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Bicycle mishap, a common and ordinary event occurring in children, can have devastating consequences associated with cervical spine injury. Furthermore, either diagnosis or surgical management of cervical spine injury in children is a challenging issue. This research report a challenging case of an anterior cervical corpectomy and fusion with plating in a 7-year-old boy due to cervical spine instability with spinal cord compression after a bicycle mishap. After 20 months of the primary surgery, the titanium-based cervical plate was removed by a second surgery to allow the growth of the cervical spine.

Pendahuluan: Adenoma hipofisis dapat menyebabkan penurunan visus dan penyempitan lapangan pandang. Beberapa penelitian telah menunjukkan bahwa lama keluhan berhubungan secara signifikan dengan hasil klinis. Sebagai rumah sakit pusat rujukan nasional, semua pasien adenoma hipofisis yang datang ke RSUPN Dr. Cipto Mangunkusumo (RSCM) dirujuk dari dokter spesialis mata, ahli saraf, dan ahli bedah saraf dari institusi lain. Tujuan: Dalam penelitian ini, kami meneliti hubungan antara durasi, yang dihitung dari saat gejala pertama kali muncul ke waktu operasi, dan hasil visus dan lapang pandang pada pasien adenoma hipofisis yang menjalani operasi transfenoidal. Metode: Penelitian ini merupakan penelitian restrospektif pada pasien adenoma hipofisis yang menjalani operasi transsfenoidal antara 2015-2017 di RSCM. Durasi antara awitan gejala dan operasi dihitung dalam bulan. Pemeriksaan visus dan lapang pandang dilakukan 1 hari sebelum operasi dan dalam 1 hingga 2 bulan pascaoperasi. Hasil: Terdapat 71 pasien (36 pria, 35 wanita) dengan penurunan visus dan lapang pandang menyempit, dengan usia rata-rata 42 tahun (20-77 tahun). Durasi rata-rata awitan untuk kedua gejala adalah 12 bulan (1-108 bulan). Sebanyak 40,5% pasien mengalami peningkatan visus pascaoperasi, dengan durasi rata-rata awitan 11 bulan. Peningkatan lapang pandang dialami pada 67,6% pasien, dengan durasi rata-rata awitan 12 bulan. Diskusi: Kesimpulan penelitian terdapat hubungan bermakna secara statistik antara durasi awitan sampai dilakukan tindakan operasi dengan luaran klinis lapang pandang. Perbaikan lapang pandang didapatkan pada pasien yang memiliki durasi awitan sampai dilakukan tindakan operasi sampai dengan 12 bulan. Kata kunci: Adenoma hipofisis, lapang pandang, operasi transfenoidal, visus

INTRAVENTRICULAR HEMORRHAGE OUTCOME OPERATED ON NEUROSURGERY DEPARTMENT OF CIPTO MANGUNKUSUMO HOSPITALABSTRACTIntroduction: Intraventricular hemorrhage (IVH) is a spontaneous hemorrhage occurring within the ventricular system, 30-45% often associated with intracerebral hemorrhage (ICH). Evaluating accurate and precise daily activity in post-stroke patients is critical for the quality of care and measurement of post-stroke outcomes. Modified Rankin Scale (mRS) is a global disability measurement scale used for the evaluation of stroke recovery.Aims: Configuring outcome data of patient with intraventricular hemorrhage operated at neurosurgery department of Cipto Mangunkusumo Hospital based on mRS.Methods: A retrospective study with cross sectional design towards patient with intraventricular hemorrhage at neurosurgery department Cipto Mangunkusmo Hospital, Jakarta, between Januari 2019 and August 2016. Subject or family member was interviewed to assess the subject’s functional status 6 month after operation using mRS.Results: There were 23 subjects mostly under 60 years old (60.8%) with 6 months IVH overall outcomes independent (47.8%) based on mRS. Majority of the subjects were admitted in severe condition with IVH score mostly >15 (65.25), mean Glasgow Coma Scale (GCS) 7.6±2.14, and mean arterial pressure >100 (87%) with factor risk for hypertension (82.6%).Discussion: Operation procedure on patient with intraventricular hemorrhage gives a relatively good outcome although with poor baseline at the time of admission.Keywords: Intracerebral hemorrhage, intraventricular hemorrhage, Modified Rankin ScaleABSTRAKPendahuluan: Perdarahan intraventrikel (intraventricular hemorrhage/IVH) merupakan perdarahan spontan yang terjadi di dalam sistem ventrikel, 30-45% sering berhubungan dengan perdarahan intraserebral (PIS). Evaluasi aktifitas sehari-hari yang akurat dan tepat pada pasien pascastroke sangat penting untuk kualitas perawatan dan pengukuran luaran pascaperawatan stroke. Modified Rankin Scale (mRS) merupakan skala pengukuran disabilitas yang dipakai secara global untuk evaluasi pemulihan dari stroke.Tujuan: Menelaah data luaran penderita perdarahan intraventrikel yang dilakukan operasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo berdasarkan mRS.Metode: Penelitian retrospektif secara potong lintang terhadap pasien dengan perdarahan intraventrikel yang dikelola oleh Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Januari 2010 hingga Agustus 2016. Subjek atau keluarga diwawancara untuk menilai status fungsional 6 bulan pascaoperasi menggunakan mRS.Hasil: Didapatkan 23 subjek yang sebagian besar berusia di bawah 60 tahun (60,8%) dengan luaran 6 bulan yang dalam keadaan independen (47,8%) berdasarkan mRS. Mayoritas subjek masuk dalam keadaan yang buruk dengan skor IVH terbanyak adalah >15 (65,2%), rerata Skala Koma Glasgow (SKG) 7,6±2,14, dan mean arterial pressure >100 (87%), serta memiliki faktor risiko hipertensi (82,6%).Diskusi: Tata laksana operasi pada pasien dengan perdarahan intraventrikel memberikan luaran yang cukup baik, walaupun pasien masuk dalam keadaan yang buruk.Kata kunci: Modified Rankin Scale, perdarahan intraserebral, perdarahan intraventrikel

BACKGROUND: Intracranial meningiomas are a common type of primary brain tumors. We would like to examine the profile of intracranial meningiomas at our institution. MATERIAL AND METHODS: We analysed the incidence and clinical, radiological, pathological features of meningiomas at Dr. Cipto Mangunkusumo General Hospital retrospectively between January 2012 and December 2017. The records of all surgically treated meningiomas were analysed from the medical record unit. RESULTS: We found 431 intracranial meningiomas were surgically resected at our institution. The patients had a median age of 45 years and were predominantly female (383 female and 48 male). WHO grade I meningiomas accounted for approximately 74 % of the intracranial meningiomas (316 of total 431 patients). WHO grade II and grade III meningiomas were found in 99 (22.9%) and 13 patients (3.1%) respectively. Of the histological subtypes, the most common are meningothelial in 71 patients (16.5%), mixed meningothelial and microcystic in 53 patients (12.3%) and mixed meningothelial and transitional in 41 patients (9.5%), whereas the uncommon subtypes such as atypical, angiomatous, anaplastic, clear cell, secretoric, chordoid, rhabdoid were found in 35 patients (8.1%). The most common site of meningioma is sphenoorbita region (223 patients; 51.9%.), followed by convexity (60 patients; 13.9%), and sphenoid wing (30 patients; 7.0%). Proptosis is the most common clinical presentation (176 patients; 40.8%), followed by decrease of visual acquity (75 patients; 17.4%) and headache (46 patients; 10.8%). CONCLUSION: This study showed intracranial meningiomas are a female preponderance among our patients. Proptosis is the most common clinical presentation, the sphenoorbita region as the most common site, whereas WHO grade I and meningothelial subtypes as the most common pathological finding.

Background. Cervical spine disease has the potential to reduce productivity in affected patients because of myelopathy and mood disorder (e.g. depression) which lead to decreasing of the patient’s quality of life. Objective. This study aims to elaborate the most frequent symptoms and pathology of C-spine disease in patients who underwent a surgical procedure over the period time from January 2012 to December 2016. Method. This study is a retrospective, conducted in Spine Division of Department of Neurosurgery, Faculty of Medicine, Universitas Indonesia (FMUI). All patients who underwent surgery for the C-spine disease are included. The data was obtained from the records in our spine database. Result. The total number of surgical procedures for spine disease over the 5 years was 345 procedures, with 127 procedures in the C-spine which are the second most common procedures of spine surgery in Department of Neurosurgery FMUI. The C-spine diseases were more common in males, aged more than 50 years old. The most frequent disease or pathology is degenerative disease, and yet, tumour cases show an increasing number and became the most common pathology in the year of 2016. The most common procedure is anterior cervical discectomy and fusion (ACDF).Conclusion. Our study showed that the most common symptoms and pathology are myelopathies and degenerative disease respectively, which has similarity with another study in the term of the most frequent pathology and surgical procedure. The finding of the more advanced neurological condition by the time of surgery as the most common symptom is found to be contradictory with other studies in western countries.