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Introduction: Various surgical procedures have been found to effectively treat intractable temporal lobe epilepsy (TLE), including transcortical selective amygdalohippocampectomy (SAH), which is intended to protect the temporal lobe and to prevent interference with vascular structure. This research analyzed the outcome of post-operative seizure-free with transcortical selective amygdalohippocampectomy for intractable mesial temporal lobe epilepsy patients in a minimum two-year follow-up after surgery. Methods: Data of one hundred ninety-two patients who had undergone transcortical selective amygdalohippocampectomy for non-lesional, medically intractable, temporal lobe epilepsy were analyzed. Result: The statistical analysis indicated that Focal to Bilateral Tonic-Clonic Seizure had a more significant outcome (p=0.019) than other seizures. In all research subjects, after three, six, and twelve years of follow-up, the chance for a seizure-free after surgery was respectively 93.2 percent, 67.9 percent, and 36.7 percent with a median average survival period for all subjects of 11.00 years (95 % CI: 8.55 – 13.44) Conclusions: Transcortical selective amygdalohippocampectomy is an effective therapy for intractable mesial temporal lobe epilepsy and provides a satisfactory outcome. The transcortical approach allows an appropriate operative field by careful dissection with limited retraction to eliminate the epileptogenic target while preventing damage to the underlying vascular and cortical structures.

Background: Degenerative spinal disease increases in proportion to life expectancy. Surgical treatments that play an essential role in the management of degenerative spinal disease have evolved from open surgery to minimally invasive surgery as well as endoscopic spinal surgery. Advanced pathological understanding, diagnostic imaging, and instrument progress have support for endoscopic spinal surgery. The study aims to report the current situation of endoscopic spinal surgery to treat degenerative spinal diseases in the Department of Neurosurgery of Kariadi Hospital.Method: Review the Endoscopy Spine Surgery case in the Department of Neurosurgery of Kariadi Hospital with degenerative spinal diseases including canal stenosis and disc herniation at all levels.Results: A total of 123 degenerative spinal diseases have been treated with endoscopic spinal surgery. Most of patients comes with HNP (89 patients, 72.4%) and operated in lumbal segment (87 patients, 70,7%). Estimated blood loss parameter in 50 years group had mean 115.00 ± 95.25 ml with p=0.001. We got high correlation between operation time and estimated blood loss with r = 0.779 and statistically significant (p=0.000)Conclusion: Endoscopic surgery appears to be an option for treating degenerative spinal diseases especially for herniation and canal stenosis. The lumbar and thoracic regions are common areas for endoscopic spinal surgery.

Background:  The aim of epilepsy surgery is to improve the quality of life of people with epilepsy. Temporal lobe epilepsy (TLE) is the most common form of intractable epilepsy with a risk of low quality of life due to uncontrolled seizures. In this study, we evaluated the quality of life among TLE patients who underwent amygdalohippocampectomy between those who were free from seizure and those who were not.Methods: This was a cross-sectional observational study. The postoperative quality of life was measured by QOLIE-31 questionnaire followed-up at least 12 months since the surgery. Results: Among 31 patients, 21 patients (67.7%) were free from seizures after 12 months of follow-up. We observed significantly higher quality of life of those seizure-free patients either as overall quality of life (p=0.001) or among domains such as seizure anxiety (p=0.003), emotional well-being (p

Introduction Intradural disc herniation (IDH) is a rare complication which comprises 0.27% of all herniated intervertebral discs. We are reporting a case of lumbar intradural disc herniation at the L4-L5 levels highlighting challenges in establishing clinical diagnosis and surgical approach involving a transdural microsurgery approach. Presentation of case A 38-year-old gentleman was presented with left radicular low back pain without motoric and autonomic involvement admitted to our neurosurgical service. Spine MRI showed an intradural, extra-axial spinal mass. Discussion Lumbar IDH is a rare pathology thus often initially diagnosed as other more common conditions. In our case, the IDH diagnosis was confirmed during surgery as the radiological examination results mimic intradural extra-axial tumor. During surgery, a hard irregular white mass was found shortly after dural incision. Histopathological results showed chondrocytes, fibrotic and necrotic appearances consistent with the diagnosis of disc herniation. Postoperatively, the patient showed improvement and pain alleviation. Conclusion We observed the beak sign which is one of the important features of IDH imaging. Surgery-wise, the challenge of dissecting the anterolateral part of the duramater from the annulus fibrosus of the intervertebral disc should be noted by the performing surgeon., Highlights • Intradural disc herniation (IDH) is a rare complication and comprises 0.27% of all herniated disc. • Radiological findings mimicking for intradural extra-axial spine tumors. • Challenge in dissecting the duramater of the anterolateral segments is a common problem. • A median or paramedian dural incision accompanied by a microsurgical technique. • Better visibility of hernia after a dural incision, avoiding damage to the nervous rootlets.

Background: Proliferation and progression of meningioma were influenced by the balance of estrogen and testosterone. Digit Ratio (DR) was a sign of prenatal exposure to estrogen and testosterone. This study intends to find the relationship between Digit Ratio and meningioma. Aim: To determine the relationship between DR and incidence of Meningioma and its Clinical Profiles (age at the onset, sex, Body Mass Indec (BMI) and histopathology grading) Methods: Analytical observational study was used with case-control design. Case group consisted of patients clinically and histopathologically diagnosed with meningioma (n=25). Patients who were not diagnosed with primary intracranial tumors were included in the control group (n=25). Matched group were conducted. Subjects of this study were patients of RSUP dr Kariadi in the period of January 2016-August 2017. This study was conducted by collecting data consisted of DR, age, sex, BMI, and grading histopathology. Tests used in this study are Chi-Square Test, Mann-Whitney Test and Fishers exact Test. Results: Digit Ratio Mean for right, left and right-left difference were 1.0041; 1.0104 and 0.0357 while for the right and left DR cutoff value 0.993; 0.989. There is a relationship between right and left Digit Ratio and incidence of meningioma (p = 0,000) with OR (Odds Ratio) Right DR = 11.17(CI95% 2,864 – 43,464) and OR left DR = 16,00 (CI95% 4,002 – 63,975). There is a relationship between Right Digit Ratio andBMI case group (p = 0,022). There is no relationship of Digit Ratio and age at onset, gender and histopathology grading (p