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Neurosurgery Department Faculty of Medicine - Universitas Sumatera Utara - H. Adam Malik General Hospital Rindu A Lantai 2, Bunga Lau No.17, Kemenangan Tani, Kec. Medan Tuntungan, Kota Medan, Sumatera Utara 20136
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Asian Australasian Neuro and Health Science Journal
Published by TALENTA PUBLISHER
ISSN : 26860848     EISSN : 26860848     DOI : https://doi.org/10.32734
Core Subject : Health, Science,
Focus and Scope Asian Australasian Neuro and Health Science Journal (AANHSJ) provides a forum for publishing the full research articles in the area of Neurosurgery and Health related to topics from the following subject areas: Neuro-Anatomy Neuro-Physiology Neuro-oncology Neuro-Spine Neuro-Pediatric Neuro-Trauma Neuro-Vascular Neuro-Fungsional Basic Science Biomoleculer in Neurology Radiology in Neurosurgery
Articles 36 Documents
Thoracic Chordoma of Thoracal 7th - 8th: A Case Report
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 1 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i1.1031

Abstract

Abstract: Spinal chordomas are rare, locally invasive, malignant neoplasm, representing 5% of all malignant tumors of the skeleton. This publication is based on a case of a thoracal chordoma in a 53 year old man at Haji Adam Malik General Hospital Medan. Patient with a major complaint of back pain accompanied by weakness in both lower limbs, beginning with numbness and tingling sensation. Based on physical examination, thoracal CT-Scan and Thoracal MRI, diagnosis of a thoracal chordoma was made. Laboratory was normal. There was no other comorbidities. Surgical treatment was applied in this case. The patient performed laminectomy tumor removal on throracal 7th-8th, followed with posterior stabilization on thoracal 5th-6th and thoracal 9th-10th. We managed to achieve near complete macroscopic tumor resection in this case. Tumor samples were taken for Histopathologhy analysis. From the microscopy finding we found a typical cell of a chordoma.On the 7th day the patient was discharged. The patient then controls for follow up and radiotherapy. Patient neurologically improved, no complications and no surgical implants failures in this case. After surgery, the patient underwent radiotherapy. The main goal of therapy in this chordoma case is total eradication, spinal decompression without neurologic impairment and prevention of recurrence.
Burst fracture Th 9-10 treat with Transthoracal Corpectomy and stabilization: A Cases Report Manurung, Halim Rahman; Ibrahim, Sabri; Dharmajaya, Ridha
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 2 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i2.1032

Abstract

Abstract. Spinal fracture and dislocation are among the most feared injuries by patients and physicians alike, as the consequences can be devastating, ranging from mild pain and discomfort to severe paralysis and even death. Spinal trauma is commonly found in patients admitted to level-one trauma centers after serious accidents like traffic, falling, and sports accidents.Injuries of the cervical spine account for one third of spinal fractures and half to two thirds of all spinal cord injuries.In the thoracolumbar spine, the most common unstable fracture is the burst fracture. Altogether, burst fractures have been reported to account for about 15% of spinal injuries.Incidence of burst fractures peaked at the thoracolumbar junction and between levels T5 and T8. In 10% of cases,more than one burst fracture was seen, thereof 53% on noncontiguous levels. Main accident mechanisms were falls, traffic, and sports. Neurological deficit was highest in patients with burst fractures of the cervical spine, independent of accident mechanism, and lowest in thoracolumbar junction fractures. Burst fractures occur frequently in high energy traumas and are most commonly associated with falling and traffic accidents.Multiple burst fractures occur in 10% of cases, half thereof on noncontiguous levels.Access to the anterior thoracic spine via the transthoracic approach (via thoracotomy) can be used for decompression and fusion. To perform adequate decompression and stabilization of the thoracic spine, obtaining good exposure is a must. Preservation and protection of the vascular structures in the thoracic cavity is the key to such an exposure. Preoperative workup should include imaging modalities (plain rontgens, MRI/CT scan) to specifically define the area of decompression. If a tumor is being evaluated, CT angiography and embolization are helpful in preoperative planning. Assistance by a thoracic surgeon for exposure is highly recommended.
Epidemiology of Pediatric Brain Tumor in the Center of Referral Hospital in North Sumatera from 2013 -2017 Putra, Prawira; Tala, Ihsan Z; Dharmajaya, Ridha; Mouza, Abdurrahman; Tandean, Steven
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 1 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i1.1033

Abstract

Brain tumors are the most common disease group of solid tumors in childhood, and children with brain tumors have a relatively poor survival rate. Epidemiologic data from a hospital-based registry provide the necessary information to obtain a full picture of the frequency of this disease, which is a great challenge in pediatric oncology. One hundred thirty four tumors in children between 0 and 17 years of age diagnosed between 2013 to 2017 were classified according the sex, and topography. Incidence of brain tumor in boys were higher than girls. From the registry data, the prevalence for boys was higher (67%). In the whole series, 54% were supratentorial, 46% infratentorial. The most common histopathologic pattern seen in the registry were pilocytic astrocytoma which accounts for 42 cases (31%) followed by medulloblastoma and craniopharygioma with the percentage of 25% and 18% respectively. The least histopathologic pattern of pediatric tumor seen in our center are diffuse astrocytoma and choroid plexus papiloma which was only seen in 1 patient for the last 5 years of our experience.
Chronic Subdural Hematoma and Massive Subgaleal Hematoma Following Pediatric Minor Head Trauma Alloyna, Dhika; Tala, Ihsan Z
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 1 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i1.1034

Abstract

Subdural hematomas result from injury to the bridging cortical veins or from extension of intracerebral contusion in the subarachnoid space. Chronic subdural hematomas are usually observed in infants and result from an undiagnosed or conservatively treated acute subdural hematoma. Treatment depend on the extension and localization of the hematoma. Subgaleal hematoma is caused by rupture of emissary veins and located between the periosteum and the scalp galea aponeurotica extending from the orbital ridges to the nuchal ridge. A 6-year-old boy presented with a fluctuant mass over the scalp following a minor head injury 4 days earlier with history of headache and vomiting. He had undergone craniotomy procedure ten months earlier due to brain abscess drainage, post operative head CT revealed no abnormal radiologic findings and no clotting disorder was found before. A plain CT head revealed a thick isodense subdural collection overlying the left cerebral convexity and presentation of massive circumferensial subgaleal hematoma. Laboratory findings suggest progressive bleeding with low hemoglobin level of 6.8 g/dL but normal coagulation panel. The patient was managed surgically with a left-sided craniotomy hematoma evacuation. The previous subgaleal and subdural drains inserted gradually showed less production 3 days after surgery were withdrawn subsequently. As the clinical symptoms resolved, he was discharged with a slight intermitten headache. The patient was loss to follow-up so there were no post operative imaging. The majority of chronic subdural hematoma which are frequently encountered in neurosurgical practice, ideally treated with surgical drainage. Minor head trauma can lead to chronic subdural hematoma and massive subgaleal hematoma and these patients should be evaluated for underlying coagulopathy.
Cervical Spine Trauma Dahlan, Rully Hanafi; Ompusunggu, Sevline Estethia; Baselim, Ismail M.; G., Yustinus Robby B.
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 2 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i2.1042

Abstract

Cervical trauma is a serious condition, that may cause permanent disability or even death. Cervical trauma occurs in 2-7% of blunt trauma patients. In Europe, the incidence of cervical trauma is approximately 9-17/100,000 annually,. The most common mechanisms of injury causing cervival trauma are traffic accidents and falls, which the most commonly injured vertebra is vertebral C2 (axis). Diagnostics of cervical trauma are based on good clinical assessment and prompt radiological imaging. Several patient groups, such as the elderly and patients with traumatic brain injury are highly susceptible to cervical trauma. The diagnostics of cervivcal trauma remain challenging for clinical practitioners and failure to diagnose cervical trauma in acute care may have serious consequences.
The Role of Minimally Invasive Spine Surgery Dahlan, Rully Hanafi; Ompusunggu, Sevline Estethia; Ade, Christian; Raharjo, Ayu Iswandari
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 2 No. 2 (2020): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v2i2.1043

Abstract

Introduction :In the past half of century, the spinal surgery techniques has advanced significantly. Along with the improvement and various of techniques and technologies in general, there has been a big movement to reduce the morbidity of surgery. Case review : As opposed to open spine surgery, minimally invasive surgical approaches can be faster, safer and require less recovery time. The minimally invasive spine surgery also need to make an efficient target of surgery. The roots in minimally invasive spine surgery (MISS) are based primarily on technique modifications. Discussion: The Williams microdiscectomy, described in 1978, revolutionized MISS by starting the evolution of lumbar discectomy from an open surgery through a 6-inch incision to a microsurgical approach through as small an opening as possible. Conclusion :We don’t use the MISS technique when the extension of tumor is more than 2 levels; extension of the tumor is 20% longer than diameter of largest retractor; the tumor > 3cm for interlaminary approach, the wide durotomy is needed; and also the case with intramedullary tumor with 80% extention, from left to the right side; en bloc as the the goal of surgery for extradural tumor
Principles of Spine Instrumentation Dahlan, Rully Hanafi; Ompusunggu, Sevline Estethia; Utomo, Putra; Choliq, Firman Nur
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 2 No. 1 (2020): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v2i1.1044

Abstract

Introduction : Spinal implants were initially, and are still, used for the supplementation of bony fusion. However, bony fusion operations were initially performed without implants.1 In the US, Wire and screw fixation of the unstable spine techniques remained to use until the pre-World War II years. 20 years after World War II, there were two major breakthroughs in spine surgery: the Harrington system for spine stabilization and deformity correction and the interspinous wiring technique of Rogers. Rogers described the technique of cervical interspinous wiring in the early 1940s. Harrington introduced his instrumentation system in 1962. Discussion : Since then, modifications of both techniques have been devised to increase their security of fixation. The next significant advance in dorsal spinal stabilization was the development of multisegmental spinal instrumentation. Multisegmental instrumentation permits sharing of the load applied to the instrumentation construct with multiple vertebrae, so that decreasing the chance of failure at the metal–bone interface.The Luque segmental wiring technique, developed in the early 1970s, was the first of this class of implants to achieve wide clinical application. Subsequent modifications have been used. Conclusion : Further modifications were the forerunners of more complex, currently used systems of universal spinal instrumentation (USI).
Abdominal Pseudocyst: A Rare Complication of Ventriculoperitoneal Shunting Faisal; Dharmajaya, Ridha; Tala, Muhammad Ihsan Zulkarnain; Mousa, Abdurrahman; Tandean, Steven
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 2 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i2.1061

Abstract

Abstract: Ventriculoperitoneal (VP) shunt placement is one of the most commonly performed procedures in neurosurgery. One rare complication is the formation of an abdominal pseudocyst, which can cause shunt malfunction.  
Medulloblastoma: Intraventricular Recurrences Setiawan, Hendy; Wijaya, Celia; Dharmajaya, Ridha
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 1 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i1.1126

Abstract

Abstract :Medulloblastoma is the most common malignant pediatric brain tumor. Incidence in adult population is less than 1 %. Medulloblastoma in adult usually between 20 and 40 years old, which is lateral hemispheric and not midline vermian. Survival rate in adult is 67% lower than adolescents is 69% and children is 72%. Location of recurrences most commonly presents at posterior fossa, spinal, supratentorial, and bone metastases. Recurrences of medulloblastoma in supratentorial ventricular is uncommon. The outcome for patients with recurrent medulloblastoma has historically been poor. 37 years old male who presented with severe headache gradually. Patient has history of headache 2 months ago and gait ataxia 1,5 months ago. Patient had surgery 2 years ago with result of hystopathology medulloblastoma. He had irradiation completely 22 months ago. Physical examination showed GCS 15 with gait ataxia. Head CT scan show multiple isodense lesion intraventricular. Before patient had surgery, Head CT scan showed hiperdense lesion at cerebellopontine angle. Seeding medulloblastoma to intraventricular is recurrences which have poor prognosis. Patient had poor condition in few days. Patient died before got reriradiation
Tuberculosis of Sacrum: A Rare Location of Spinal Tuberculosis Sinaga, Patrice LWY; Ibrahim, Sabri; Dharmajaya, Ridha
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 1 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i1.1127

Abstract

Abstract :Tuberculosis is one of the most common infectious diseases in the world. The thoracolumbar spine is the commonest form of vertebral tuberculosis, whereas isolated tuberculosis of the sacrum is rarely reported in the literature. A male patient of 22-year old had complained low back pain since 2 years before admission to hospital without history of trauma on back. He also got low-grade fever and weight loss. There was no tuberculosis contagion found, no cough or night sweat. Clinical examination revealed neurological deficit with strength of both lower extremities were 4 and hipestesia in the level of lumbal 5 and downward. Radiographs of lumbosacral showed deformity of lumbal 5. CT scans of spine showed deformity of sacrum. MRI revealed spondylolisthesis L5-S1, S1-S2, S2-S3 and mass in the anterior posterior and lateral of paralumbal 5 and parasacral. There is no involvement of gluteus muscle and the around muscle. The patient underwent surgical of sequestrectomy with drainage abscess and lumbo-sacral-illiac fusion. The culture of sacral tissue showed Mycobacterium tuberculosis. The patient was treated with combination of four antituberculosis agents.

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