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Siahaan AMP, Nainggolan BWM, Susanto M, Indharty RS, Tandean S. Managing the "big black brain" in low resource setting: A case report of early outcome after hinge craniotomy. Surg Neurol Int 2023; 14:427. [PMID: 38213438 PMCID: PMC10783690 DOI: 10.25259/sni_715_2023] [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: 08/26/2023] [Accepted: 11/09/2023] [Indexed: 01/13/2024] Open
Abstract
Background The big black brain (BBB) phenomenon is described as an infant's response to an acute subdural hematoma (SDH). It is characterized by hypodensity and swelling of the supratentorial compartment as a whole. Numerous factors may contribute to the formation of the BBB. Due to its high morbidity and mortality, the management of BBB is still debatable. In this report, we describe a 2-month-old boy who had bilateral hemispheric hypodensity and underwent hinge craniotomy. Case Description The patient was referred to our hospital with decreased consciousness. The patient had a history of seizures and cardiopulmonary arrest. There is no history of trauma. The computed tomography revealed a subacute SDH on the left parietal and occipital lobe along with hypodensity in both hemispheres with preservation of posterior fossa, consistent with hemispheric hypodensity. We performed a hinge craniotomy for the emergency procedure and evacuated only the hemisphere with the bleeding side. The patient cried spontaneously 24 hours after the procedure and was discharged six days later. Conclusion Early outcomes of hinge craniotomy as an alternative procedure for treating the BBB were positive. However, long-term outcomes, particularly the infant's development, should be monitored.
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Affiliation(s)
| | | | - Martin Susanto
- School of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Rr Suzy Indharty
- Department of Neurosurgery, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Steven Tandean
- Department of Neurosurgery, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
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Siahaan AMP, Indharty S, Tandean S, Tommy T, Loe ML, Nainggolan BWM, Pangestu D, Susanto M. Middle meningeal artery embolization and pediatric chronic subdural hematoma: a systematic review of the literature. Neurosurg Rev 2023; 46:239. [PMID: 37697174 DOI: 10.1007/s10143-023-02130-0] [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: 07/20/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
Chronic subdural hematoma (CSDH) is a disease commonly found in the elderly and not a typical finding in pediatric population. History of shunt surgery, child abuse, and blood disorder are some of the common causes of pediatric CSDH (pCSDH). There is growing evidence about the role of middle meningeal artery embolization (MMAE) to manage CSDH in the elderly population with a high risk of rebleeding. However, the evidence in the pediatric population is still sparse. A systematic literature search was conducted on PubMed, Scopus, and Web of Science database from January, 2023, to March, 2023. Search strings were generated based on the combination of modified search terms, such as CSDH, MMA embolization, and child. Risk of bias was assessed using the Cochrane Risk of Bias in Nonrandomized Study for Intervention. Nine articles were included in this review. The success rate of MMA embolization in pediatric CSDH was 88.8%. Histories of ventriculoperitoneal shunt, blood coagulation disorder, and trauma were the causes of CSDH. Time to achieve success was varied from 2 to 9 months. No study with low risk of bias was found. This systematic review found no high-quality evidence regarding the role of MMA embolization in the management of pCSDH. However, due to its high success rate, MMAE could be a promising approach to treat pCSDH.
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Affiliation(s)
| | - Suzy Indharty
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Thomas Tommy
- Department of Neurosurgery, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | | | | | - Dimas Pangestu
- Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Martin Susanto
- Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Siahaan AMP, Tandean S, Nainggolan BWM, Tarigan J, Sitanggang JS. A Critical Analysis of Intracranial Hemorrhage as a Fatal Complication of Dengue Fever. J Korean Neurosurg Soc 2023; 66:494-502. [PMID: 36642946 PMCID: PMC10483153 DOI: 10.3340/jkns.2022.0205] [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: 09/14/2022] [Revised: 12/21/2022] [Accepted: 01/12/2023] [Indexed: 01/17/2023] Open
Abstract
Dengue fever is the most rapidly spreading mosquito-borne virus in the world, infecting about 100 million individuals. A rare but possibly dangerous consequence of dengue illness is intracranial hemorrhage (ICH). Currently, the pathogenesis of ICH is unknown. A number of studies have found a variety of risk factors for ICH in dengue. In addition, studies have reported the use of emergency surgery while monitoring thrombocytopenia in the therapy of dengue ICH. This review enumerates the potential predictors of ICH in dengue, discusses the use of brain imaging, and mentions the possibility of emergency surgery.
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Affiliation(s)
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Junita Tarigan
- Division of Infection and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Johan Samuel Sitanggang
- Undergraduate Program in Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Indharty RS, Japardi I, Irina RS, Tandean S, Siahaan AMP, Loe ML, Ivander A. Comparison of direct cortical stimulation and transcranial magnetic stimulation in brain tumor surgery: systematic review and meta analyses. J Neurooncol 2023; 163:505-514. [PMID: 37438656 PMCID: PMC10393852 DOI: 10.1007/s11060-023-04378-4] [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: 05/20/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Brain malignancy and, at the same time central nervous system malignancy are two of the most difficult problems in the oncology field of practice. Brain tumors located near or within eloquent areas may represent another challenge toward neurosurgeon treatment. As such, electrical stimulation, either directly or through other methods, may prove necessary as proper mapping of the eloquent area thus may create a proper resection guide. Minimal resection will hopefully preserve patient neurological function and ensure patient quality of life. METHODS This research is a systematic review and meta-analysis that aim to compare outcomes, primarily adverse event analysis, between direct cortical stimulation and transcortical magnetic stimulation. RESULTS Fourteen studies were identified between 2010 and the 2023 interval. While this number is sufficient, most studies were not randomized and were not accompanied by blinding. Meta-analysis was then applied as a hypothesis test, which showed that TMS were not inferior compared to DCS in terms of motoric and lingual outcome which were marked subjectively by diamond location and objectively through a p-value above 0.05. CONCLUSION TMS is a noninvasive imaging method for the evaluation of eloquent brain areas that is not inferior compared to the invasive gold-standard imaging method (DCS). However its role as adjuvant to DCS and alternative only when awake surgery is not available must be emphasized.
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Affiliation(s)
- Rr Suzy Indharty
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Dr. Mansyur St. No. 5, Padang Bulan, Medan Baru, Medan, Sumatera Utara, 20155, Indonesia.
| | - Iskandar Japardi
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Dr. Mansyur St. No. 5, Padang Bulan, Medan Baru, Medan, Sumatera Utara, 20155, Indonesia
| | - Rr Sinta Irina
- Anesthesiology and Intensive Care Study Program, Universitas Sumatera Utara, Medan, Indonesia
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Dr. Mansyur St. No. 5, Padang Bulan, Medan Baru, Medan, Sumatera Utara, 20155, Indonesia
| | - Andre Marolop Pangihutan Siahaan
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Dr. Mansyur St. No. 5, Padang Bulan, Medan Baru, Medan, Sumatera Utara, 20155, Indonesia
| | - Michael Lumintang Loe
- Department of Neurosurgery, Faculty of Medicine, University of Palangka Raya, Palangkaraya, Indonesia
- Department of Neurosurgery, Siloam Hospital, Medan, Indonesia
| | - Alvin Ivander
- Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Zulhendri F, Lesmana R, Tandean S, Christoper A, Chandrasekaran K, Irsyam I, Suwantika AA, Abdulah R, Wathoni N. Recent Update on the Anti-Inflammatory Activities of Propolis. Molecules 2022; 27:molecules27238473. [PMID: 36500579 PMCID: PMC9740431 DOI: 10.3390/molecules27238473] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 12/09/2022]
Abstract
In recent years, research has demonstrated the efficacy propolis as a potential raw material for pharmaceuticals and nutraceuticals. There is limited report detailing the mechanisms of action of propolis and its bioactive compounds in relation to their anti-inflammatory properties. Thus, the aim of the present review is to examine the latest experimental evidence (2017-2022) regarding the anti-inflammatory properties of propolis. A systematic scoping review methodology was implemented. After applying the exclusion criteria, a total of 166 research publications were identified and retrieved from Scopus, Web of Science, and Pubmed. Several key themes related to the anti-inflammatory properties of propolis were subsequently identified, namely in relation to cancers, oral health, metabolic syndrome, organ toxicity and inflammation, immune system, wound healing, and pathogenic infections. Based on the latest experimental evidence, propolis is demonstrated to possess various mechanisms of action in modulating inflammation towards the regulatory balance and anti-inflammatory environment. In general, we summarize that propolis acts as an anti-inflammatory substance by inhibiting and downregulating TLR4, MyD88, IRAK4, TRIF, NLRP inflammasomes, NF-κB, and their associated pro-inflammatory cytokines such as IL-1β, IL-6, IFN-γ, and TNF-α. Propolis also reduces the migration of immune cells such as macrophages and neutrophils, possibly by downregulating the chemokines CXCL9 and CXCL10.
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Affiliation(s)
- Felix Zulhendri
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
- Kebun Efi, Kabanjahe 22171, Indonesia
| | - Ronny Lesmana
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
- Biological Activity Division, Central Laboratory, Universitas Padjadjaran, Bandung 45363, Indonesia
- Correspondence: (R.L.); (S.T.)
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan 20222, Indonesia
- Correspondence: (R.L.); (S.T.)
| | - Andreas Christoper
- Postgraduate Program of Medical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, Indonesia
| | | | - Ilham Irsyam
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Sumatera Utara, Medan 20222, Indonesia
| | - Auliya A. Suwantika
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Rizky Abdulah
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung 45363, Indonesia
| | - Nasrul Wathoni
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, Indonesia
- Research Center of Biopolymers for Drug and Cosmetic Delivery, Bandung 45363, Indonesia
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Tandean S, Siahaan AMP, Loe ML, Indharty RS, Julijamnasi, Sitorus MS, Japardi I, July J. Case report: Implantation metastasis following stereotactic biopsy of pineal parenchymal tumor of intermediate differentiation in an adult patient: An exceptionally rare complication. Front Neurol 2022; 13:1019955. [DOI: 10.3389/fneur.2022.1019955] [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] [Received: 08/15/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
Implantation metastasis following stereotactic biopsy in the brain had been reported as a rare complication. A 36-years-old female patient was treated with ventriculoperitoneal (VP) shunt and stereotactic biopsy of a pineal parenchymal tumor of intermediate differentiation (PPTID) with hydrocephalus. The patient underwent five cycles of radiotherapy on the pineal area. Seven years after the procedure, the patient developed left hemiparesis with the brain MRI findings showing an enhanced mass along the biopsy tract. Craniotomy tumor removal was carried out and the pathological assessment was consistent with those of the PPTID. Radiation on metastase area and craniospinal was subsequently performed. The patient was disease-free during the 2-year follow-up assessments. The potential occurrence of implantation metastasis following the stereotactic biopsy of PPTID should be considered in the treatment plan and follow-up assessments and evaluations. Expanding the radiation area to cover the entire biopsy tract may be favorable to lower the risk of implantation metastasis.
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Siahaan AMP, Tandean S, Indharty RS, Nainggolan BWM, Susanto M. Paroxysmal sympathetic hyperactivity syndrome in tuberculous meningitis with paradoxical reaction. Int J Surg Case Rep 2022; 99:107619. [PMID: 36096085 PMCID: PMC9568713 DOI: 10.1016/j.ijscr.2022.107619] [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: 08/13/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction and importance Paroxysmal sympathetic hyperactivity syndrome is frequently reported in traumatic brain injury. However, it may occur in non-traumatic brain injury, such as tuberculous meningitis with hydrocephalus. Case presentation We reported a 38-year-old male who presented with acute decrease of consciousness and hemiparesis that was developed during antitubercular drugs therapy. CT Scan showed hydrocephalus and granuloma lesion. Emergency ventriculoperitoneal shunting were performed. During treatment, the patient developed paroxysmal sympathetic syndrome during treatment that was controlled based on symptom elimination and prevention. Clinical discussion Brain tuberculosis remains a difficult problem for clinicians. Even when antitubercular drugs are administered according to protocol, paradoxical reactions can occur. If hydrocephalus develops, ventriculoperitoneal shunting is one of the options for lowering intracranial pressure. Paroxysmal sympathetic hyperactivity may occur in brain tuberculosis and should be detected as soon as possible to avoid serious morbidity. Conclusion Paroxysmal sympathetic hyperactivity may be developed in brain tuberculosis. Early identification and treatment are mandatory. Paroxysmal sympathetic hyperactivity (PSH) syndrome may be observed in non-traumatic brain injury Treatment of PSH was based on symptoms elimination and symptoms prevention. Paradoxical reaction in tuberculosis, characterized by the appearance of new clinical symptoms during antitubercular drug therapy Ventriculoperitoneal shunting to reduce intracranial pressure in hydrocephalus following meningitis tuberculosis
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Siahaan AMP, Tandean S, Nainggolan BWM. Spontaneous epidural hematoma induced by rivaroxaban: A case report and review of the literature. Surg Neurol Int 2022; 13:420. [PMID: 36324933 PMCID: PMC9610455 DOI: 10.25259/sni_608_2022] [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: 07/07/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Trauma is the most frequent reason for epidural bleeding. However, numerous investigation had discovered that anticoagulants such as rivaroxaban could cause epidural hematoma. Here, we present a case of epidural hematoma in young man who got rivaroxaban as treatment of deep vein thrombosis. Case Description: A 27-year-old male with a history of deep vein thrombosis and one month of rivaroxaban medication presented with seizure and loss of consciousness following a severe headache. A CT scan of the head revealed epidural bleeding, and emergency blood clot removal was performed. As a reversal, prothrombin complex was utilized. Conclusion: Rivaroxaban has the potential to cause an epidural hemorrhage. Reversal anticoagulant should be administered before doing emergency surgery.
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Affiliation(s)
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Siahaan AMP, Tandean S, Saragih EB, Nainggolan BWM. Spontaneous acute subdural hematoma in dengue fever: Case report and review of the literature. Int J Surg Case Rep 2022; 98:107512. [PMID: 35985111 PMCID: PMC9411658 DOI: 10.1016/j.ijscr.2022.107512] [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: 07/05/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction and importance A very uncommon dengue fever consequence is subdural hematoma. IgG positivity, increased AST, and ALT levels may all be risk factors for bleeding in dengue fever patients. Case presentation We report the case of a 65-year-old man who presented with dengue fever symptoms and developed altered consciousness and focal neurological deficits. The findings of the tests showed thrombocytopenia, increased AST and ALT, positive anti-dengue IgG, and subdural hematoma on brain imaging. The urgent operations were completed satisfactorily. Clinical discussion Dengue-related intracerebral haemorrhage is still a complicated condition. Thrombocytopenia and leukopenia are the first symptoms that point to dengue. Some risk factors, such as thrombocytopenia and increased AST and ALT, have been identified as bleeding factors in dengue fever. For a possible intracerebral haemorrhage, radiological imaging should be performed. In an emergency neurosurgery setting, thrombocyte administration could be used to monitor thrombocytopenia. Conclusion Subdural hematoma is a possible dengue fever complication. If the patient's symptoms with thrombocytopenia and elevated liver enzymes indicate the possibility of intracranial haemorrhage, immediate radiological imaging should be performed. Elevated AST and ALT as a risk factor of intracranial bleeding in dengue fever Immediate radiological imaging to the patients with positive IgG and intracranial haemorrhage symptoms. Emergency surgical intervention should be conducted depending on patient's status with thorough care in hematologic profile.
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Zulhendri F, Perera CO, Tandean S, Abdulah R, Herman H, Christoper A, Chandrasekaran K, Putra A, Lesmana R. The Potential Use of Propolis as a Primary or an Adjunctive Therapy in Respiratory Tract-Related Diseases and Disorders: A Systematic Scoping Review. Biomed Pharmacother 2022; 146:112595. [PMID: 35062065 DOI: 10.1016/j.biopha.2021.112595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/14/2021] [Revised: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022] Open
Abstract
Propolis is a resinous beehive product that is collected by the bees from plant resin and exudates, to protect and maintain hive homeostasis. Propolis has been used by humans therapeutically to treat many ailments including respiratory tract-related diseases and disorders. The aim of the present systematic scoping review is to evaluate the experimental evidence to support the use of propolis as a primary or an adjunctive therapy in respiratory tract-related diseases and disorders. After applying the exclusion criteria, 158 research publications were retrieved and identified from Scopus, Web of Science, Pubmed, and Google Scholar. The key themes of the included studies were pathogenic infection-related diseases and disorders, inflammation-related disorders, lung cancers, and adverse effects. Furthermore, the potential molecular and biochemical mechanisms of action of propolis in alleviating respiratory tract-related diseases and disorders are discussed. In conclusion, the therapeutic benefits of propolis have been demonstrated by various in vitro studies, in silico studies, animal models, and human clinical trials. Based on the weight and robustness of the available experimental and clinical evidence, propolis is effective, either as a primary or an adjunctive therapy, in treating respiratory tract-related diseases.
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Affiliation(s)
- Felix Zulhendri
- Kebun Efi, Kabanjahe 22171, North Sumatra, Indonesia; Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Indonesia; Research Fellow, Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Indonesia.
| | - Conrad O Perera
- School of Chemical Sciences, University of Auckland, 23 Symonds Street, Auckland CBD, Auckland 1010, New Zealand.
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan 20222, Sumatera Utara, Indonesia.
| | - Rizky Abdulah
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Indonesia; Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Indonesia.
| | - Herry Herman
- Department of Orthopaedics, Faculty of Medicine, Universitas Padjadjaran, Indonesia.
| | - Andreas Christoper
- Postgraduate Program of Medical Science, Faculty of Medicine, Universitas Padjadjaran, Indonesia.
| | | | - Arfiza Putra
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Sumatera Utara Medan 20222, Sumatera Utara, Indonesia.
| | - Ronny Lesmana
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Indonesia; Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Indonesia; Biological Activity Division, Central Laboratory, Universitas Padjadjaran, Indonesia.
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Zulhendri F, Perera CO, Tandean S. Can Propolis Be a Useful Adjuvant in Brain and Neurological Disorders and Injuries? A Systematic Scoping Review of the Latest Experimental Evidence. Biomedicines 2021; 9:1227. [PMID: 34572413 PMCID: PMC8470086 DOI: 10.3390/biomedicines9091227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/19/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022] Open
Abstract
Propolis has been used therapeutically for centuries. In recent years, research has demonstrated its efficacy as a potential raw material for pharmaceuticals and nutraceuticals. The aim of the present scoping review is to examine the latest experimental evidence regarding the potential use of propolis in protecting the brain and treating neurological disorders and injuries. A systematic scoping review methodology was implemented. Identification of the research themes and knowledge gap was performed. After applying the exclusion criteria, a total of 66 research publications were identified and retrieved from Scopus, Web of Science, Pubmed, and Google Scholar. Several key themes where propolis is potentially useful were subsequently identified, namely detoxification, neuroinflammation, ischemia/ischemia-reperfusion injury/traumatic brain injury, Alzheimer's disease, Parkinson's disease, and epilepsy models, depression, cytotoxicity, cognitive improvement, regenerative medicine, brain infection, and adverse effects. In conclusion, propolis is shown to have protective and therapeutic benefits in alleviating symptoms of brain and neurological disorders and injuries, demonstrated by various in vitro studies, animal models, and human clinical trials. Further clinical research into this area is needed.
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Affiliation(s)
| | - Conrad O Perera
- Food Science Program, School of Chemical Sciences, University of Auckland, 23 Symonds Street, Auckland CBD, Auckland 1010, New Zealand
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan 20222, Sumatera Utara, Indonesia
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Siahaan AMP, Indharty RS, Chrestella J, Sadewo W, Tandean S, Syarifah S. Sustained Tau Phosphorylation and Microglial Activation Following Repetitive Traumatic Brain Injury. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.5471] [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: 11/05/2022] Open
Abstract
BACKGROUND: Repetitive traumatic brain injury (TBI), even without acute sequela, can induce a delayed neurodegenerative with overexpression of phosphorylated tau (p-tau) as hallmark, caused by chronic inflammation mediated in part by microglial activation.
AIM: The aim of this study was to examine the dynamics of p-tau accumulation and microglial activation following repetitive TBI.
MATERIALS AND METHODS: Thirty Sprague–Dawley rats were randomized into a sham control group and two treatment groups receiving three successive closed-skull impacts (TBI model) from a 40-g mass dropped from a 1-m height on alternating days (days 0, 1, 3, and 7). The first treatment group was sacrificed on the last day of trauma and the second treatment group after 7 days of no trauma. The expression level of p-tau was evaluated by AT-8 antibody immunostaining and microglial activation by anti-CD-68 immunostaining.
RESULTS: Immunoexpression of AT-8 was significantly elevated 7 days after TBI compared to the last day of trauma and compared to the sham control group, while CD-68 expression was significantly higher than sham controls on the last day of trauma and remained elevated for 7 days without trauma.
CONCLUSION: The study showed that brain trauma can induce p-tau overexpression and microglial activation that is sustained during the non-trauma period.
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Indharty S, Japardi I, Tandean S, Siahaan AMP, Loe ML, Riawan W. Efficacy of Neuroprotection from Curcumin through Heat Shock Protein 70 Induction in Traumatic Brain Injury – Rat Model. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.4933] [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: 11/05/2022] Open
Abstract
BACKGROUND: Traumatic brain injury (TBI) is the most common problem that caused morbidity and mortality in the world. Secondary brain injury is a complex cascade that causes brain cell apoptosis. Curcumin is a natural product that has neuroprotective properties.
AIM: This study aimed to investigate the effect of curcumin toward heat shock protein 70 (HSP 70) expression against the expression apoptosis marker (apoptosis-inducing factor [AIF], caspase-3, and TUNEL assay) in brain tissue after TBI.
METHODS: Thirty-three Sprague Dawley rats were randomized into three treatment groups, that is, sham-operated controls, closed head trauma (CHT), and CHT with curcumin extract (treatment group). In the treatment group, curcumin was given 500 mg/kg per oral for 7 days, then brain tissues were investigated (marker AIF, caspase-3, TUNEL assay, and HSP 70) through immunohistochemistry. Statistical test using one-way ANOVA test and Tukey honestly significant difference as post hoc test.
RESULTS: The mean of positive AIF stained cells in Group A was 5.36 ± 2.11, Group B was 12.82 ± 1.40, and Group C was 3.82 ± 1.40, with a significant difference of AIF expression between Groups C and B (p < 0.05). Mean of positive caspase-3 stained cells in Group A was 5.45 ± 2.30, Group B was 13.82 ± 2.44, and Group C was 3.82 ± 1.54, with a significant difference of caspase-3 expression between Groups C and B (p < 0.05). Mean of positive TUNEL assay stained cells in Group A was 4.82 ± 2.04, Group B was 11.55 ± 1.51, and Group C was 3.55 ± 1.70, with a significant difference between Groups C and B (p < 0.05). Mean of positive HSP 70 stained cells in Group A was 6.82 ± 2.14, Group B was 3.91 ± 2.26, and Group C was 10.27 ± 2.45 with a significant difference of HSP 70 expression distribution within groups (p < 0.05).
CONCLUSION: Curcumin may protect brain cells from apoptosis after close head trauma by upregulated HSP 70 expression.
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July J, Patricia D, Gunawan PY, Setiajaya H, Ginting TE, Putra TP, Wuisan Z, Budhiarko D, Masykura N, Prayogi G, Utomo AR, Tandean S, Loe ML. Clinicopathological associations and prognostic values of IDH1 gene mutation, MGMT gene promoter methylation, and PD-L1 expressions in high-grade glioma treated with standard treatment. Pan Afr Med J 2020; 36:309. [PMID: 33282092 PMCID: PMC7687483 DOI: 10.11604/pamj.2020.36.309.24831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 07/06/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION the objective was to evaluate the impact of IDH1 R132H mutation, MGMT methylation and PD-L1 expression in high grade glioma that received standard therapy (surgery, radiation and chemotherapy) to overall survival (OS). METHODS this is a retrospective study of 35 high grade glioma cases. Genotyping of IDH1 gene alteration on the mutation hotspot R132 (Sanger sequencing method with Applied Biosystems 3500 Genetic Analyzer), EZ DNA Methylation-Gold kit (Zymo Research) is used to study the methylation, Cell line BT549 (ATCC HTB-122) and HCT-116 (ATCC CCL-247) were used as unmethylated control and partially methylated control respectively. Anti-human PD-L1 antibody clone E1L3N®from Cell Signalling Technology (USA) and Rabbit XP®were used to see PDL-1 expression. RESULTS anaplastic astrocytoma cases had more MGMT promoter methylation (50%) than glioblastoma multiforme (GBM) (20%), more IDH1 R132H mutation (42%) than GBM (4.3%). Immunohistochemistry tumor proportion score method (TPS) identified 17% and 8.7% were PD-L1 positive in AA and GBM groups, respectively. Cases with IDH1 R132H mutation and MGMT methylation still showed better OS although with high PD-L1 expression. CONCLUSION IDH1 R132H mutation and MGMT methylation were good prognostic markers. High expression of PD-L1 apparently might not indicate poor overall survival in the presence of IDH1 R132 mutation and MGMT methylation.
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Affiliation(s)
- Julius July
- Department of Neurosurgery, Medical Faculty of Universitas Pelita Harapan, Neuroscience Centre of Siloam Hospital Lippo Village, Tangerang, Indonesia
- Mochtar Riady Institute for Nanotechnology and Medical Science group, Universitas Pelita Harapan, Lippo Village, Tangerang, Indonesia
| | - Diana Patricia
- Department of Pathology, Medical Faculty of Universitas Pelita Harapan, Neuroscience Centre of Siloam Hospital Lippo Village, Tangerang, Indonesia
| | - Pricilla Yani Gunawan
- Department of Neurology, Medical Faculty of Universitas Pelita Harapan, Neuroscience Centre of Siloam Hospital Lippo Village, Tangerang, Indonesia
| | - Handrianto Setiajaya
- Division of Neurosurgery, Department of Surgery, Rumah Sakit Pusat Angkatan Darat Gatot Subroto, Jakarta, Indonesia
| | - Teridah Ernala Ginting
- Mochtar Riady Institute for Nanotechnology and Medical Science group, Universitas Pelita Harapan, Lippo Village, Tangerang, Indonesia
| | | | - Zerlina Wuisan
- Stemcell and Cancer Institute, PT Kalbe Farma Tbk, Jakarta, Indonesia
| | - Dini Budhiarko
- Stemcell and Cancer Institute, PT Kalbe Farma Tbk, Jakarta, Indonesia
| | | | - Gintang Prayogi
- Stemcell and Cancer Institute, PT Kalbe Farma Tbk, Jakarta, Indonesia
| | | | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan 20155, Medan, Indonesia
| | - Michael Lumintang Loe
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan 20155, Medan, Indonesia
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July J, Bastiaan N, Tandean S, Loe ML. Profile of Daily Life in Children with Brain Tumors: An Assessment of PedsQL 4.0 Generic Core Scales before and after Treatment. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.4529] [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: 11/05/2022] Open
Abstract
BACKGROUND: Pediatric brain tumors are the most common solid tumor and cause of death among all childhood cancers. In America, brain tumor prevalence is 21.42/100.000 population. Even though survival rate is improving, the impact of treatment for long-term quality of life is still a challenge.
AIM: We aimed to investigate quality of life score using PedsQL 4.0 Generic Core Scales.
METHODS: The data collected based on the inclusion criteria from patient’s medical records 2015–2017 period on January 2018–May 2018 in Siloam Hospital, Lippo Village, Karawaci. Twenty-six brain tumor pediatric patients with surgical treatment were evaluated using PedsQL 4.0 Generic Core Scales. The evaluation included before and after condition of the patient. PedsQL 4.0 Generic Core Scales were divided into four categories; physical function, emotional function, social function, and school function. They were analyzed statically using Wilcoxon test with p < 0.05 considered as statistically significant.
RESULTS: The result showed that before treatment score of PedsQL 4.0 Generic Core Scales was classified as medium functioning (58.54/92) and after treatment score of PedsQL 4.0 Generic Core Scales was classified as intermediate functioning (37.3/92).
CONCLUSION: The conclusion is that patient after treatment (surgery, chemotherapy, and radiation) shows improved quality of life score using PedsQL 4.0 Generic Core Scales.
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Indharty RRS, Japardi I, Siahaan AMP, Tandean S, Loe ML. Efficacy of Minocycline in Neural Stem Cells Proliferation after Traumatic Brain Injury. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.3875] [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: 11/05/2022] Open
Abstract
BACKGROUND: Neuroinflammation is an important secondary injury mechanism that contributes to neurological impairments after traumatic brain injury (TBI). There is a robust evidence that neuroinflammation will diminish neurogenesis after TBI. Therefore, strategies to attenuate the inflammatory responses are potential to increase neurogenesis following TBI. Minocycline, a second-generation tetracycline antibiotic derivate, has potent anti-inflammatory effect by reducing microglial activation and suppressing some pro-inflammatory cytokines.
AIM: The aim of this study is to investigate if minocycline could enhance neurogenesis after TBI.
METHODS: Thirty Sprague Dawley rats were randomized into three treatments group, i.e., sham-operated controls, closed head injury (CHI), and CHI with minocycline. We used the modified Feeney’s weight-drop model for making CHI. For the treatment group, we gave minocycline per oral (50 mg/kg) twice daily for the first 2 days followed by 25 mg/kg once daily for 3 consecutive days. Animals were sacrificed on day 5. To assess the proliferation capacity of neural stem cells (NSC), we performed immunohistochemistry staining with SOX2, brain-derived neurotropic factor (BDNF), and NFR. Cell counts were carried out using light microscope with 1000 times magnification in 20 high-power fields.
RESULTS: SOX2, NF-E2-related factor 2 (NRF-2), and BDNF were upregulated in the CHI group compared to the sham-operated group (p < 0.05). NRF-2, BDNF, and SOX2 were upregulated also significantly in the CHI+ minocycline group compared to the sham-operated group and the CHI group (p < 0.05).
CONCLUSION: Minocycline increased the proliferation capacity of NSC.
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Loe ML, Indharty RS, Siahaan AMP, Tandean S, Riawan W. The Effect of Intranasal Administration of ACTH Analogue Toward Neural Progenitor/Stem Cells Proliferation after Traumatic Brain Injury. SAINS MALAYS 2020. [DOI: 10.17576/jsm-2020-4902-15] [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: 11/17/2022]
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Tandean S, Japardi I, Loe ML, Riawan W, July J. Protective Effects of Propolis Extract in a Rat Model of Traumatic Brain Injury via Hsp70 Induction. Open Access Maced J Med Sci 2019; 7:2763-2766. [PMID: 31844433 PMCID: PMC6901855 DOI: 10.3889/oamjms.2019.736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND: Traumatic brain injury (TBI) is one of the major global health problems. Secondary brain injury is a complex inflammation cascades process that causes brain cell apoptosis. Propolis is a natural product that has neuroprotective property. AIM: This study aimed to investigate the effect of propolis toward Hsp70 expression with apoptosis marker in brain tissue after TBI. METHODS: Thirty-three Sprague Dawley rats were randomised into three treatments group, i.e. sham-operated controls, closed head injury (CHI), and CHI with propolis extract (treatment group). In the treatment group, propolis was given 200 mg/kg per oral for 7 days then harvested brain tissues after sacrificed by cervical dislocation at day 8. We investigated Hsp70, Caspase 3, apoptosis-inducing factor (AIF), and TUNEL assay expression using immunohistochemistry staining. Statistical test using one-way ANOVA test and Tukey HSD as post hoc test. RESULTS: Mean of positive Hsp70 stained cells in group 1 was 6.82 ± 2.14, group 2 was 3.91 ± 2.26, and group 3 was 9.64 ± 3.53 with a significant difference of Hsp70 expression distribution within groups (p = 0.0001). Mean of positive caspase 3 stained cells in group 1 was 5.45 ± 2.30, group 2 was 13.82 ± 2.44, and group 3 was 7.03 ± 1.54 with a significant difference of caspase3 expression distribution within groups (p=0.0001). Mean of positive AIF stained cells in group 1 was 5.36 ± 2.11, group 2 was 12.82 ± 1.40, and group 3 was 8.09 ± 1.81 with a significant difference of AIF expression distribution within groups (p = 0.0001). Mean of positive TUNEL assay stained cells in group 1 was 4.82 ± 2.04, group 2 was 11.55 ± 1.51, and group 3 was 7.64 ± 1.96 with a significant difference of TUNEL test expression distribution within groups (p = 0.0001). CONCLUSION: Propolis may protect brain cell from apoptosis after injury by maintaining Hsp70 expression in addition to antioxidant and anti-inflammatory.
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Affiliation(s)
- Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Iskandar Japardi
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Michael Lumintang Loe
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Wibi Riawan
- Department of Biochemistry, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Julius July
- Department of Neurosurgery, Faculty of Medicine, Universitas Pelita Harapan (UPH), Neuroscience Centre Siloam Hospital Lippo Village, Tanggerang, Indonesia
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Indharty RRS, Japardi I, Siahaan AMP, Tandean S. Mangosteen extract reduce apoptosis via inhibition of oxidative process in rat model of traumatic brain injury. Bali Med J 2019. [DOI: 10.15562/bmj.v8i1.1153] [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: 11/05/2022] Open
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Tandean S, Hendriansyah L, Djokomuljanto S, Saputra NA, Juliansen A, Valentina S, Mulry MA, July J. Neuroendoscopic aspiration and lavage of intraventricular empyema following shunt infection in infants. Pan Afr Med J 2018; 31:15. [PMID: 30918543 PMCID: PMC6430859 DOI: 10.11604/pamj.2018.31.15.16631] [Citation(s) in RCA: 5] [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: 07/23/2018] [Accepted: 08/10/2018] [Indexed: 11/14/2022] Open
Abstract
Bacterial ventriculitis is one of the most common and serious complications of shunt placement. Shunt infection has varied management and is difficult to treat neurosurgically. We report a case of intraventricular empyema due to shunt infection. Standard management was failed for this case and reaccumulation of pus in the both ventricles. Neuroendoscopic surgery with intraventricular lavage and aspiration using cannula nasogastric tube (NGT) through a single burr hole, has successfully decreased the accumulation of intraventricular empyema. After lavage and aspiration, antibiotic can be distributed effectively to the affected area. Follow up imaging and cerebrospinal fluid (CSF) culture shown a good result and shorter length of stay in the hospital. Neuroendoscopy appears effective and safe for the management of bacterial ventriculitis due to shunt infection in infant. The strategy described in this report might be useful to treat intraventricular empyema.
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Affiliation(s)
- Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Pelita Harapan University, Neuroscience Centre Siloam Hospital Lippo Village, Tanggerang, Indonesia.,Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Lutfi Hendriansyah
- Department of Neurosurgery, Faculty of Medicine, Pelita Harapan University, Neuroscience Centre Siloam Hospital Lippo Village, Tanggerang, Indonesia
| | | | - Nico Adi Saputra
- Department of Neurosurgery, Faculty of Medicine, Pelita Harapan University, Neuroscience Centre Siloam Hospital Lippo Village, Tanggerang, Indonesia
| | - Andry Juliansen
- Department of Pediatric, Siloam Lippo Karawaci Hospital, Tanggerang, Indonesia
| | - Silvia Valentina
- Faculty of Medicine, Pelita Harapan University, Tanggerang, Indonesia
| | - Monica Ann Mulry
- Undergraduate School of Medicine National University of Ireland, Galway, Ireland
| | - Julius July
- Department of Neurosurgery, Faculty of Medicine, Pelita Harapan University, Neuroscience Centre Siloam Hospital Lippo Village, Tanggerang, Indonesia
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Tandean S, Risfandi M, Japardi I. Pediatric gunshot penetrating head injury: a case report with 2-year follow-up. Med J Indones 2018. [DOI: 10.13181/mji.v26i4.1472] [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: 10/18/2022] Open
Abstract
Gunshot is a rare subset of penetrating head injury, and generally the victim dies before arriving at the hospital. This paper reported a case of an intracranial gunshot injury in a 12 year-old boy that was shot by his friend, whose primary intention was to play around, using a revolver. A missile projectile penetrated from mid frontal and came out from right occipital. Vital signs were stable with GCS 8 from physical examination. A rational management strategy should permit a good outcome. The only complications that occured were hydrocephalus, yet it was managed by VP–shunt. Skull defect was closed using titanium mesh. A two-year follow-up showed a good result. The patient was able to do daily activity and back to school again.
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