Background. Moyamoya disease (MMD) patients who untreated with bypass surgery are prone to frequent and recurrent ischemic stroke or transient ischemic attack (TIA). Although, multiple traditional risk factors can account for this event, recent COVID-19 pandemic also contributed to the increased rate of stroke recurrence among this population by means of multiple pathogenesis, including thrombosis. Case presentation. Herein we described an MMD patient who suffered from acute ischemic stroke lately after the resolution of COVID-19 infection with neurocognitive deficits as the prominent symptoms. Coagulopathy with the resulting thrombosis was thought to play a central role in this case. Conclusions. COVID-19 infection may increase the risk of stroke recurrence among patients with MMD, particularly those who do not yet undergo surgical bypass procedure. Coagulopathy with thrombosis was thought to play a central role, even after the infection itself had subsided.
{"title":"Coagulopathy and thrombosis following COVID-19 resolution resulting in late Hyperacute ischemic stroke in moyamoya disease – A case report","authors":"A. Soejitno, Putu Ayu Dyah Meita Wulandari","doi":"10.37897/rjn.2023.2.8","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.8","url":null,"abstract":"Background. Moyamoya disease (MMD) patients who untreated with bypass surgery are prone to frequent and recurrent ischemic stroke or transient ischemic attack (TIA). Although, multiple traditional risk factors can account for this event, recent COVID-19 pandemic also contributed to the increased rate of stroke recurrence among this population by means of multiple pathogenesis, including thrombosis. Case presentation. Herein we described an MMD patient who suffered from acute ischemic stroke lately after the resolution of COVID-19 infection with neurocognitive deficits as the prominent symptoms. Coagulopathy with the resulting thrombosis was thought to play a central role in this case. Conclusions. COVID-19 infection may increase the risk of stroke recurrence among patients with MMD, particularly those who do not yet undergo surgical bypass procedure. Coagulopathy with thrombosis was thought to play a central role, even after the infection itself had subsided.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48020207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdul Gofir, Raymond Aris Nimrod Alvonsius Silalahi, K. Dananjoyo, Ismail Setyopranoto
Background. Stroke is the highest cause of death in Indonesia. Impaired glucose tolerance becomes one of the metabolic risk factors that contribute to ischemic stroke. This study will observe the role of HbA1c level on ischemic stroke in “Dr. Sardjito” General Hospital due to limited research data of this aspect in Indonesia. Objective. The objective of this study is to explore the role of HbA1c level on ischemic stroke in prediabetic patients of “Dr. Sardjito” General Hospital, Yogyakarta. Method. This study design is non-experimental, observational study with correlation analysis approach. The research collected 106 data of non-diabetic and prediabetic ischemic stroke patients’ medical records in “Dr. Sardjito” General Hospital, recorded from 2012 until 2015. Result. A Comparison of HbA1c level in prediabetic ischemic stroke patients were significantly higher (p<0.001), compared to non-diabetic ischemic stroke patients (mean rank 80.00 vs. 27.00). Multivariate analysis was performed and showed elevated HbA1c level, modified with decreased diastolic blood pressure, associated 70.8% in determining ischemic stroke in prediabetic patients of “Dr. Sardjito” General Hospital. Conclusion. Elevated HbA1c level, modified with decreased diastolic blood pressure, has significant predisposition role on ischemic stroke patients with prediabetes in “Dr. Sardjito” General Hospital.
{"title":"HBA1C level and its role on ischemic stroke patients with prediabetes","authors":"Abdul Gofir, Raymond Aris Nimrod Alvonsius Silalahi, K. Dananjoyo, Ismail Setyopranoto","doi":"10.37897/rjn.2023.2.11","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.11","url":null,"abstract":"Background. Stroke is the highest cause of death in Indonesia. Impaired glucose tolerance becomes one of the metabolic risk factors that contribute to ischemic stroke. This study will observe the role of HbA1c level on ischemic stroke in “Dr. Sardjito” General Hospital due to limited research data of this aspect in Indonesia. Objective. The objective of this study is to explore the role of HbA1c level on ischemic stroke in prediabetic patients of “Dr. Sardjito” General Hospital, Yogyakarta. Method. This study design is non-experimental, observational study with correlation analysis approach. The research collected 106 data of non-diabetic and prediabetic ischemic stroke patients’ medical records in “Dr. Sardjito” General Hospital, recorded from 2012 until 2015. Result. A Comparison of HbA1c level in prediabetic ischemic stroke patients were significantly higher (p<0.001), compared to non-diabetic ischemic stroke patients (mean rank 80.00 vs. 27.00). Multivariate analysis was performed and showed elevated HbA1c level, modified with decreased diastolic blood pressure, associated 70.8% in determining ischemic stroke in prediabetic patients of “Dr. Sardjito” General Hospital. Conclusion. Elevated HbA1c level, modified with decreased diastolic blood pressure, has significant predisposition role on ischemic stroke patients with prediabetes in “Dr. Sardjito” General Hospital.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47283578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. A. Nazwar, Farhad Bal'afif, D. W. Wardhana, M. Mustofa, Akhmad Ferro Avisena, Abduraoof Omar R Saadawi, Anindhita Prisca
Background. This case report highlights the importance of accurate diagnosis and treatment for intramedullary spinal cord hemangioma, which is a rare condition that can present with common symptoms of various spinal cord pathologies. The report recommends decompression laminectomy as the appropriate intervention for this condition. This report adds to the existing clinical literature on intramedullary spinal cord hemangioma and can assist clinicians in the diagnosis and treatment of similar cases. Case report. The patient is a 30-year-old female who complained of left leg heaviness, cramps, numbness, and urinary incontinence. MRI revealed a suspected intradural intramedullary lesion, as high as VTh5, suspected to be ependymoma or astrocytoma. The patient underwent decompressive laminectomy on thoracalis vertebra 5-7 and spinal cord mass with hemorrhage and calcification components was observed on post-operative Spinal CT Angiography. The mass was found to have a feeder artery from spinal branches of the left right a. intercostalis at T5 level and spinal branches of the left a. intercostalis at T6 level. Thoracolumbar spondylosis was also observed. Conclusion. The clinical impact of vertebral hemangioma lies in its potential to cause neurological deficits due to spinal cord or nerve root compression. Early diagnosis and treatment through imaging modalities such as MRI and surgical intervention, such as laminectomy, can alleviate symptoms and prevent disability or mortality. However, careful consideration of the patient’s clinical history, imaging findings, and neurological status is necessary for accurate diagnosis and appropriate management.
{"title":"Rare case of vertebral hemangioma causing spinal compression - diagnosis and treatment: Space Occupying Lesion (SOL) study","authors":"T. A. Nazwar, Farhad Bal'afif, D. W. Wardhana, M. Mustofa, Akhmad Ferro Avisena, Abduraoof Omar R Saadawi, Anindhita Prisca","doi":"10.37897/rjn.2023.2.9","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.9","url":null,"abstract":"Background. This case report highlights the importance of accurate diagnosis and treatment for intramedullary spinal cord hemangioma, which is a rare condition that can present with common symptoms of various spinal cord pathologies. The report recommends decompression laminectomy as the appropriate intervention for this condition. This report adds to the existing clinical literature on intramedullary spinal cord hemangioma and can assist clinicians in the diagnosis and treatment of similar cases. Case report. The patient is a 30-year-old female who complained of left leg heaviness, cramps, numbness, and urinary incontinence. MRI revealed a suspected intradural intramedullary lesion, as high as VTh5, suspected to be ependymoma or astrocytoma. The patient underwent decompressive laminectomy on thoracalis vertebra 5-7 and spinal cord mass with hemorrhage and calcification components was observed on post-operative Spinal CT Angiography. The mass was found to have a feeder artery from spinal branches of the left right a. intercostalis at T5 level and spinal branches of the left a. intercostalis at T6 level. Thoracolumbar spondylosis was also observed. Conclusion. The clinical impact of vertebral hemangioma lies in its potential to cause neurological deficits due to spinal cord or nerve root compression. Early diagnosis and treatment through imaging modalities such as MRI and surgical intervention, such as laminectomy, can alleviate symptoms and prevent disability or mortality. However, careful consideration of the patient’s clinical history, imaging findings, and neurological status is necessary for accurate diagnosis and appropriate management.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46548289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Virgi Mayang Maharani, Ken Wirastuti, Meyvita Silviana, Naili Sofi Riasari
Parkinson’s disease (PD) is the second most common neurodegenerative disease. The accumulation of α-synuclein protein in the basal ganglia is the underlying pathogenesis of PD. Genetic abnormalities are one of the predisposing factors for PD. PDs with GBA gene mutations have abnormalities coding for β-glucocerebrosidase (GCase) enzymes in lysosomes, which lead to increased accumulation of α-synuclein. Ambroxol has long been known as a therapy for airway disorders which also has antioxidant benefits. However, recently, there have been many experimental studies examining the benefits of ambroxol in neurodegenerative diseases, including PD. This study aims to examine experimental studies of ambroxol administration in PD.
{"title":"Ambroxol therapy for Parkinson’s disease: Systematic literature review","authors":"Virgi Mayang Maharani, Ken Wirastuti, Meyvita Silviana, Naili Sofi Riasari","doi":"10.37897/rjn.2023.2.1","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.1","url":null,"abstract":"Parkinson’s disease (PD) is the second most common neurodegenerative disease. The accumulation of α-synuclein protein in the basal ganglia is the underlying pathogenesis of PD. Genetic abnormalities are one of the predisposing factors for PD. PDs with GBA gene mutations have abnormalities coding for β-glucocerebrosidase (GCase) enzymes in lysosomes, which lead to increased accumulation of α-synuclein. Ambroxol has long been known as a therapy for airway disorders which also has antioxidant benefits. However, recently, there have been many experimental studies examining the benefits of ambroxol in neurodegenerative diseases, including PD. This study aims to examine experimental studies of ambroxol administration in PD.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47767255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose. Present study describe the case of lumbar radiculopathy with radiating pain up to knee joint managed with Mulligan bent leg raise (BLR)technique. Case presentation. Total six intervention sessions were carried out over two consecutive weeks, three times per week. Three repetitions of BLR techniques with 5-10 seconds of sustained stretch with one minute rest between each repetition were given on first visit. On consecutive visits six repetitions were delivered in pain free zone. Study outcomes were measured by using straight leg raise (SLR) range of motion and “visual analog scale (VAS)” for back and leg pain. After two weeks of interventions, range of motion of SLR was increased from 45° to 56° while VAS score improve by 3 points both in back and radiating thigh pain. Conclusions. Mulligan BLR technique resulted in reduction in back and radiating thigh pain as well as increase in range of SLR. Therefore, Mulligan BLR technique can be used a first line of treatment in lumbar radiculopathy with radiating pain up to knee joint.
{"title":"Efficacy of Mulligan bent leg raise technique on neurophysiologic response in lumbar radiculopathy with radiating pain up to knee joint – A case study","authors":"Disha Saini, M. Malik, S. Punia, Varun Singh","doi":"10.37897/rjn.2023.2.10","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.10","url":null,"abstract":"Purpose. Present study describe the case of lumbar radiculopathy with radiating pain up to knee joint managed with Mulligan bent leg raise (BLR)technique. Case presentation. Total six intervention sessions were carried out over two consecutive weeks, three times per week. Three repetitions of BLR techniques with 5-10 seconds of sustained stretch with one minute rest between each repetition were given on first visit. On consecutive visits six repetitions were delivered in pain free zone. Study outcomes were measured by using straight leg raise (SLR) range of motion and “visual analog scale (VAS)” for back and leg pain. After two weeks of interventions, range of motion of SLR was increased from 45° to 56° while VAS score improve by 3 points both in back and radiating thigh pain. Conclusions. Mulligan BLR technique resulted in reduction in back and radiating thigh pain as well as increase in range of SLR. Therefore, Mulligan BLR technique can be used a first line of treatment in lumbar radiculopathy with radiating pain up to knee joint.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45989258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Eltoukhy, Ahmed Esmael, A. Abdelkhalek, Asem Nagy
Background. Multiple sclerosis (MS) is a chronic inflammatory immune-mediated disease, distinguished by demyelination and oligodendropathy in the central nervous system. Cognitive impairment (CI) can impact patients at any stage of MS, including those with clinically isolated syndrome (CIS). Patients and methods. This is a prospective cross-sectional study which enrolled 60 patients with RRMS. They were subjected to cognitive scale assessment, routine brain MRI study and volumetric assessment of hippocampus. Results. This study found a significant positive correlation between duration of disease and Subjective memory complaints questionnaire (r=0.525, p=0.001). A significant negative correlation existed between disease duration and MMSE score (r=-0.404, p=0.001) and between disease duration and MoCA score (r=-0.310, p=0.016). No significant difference between both groups regarding the relative hippocampal volume. Mean relative right hippocampal volume is 0.0026 for cases versus 0.0027 among control group and mean relative left hippocampal volume is 0.0025 for cases versus 0.0026 among control group. Conclusion. Multiple sclerosis disease duration had an impact on cognitive state. However, hippocampal volume assessment did not predict the cognitive affection in patient with RRMS.
{"title":"Hippocampal volume in cases of relapsing remitting multiple sclerosis and its correlation with cognitive impairment","authors":"K. Eltoukhy, Ahmed Esmael, A. Abdelkhalek, Asem Nagy","doi":"10.37897/rjn.2023.2.4","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.4","url":null,"abstract":"Background. Multiple sclerosis (MS) is a chronic inflammatory immune-mediated disease, distinguished by demyelination and oligodendropathy in the central nervous system. Cognitive impairment (CI) can impact patients at any stage of MS, including those with clinically isolated syndrome (CIS). Patients and methods. This is a prospective cross-sectional study which enrolled 60 patients with RRMS. They were subjected to cognitive scale assessment, routine brain MRI study and volumetric assessment of hippocampus. Results. This study found a significant positive correlation between duration of disease and Subjective memory complaints questionnaire (r=0.525, p=0.001). A significant negative correlation existed between disease duration and MMSE score (r=-0.404, p=0.001) and between disease duration and MoCA score (r=-0.310, p=0.016). No significant difference between both groups regarding the relative hippocampal volume. Mean relative right hippocampal volume is 0.0026 for cases versus 0.0027 among control group and mean relative left hippocampal volume is 0.0025 for cases versus 0.0026 among control group. Conclusion. Multiple sclerosis disease duration had an impact on cognitive state. However, hippocampal volume assessment did not predict the cognitive affection in patient with RRMS.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44914114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harvey Sudharta, F. A. Chandra, Nadya Novemia, André, Jimmy Fransisco Abadinta Barus, Poppy Kristina Sasmita
Objectives. Stroke is an acute cerebrovascular disease with high morbidity and mortality rate. Many stroke management strategies can improve prognosis and quality of life, but only to a certain extent. Phosphodiesterase inhibitor-5 (PDE-5i) has shown benefits in numerous preclinical studies, but human studies have been inconclusive. Material and Methods. For this narrative review, we conducted a systematic search following the PRISMA statement guideline from inception until November 2022. The search was conducted in PubMed, ScienceDirect, EBSCOhost, and ProQuest. We included all human and animal studies on this topic, including preclinical studies, randomized clinical trials, and case studies. All the excluded studies are reviews or non-English studies. Review. Many PDE-5i have shown benefits in anatomical and functional outcomes in preclinical acute experimental stroke models. PF-03049423 was safe and well tolerated in humans but had no significant impact on neurological or functional outcomes. Sildenafil on acute/subacute was deemed safe to use and demonstrated improvement over baseline, but power remains unknown due to the lack of a control group. Tadalafil use resulted in a reduction in regional cerebral blood flow in subjects with a history of stroke. Conclusions. Despite promising results in preclinical studies, current evidence shows that PDE-5i does not affect clinical or functional recovery in people with acute stroke. The disparity in the intricacy of stroke pathophysiology between human and animal models was crucial. Further research in a larger population with more consistent stroke onset, medicines, and doses is required for a more conclusive result.
{"title":"Phosphodiesterase type 5 Inhibitors (PDE-5I) as a potential therapeutic drug in stroke: A systematic narrative review","authors":"Harvey Sudharta, F. A. Chandra, Nadya Novemia, André, Jimmy Fransisco Abadinta Barus, Poppy Kristina Sasmita","doi":"10.37897/rjn.2023.2.3","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.3","url":null,"abstract":"Objectives. Stroke is an acute cerebrovascular disease with high morbidity and mortality rate. Many stroke management strategies can improve prognosis and quality of life, but only to a certain extent. Phosphodiesterase inhibitor-5 (PDE-5i) has shown benefits in numerous preclinical studies, but human studies have been inconclusive. Material and Methods. For this narrative review, we conducted a systematic search following the PRISMA statement guideline from inception until November 2022. The search was conducted in PubMed, ScienceDirect, EBSCOhost, and ProQuest. We included all human and animal studies on this topic, including preclinical studies, randomized clinical trials, and case studies. All the excluded studies are reviews or non-English studies. Review. Many PDE-5i have shown benefits in anatomical and functional outcomes in preclinical acute experimental stroke models. PF-03049423 was safe and well tolerated in humans but had no significant impact on neurological or functional outcomes. Sildenafil on acute/subacute was deemed safe to use and demonstrated improvement over baseline, but power remains unknown due to the lack of a control group. Tadalafil use resulted in a reduction in regional cerebral blood flow in subjects with a history of stroke. Conclusions. Despite promising results in preclinical studies, current evidence shows that PDE-5i does not affect clinical or functional recovery in people with acute stroke. The disparity in the intricacy of stroke pathophysiology between human and animal models was crucial. Further research in a larger population with more consistent stroke onset, medicines, and doses is required for a more conclusive result.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41635496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Gusti, A. Sri, Mahendra Dewi, Desak Made, Cittarasmi Saraswati Seputra, N. Sriwidyani, Desak Made Cittarasmi, Saraswati Seputra
Background. Central Nervous System (CNS) tumor is neoplasm that located in central nervous system, which include brain and medulla spinalis. Despite its significant raise of incidence and morbidities, limited epidemiological data was available. Therefore, this study aimed to describe the epidemiological characteristic of CNS tumor over a 3-year period in a single tertiary hospital in Bali, Indonesia. Methods. This study was a descriptive study with cross sectional design. This study included all patients aged 18 year or over who were histopathologically diagnosed with central nervous tumor at “Prof. Dr. I.G.N.G. Ngoerah General Hospital”, Denpasar, between January 2020 and December 2022. Data about age, gender, tumor location, histopathological type, tumor grading, and source of metastases in secondary CNS tumor were obtained from medical record. Result. A total of 221 cases were recorded during this study period. The prevalence of primary CNS tumor was 81.9% while secondary CNS tumor was 18.1%. The majority of case, both in primary and secondary CNS tumor were female in age group of 50-59. Supratentorial constituted the most common lesion site in primary and secondary CNS tumor. The most frequent histopathological type of primary CNS tumor was meningioma, making up 48.1% of cases, followed by diffuse astrocytic and oligodendroglial tumors (26.5%), and tumor of the cranial and paraspinal nerve (9.9%). Carcinoma is the most common histological type in secondary CNS tumor with lung and breast tumor being the majority source of secondary CNS tumor, found in 40% and 27.5%, respectively. Conclusion. Adult female with age of 50-59 is the most affected group in CNS tumor. Primary CNS tumor were commonly found in supratentorial with meningioma and WHO grade I being the most frequent histopathological type and grade. Secondary CNS tumor were mostly found in supratentorial and originated from primary lung tumor.
{"title":"Central Nervous System tumor at “Prof. Dr. I.G.N.G. Ngoerah” General Hospital, Denpasar: An epidemiological study between 2020-2022","authors":"I. Gusti, A. Sri, Mahendra Dewi, Desak Made, Cittarasmi Saraswati Seputra, N. Sriwidyani, Desak Made Cittarasmi, Saraswati Seputra","doi":"10.37897/rjn.2023.2.5","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.5","url":null,"abstract":"Background. Central Nervous System (CNS) tumor is neoplasm that located in central nervous system, which include brain and medulla spinalis. Despite its significant raise of incidence and morbidities, limited epidemiological data was available. Therefore, this study aimed to describe the epidemiological characteristic of CNS tumor over a 3-year period in a single tertiary hospital in Bali, Indonesia. Methods. This study was a descriptive study with cross sectional design. This study included all patients aged 18 year or over who were histopathologically diagnosed with central nervous tumor at “Prof. Dr. I.G.N.G. Ngoerah General Hospital”, Denpasar, between January 2020 and December 2022. Data about age, gender, tumor location, histopathological type, tumor grading, and source of metastases in secondary CNS tumor were obtained from medical record. Result. A total of 221 cases were recorded during this study period. The prevalence of primary CNS tumor was 81.9% while secondary CNS tumor was 18.1%. The majority of case, both in primary and secondary CNS tumor were female in age group of 50-59. Supratentorial constituted the most common lesion site in primary and secondary CNS tumor. The most frequent histopathological type of primary CNS tumor was meningioma, making up 48.1% of cases, followed by diffuse astrocytic and oligodendroglial tumors (26.5%), and tumor of the cranial and paraspinal nerve (9.9%). Carcinoma is the most common histological type in secondary CNS tumor with lung and breast tumor being the majority source of secondary CNS tumor, found in 40% and 27.5%, respectively. Conclusion. Adult female with age of 50-59 is the most affected group in CNS tumor. Primary CNS tumor were commonly found in supratentorial with meningioma and WHO grade I being the most frequent histopathological type and grade. Secondary CNS tumor were mostly found in supratentorial and originated from primary lung tumor.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43669031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerebral malformations, known as cavernomas, are low flow vascular malformations that have a multilobulated appearance. A large percent of cavernous malformations have seizures as initial symptoms. We report a case of a 48 years old patient presented in the neurological department for seizure work-up. We performed serial brain imaging to follow the evolution of bleeding cavernomas and electroencephalography to find epileptogenic cavernomas. Conservative management was decided and the evolution under antiepileptic drugs was good, but with some compliance issues further discussed.
{"title":"Cerebral cavernomatosis and epilepsy: treatment and serial imaging follow-up","authors":"C. Bistriceanu, D. Cuciureanu","doi":"10.37897/rjn.2023.2.7","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.7","url":null,"abstract":"Cerebral malformations, known as cavernomas, are low flow vascular malformations that have a multilobulated appearance. A large percent of cavernous malformations have seizures as initial symptoms. We report a case of a 48 years old patient presented in the neurological department for seizure work-up. We performed serial brain imaging to follow the evolution of bleeding cavernomas and electroencephalography to find epileptogenic cavernomas. Conservative management was decided and the evolution under antiepileptic drugs was good, but with some compliance issues further discussed.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47102102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 27-year-old male presented with paralysis and tingling sensations in bilateral lower limbs. History revealed a D4-D6 spinal fixation secondary to a road traffic accident. Magnetic Resonance Imaging (MRI) diagnosed the case as post-traumatic syringomyelia secondary to spinal cord injury. Following the surgeon’s clearance, a targeted early rehabilitation intervention (TERI) for functional independence, bed mobility and transfers was initiated and continued for four weeks. Patient showed considerable improvements in Barthel index (40-85%) and Karnofsky Performance Status (20-70%). Physiotherapy Targeted early rehabilitation intervention can be a valuable adjunct to other management strategies in spinal cord lesions.
{"title":"Physiotherapy to improve functional independence in post traumatic syringomyelia (pts): Case report","authors":"Prishita Koul, Raghuveer Raghumahanti","doi":"10.37897/rjn.2023.2.6","DOIUrl":"https://doi.org/10.37897/rjn.2023.2.6","url":null,"abstract":"A 27-year-old male presented with paralysis and tingling sensations in bilateral lower limbs. History revealed a D4-D6 spinal fixation secondary to a road traffic accident. Magnetic Resonance Imaging (MRI) diagnosed the case as post-traumatic syringomyelia secondary to spinal cord injury. Following the surgeon’s clearance, a targeted early rehabilitation intervention (TERI) for functional independence, bed mobility and transfers was initiated and continued for four weeks. Patient showed considerable improvements in Barthel index (40-85%) and Karnofsky Performance Status (20-70%). Physiotherapy Targeted early rehabilitation intervention can be a valuable adjunct to other management strategies in spinal cord lesions.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43668582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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