makhlouf W, Malcolm G, Malomo A, Malomo T, Mani MK, Marçal TG, Marchello J, Marchesini N, Marhold F, Marklund N, Martín-Láez R, Mathaneswaran V, Mato-Mañas DJ, Maye H, McLean AL, McMahon C, Mediratta S, Mehboob M, Meneses A, Mentri N, Mersha H, Mesa AM, Meyer C, Millward C, Mimbir SA, Mingoli A, Mishra P, Mishra T, Misra B, Mittal S, Mohammed I, Moldovan I, Molefe M, Moles A, Moodley P, Morales MAN, Morgan L, Morillo GDC, Moustafa W, Moustakis N, Mrichi S, Munjal SS, Muntaka AJM, Naicker D, Nakashima PEH, Nandigama PK, Nash S, Negoi I, Negoita V, Neupane S, Nguyen MH, Niantiarno FH, Noble A, Nor MAM, Nowak B, Oancea A, O'Brien F, Okere O, Olaya S, Oliveira L, Oliveira LM, Omar F, Ononeme O, Opšenák R, Orlandini S, Osama A, Osei-Poku D, Osman H, Otero A, Ottenhausen M, Otzri S, Outani O, Owusu EA, Owusu-Agyemang K, Ozair A, Ozoner B, Paal E, Paiva MS, Paiva W, Pandey S, Pansini G, Pansini L, Pantel T, Pantelas N, Papadopoulos K, Papic V, Park K, Park N, Paschoal EHA, Paschoalino MCDO, Pathi R, Peethambaran A, Pereira TA, Perez IP, Pérez CJP, Periyasamy T, Peron S, Phillips M, Picazo SS, Pinar E, Pinggera D, Piper R, Pirakash P, Popadic B, Posti JP, Prabhakar RB, Pradeepan S, Prasad M, Prieto PC, Prince R, Prontera A, Provaznikova E, Quadros D, Quintero NJR, Qureshi M, Rabiel H, Rada G, Ragavan S, Rahman J, Ramadhan O, Ramaswamy P, Rashid S, Rathugamage J, Rätsep T, Rauhala M, Raza A, Reddycherla NR, Reen L, Refaat M, Regli L, Ren H, Ria A, Ribeiro TF, Ricci A, Richterová R, Ringel F, Robertson F, Rocha CMSC, Rogério JDS, Romano AA, Rothemeyer S, Rousseau GRG, Roza R, Rueda KDF, Ruiz R, Rundgren M, Rzeplinski R, S.Chandran R, Sadayandi RA, Sage W, Sagerer ANJ, Sakar M, Salami M, Sale D, Saleh Y, Sánchez-Viguera C, Sandila S, Sanli AM, Santi L, Santoro A, Santos AKDD, Santos SCD, Sanz B, Sapkota S, Sasidharan G, Sasillo I, Satoskar R, Sayar AC, Sayee V, Scheichel F, Schiavo FL, Schupper A, Schwarz A, Scott T, Seeberger E, Segundo CNC, Seidu AS, Selfa A, Selmi NH, Selvarajah C, Şengel N, Seule M, Severo L, Shah P, Shahzad M, Shangase T, Sharma M, Shiban E, Shimber E, Shokunbi T, Siddiqui K, Sieg E, Siegemund M, Sikder SR, Silva ACV, Silva A, Silva PA, Singh D, Skadden C, Skola J, Skouteli E, Słoniewski P, Smith B, Solanki G, Solla DF, Solla D, Sonmez O, Sönmez M, Soon WC, Stefini R, Stienen MN, Stoica B, Stovell M, Suarez MN, Sulaiman A, Suliman M, Sulistyanto A, Sulubulut Ş, Sungailaite S, Surbeck M, Szmuda T, Taddei G, Tadele A, Taher ASA, Takala R, Talari KM, Tan BH, Tariciotti L, Tarmohamed M, Taroua O, Tatti E, Tenovuo O, Tetri S, Thakkar P, Thango N, Thatikonda SK, Thesleff T, Thomé C, Thornton O, Timmons S, Timoteo EE, Tingate C, Tliba S, Tolias C, Toman E, Torres I, Torres L, Touissi Y, Touray M, Tropeano MP, Tsermoulas G, Tsitsipanis C, Turkoglu ME, Uçkun ÖM, Ullman J, Ungureanu G, Urasa S, Ur-Rehman O, Uysal M, Vakis A, Valeinis E, Valluru V, Vannoy D, Vargas P, Varotsis P, Varshney R, Vats A, Veljanoski D, Venturini S, Verma A, Villa C, Villa G, Villar S, Villard E, Viruez A, Voglis S, Vulekovic P, Wadanamby S, Wagner K, Walshe R, Walter J, Waseem M, Whitworth T, Wijeyekoon R, Williams A, Wilson M, Win S, Winarso AWW, Ximenes AWP, Yadav A, Yadav D, Yakoub KM, Yalcinkaya A, Yan G, Yaqoob E, Yepes C, Yılmaz AN, Yishak B, Yousuf FB, Zahari MZ, Zakaria H, Zambonin D, Zavatto L, Zebian B, Zeitlberger AM, Zhang F, Zheng F, Ziga M. Casemix, management, and mortality of patients rreseceiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study. Lancet Neurol 2022; 21:438-449. [PMID: 35305318 DOI: 10.1016/s1474-4422(22)00037-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/19/2021] [Accepted: 01/17/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development. METHODS We did a prospective observational cohort study of consecutive patients with TBI undergoing emergency neurosurgery, in a convenience sample of hospitals identified by open invitation, through international and regional scientific societies and meetings, individual contacts, and social media. Patients receiving emergency neurosurgery for TBI in each hospital's 30-day study period were all eligible for inclusion, with the exception of patients undergoing insertion of an intracranial pressure monitor only, ventriculostomy placement only, or a procedure for drainage of a chronic subdural haematoma. The primary outcome was mortality at 14 days postoperatively (or last point of observation if the patient was discharged before this time point). Countries were stratified according to their Human Development Index (HDI)-a composite of life expectancy, education, and income measures-into very high HDI, high HDI, medium HDI, and low HDI tiers. Mixed effects logistic regression was used to examine the effect of HDI on mortality while accounting for and quantifying between-hospital and between-country variation. FINDINGS Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24-51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34-69) and the youngest in the low HDI tier (median 28 years, IQR 20-38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6-32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55-5·2) and high HDI tier (2·26, 1·23-4·15), but not the low HDI tier (1·66, 0·61-4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17-2·49). INTERPRETATION Patients receiving emergency neurosurgery for TBI differed considerably in their admission characteristics and management across human development settings. Level of human development was associated with mortality. Substantial opportunities to improve care globally were identified, including reducing delays to surgery. Between-hospital variation in mortality suggests changes at an institutional level could influence outcome and comparative effectiveness research could identify best practices. FUNDING National Institute for Health Research Global Health Research Group.
Collapse
Affiliation(s)
- David Clark
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK; Neurosurgery Division, University Teaching Hospital, Lusaka, Zambia.
| | - Alexis Joannides
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Amos Olufemi Adeleye
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Dr Soetomo Hospital, Surabaya, Jawa Timur, Indonesia
| | - Tom Bashford
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Hagos Biluts
- Neurosurgery Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
| | - Karol Budohoski
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Ari Ercole
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Rocío Fernández-Méndez
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Anthony Figaji
- Division of Neurosurgery and Neurosciences Institute, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Deepak Kumar Gupta
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Roger Härtl
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Corrado Iaccarino
- Neurosurgery Division, University Hospital of Parma, Parma, Emilia-Romagna, Italy
| | - Tariq Khan
- Department of Neurosurgery, North West General Hospital & Research Center, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Tsegazeab Laeke
- Neurosurgery Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
| | - Andrés Rubiano
- Department of Neurosurgery, Universidad El Bosque, Bogota, Colombia
| | - Hamisi K Shabani
- Department of Neurological Surgery, Muhimbili Orthopaedic Institute and Muhimbili University College of Allied Health Sciences, Dar es Salaam, Tanzania
| | | | - Manoj Tewari
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, India
| | - Abenezer Tirsit
- Neurosurgery Unit, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
| | - Myat Thu
- Department of Neurosurgery, Yangon General Hospital, Yangon, Yangon Region, Myanmar
| | - Manjul Tripathi
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, India
| | - Rikin Trivedi
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Bhagavatula Indira Devi
- Department of Neurosurgery, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Franco Servadei
- Humanitas Clinical and Research Center-IRCCS and Department of Biomedical Sciences, Humanitas University, Milano, Italy
| | - David Menon
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Angelos Kolias
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Peter Hutchinson
- National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Utomo SA, Bajamal AH, Yuyun Yueniwati Prabowowati Wadjib, Haq IBI, Varidha VU, Fauziah D. The role of apparent diffusion coefficient in differentiating typical from atypical meningioma. Bali Med J 2022. [DOI: 10.15562/bmj.v11i1.3244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Differentiation of typical from atypical meningiomas would greatly improve surgical planning and further treatment options. Appparent diffusion coefficient (ADC) has the potential to characterize meningioma subtypes. This study aimed to assess the value of ADC in differentiating typical and atypical meningiomas.
Method: A retrospective study was conducted using medical records at RSUD Dr. Soetomo Surabaya in January 2019 – September 2021. ADC values were obtained by placing three ROIs on tumors. We used receiver operating curve (ROC) analysis to determine the optimal cut-off ADC value to differentiate meningioma grading and Mann-Whitney U test to evaluate the difference in ADC values between the two groups. In addition, Chi-square was used to assess the correlation between ADC values and the type of meningioma.
Results: The ADC values in typical meningiomas ranged from 1.12 - 2.47 × 10-3 mm2/s with an average of 1.45 ± 0.38 × 10-3 mm2/s, while in atypical meningiomas ranged from 0.64 – 1.12 × 10-3 mm2/s with an average of 0.81 ± 0.20 × 10-3 mm2/s. Based on ROC analysis to distinguish typical and atypical meningiomas, the cut-off mean ADC value is 1.12 × 10-3 mm2/s with a sensitivity of 100%, specificity of 96.87%, and area under the curve (AUC) of 0.996. The cut-off difference in the ADC value and the relationship between the ADC value and meningioma type based on histopathology were significant.
Conclusion: Typical meningiomas have higher ADC values than atypical cases. ADC value can help differentiate typical from atypical meningiomas.
Collapse
|
17
|
Apriawan T, Widjiati W, Utomo DN, Fauzi AA, Subagio EA, Utomo B, Islam AA, Bajamal AH, Sudiana IK. Periosteum-induced ossification effect in skull defect through interleukin-8 and NF-κB pathway: An experimental study with Oryctolagus cuniculus rabbits. Surg Neurol Int 2022; 13:140. [PMID: 35509533 PMCID: PMC9062897 DOI: 10.25259/sni_62_2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/07/2022] [Indexed: 11/04/2022] Open
Abstract
Background:
The purpose of this study was to analyze the response of inflammatory cytokines interleukin-8 (IL-8) and NF-κB to the closure of skull defect with periosteum as a scaffolding material in bone healing used after surgery.
Methods:
Thirty Oryctolagus cuniculus rabbits underwent a craniotomy to create a 20 mm diameter round defect in the parietal bones. The parietal bones were returned to its place and stabilized by an internal plate fixation. The defects were either left empty or implanted with periosteum. At 6 weeks, the specimens were euthanized and examined.
Results:
Histological examination showed a more well-developed formation of woven bone in the periosteum group. Immunohistochemical examinations showed that the use of periosteum in the closure of skull defects reduced the NF-κB and IL-8 response which affected the ossification process.
Conclusion:
The experiment showed that the use of periosteum was linked with IL-8 and NF-κB downregulation toward ossification effects at any point throughout the trial. Periosteum usage might be beneficial as a scaffolding material in bone healing for autograft cranioplasty in animal model and could be applied to clinical practice.
Collapse
Affiliation(s)
- Tedy Apriawan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital,
| | | | - Dwikora Novembri Utomo
- Departments of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya,
| | - Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital,
| | - Eko Agus Subagio
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital,
| | - Budi Utomo
- Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya,
| | - Andi Asadul Islam
- Department of Neurosurgery, Faculty of Medicine, Universitas Hasanuddin – Dr. Wahidin Sudirohusodo Central General Hospital, Makassar, South Celebes,
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital,
| | - I. Ketut Sudiana
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| |
Collapse
|
18
|
Utomo SA, Bajamal AH, Yueniwati PW Y, Haq IBI, Fauziah D, Fajarini ES. Advanced MRI prediction of meningioma histopathological classification: a literature review and case presentations. Bali Med J 2022. [DOI: 10.15562/bmj.v11i1.3100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
19
|
Bajamal AH, Permana KR, Faris M, Zileli M, Peev NA. Classification and Radiological Diagnosis of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations. Neurospine 2022; 18:656-666. [PMID: 35000319 PMCID: PMC8752700 DOI: 10.14245/ns.2142650.325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/16/2021] [Indexed: 11/19/2022] Open
Abstract
The aim of this review to determine recommendations for classification and radiological diagnosis of thoracolumbar spine fractures. Recommendation was made through a literature review of the last 10 years. The statements created by the authors were discussed and voted on during 2 consensus meetings organized by the WFNS (World Federation Neurosurgical Societies) Spine Committee. The literature review was yielded 256 abstracts, of which 32 were chosen for full-text analysis. Thirteen papers evaluated the reliability of a classification system by our expert members and were also chosen in this guideline analysis. This literature review-based recommendation provides the classification and radiologic diagnosis in thoracolumbar spine fractures that can elucidate the management decision-making in clinical practice.
Collapse
Affiliation(s)
- Abdul Hafid Bajamal
- Division of Neuro-Spine, Department of Neurosurgery, Faculty of Medicine - Universitas Airlangga, Surabaya, Indonesia.,Airlangga University Hospital Surabaya, Surabaya, Indonesia
| | - Khrisna Rangga Permana
- Division of Neuro-Spine, Department of Neurosurgery, Faculty of Medicine - Universitas Airlangga, Surabaya, Indonesia.,Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Muhammad Faris
- Division of Neuro-Spine, Department of Neurosurgery, Faculty of Medicine - Universitas Airlangga, Surabaya, Indonesia.,Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Mehmet Zileli
- Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey
| | - Nikolay A Peev
- Department of Neurosurgery, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| |
Collapse
|
20
|
Costa F, Sharif S, Bajamal AH, Shaikh Y, Anania CD, Zileli M. Clinical and Radiological Factors Affecting Thoracolumbar Fractures Outcome: WFNS Spine Committee Recommendations. Neurospine 2022; 18:693-703. [PMID: 35000322 PMCID: PMC8752690 DOI: 10.14245/ns.2142518.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022] Open
Abstract
To obtain a list of recommendations about clinical and radiological factors affecting outcome in thoraco-lumbar fractures with the aim of helping spine surgeons in daily practice. A systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020 on the topic "thoracolumbar fracture AND radiology AND surgical outcomes" and "thoracolumbar fracture AND radiology AND surgical outcomes." A total of 58 papers were analyzed and WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meetings to formulate the specific recommendations the first in Peshawar in December 2019 and in a subsequent virtual meeting in June 2020 to reach an agreement. Both meetings utilized the Delphi method to analyze preliminary literature review statements based on the current evidence levels to generate recommendations through a comprehensive voting session. Eight statements were presented and reached the consensus about this topic. A variety of clinical factors is known to influence outcome of patients with thoracolumbar fractures. Some of these are well-known established factors such as blood pressure augmentation and patient age, while some are not well studied. Overall, the quality of evidence is low and we need more randomized controlled studies to validate our results. Similarly, radiological factors that can predict outcome are well stated and there is a high accordance worldwide. In reverse, still under debate is the application to choose which surgical treatment is advisable based on them.
Collapse
Affiliation(s)
- Francesco Costa
- IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Abdul Hafid Bajamal
- Division of Neuro-Spine, Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Airlangga, Indonesia.,Airlangga University Hospital, Surabaya, Indonesia
| | - Yousuf Shaikh
- Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | | | - Mehmet Zileli
- Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey
| |
Collapse
|
21
|
Permana GI, Faris M, Subagio EA, Bajamal AH. The effects of the coronavirus disease 2019 pandemic on neurospine surgery practice in the referral center hospital developing country. Surg Neurol Int 2022; 12:620. [PMID: 34992936 PMCID: PMC8720481 DOI: 10.25259/sni_708_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/13/2021] [Indexed: 11/08/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic represents a once in a century challenge to human health care with over 4.5 million cases and over 300,000 deaths thus far. Surgical practice has been significantly impacted with all specialties writing guidelines for how to manage during this crisis. This study reported the effect of the COVID-19 pandemic on the neurosurgical practice, especially neurospine, in the outpatient visit, emergency department, and the surgical procedure. Methods: This study is the comparative retrospective about neurospine practice in the outpatient visit, emergency department, and the surgical procedure among before and during COVID-19 pandemic. We recorded data from January to December 2019 (before COVID-19 pandemic) and compared with the same period in the 2020 (during a COVID-19 pandemic). Results: A total of the outpatient visits, the average number per month was 28 ± 10.5 visits per month before the pandemic. The average number outpatient visit per month during the pandemic was 19 ± 11.1 visits per month, with the lowest in July 2020. The result of the average monthly neurospine surgical procedure before the pandemic was 5 ± 1.9 operations per month. Compared during the pandemic, there was decreased in the neurospine surgical procedure with the average number was 2 ± 2.7 operations per month. The decreased number significantly happens in the surgical procedure and emergency department patient (P < 0.05), while in the outpatient visit, the decreased statistically not significantly (P > 0.05). Conclusion: The COVID-19 pandemic changed all scopes of medical practice and training. Considering the limitation in the available resources, the number of educational cases may decrease in subspecialized disciplines such as neurospine neurosurgery. The COVID-19 pandemic affects in the neurospine and neurosurgery treatment policy in the referral tertiary hospital.
Collapse
Affiliation(s)
- Galih Indra Permana
- Department of Neurosurgery, Airlangga University, - Dr. Soetomo General Academic Hospital, Surabaya, West Java, Indonesia
| | - Muhammad Faris
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, West Java, Indonesia
| | - Eko Agus Subagio
- Department of Neurosurgery, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, West Java, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Airlangga University, - Dr. Soetomo General Academic Hospital, Surabaya, West Java, Indonesia
| |
Collapse
|
22
|
Parenrengi MA, Suryaningtyas W, Al Fauzi A, Hafid Bajamal A, Kusumastuti K, Utomo B, Muslim Hidayat Thamrin A, Sulistiono B. Nimotuzumab as Additional Therapy for GLIOMA in Pediatric and Adolescent: A Systematic Review. Cancer Control 2022; 29:10732748211053927. [PMID: 35191733 PMCID: PMC8874160 DOI: 10.1177/10732748211053927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Pediatric gliomas represent the most common brain tumor in children and its higher grades are associated with higher recurrence and low survival rate. All therapeutic modalities are reported to be insufficient to achieve satisfactory result, with follow-up treatment such as adjuvant radiotherapy and chemotherapy recommended to increase survival and hinder tumor progression. Nimotuzumab is a monoclonal antibody that acts as an inhibitor of epidermal growth factor receptor found on the surface of glioma cells and had been studied for its usage in pediatric gliomas in recent years. METHODS A systematic review is performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A through literature search was conducted on PubMed, Scopus, Cochrane, and clinicaltrials.gov database. Articles were selected systematically based on the PRISMA protocol and reviewed completely. The relevant data were summarized and discussed. We measured overall survival, progression-free survival, and adverse Events (AE) for nimotuzumab usage as an adjunct therapy in pediatric glioma population. RESULT From 5 studies included for qualitative analysis, 151 patients are included with overall survival (OS) that vary from 3.2-22.8 mo, progression-free survival (PFS) from 1.7-21.6 mo, and relatively low serious adverse events (0-21) are recorded. Follow-up ranged from 2.4-66 mo with four studies reporting diffuse intrinsic pontine glioma (DIPG) patients and only one study reporting nimotuzumab usage in pediatric high-grade glioma (HGG) patients with better outcome in HGG patients than DIPG. CONCLUSION There are no significant differences in the PFS and OS of nimotuzumab as adjunct therapy for pediatric compared to result of standard therapy in majority of previous studies. There were also no differences in the AE of nimotuzumab for pediatric glioma between studies, and low event of serious adverse events indicating its safety. But still there is an evidence of possible benefit of nimotuzumab as adjuvant therapy in pediatric glioma. We recommend further studies with larger number of patients that may lead to possibly different results. There should also be more studies with better level of evidence to further validate the effect of nimozutumab on pediatric glioma.
Collapse
Affiliation(s)
- Muhammad A Parenrengi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Wihasto Suryaningtyas
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Kurnia Kusumastuti
- Department of Neurology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Budi Utomo
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ahmad Muslim Hidayat Thamrin
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Bagus Sulistiono
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| |
Collapse
|
23
|
Utomo SA, Bajamal AH, Yueniwati Y, Sanjaya ID, Fauziah D. Apparent Diffusion Coefficient Values and Dynamic Contrast-Enhanced Magnetic Resonance Perfusion are Potential Predictors for Grading Meningiomas. Int J Med Sci 2022; 19:1364-1376. [PMID: 36035372 PMCID: PMC9413562 DOI: 10.7150/ijms.75092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/08/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose: Distinguishing between high-grade and low-grade meningiomas might be difficult but has high clinical value in deciding precise treatment and prognostic factors. Magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) values and dynamic contrast enhancement (DCE) may have a significant role in capturing such complexities. Methods: Data from our hospital database on meningioma patients from January 2020 to December 2021 were obtained. The MRI results of all patients were evaluated for mean ADC value and DCE parameters, including time-signal intensity curves (TIC), maximum signal intensity (SImax), time to maximum signal intensity (Tmax), maximum contrast enhancement ratio (MCER), and slope. Results: In this retrospective analysis, 33 individuals were included. Twenty-eight (84.8%) patients were pathologically diagnosed with low-grade meningioma and five (15.2%) patients with high-grade meningioma. There is a crossover between high- and low-grade meningiomas in conventional MRI. Tumor size, location, shape, necrotic/cystic changes, peritumoral edema, and enhancement patterns did not differ substantially between groups (p = 0.39, 0.23, 0.28, 0.57, 0.56, and 0.33, respectively). The mean ADC and Tmax values of high-grade meningiomas were substantially lower than those of low-grade meningiomas (p = 0.002 and 0.02, respectively). An optimal cut-off of 0.87 × 10-3 mm2s-1 for the mean ADC value (area under the curve [AUC] = 0.94, sensitivity = 80%, specificity = 92.8%) and 42 s for Tmax (AUC = 0.84, sensitivity = 80%, specificity = 89.3%) was suggested. High-grade meningiomas had significantly higher TIC, SImax, MCER, and slope than low-grade meningiomas (p = 0.004, < 0.001, 0.01, and 0.001, respectively). Type IV TIC had a sensitivity of 80% and specificity of 89.3% in distinguishing high-grade meningiomas from low-grade meningiomas. Optimal cut-offs of 940.2 for SImax (AUC = 0.98, sensitivity = 80%, specificity = 96.4%), 245% for MCER (AUC = 0.94, sensitivity = 80%, specificity = 85.7%), and 5% per second for slope (AUC = 0.97, sensitivity = 80%, specificity = 96.4%) were estimated. Conclusion: The ADC value and DCE-MRI parameters (TIC, SImax, Tmax, MCER, and slope) are potential predictors for separating high-grade from low-grade meningiomas.
Collapse
Affiliation(s)
- Sri Andreani Utomo
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Indonesia.,Department of Radiology, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Yuyun Yueniwati
- Department of Radiology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Irfan Deny Sanjaya
- Department of Radiology, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Dyah Fauziah
- Department of Anatomical Pathology, Faculty of Medicine, Universitas Airlangga, Indonesia
| |
Collapse
|
24
|
Bajamal AH, Apriawan T, Ranuh IAR, Servadei F, Faris M, Al Fauzi A. Comparison of half-molar sodium lactate and mannitol to treat brain edema in severe traumatic brain injury: A systematic review. Chin J Traumatol 2021; 24:344-349. [PMID: 34344615 PMCID: PMC8606601 DOI: 10.1016/j.cjtee.2021.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/04/2021] [Accepted: 06/17/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Hypertonic fluids such as mannitol and half-molar sodium lactate are given to treat intracranial hypertension in patients with severe traumatic brain injury (TBI). In this study, sodium lactate was compared to mannitol in patients with TBI to investigate the efficacy in reducing intracranial pressure (ICP). METHODS This study was a systematic review with literature research on articles published in any year in the databases of PubMed, ScienceDirect, Asian Journal of Neurosurgery, and Cochrane Central Register of Controlled Trials. The keywords were "half-molar sodium lactate", "mannitol", "cerebral edema or brain swelling", and "severe traumatic brain injury". The inclusion criteria were (1) studies published in English, (2) randomized control trials or retrospective/prospective studies on TBI patients, and (3) therapies including half-molar sodium lactate and mannitol and (4) sufficient data such as mean difference (MD) and risk ratio (RR). Data analysis was conducted using Review Manager 5.3. RESULTS From 1499 studies, a total of 8 studies were eligible. Mannitol group reduced ICP of 0.65 times (MD 0.65; p = 0.64) and improved cerebral perfusion pressure of 0.61 times (MD 0.61; p = 0.88), better than the half-molar group of sodium lactate. But the half-molar group of sodium lactate maintained the mean arterial pressure level of 0.86 times, better than the mannitol group (MD 0.86; p = 0.09). CONCLUSION Half-molar sodium lactate is as effective as mannitol in reducing ICP in the early phase of brain injury, superior over mannitol in an extended period. It is able to prevent intracranial hypertension and give better brain tissue perfusion as well as more stable hemodynamics. Blood osmolarity is a concern as it increases serum sodium.
Collapse
Affiliation(s)
- Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Tedy Apriawan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - I.G.M. Aswin R. Ranuh
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Franco Servadei
- Department of Neurosurgery, Humanitas Clinical and Research Hospital, Humanitas University, Milan, Italy
| | - Muhammad Faris
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia,Corresponding author.
| |
Collapse
|
25
|
Fahmi A, Subianto H, Nugraha P, Hamdan M, Fauzi AA, Sensusiati AD, Utomo B, Sarno R, Turchan A, Machfoed MH, Taira T, Bajamal AH. VIM Line Technique for Determining the Ventral Intermediate Location. Turk Neurosurg 2021; 31:601-606. [PMID: 33978218 DOI: 10.5137/1019-5149.jtn.31961-20.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM To prove that VIM line technique created by using a mathematical model, can be used to identify the location of the ventral intermediate nucleus of the thalamus (VIM) MATERIAL and METHODS: Eleven patients with Parkinson?s disease (PD) were assessed. To determine the VIM location, 3-T magnetic resonance imaging and stereotactic protocol 128-slice computed tomography were used. The VIM line technique was performed by drawing a line from the end-point of the right external globus pallidus to that of the left external globus pallidus in the intercommissural plane. PD severity was measured using the Unified Parkinson?s Disease Rating Scale (UPDRS). RESULTS A mathematical model was constructed to describe the VIM line technique for determining the VIM location. UPDRS scores before and after thalamotomy showed a significant decreasing trend (p=0.003). CONCLUSION The VIM line technique using the mathematical model can be considered a referential method to determine the VIM location. Its effectiveness was demonstrated by decreased UPDRS scores in patients after VIM thalamotomy.
Collapse
Affiliation(s)
- Achmad Fahmi
- Universitas Airlangga, Faculty of Medicine, Post Graduate Doctoral Program, Surabaya, Indonesia
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Darlan D, Prasetya GB, Ismail A, Pradana A, Fauza J, Dariansyah AD, Wardana GA, Apriawan T, Bajamal AH. Algorithm of Traumatic Brain Injury in Pregnancy (Perspective on Neurosurgery). Asian J Neurosurg 2021; 16:249-257. [PMID: 34268147 PMCID: PMC8244712 DOI: 10.4103/ajns.ajns_243_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/06/2020] [Accepted: 12/28/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The maternal deaths due to obstetrical cases declined, but the maternal deaths that caused by nonobstetrical cases still increase. The study reported that traumatic cases in pregnancy are the highest causes of mortality in pregnancy (nonobstetrical cases) in the United States. Another study reported that 1 in 12 pregnant women that experienced traumatic accident and as many as 9.1% of the trauma cases were caused by traumatic brain injury (TBI). The female sex hormone has an important role that regulates the hemodynamic condition. Anatomical and physiological changes during pregnancy make the examination, diagnosis, and treatment of TBI different from non-pregnant cases. Therefore, it is very important to lead the algorithm for each institution based on their own resources. CASE SERIES A 37-year-old woman with a history of loss of consciousness after traffic accident. She rode a motorbike then hit the car. She was referred at 18 weeks' gestation. Glasgow Coma Scale (GCS) E1V1M4, isochoric of the pupil, reactive to the light reflex, and right-sided hemiparesis. The non-contrast head computed tomography (CT) scan revealed subdural hematoma (SDH) in the left frontal-temporal-parietal region, SDH of the tentorial region, burst lobe intracerebral hemorrhage, and cerebral edema. There was not a fetal distress condition. The next case, a 31 years old woman, in 26 weeks gestation, had a history of unconscious after motorcycle accident then she fell from the height down to the field about 3 m. GCS E1V1M3, isochoric of the pupil, but the pupil reflex decreased. Noncontrast CT scan revealed multiple contusion, subarachnoid hemorrhage, and cerebral edema. She had a good fetal condition. DISCUSSION We proposed the algorithm of TBI in pregnancy that we already used in our hospital. The main principle of the initial management must be resuscitating the mother and that also the maternal resuscitation. The primary and secondary survey is always prominent of the initial treatment. CONCLUSION The clinical decision depends on the condition of the fetal, the surgical lesion of the intracranial, and also the resources of the neonatal intensive care unit in our hospital.
Collapse
Affiliation(s)
- Ditto Darlan
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Galan Budi Prasetya
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Arif Ismail
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Aditya Pradana
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Joandre Fauza
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ahmad Data Dariansyah
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Gigih Aditya Wardana
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Tedy Apriawan
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| |
Collapse
|
27
|
Zileli M, Sharif S, Fornari M, Ramani P, Jian F, Fessler R, Kim SH, Takami T, Shimokawa N, Dechambenoit G, Qureshi M, Konovalov N, Masini M, Osorio-Fonseca E, Sanchez JAS, Bajamal AH, Parthiban J, Sih IM, Alves ÓL, Oertel J, Rasulic L, Costa F, Peul WC, Sharma K, Eldin MM, Ismail NJ, Esene IN, Hossain M, Kalevski S, Hausmann ON, Yaman O, Arif S, Brady Z. Reply to Commentary on "History of Spinal Neurosurgery and Spine Societies". Neurospine 2021; 18:254-255. [PMID: 33819953 PMCID: PMC8021844 DOI: 10.14245/ns.2142236.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mehmet Zileli
- Department of Neurosurgery, Ege University, Izmir, Turkey, Izmir, Turkey
| | - Salman Sharif
- Liaquat National Hospital & Medical College, Karachi, Pakistan
| | | | - Premenand Ramani
- Department of Neurosurgery, L.T.M. Medical College, University of Mumbai, Mumbai, India
| | - Fengzeng Jian
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Richard Fessler
- Department of Neurosurgery, Rush University Medical Center, Chicago, United States
| | - Se-Hoon Kim
- Department of Neurosurgery, Ansan Hospital, Korea University Medical Center, Ansan, Korea
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka Medical College, Takatsuki, Japan
| | | | | | - Mahmood Qureshi
- President Continental Association of African Neurosurgical Socieites (CAANS), Nairobi, Kenya
| | - Nikolay Konovalov
- Department of Neurosurgery, Burdenko Institute, Moscow, Russian Federation
| | - Marcos Masini
- Department of Neurosurgery, São Paulo State University, São Paulo, Brazil
| | | | | | | | - Jutty Parthiban
- Department of Neurosurgery, Kovai Medical Center, Tamilnadu, India
| | - Ibet Marie Sih
- University of the Philippines, St. Luke's Medical Center, Bonifacio Global City, Philippines
| | | | - Joachim Oertel
- Department of Neurosurgery, University of Saarland, Homburg, Saar, Germany
| | - Lukas Rasulic
- Department of Neurosurgery, University of Belgrade, Clinical Center of Serbia, Belgrade, Serbia, Slovenia
| | - Francesco Costa
- Department of Neurosurgery, Humanitas University, Milan, Italy
| | - Wilco C Peul
- Department of Neurosurgery, Leiden University Medical Centre, Leiden, Netherlands
| | - Krishna Sharma
- Department of Neurosurgery, Nepal Medical College and Teaching Hospital, Kathmandu University, Kathmandu, Nepal
| | | | | | - Ignatius Ngene Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Mohammad Hossain
- Department of Neurosurgery, Bangabandhu Shiek Mujib Medical University, Dhka, Bangladesh
| | - Svetoslav Kalevski
- Multi-profile Hospital "St Anna-Varna", Medical University of Varna, Varna, Bulgaria
| | - Oliver N Hausmann
- Department of Neurosurgery, Hirslanden Klinik St. Anna Lucerne, Lucerne, Switzerland
| | | | | | | |
Collapse
|
28
|
Utomo SA, Bajamal AH, Faris M, Ardiansyah D, Lunardhi JH. Long Completely Cystic Sciatic Schwannoma: A Rare Case. Case Rep Oncol 2021; 14:561-567. [PMID: 33976634 PMCID: PMC8077366 DOI: 10.1159/000514633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/21/2021] [Indexed: 11/19/2022] Open
Abstract
Schwannomas are the most common peripheral nerve sheath tumors. Benign schwannomas with malignant transformation are rarely reported. Most common schwannomas occur in the head and neck region. Sciatic schwannomas are rare, as are completely cystic schwannomas. Sciatic nerve schwannomas represent less than 1% of all schwannomas. Benign tumors in the sciatic nerve consist of 60% neurofibromas and 38% schwannomas. In general, a schwannoma induces chronic symptoms. It can be misleading, sometimes mimicking degenerative spinal pathology due to disc herniation. Schwannoma involving the sciatic nerve can be asymptomatic or may present with sciatica or neurological deficits. Most schwannomas are solid or heterogeneous tumors, and completely cystic schwannomas are rare. The differential diagnoses of nondiscogenic sciatica include lumbar disc herniation, tumor, abscess, hematoma, facet syndrome, lumbar instability, sacroiliitis, piriformis syndrome, and sciatic neuritis. We report a rare case of a long completely cystic sciatic schwannoma in the left foraminal L5–S1 zone extending to the left ischial groove with chronic sciatica that was diagnosed radiologically with a combination of conventional MRI and MR neurography and confirmed histopathologically by surgical resection. The patient previously had conservative therapy, but the complaints were not reduced. Nonsurgical therapy is considered the first choice, and surgical therapy is indicated in cases that do not respond to conservative therapy, with recurrent cysts, severe pain, or neurological deficits.
Collapse
Affiliation(s)
- Sri Andreani Utomo
- Doctoral Program Health Science, Airlangga University, Surabaya, Indonesia.,Radiology Department, Airlangga University, Surabaya, Indonesia
| | | | - Muhammad Faris
- Neurosurgery Department, Airlangga University, Surabaya, Indonesia
| | | | | |
Collapse
|
29
|
Fahmi A, Subianto H, Nugraha P, Hamdan M, Al Fauzi A, Sensusiati AD, Utomo B, Sarno R, Turchan A, Macfoed MH, Taira T, Bajamal AH. Vim line technique thalamotomy for Parkinson tremor: Case series. Int J Surg Case Rep 2021; 77:573-575. [PMID: 33395848 PMCID: PMC7708753 DOI: 10.1016/j.ijscr.2020.11.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022] Open
Abstract
Vim thalamotomy is a usual procedure to control Parkinson tremor. The ventral intermediate nucleus of the thalamus is difficult to identify. The precision is crucial importance for the successful Vim thalamotomy. Vim line technique (VLT) is useful for the determination of the vim location.
Introduction The ventral intermediate (Vim) nucleus of the thalamus is difficult to identify even with 3 T magnetic resonance imaging. Stereotactic Vim thalamotomy is a usual procedure to control Parkinson tremor. Successful relieving of the tremor depends on the accuracy of defining the Vim location. Presentation of cases Three patients with Parkinson tremor were subjected to stereotactic thalamotomy using the Vim line technique (VLT) so as to precisely determine the Vim location. All patients showed good results, with improved tremors, as indicated by the UPDRS score, without any complications. Discussion The precise targeting of the Vim nucleus is crucial importance for the successful Vim thalamotomy. Various method has been developed to determine Vim location. Atlas based and Guiot’s technique routinely used by neurosurgeon. VLT is a new technique that has been developed to determine the Vim location on MRI. Conclusion VLT is useful for the determination of the Vim location. However, further research is warranted to prove its effectiveness.
Collapse
Affiliation(s)
- Achmad Fahmi
- Post Graduate Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
| | - Heri Subianto
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Priya Nugraha
- Department of Neurology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Hamdan
- Department of Neurology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Budi Utomo
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Riyanarto Sarno
- Department of Informatics, Institut Teknologi Sepuluh November, Surabaya, Indonesia
| | - Agus Turchan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Mohammad Hasan Macfoed
- Department of Neurology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Takaomi Taira
- Department of Neurosurgery, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| |
Collapse
|
30
|
Suryaningtyas W, Wahyuhadi J, Turchan A, Subagio EA, Parenrengi MA, Apriawan T, Al Fauzi A, Bajamal AH. Neurosurgery at the epicenter of the COVID-19 pandemic in Indonesia: experience from a Surabaya academic tertiary hospital. Neurosurg Focus 2020; 49:E5. [PMID: 33260130 DOI: 10.3171/2020.9.focus20559] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/22/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Global outbreak of the novel coronavirus disease 2019 (COVID-19) has forced healthcare systems worldwide to reshape their facilities and protocols. Although not considered the frontline specialty in managing COVID-19 patients, neurosurgical service and training were also significantly affected. This article focuses on the impact of the COVID-19 outbreak at a low- and/or middle-income country (LMIC) academic tertiary referral hospital, the university and hospital policies and actions for the neurosurgical service and training program during the outbreak, and the contingency plan for future reference on preparedness for service and education. METHODS The authors collected data from several official databases, including the Indonesian Ministry of Health database, East Java provincial government database, hospital database, and neurosurgery operative case log. Policies and regulations information was obtained from stakeholders, including the Indonesian Society of Neurological Surgeons, the hospital board of directors, and the dean's office. RESULTS The curve of confirmed COVID-19 cases in Indonesia had not flattened by the 2nd week of June 2020. Surabaya, the second-largest city in Indonesia, became the epicenter of the COVID-19 outbreak in Indonesia. The neurosurgical service experienced a significant drop in cases (50% of cases from normal days) along all lines (outpatient clinic, emergency room, and surgical ward). Despite a strict preadmission screening, postoperative COVID-19 infection cases were detected during the treatment course of neurosurgical patients, and those with a positive COVID-19 infection had a high mortality rate. The reduction in the overall number of cases treated in the neurosurgical service had an impact on the educational and training program. The digital environment found popularity in the educational term; however, digital resources could not replace direct exposure to real patients. The education stakeholders adjusted the undergraduate students' clinical postings and residents' working schemes for safety reasons. CONCLUSIONS The neurosurgery service at an academic tertiary referral hospital in an LMIC experienced a significant reduction in cases. The university and program directors had to adapt to an off-campus and off-hospital policy for neurosurgical residents and undergraduate students. The hospital instituted a reorganization of residents for service. The digital environment found popularity during the outbreak to support the educational process.
Collapse
Affiliation(s)
- Wihasto Suryaningtyas
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and
| | - Joni Wahyuhadi
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and.,2The COVID-19 Curative Taskforce for The East Java Region, East Java Provincial Government, Surabaya, Indonesia
| | - Agus Turchan
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and
| | - Eko Agus Subagio
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and
| | - Muhammad Arifin Parenrengi
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and
| | - Tedy Apriawan
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and
| | - Asra Al Fauzi
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and
| | - Abdul Hafid Bajamal
- 1Department of Neurosurgery, Universitas Airlangga Faculty of Medicine-Dr. Soetomo Academic General Hospital, Surabaya; and
| |
Collapse
|
31
|
Zileli M, Sharif S, Fornari M, Ramani P, Jian F, Fessler R, Kim SH, Takami T, Shimokawa N, Dechambenoit G, Qureshi M, Konovalov N, Masini M, Osorio-Fonseca E, Sanchez JAS, Bajamal AH, Parthiban J, Sih IM, Alves ÓL, Oertel J, Rasulic L, Costa F, Peul WC, Sharma K, Eldin MM, Ismail NJ, Esene IN, Hossain M, Kalevski S, Hausmann ON, Yaman O, Arif S, Brady Z. History of Spinal Neurosurgery and Spine Societies. Neurospine 2020; 17:675-694. [PMID: 33401848 PMCID: PMC7788429 DOI: 10.14245/ns.2040622.311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Mehmet Zileli
- Department of Neurosurgery, Ege University, Izmir, Turkey
| | - Salman Sharif
- Liaquat National Hospital & Medical College, Karachi, Pakistan
| | | | - Premenand Ramani
- Department of Neurosurgery, L.T.M. Medical College, University of Mumbai, Mumbai, India
| | - Fengzeng Jian
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Richard Fessler
- Department of Neurosurgery, Rush University Medical Center, Chicago, USA
| | - Se-Hoon Kim
- Department of Neurosurgery, Ansan Hospital, Korea University Medical Center, Ansan, Korea
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka Medical College, Takatsuki, Japan
| | | | | | - Mahmood Qureshi
- President Continental Association of African Neurosurgical Socieites (CAANS), Nairobi, Kenya
| | - Nikolay Konovalov
- Department of Neurosurgery, Burdenko Institute, Moscow, Russian Federation
| | - Marcos Masini
- Department of Neurosurgery, São Paulo State University, São Paulo, Brazil
| | | | | | | | - Jutty Parthiban
- Department of Neurosurgery, Kovai Medical Center, Tamilnadu, India
| | - Ibet Marie Sih
- University of the Philippines, St. Luke’s Medical Center, Bonifacio Global City, The Philippines
| | | | - Joachim Oertel
- Department of Neurosurgery, University of Saarland, Homburg, Saar, Germany
| | - Lukas Rasulic
- Department of Neurosurgery, University of Belgrade, Clinical Center of Serbia, Belgrade, Serbia, Slovenia
| | - Francesco Costa
- Department of Neurosurgery, Humanitas University, Milan, Italy
| | - Wilco C. Peul
- Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Krishna Sharma
- Department of Neurosurgery, Nepal Medical College and Teaching Hospital, Kathmandu University, Kathmandu, Nepal
| | | | | | - Ignatius Ngene Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Mohammad Hossain
- Department of Neurosurgery, Bangabandhu Shiek Mujib Medical University, Dhka, Bangladesh
| | - Svetoslav Kalevski
- Multi-profile Hospital “St Anna-Varna”, Medical University of Varna, Varna, Bulgaria
| | - Oliver N. Hausmann
- Department of Neurosurgery, Hirslanden Klinik St. Anna Lucerne, Lucerne, Switzerland
| | | | | | | |
Collapse
|
32
|
Apriawan T, Permana KR, Darlan D, Arifianto MR, Fitra F, Alfauzi A, Bajamal AH. Polylactic Acid Implant for Cranioplasty with 3-dimensional Printing Customization: A Case Report. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.5156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Cranioplasty is aimed to restore the structure and function of the lost portion of the skull defect. Many materials can be used for cranioplasty, such as the bones of the patient (autograft), the bones of other patients (allograft), bones of animals (xenograft), or synthetic materials such as acrylic or titanium mesh. These materials are quite expensive and sometimes require complex processes. Manual shaping of material for cranioplasty is also quite time-consuming and prone to cause esthetic dissatisfaction. The author will discuss the case of using polylactic acid (PLA) implant with 3-dimensional (3D) printing customization as a cheap and accurate cosmetic solution for cranioplasty procedures.
CASE REPORT: We report 2 cases of skull defect underwent cranioplasty. The first case, female, 20-year-old, had a history of severe traumatic brain injury (TBI) and epidural hematoma. She underwent decompression craniotomy on the left frontotemporoparietal region of her skull. The second case, male, 46-year-old, had a history of spontaneous intracerebral hemorrhage due to arteriovenous malformation (AVM). He underwent decompression craniotomy on the right frontotemporoparietal region of her skull. Both the data of computerized tomography (CT) scan were reconstructed to get 3D model of skull defect. Prosthesis was made by 3D printer accordingly using PLA as material. There was no complication reported postoperatively and cosmetic satisfaction was obtained on both cases.
CONCLUSION: The use of PLA implant with 3D printing customization was proved to be cost-effective and good cosmetic satisfaction with no complication reported following cranioplasty procedure.
Collapse
|
33
|
Destiansyah RA, Rahmadhan MA, Niantiarno FH, Yusuf Y, Dustur S, Permana GI, Balafif F, Ranuh IAR, Apriawan T, Bajamal AH. Modification of Periosteal Flap as Management of Cerebrospinal Fluid Leakage after Frontal Sinus Fracture Surgery in Moderate Traumatic Brain Injury Patients. Asian J Neurosurg 2020; 15:1076-1080. [PMID: 33708693 PMCID: PMC7869298 DOI: 10.4103/ajns.ajns_206_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/23/2019] [Accepted: 11/19/2019] [Indexed: 11/04/2022] Open
Abstract
Main management for the frontal sinus fracture is using the pericranial flap. Pericranial flaps based on the supraorbital and supratrochlear vasculature have previously been used with significant success for the separation of intracranial and extracranial spaces after major trauma. Defect closure was modified due to lack of the frontal periosteum; the graft was made from the temporal side of periosteum to make primary periosteal flap longer. Defect closure could be optimum. Evaluation for 6 months showed a significant improvement without major complications. In this article, we propose a new modification technique as one of promising alternatives.
Collapse
Affiliation(s)
- Rifqi Aulia Destiansyah
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mustaqim Apriyansa Rahmadhan
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Fajar Herbowo Niantiarno
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Yusuf Yusuf
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Shafhan Dustur
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Galih Indra Permana
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Fachriy Balafif
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Igm Aswin Rahmadi Ranuh
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Tedy Apriawan
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia
| |
Collapse
|
34
|
Suryaningtyas W, Parenrengi MA, Bajamal AH, Rantam FA. Lipid Peroxidation Induces Reactive Astrogliosis by Activating WNT/β-Catenin Pathway in Hydrocephalus. Malays J Med Sci 2020; 27:34-42. [PMID: 32684804 PMCID: PMC7337957 DOI: 10.21315/mjms2020.27.3.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/23/2020] [Indexed: 01/14/2023] Open
Abstract
Background Hydrocephalus induces mechanical and biochemical changes in neural cells of the brain. Astrogliosis, as the hallmark of cellular changes in white matter, is involved in demyelination process, re-myelination inhibitory effect, and inhibition of axonal elongation and regeneration. The pathophysiology of this process is not well understood. The purpose of the present study is to elucidate the effect of lipid peroxidation product on astrogliosis through WNT/ β-catenin in kaolin-induced hydrocephalic rats. Methods The study used kaolin-induced hydrocephalic rats. Obstructive hydrocephalus was expected to develop within seven days after induction. The hydrocephalus animals were killed at day 7, 14 and 21 after induction. One group of the saline-injected animals was used for sham-treatment. Results We demonstrated that the hydrocephalic rats exhibited a high expression of 4-hydroxynonenal (4-HNE) in the periventricular area. The expression of β-catenin also increased, following the pattern of 4-HNE. Reactive astrocyte, expressed by positive glial fibrillary acidic protein (GFAP), was upregulated in an incremental fashion as well as the microglia. Conclusion This work suggests that lipid peroxidation product, 4-HNE, activated the WNT/β-catenin pathway, leading to the development of reactive astrocyte and microglia activation in hydrocephalus.
Collapse
Affiliation(s)
- Wihasto Suryaningtyas
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Muhammad Arifin Parenrengi
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Fedik Abdul Rantam
- Department of Veterinary Microbiology, Faculty of Veterinary Medicine and Laboratory for Stem Cell Research, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| |
Collapse
|
35
|
Fahmi A, Subianto H, Suroto NS, Utomo B, Sarno R, Turchan A, Bajamal AH. Stereotactic aspiration of spontaneous intracerebral hematoma: Case series. Int J Surg Case Rep 2020; 72:229-232. [PMID: 32544834 PMCID: PMC7298528 DOI: 10.1016/j.ijscr.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 12/02/2022] Open
Abstract
Stereotactic hematoma evacuation can be performed without anticoagulant agent. Stereotactic evacuation of intracerebral hematoma can be adopted in any center. Stereotactic evacuation of intracerebral hematoma is a safe procedure. Stereotactic surgery can minimize brain injury.
Introduction Minimally invasive techniques such as stereotactic aspiration of spontaneous intracerebral hematoma (SICH) evacuation can minimize brain tissue damage due to surgery. We share our experience of adopting stereotactic aspiration of SICH in our center without compromising safety. Presentation of cases Three stereotactic aspiration procedures for SICH immediately after 24 h of onset are reported. All cases showed good results. Level of consciousness of all the patient returned to normal. Two patients could carry out routine activities independently. One patient has left hemiparesis. Discussion Stereotactic aspiration of SICH has been newly implemented at our center with acceptable results achieved. Patient selection has an important role in determining the choice of technique. The procedures were done without anticoagulant agent. Stereotactic aspiration of SICH is associated with limited brain tissue damage, shorter duration of surgery, reduced length of stay, faster postoperative healing, and better functional improvement. Conclusion Stereotactic aspiration of SICH is a minimally invasive defined strategy for hematoma evacuation without compromising safety.
Collapse
Affiliation(s)
- Achmad Fahmi
- Post Graduate Doctoral Program, Faculty of Medicine, Universitas Airlangga, Indonesia; Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Indonesia.
| | - Heri Subianto
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Nur Setiawan Suroto
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Budi Utomo
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Riyanarto Sarno
- Department of Informatics, Institute Teknologi Sepuluh November, Indonesia
| | - Agus Turchan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Indonesia
| |
Collapse
|
36
|
Kato Y, Liew BS, Sufianov AA, Rasulic L, Arnautovic KI, Dong VH, Florian IS, Olldashi F, Makhambetov Y, Isam B, Thu M, Enkhbayar T, Kumarasinghe N, Bajamal AH, Nair S, Sharif S, Sharma MR, Landeiro JA, Yampolsky CG, El-Ghandour NMF, Hossain AM, Sim S, Chemate S, Burhan H, Feng L, Andrade H, Germano IM. Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries. Chin Neurosurg J 2020; 6:19. [PMID: 32922948 PMCID: PMC7398343 DOI: 10.1186/s41016-020-00194-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 04/13/2020] [Indexed: 01/19/2023] Open
Abstract
Globally, the discipline of neurosurgery has evolved remarkably fast. Despite being one of the latest medical specialties, which appeared only around hundred years ago, it has witnessed innovations in the aspects of diagnostics methods, macro and micro surgical techniques, and treatment modalities. Unfortunately, this development is not evenly distributed between developed and developing countries. The same is the case with neurosurgical education and training, which developed from only traditional apprentice programs in the past to more structured, competence-based programs with various teaching methods being utilized, in recent times. A similar gap can be observed between developed and developing counties when it comes to neurosurgical education. Fortunately, most of the scholars working in this field do understand the coherent relationship between neurosurgical education and neurosurgical practice. In context to this understanding, a symposium was organized during the World Federation of Neurological Surgeons (WFNS) Special World Congress Beijing 2019. This symposium was the brain child of Prof. Yoko Kato—one of the eminent leaders in neurosurgery and an inspiration for female neurosurgeons. Invited speakers from different continents presented the stages of development of neurosurgical education in their respective countries. This paper summarizes the outcome of these presentations, with particular emphasis on and the challenges faced by developing countries in terms of neurosurgical education and strategies to cope with these challenges.
Collapse
Affiliation(s)
- Y Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - B S Liew
- Department of Neurosurgery, Hospital Sungai Buloh, Sungai Buloh, Selangor Malaysia
| | - A A Sufianov
- Federal State-Financed Institution "Federal Centre of Neurosurgery" of Ministry of Health of the Russian Federation, Tyumen, Russia.,I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - L Rasulic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - K I Arnautovic
- Semmes-Murphey Clinic and Department of Neurosurgery, University of Tennessee, Memphis, TN USA
| | - V H Dong
- Neurosurgery Center of Viet Duc university hospital, Hanoi, Vietnam
| | - I S Florian
- Department of Neurosurgery, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Cluj County Romania
| | - F Olldashi
- Department of Neurosurgery, University Hospital of Trauma, Tirana, Albania
| | | | - B Isam
- Federal State-Financed Institution "Federal Centre of Neurosurgery" of Ministry of Health of the Russian Federation, Tyumen, Russia
| | - M Thu
- Neurosurgical Centre, Yangon General Hospital, Yangoon, Myanmar
| | - Ts Enkhbayar
- Mongolian Neurosurgical Society, Ulaabaatar, Mongolia
| | | | - A H Bajamal
- Department of Neurosurgery, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | - S Nair
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - S Sharif
- Institute of Postgraduate Studies and Medical Sciences, Liaquat National Hospital & Medical College, Karachi, Pakistan
| | - M R Sharma
- Department of Neurosurgery, TU Teaching Hospital, Kathmandu, Nepal
| | - J A Landeiro
- Department of Neurosurgery, Universidade Federal Fluminense, Niterói, Brazil
| | - C G Yampolsky
- Department of Neurosurgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - N M F El-Ghandour
- Department of Neurosurgery, Faculty of Medicine, Cairo University, 81 Nasr Road, Nasr City, Cairo, Egypt
| | - A M Hossain
- Bangladesh Society of Neurosurgeons, Dhaka, Bangladesh
| | - S Sim
- Khema Clinic, 18 Street, Phnom Penh, 528 Cambodia
| | - S Chemate
- DNB Neurosurgery, Apollo Hospital, Chennai, India
| | - Hira Burhan
- Institute of Neurosciences, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal
| | - L Feng
- China International Neuroscience Institute, Beijing, China
| | - H Andrade
- Department of Neurosurgery, University Medicine Mannheim, Mannheim, Germany
| | | |
Collapse
|
37
|
Sharif S, Shaikh Y, Bajamal AH, Costa F, Zileli M. Fusion Surgery for Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations. World Neurosurg X 2020; 7:100077. [PMID: 32613190 PMCID: PMC7322802 DOI: 10.1016/j.wnsx.2020.100077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/11/2020] [Indexed: 02/06/2023] Open
Abstract
Lumbar spine stenosis represents a complex degenerative pathology that has been a subject of significant dispute when it comes to fusion. A review of the literature from 2008 to 2019 was performed on the role of fusion in the treatment of lumbar spinal stenosis using PubMed, Ovid Medline, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. Using the key words "lumbar spinal stenosis," "lumbar fusion," "lumbar decompression," and "lumbar pedicle screw fixation," the search revealed 490 papers. Of these, only Level 1 or Level 2 evidence papers were selected, leading to only 3 randomized controlled trials (RCTs) that were analyzed. None of the good-quality studies (RCTs) performed so far have proven any clinical benefit of adding fusion to degenerative lumbar spine decompression. The effect of spinal instability on the outcome following decompression remains controversial. At present, no unanimous criteria exist among the RCTs to identify what constitutes true instability. Fusion for instability or stenosis alone remains controversial, and the results are unconvincing. At this point, the issue expands to not only lumbar degenerative diseases but spinal fractures and lumbar isthmic spondylolisthesis. We thereby present the consensus of the World Federation of Neurosurgical Societies Spine Committee, which formulated the indications for lumbar spine fusion in degenerative lumbar stenosis.
Collapse
Affiliation(s)
- Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital & Medical College, Karachi, Pakistan
| | - Yousuf Shaikh
- Department of Neurosurgery, Liaquat National Hospital & Medical College, Karachi, Pakistan
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Airlangga University, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Francesco Costa
- Department of Neurosurgery, Humanitas Research Hospital, Milan, Italy
| | - Mehmet Zileli
- Department of Neurosurgery, Ege University Bornova, Izmir, Turkey
| |
Collapse
|
38
|
Servadei F, Tropeano MP, Spaggiari R, Cannizzaro D, Al Fauzi A, Bajamal AH, Khan T, Kolias AG, Hutchinson PJ. Footprint of Reports From Low- and Low- to Middle-Income Countries in the Neurosurgical Data: A Study From 2015 to 2017. World Neurosurg 2019; 130:e822-e830. [DOI: 10.1016/j.wneu.2019.06.230] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/28/2019] [Accepted: 06/29/2019] [Indexed: 11/26/2022]
|
39
|
Bajamal AH, Kim SH, Arifianto MR, Faris M, Subagio EA, Roitberg B, Udo-Inyang I, Belding J, Zileli M, Parthiban JKBC. Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations. Neurospine 2019; 16:421-434. [PMID: 31607074 PMCID: PMC6790723 DOI: 10.14245/ns.1938274.137] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 09/15/2019] [Indexed: 12/11/2022] Open
Abstract
Objective This study was conducted to determine and recommend the most up-to-date information on the indications, complications, and outcomes of posterior surgical treatments for cervical spondylotic myelopathy (CSM) on the basis of a literature review.
Methods A comprehensive literature search was performed, using the MEDLINE (PubMed), the Cochrane Register of Controlled Trials, and Web of Science databases, for peer-reviewed articles published in English during the last 10 years.
Results Posterior techniques, which include laminectomy alone, laminectomy with fusion, and laminoplasty, are often used in patients with involvement of 3 or more levels. Posterior decompression for CSM is effective for improving patients’ neurological function. Complications resulting from posterior cervical spine surgery include injury to the spinal cord and nerve roots, complications related to posterior screw fixation or instrumentation, C5 palsy, spring-back closure of lamina, and postlaminectomy kyphosis.
Conclusion It is necessary to consider multiple factors when deciding on the appropriate operation for a particular patient. Surgeons need to tailor preoperative discussions to ensure that patients are aware of these facts. Further research is needed on the cost-to-benefit analysis of various surgical approaches, the comparative efficacy of surgical approaches using various techniques, and long-term outcomes, as current knowledge is deficient in this regard.
Collapse
Affiliation(s)
- Abdul Hafid Bajamal
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Airlangga University, Surabaya, Indonesia
| | - Se-Hoon Kim
- Department of Neurosurgery, Korea University Ansan Hospital, Ansan, Korea
| | - Mohammad Reza Arifianto
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Airlangga University, Surabaya, Indonesia
| | - Muhammad Faris
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Airlangga University, Surabaya, Indonesia
| | - Eko Agus Subagio
- Department of Neurosurgery, Dr. Soetomo Academic General Hospital, Airlangga University, Surabaya, Indonesia
| | - Ben Roitberg
- Department of Neurosurgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Inyang Udo-Inyang
- Department of Neurosurgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jonathan Belding
- Department of Neurosurgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Mehmet Zileli
- Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, Turkey
| | | | | |
Collapse
|
40
|
Hutchinson PJ, Kolias AG, Tajsic T, Adeleye A, Aklilu AT, Apriawan T, Bajamal AH, Barthélemy EJ, Devi BI, Bhat D, Bulters D, Chesnut R, Citerio G, Cooper DJ, Czosnyka M, Edem I, El-Ghandour NMF, Figaji A, Fountas KN, Gallagher C, Hawryluk GWJ, Iaccarino C, Joseph M, Khan T, Laeke T, Levchenko O, Liu B, Liu W, Maas A, Manley GT, Manson P, Mazzeo AT, Menon DK, Michael DB, Muehlschlegel S, Okonkwo DO, Park KB, Rosenfeld JV, Rosseau G, Rubiano AM, Shabani HK, Stocchetti N, Timmons SD, Timofeev I, Uff C, Ullman JS, Valadka A, Waran V, Wells A, Wilson MH, Servadei F. Consensus statement from the International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury : Consensus statement. Acta Neurochir (Wien) 2019; 161:1261-1274. [PMID: 31134383 PMCID: PMC6581926 DOI: 10.1007/s00701-019-03936-y] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach. METHODS The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries. RESULTS The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval. CONCLUSIONS In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.
Collapse
Affiliation(s)
- Peter J Hutchinson
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK.
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.
| | - Angelos G Kolias
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Tamara Tajsic
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Amos Adeleye
- Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria
| | - Abenezer Tirsit Aklilu
- Neurosurgical Unit, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Tedy Apriawan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Soetomo General Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Soetomo General Hospital, Surabaya, Indonesia
| | - Ernest J Barthélemy
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - B Indira Devi
- Department of Neurosurgery, National Institute for Mental Health and Neurosciences, Bangalore, India
| | - Dhananjaya Bhat
- Department of Neurosurgery, National Institute for Mental Health and Neurosciences, Bangalore, India
| | - Diederik Bulters
- Wessex Neurological Centre, University Hospital Southampton, Southampton, UK
| | - Randall Chesnut
- Harborview Medical Center, University of Washington, Seattle, WA, USA
| | - Giuseppe Citerio
- School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
- Neuro-Intensive Care, Department of Emergency and Intensive Care, ASST, San Gerardo Hospital, Monza, Italy
| | - D Jamie Cooper
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care, Alfred Hospital, Melbourne, Victoria, Australia
| | - Marek Czosnyka
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK
| | - Idara Edem
- Division of Neurosurgery, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | | | - Anthony Figaji
- Division of Neurosurgery and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Kostas N Fountas
- Department of Neurosurgery, University Hospital of Larissa and University of Thessaly, Larissa, Greece
| | - Clare Gallagher
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Corrado Iaccarino
- Department of Neurosurgery, Azienda Ospedaliero Universitaria di Parma, Parma, Italy
| | - Mathew Joseph
- Department of Neurosurgery, Christian Medical College, Vellore, India
| | - Tariq Khan
- Department of Neurosurgery, North West General Hospital and Research Center, Peshawar, Pakistan
| | - Tsegazeab Laeke
- Neurosurgical Unit, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Oleg Levchenko
- Department of Neurosurgery, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
| | - Baiyun Liu
- Department of Neurosurgery, Beijing Tiantan Medical Hospital, Capital Medical University, Beijing, China
| | - Weiming Liu
- Department of Neurosurgery, Beijing Tiantan Medical Hospital, Capital Medical University, Beijing, China
| | - Andrew Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Paul Manson
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Anna T Mazzeo
- Anesthesia and Intensive Care Unit, Department of Surgical Sciences, University of Torino, Torino, Italy
| | - David K Menon
- Division of Anaesthesia, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Daniel B Michael
- Oakland University William Beaumont School of Medicine and Michigan Head & Spine Institute, Auburn Hills, MI, USA
| | - Susanne Muehlschlegel
- Departments of Neurology, Anesthesia/Critical Care & Surgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - David O Okonkwo
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kee B Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Jeffrey V Rosenfeld
- Department of Neurosurgery, Alfred Hospital, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Gail Rosseau
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Andres M Rubiano
- INUB/MEDITECH Research Group, El Bosque University, Bogotá, Colombia
- MEDITECH Foundation, Clinical Research, Cali, Colombia
| | - Hamisi K Shabani
- Department of Neurosurgery, Muhimbili Orthopedic-Neurosurgical Institute, Dar es Salaam, Tanzania
| | - Nino Stocchetti
- Department of Physiopathology and Transplantation, Milan University, Milan, Italy
- Neuroscience Intensive Care Unit, Department of Anaesthesia and Critical Care, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Shelly D Timmons
- Department of Neurological Surgery, Penn State University Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Ivan Timofeev
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, UK
| | - Chris Uff
- Department of Neurosurgery, The Royal London Hospital, London, UK
- Queen Mary University of London, London, UK
| | - Jamie S Ullman
- Department of Neurosurgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | - Alex Valadka
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Vicknes Waran
- Neurosurgery Division, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Adam Wells
- Department of Neurosurgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Mark H Wilson
- Imperial Neurotrauma Centre, Department of Surgery and Cancer, Imperial College, London, UK
| | - Franco Servadei
- Department of Neurosurgery, Humanitas University and Research Hospital, Milan, Italy
| |
Collapse
|
41
|
Suryaningtyas W, Arifin M, Rantam FA, Bajamal AH, Dahlan YP, Dewa Gede Ugrasena I, Maliawan S. Erythropoietin protects the subventricular zone and inhibits reactive astrogliosis in kaolin-induced hydrocephalic rats. Childs Nerv Syst 2019; 35:469-476. [PMID: 30661113 DOI: 10.1007/s00381-019-04063-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/14/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To elucidate the potential role of erythropoietin (EPO) as a neuroprotective agent against reactive astrogliosis and reducing the thinning rate of subventricular zone (SVZ) in kaolin-induced hydrocephalic rats. METHOD Thirty-six ten-week-old Sprague-Dawley rats were used in this study. Hydrocephalus was induced with 20% kaolin suspension injected into the cistern of thirty rats and leaving the six rats as normal group. The hydrocephalic rats were randomly divided into hydrocephalic and treatment group. The treatment group received daily dose of recombinant human erythropoietin (rhEPO) from day 7 to day 21 after induction. The animals were sacrificed at 7 (only for hydrocephalic group) and 14 or 21 (for both groups) days after induction. Brain was removed and was prepared for histological analysis by hematoxylin and eosin staining as well as immunohistochemistry for 4-HNE, GFAP, Iba-1, and Ki-67. RESULTS Histopathological analysis showed that animals treated with rhEPO had a reduced astrocyte reactivity displayed by lower GFAP expression. Hydrocephalic rats received rhEPO also displayed reduced microglial activation shown by lower Iba-1 protein expression. Exogenous rhEPO exerted its protective action in reducing astrogliosis by inhibiting lipid peroxidation that was documented in this study as lower expression of 4-HNE than non-treated group. The SVZ thickness was progressively declining in hydrocephalus group, while the progression rate could be reduced by rhEPO. CONCLUSION Erythropoietin has a potential use for inhibiting lipid peroxidation, and reactive astrogliosis in hydrocephalic animal model. The reduced thinning rate of SVZ demonstrated that EPO also had effect in reducing the hydrocephalus progressivity. Further research is warranted to explore its efficacy and safety to use in clinical setting.
Collapse
Affiliation(s)
- Wihasto Suryaningtyas
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen Prof Moestopo 6-8, Surabaya, Indonesia.
| | - Muhammad Arifin
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen Prof Moestopo 6-8, Surabaya, Indonesia
| | - Fedik Abdul Rantam
- Department of Veterinary Microbiology - Faculty of Veterinary Medicine And Laboratory for Stem Cell Research - Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen Prof Moestopo 6-8, Surabaya, Indonesia
| | - Yoes Prijatna Dahlan
- Department of Parasitology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - I Dewa Gede Ugrasena
- Department of Child Health, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Sri Maliawan
- Department of Neurosurgery, Faculty of Medicine Universitas Udayana - Sanglah General Hospital, Denpasar, Indonesia
| |
Collapse
|
42
|
Arifin M, Suryaningtyas W, Bajamal AH. Frontoethmoidal encephalocele: clinical presentation, diagnosis, treatment, and complications in 400 cases. Childs Nerv Syst 2018; 34:1161-1168. [PMID: 29305685 DOI: 10.1007/s00381-017-3716-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/25/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study is to review a large series of frontoethmoidal encephalocele (FEE) regarding their clinical presentation, the progressiveness of the mass volume, the skin stigmata as well as its surgical approach and post-surgical complications. METHOD Records of all FEE patients treated in Soetomo General Hospital, Surabaya, and Charity Foundation Program from 2008 to 2015 were reviewed. Detailed patient's demography, clinical findings, radiology results, operative procedures, and complications were documented. Follow-up was organized in weekly basis for the first 1 month after surgery or more often when situation or complication occurred. Wound healing, neurological assessment for new or progressive deficit, pseudomeningocele, skin breakdown, cerebrospinal fluid (CSF) leakage, exposed implant, recurrent mass, and cosmetic results were documented. Since most of the patients had no direct phone line at their hometown, we relied on social worker to contact them. RESULTS One-stage surgery was performed for 400 patients with FEE (212 were male and 188 were female). Of 400 patients, 388 (97%) were younger than 18 years old. Most FEEs were nasoethmoidal, either isolated or combined with nasoorbital type (347 cases [86.75%]); nasofrontal subtypes were seen in 34 cases (8.5%) and nasoorbital in 14 cases (1.5%). The mean operative time was 2 h (range 30 min-3 h). There were only two patients (0.5%) needed postoperative blood transfusions. Mean hospitalization time was 5 days (range 4-7 days). Overall, complication rate in our series was 12.5%, mostly was CSF leakage and wound dehiscence. CONCLUSION The current socioeconomic conditions and local facility should be considered to treat these specific disease processes. The refined and meticulous technique, especially in choosing the approach and handling the dural closure, is essential in lowering the complication rate.
Collapse
Affiliation(s)
- Muhammad Arifin
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen, Prof Moestopo 6-8, Surabaya, Indonesia
| | - Wihasto Suryaningtyas
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen, Prof Moestopo 6-8, Surabaya, Indonesia.
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen, Prof Moestopo 6-8, Surabaya, Indonesia
| |
Collapse
|
43
|
Turchan A, Rochman TF, Ibrahim A, Fauziah D, Wahyuhadi J, Parenrengi MA, Fauzi AA, Sufarnap E, Bajamal AH, Ferdiansyah, Suroto H, Purwati, Rantam FA, Paramadini AW, Lumenta CB. Duraplasty using amniotic membrane versus temporal muscle fascia: A clinical comparative study. J Clin Neurosci 2018; 50:272-276. [DOI: 10.1016/j.jocn.2018.01.069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/20/2017] [Accepted: 01/18/2018] [Indexed: 10/18/2022]
|
44
|
Abstract
Traumatic supra- and infra-tentorial extradural hematoma (TSIEDH) is a rare lesion constituting <2% of all extradural hematomas. There are only a few published articles about TSIEDH. This study included three patients with TSIEDH who were treated and operated at Dr. Soetomo General Hospital, Surabaya, Indonesia, from August 2015 to July 2016. Two patients sustained injuries in traffic accidents and one patient was injured by fall. The male to female ratio was 1:2. Glasgow Coma Scale (GCS) score ≤8 was present in one and GCS score of 9–12 was present in two patients. The brain computed tomography scan verified linear fracture of occipital bone in one and linear fracture of occipital bone with lambdoid suture separation in two patients. Early diagnosis and early surgical intervention of TSIEDH are imperative because the deterioration of TSIEDH is sudden and quick. We presented our experience in treating patients with TSIEDH in Dr. Soetomo General Hospital, Surabaya, Indonesia.
Collapse
Affiliation(s)
- Yunus Kuntawi Aji
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Tedy Apriawan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| |
Collapse
|
45
|
Arifianto MR, Ma'ruf AZ, Ibrahim A, Bajamal AH. Interhemispheric and Infratentorial Subdural Empyema with Preseptal Cellulitis as Complications of Sinusitis: A Case Report. Pediatr Neurosurg 2018; 53:128-133. [PMID: 29131135 DOI: 10.1159/000481512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 09/12/2017] [Indexed: 11/19/2022]
Abstract
Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency. The location where subdural empyema may appear is a challenge in diagnosis and treatment. We report the case of a 17-year-old boy who presented in a state of somnolence due to interhemispheric and infratentorial subdural empyema with preseptal cellulitis secondary to pansinusitis. Early diagnosis and aggressive antibiotic treatment combined with neurosurgical operation were mandatorily implemented. The case was managed using a multidisciplinary approach including the ENT, eye, and nutrition departments. The boy achieved clinical improvement, with impairment of eye movement as the only persistent symptom before discharge. Daily supervision at the primary health care center with continuous antibiotic treatment was recommended to the patient. Pertinent literature with controversies in the management of subdural empyema will be briefly discussed in this case report.
Collapse
|
46
|
Abstract
Traumatic brain injury (TBI) following increased intracranial pressure (ICP) is a neuroemergency case which should be managed promptly to prevent secondary brain injury. This will lead to a condition called cerebral energy dysfunction which is an important determinant factor toward worse outcome. Lactate, which was historically known as an end waste product, now is considered as an alternative cerebral energetic fuel. Hypertonic sodium lactate (HSL) is a promising hyperosmolar fluid which serves not only to decrease ICP but also to readily supply exogenous lactate to fulfill increased cerebral energy demand. Pioneer studies have shown the harmlessness and usefulness of HSL in treating pathological condition including TBI.
Collapse
Affiliation(s)
| | - Achmad Zuhro Ma'ruf
- Department of Neurosurgery, Kanudjoso Djatiwibowo Hospital, Balikpapan, Indonesia
| | - Arie Ibrahim
- Department of Neurosurgery, AW Syahranie Hospital / Faculty of Medicine - Mulawarman University, Samarinda, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Dr. Soetomo General Hospital / Faculty of Medicine - Airlangga University, Surabaya, Indonesia
| |
Collapse
|
47
|
Al Fauzi A, Sumorejo P, Suroto NS, Parenrengi MA, Wahyuhadi J, Turchan A, Mahyudin F, Suroto H, Rantam FA, Machfoed MH, Bajamal AH, Lumenta CB. Clinical Outcomes of Repeated Intraventricular Transplantation of Autologous Bone Marrow Mesenchymal Stem Cells in Chronic Haemorrhagic Stroke. A One-Year Follow Up. Open Neurol J 2017; 11:74-83. [PMID: 29290837 PMCID: PMC5738743 DOI: 10.2174/1874205x01711010074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/11/2017] [Accepted: 11/23/2017] [Indexed: 01/09/2023] Open
Abstract
Object: Stroke, one of the most devastating diseases, is a leading cause of death and disability throughout the world and is also associated with emotional and economic problems. The main goal of this study was to investigate the clinical outcome of the intraventricular transplantation of bone marrow mesenchymal stem cells (BM-MSCs) in post-haemorrhagic stroke patients. Method: This study was done consisting of eight patients with supratentorial haemorrhagic stroke, who had undergone 24 weeks of standard treatment of stroke with stable neurological deficits. All of the patients received stem cell transplantation intraventricularly using autologous BM-MSCs. Six months and Twelve months after stem cells treatment, the clinical outcomes were measured using the National Institute of Health Stroke Scale (NIHSS) and adverse effect also observed. Result: The results of this study showed improvement of NIHSS score values before and after the treatment in five patients. No adverse effects or complications were detected during the 1-year observation. Conclusion: Intraventricular transplantation of BM-MSCs has shown benefits in improving the functional status of post-haemorrhagic stroke patients with no adverse effect.
Collapse
Affiliation(s)
- Asra Al Fauzi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya Neuroscience Institute, Surabaya, Indonesia
| | - Purwati Sumorejo
- Cell and Tissue Bank, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Nur Setiawan Suroto
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya Neuroscience Institute, Surabaya, Indonesia
| | - Muhammad Arifin Parenrengi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya Neuroscience Institute, Surabaya, Indonesia
| | - Joni Wahyuhadi
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya Neuroscience Institute, Surabaya, Indonesia
| | - Agus Turchan
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya Neuroscience Institute, Surabaya, Indonesia
| | | | - Heri Suroto
- Cell and Tissue Bank, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Fedik Abdul Rantam
- Stem Cell Research and Development Center, Universitas Airlangga, Surabaya, Indonesia
| | - Mochammad Hasan Machfoed
- Department of Neurology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya Neuroscience Institute, Surabaya, Indonesia
| | - Christianto Benjamin Lumenta
- Department of Neurosurgery, Academic Teaching Hospital Munich-Bogenhausen, Technical University of Munich, Germany
| |
Collapse
|
48
|
Suryaningtyas W, Arifin M, Turchan A, Bajamal AH. Development of pediatric neurosurgical service at Dr. Soetomo Hospital, Surabaya, Indonesia. Childs Nerv Syst 2017; 33:1451-1458. [PMID: 28695337 DOI: 10.1007/s00381-017-3503-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/26/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE This review traces the history of pediatric neurosurgery at Dr. Soetomo General Hospital (DSGH) and its role in advancing the field of pediatric neurosurgery. METHODS The history, the founding fathers, and the next generations of the pediatric neurosurgery in DSGH were traced back from original sources and authors' life stories. RESULT Pediatric neurosurgical service at DSGH has its own unique perspective being a pediatric service in general hospital setting. It serves second largest city of Indonesia - the fifth most populated country in the world. Historical vignette and future perspectives are narratively presented. CONCLUSION As a pediatric neurosurgical service at general hospital in developing country, its development deserves a special mention.
Collapse
Affiliation(s)
- Wihasto Suryaningtyas
- Department of Neurosurgery, Airlangga University Faculty of Medicine-Dr. Soetomo General Hospital, Surabaya, Indonesia.
| | - Muhammad Arifin
- Department of Neurosurgery, Airlangga University Faculty of Medicine-Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Agus Turchan
- Department of Neurosurgery, Airlangga University Faculty of Medicine-Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Airlangga University Faculty of Medicine-Dr. Soetomo General Hospital, Surabaya, Indonesia
| |
Collapse
|
49
|
Aji YK, Apriawan T, Bajamal AH. Conservative treatment of corpus callosum hemorrhage in severe traumatic brain injury: a case report. Bali Med J 2017. [DOI: 10.15562/bmj.v6i3.684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
50
|
Affiliation(s)
- Wihasto Suryaningtyas
- Department of Neurosurgery, Airlangga University Faculty of Medicine - Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen, Prof Moestopo 6-8, Surabaya, Indonesia.
| | - Muhammad Arifin
- Department of Neurosurgery, Airlangga University Faculty of Medicine - Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen, Prof Moestopo 6-8, Surabaya, Indonesia
| | - Abdul Hafid Bajamal
- Department of Neurosurgery, Airlangga University Faculty of Medicine - Dr. Soetomo General Hospital, Gedung Pusat Diagnostik Terpadu (GDC) Lantai 5, RSUD Dr. Soetomo, Jl. Mayjen, Prof Moestopo 6-8, Surabaya, Indonesia
| |
Collapse
|