AKSONA 2022-07-31T11:36:11+00:00 Dr. Paulus Sugianto, dr., Sp.N(K), FAAN Open Journal Systems <p><strong>AKSONA - <a href="">e-ISSN: 2807-7970 </a> - </strong>is a peer-reviewed scientific journal that continiously published 2 (two) times a year in January and July by the Department of Neurology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital Surabaya in collaboration with the <a href="">Indonesian Neurological Association (INA) Surabaya branch / PERDOSSI Surabaya</a>. The journal publishes original articles, case reports and reviews article related to neurology and neuroscience. Aksona has also been indexed in several reputable indexing institutions, such as <a href=";user=qD-06pwAAAAJ" target="_blank" rel="noopener">Google Scholar</a>, <a href=";query=Effect%20of%20Anticoagulants%20or%20Antiplatelets%20Administration%20on%20Mortality%20Case%20in%20COVID-19%20Patients%20with%20Acute%20Ischemic%20Stroke%3A%20A%20Systematic%20Review%20and%20Meta-Analysis&amp;sortBy=relevance" target="_blank" rel="noopener">Mendeley</a>, <a href=";from_ui=yes" target="_blank" rel="noopener">Crossref</a>, <a href="" target="_blank" rel="noopener">Garuda</a>, <a href=";search_text=AKSONA&amp;search_type=kws&amp;search_field=full_search&amp;and_facet_source_title=jour.1423436" target="_blank" rel="noopener">Dimensions</a>, and <a href="">Scilit</a>. </p> <p>The manuscript should be prepared according to<a href="" target="_blank" rel="noopener"> the Guidelines for Author</a>, arranged according to its <a href="" target="_blank" rel="noopener">respective template</a>, and submitted via the <a href="" target="_blank" rel="noopener">Online Submission</a> at the sidebar. All necessary forms, such as <a href="" target="_blank" rel="noopener">Authors' Form</a> should be completed. It is recommended to <a href="">check the required completeness</a> before submitting. Starting in 2022, AKSONA will only accept submissions and publish article in English.</p> <p> </p> Partial Transvenous Coil Embolization with Significant Clinical Improvement in Patient with Indirect Carotid Cavernous Fistula 2022-07-07T05:51:07+00:00 Muh. Wildan Yahya Achmad Firdaus Sani Dedy Kurniawan Mohammad Saiful Ardhi <p><strong>Highlight:</strong></p> <ol> <li>CCF is a rare vascular malformation with challenging management.</li> <li>Partial transvenous embolization is quite effective as an alternative therapy for indirect CCF type D.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> An indirect carotid-cavernous fistula (CCF) is an abnormal connection between the internal or external carotid artery and the cavernous sinus. The optic, trochlear, abducens, and trigeminal nerves are located in the cavernous sinus. Head Computed Tomography (CT) scan, Magnetic Resonance Imaging (MRI), and Cerebral Angiography are some imaging modalities used to establish and diagnose carotid-cavernous fistula. Endovascular intervention can be performed with trans-arterial or trans-venous access. In some cases, complete embolization by endovascular treatment is not possible because of difficult angioarchitecture. <strong>Case:</strong> A 61-year-old female reported having pain in her left eye (numerical rating scale was 6). The left eye was bulging, reddish, ptosis, and unable to move. The patient felt double vision when opening both eyes, complained of intermittent stabbing headaches on the left side, and heard a bruit from the left side of the head. The cerebral angiography showed bilateral indirect CCF Barrow type D. The procedure involved partial transvenous embolization with coiling. The angiographic evaluation showed partial occlusion, and residual flow from the fistula was still visible on angiography. There was a significant clinical improvement several days after the procedure and a five-month follow-up. <strong>Conclusion:</strong> This case report showed that partial targeted transvenous embolization is quite effective in indirect CCF when complete embolization is impossible.</p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Muh. Wildan Yahya, Achmad Firdaus Sani, Dedy Kurniawan, Mohammad Saiful Ardhi Homonymous Hemianopia Secondary to A Long Fusiform Aneurysm of Posterior Cerebral Artery in A Patient with Connective Tissue Disease 2022-07-08T12:03:12+00:00 Pinto Desti Ramadhoni Asep Riswandi <p><strong>Highlight:</strong></p> <ol> <li>Fusiform aneurysms are uncommon, accounting for only 1% of total intracranial aneurysms, and posterior circulation involvement is only 3-13% of cases of intracranial aneurysms.</li> <li>Connective tissue diseases are very rare as the cause of this vasculopathy.</li> <li>Homonymous hemianopia due to the mass effect or dilated blood vessels compressing the left optic tract.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction: </strong>Fusiform aneurysms are uncommon, accounting for 1% of all intracranial aneurysms. Dissection and atherosclerosis are the main causes of this vasculopathy, but connective tissue disease is a very uncommon cause. Ehlers-Danlos Syndrome is the most common connective tissue disease, accounting for 11% of all cases. Symptoms depend on the location and size of the aneurysm, including headaches, blurred or double vision, and focal neurological deficits. <strong>Case: </strong>A 36-year-old man suddenly experienced blurred vision in both eyes on the right, starting with a chronic left-sided headache and no history of cardiovascular disease. In the confrontation test, Humphrey gave the right homonymous hemianopia. A head CT scan showed a lobulated lesion which showed enhancement in the left suprasellar region, and cerebral digital subtraction angiography (DSA) gave the impression of a long fusiform aneurysm L PCA. Clinically, the patient’s skin on the left side of his face was darker than on the right, his skin was more elastic, and his blood vessels were wider and more prominent on the side of the fusiform aneurysm. <strong>Conclusion: </strong>Posterior circulation involvement is only 3-13% of cases of intracranial aneurysms. Many cases of intracranial aneurysms are not detected before rupture, resulting in delays in treatment. Surgical or endovascular surgery can be performed if the size is &gt;10 mm and causes clinical symptoms. Symptoms of ischemia are managed with antiplatelets or anticoagulants. <em>I</em>ncidentally detected unruptured aneurysms are generally managed conservatively because of the highly friable nature of the blood vessels in patients with connective tissue diseases.</p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Pinto Desti Ramadhoni, Asep Riswandi Description of Stroke Patients with History of Smoking Activities 2022-05-24T04:06:01+00:00 Paulus Sugianto Fatih Nugraha Abdillah Isnin Anang Marhana Fidiana Fidiana <p><strong>Highlight:</strong></p> <ol> <li>Smoking raises the risk of cardiovascular disease, which can lead to stroke.</li> <li>A total of 33 stroke patients were selected from 579 samples. The results show some tendencies.</li> <li>The tendency of stroke patients with a history of activity to smoke can be explained for a number of reasons.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction: </strong>Smoking is a habit of Indonesian society and can be found in many places. Smoking increases the risk of cardiovascular problems, which can lead to stroke. <strong>Objective:</strong> Provides an overview of stroke patients who smoke from January to December 2020. <strong>Methods:</strong> This retrospective, descriptive research used medical records and extra data from telephone interviews with patients. A non-probability purposive sampling strategy with a total sampling method is used in this investigation. The observed variables include age, gender, number of cigarettes consumed per day, length of smoking history, type of stroke, and comorbidity. <strong>Results:</strong> The sample consisted of 33 participants chosen among 579 stroke patients. The age range of 56–65 (39.4%) was found to be the most prevalent in the 33 samples, and the sex group was dominated by men (100%). Then, for the smoking habit, the highest number of cigarettes consumed per day was dominated by the group of 9-16 cigarettes per day (45.46%). The group dominates the long smoking history with a smoking history of 30-50 years (42.43%). Ischemic stroke, also known as cerebral infarction, was the most common type (78.79%) among the samples. Of the 33 samples of stroke patients who smoked, 4 (12.12%) experienced comorbidities, including coronary heart disease, diabetes mellitus, and essential thrombocytosis. <strong>Conclusion</strong><strong>: </strong>Several factors describe the tendency of stroke patients with a smoking history.</p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Paulus Sugianto, Fatih Nugraha Abdillah, Isnin Anang Marhana, Fidiana Fidiana Electroencephalogram in Children who Experienced First Unprovoked Seizure 2022-05-20T03:50:06+00:00 Arinda Putri Auna Vanadia Prastiya Indra Gunawan Abdurachman Abdurachman Martono Tri Utomo Hanik Badriyah Hidayati <p><strong>Highlight:</strong></p> <ol> <li>Epiletiform abnormalities on the EEG provide additional clinical infromation about seizures</li> <li>The majority of patients who have a first unprovoked seizure have an abnormal EEG (Abnormal II).</li> <li>Using EEG as a supporting diagnostic tool in patients experiencing their first unprovoked seizures may provide more information to improve treatment</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction: </strong>The first unprovoked seizure is defined as a series of seizures that occur within 24 hours and are followed by recovery of consciousness with unknown triggering causes such as head trauma, central nervous system infections, tumors, or hypoglycemia. The first unprovoked seizure is a thing that cannot be underestimated. According to a previous study, less than half of those who experience their first unprovoked seizure will have another. An electroencephalogram (EEG) is one of the supporting examinations for the first unprovoked seizure. <strong>Objective:</strong> This study aims to determine the EEG as the first unprovoked seizure supporting examination. <strong>Methods: </strong>This is a retrospective, descriptive, observational study with sampling from the patient's medical record at Dr. Soetomo General Hospital Surabaya from January 2017 to December 2018 based on predetermined inclusion and exclusion criteria. <strong>Results: </strong>The EEG results in children who experienced their first unprovoked seizure were more abnormal (52.9%) than normal (47.1%), with an abnormal EEG breakdown of abnormal II (17.6%) and abnormal III (35.3%). There were no patients in this study who had EEG abnormal I. All patients with EEG abnormal II (17.6%) had an intermittent slow EEG waveform, while all patients with EEG abnormal III (35.3%) had a sharp waveform. The most common location of EEG wave abnormalities was temporal (55.6%). <strong>Conclusion: </strong>In the first unprovoked seizure, an EEG examination can assist clinicians as a seizure diagnostic assistant tool. It is hoped that the results of the EEG can provide better management of the first unprovoked seizure.</p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Arinda Putri Auna Vanadia, Prastiya Indra Gunawan, Abdurachman Abdurachman, Martono Tri Utomo, Hanik Badriyah Hidayati Stress Levels Determine Migraine Incidence in Medical Students of Duta Wacana Christian University 2022-05-10T08:18:09+00:00 Jonathan Dave Esdras Ardi Pramudita Rizaldy Taslim Pinzon <p><strong>Highlight:</strong></p> <ol> <li>Stress can trigger migraine.</li> <li>There is a significant relationship between stress levels and the occurence of migraine</li> <li>The higher the stress level, the higher the risk of migraine</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> Migraine is the second most common primary headache after tension-type headache. Stress is one of the factors that can contribute to migraine occurrence. Medical students are subjected to a high-stress level due to their educational program, which increases their risk of migraine. <strong>Objective:</strong> To measure the relationship between stress levels and migraine occurrence in medical students of Duta Wacana Christian University, batch 2020. <strong>Methods:</strong> This study used an observational analytical design with a cross-sectional method and involved 61 respondents from the medical students of Duta Wacana Christian University, batch 2020, who met the inclusion and exclusion criteria. Respondents were required to approve informed consent and complete the <em>Perceived Stress Scale</em> and <em>Migraine Screen Questionnaire</em> before conducting the research. <strong>Results:</strong> The <em>Chi-Square for Trend</em> statistical analysis for trends showed that stress levels were related to migraine (p &lt; 0.05), age variables revealed no association with migraine (p &gt; 0.05), and gender revealed that the sexes had a relationship with migraine (p &lt; 0.05). Using Fisher's statistical technique, this study found that menstrual status has no association with migraine (p &gt; 0.05). <strong>Conclusion:</strong> Stress levels and migraine frequency were significantly correlated, meaning that high-stress levels can trigger migraines.</p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Jonathan Dave, Esdras Ardi Pramudita, Rizaldy Taslim Pinzon An Overview of the Quality of Life of Post Severe Brain Injury Patients within 2018-2020 Period of Time in Dr. Soetomo General Academic Hospital based on Short Form-36 2022-06-09T02:10:29+00:00 Agus Turchan Alivery Raihanada Armando Meisy Andriana Martha Kurnia Kusumawardani <p><strong>Highlight:</strong></p> <ol> <li>Until today, Traumatic Brain Injury is still a major cause of death, disability, and a serious health issue</li> <li>Traumatic Brain Injury patients have a good quality of life if they get adequate therapy and on time interventions</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction: </strong>Approximately 90 million traumatic brain injury (TBI) cases worldwide exist yearly. TBI pathophysiology varies, which may cause diverse complications. These complications may decrease the patients’ quality of life. <strong>Objective: </strong>Describing the quality of life of traumatic brain-injured patients after being treated at Dr. Soetomo General Academic Hospital Period 2018-2020. <strong>Methods</strong>: This research is a descriptive cross-sectional study using SF-36 questionnaire data from patients with post-severe brain injury at Dr. Soetomo General Academic Hospital in 2018-2020. <strong>Results:</strong> The value of the physical component (59.9) and mental component (68.6) in patients with severe brain injury at Dr. Soetomo General Academic Hospital showed a good quality of life, with values ​​in the SF-36 domains, namely physical function (58.2), physical limitations (46.7), body pain (73.6), general health (61.3), vitality (65.3), social functioning (72.5), emotional limitations (60), and mental health (76.5) is above the threshold value (50) except for physical limitations (46.7).<strong>Conclusion:</strong> Patients with severe brain injury had a good quality of life after receiving treatment in Dr. Soetomo General Academic Hospital.</p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Agus Turchan, Alivery Raihanada Armando, Meisy Andriana, Martha Kurnia Kusumawardani Characteristics of Patients with Low Back Pain among Healthcare Professionals at John Piet Wanane General Hospital: A Cross-Sectional Study 2022-07-07T05:51:52+00:00 Lu Jordy Luhur Agustinus Ruma Paulus Sugianto <p><strong>Highlight:</strong></p> <ol> <li>Healthcare professionals have a higher risk of suffering LBP than other industrial workers.</li> <li>Adult women who have a high body mass index are likely to experience LBP.</li> <li>Healthcare professional should maintain a healthy lifestyle to increase productivity and decrase mortality</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> Low back pain (LBP) is musculoskeletal pain, tension, or stiffness that occurs below the costal margin and above the inferior gluteal folds, with or without sciatica. It has been found that healthcare professionals are more likely to experience LBP than other industrial workers. Many factors contribute to higher rates of LBP, including occupation, age, obesity, family history, lack of exercise, and psychosocial condition.<strong> Objective: </strong>To determine LBP’s prevalence and risk factors among healthcare professionals at John Piet Wanane General Hospital. <strong>Methods: </strong>This is a cross-sectional study that included 158 healthcare professionals. The data was collected using questionnaires and analyzed using univariate and multivariate logistic regression. <strong>Results: </strong>The overall prevalence of LBP in this study was 62.7%. Descriptive statistics showed that LBP was most common in the female group (71.7%), age group 35-50 years (52.5%), overweight group (61.6%), married group (80.8%), never or rarely exercise group (84.8%), non-smoking group (85.9%), non-drinkers group (84.8%), and moderate perceived stress group (63.6%). Multivariate logistic regression analysis showed that BMI was significantly associated with LBP. Compared with underweight participants, overweight participants were four times more likely to experience LBP (OR = 4.344, 95% CI: 1.297-14.552).<strong> Conclusion: </strong>This study demonstrates a high prevalence of LBP among healthcare professionals. High BMI, especially being overweight, increases the risk of developing LBP. Overweight and obesity among healthcare professionals may affect their credibility in providing patients with healthy nutrition and exercise advice. Healthcare professionals should maintain a healthy lifestyle to increase productivity and decrease mortality.</p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Lu Jordy Luhur, Agustinus Ruma, Paulus Sugianto Thrombosis Mechanisms in Obese and Ischemic Stroke COVID-19 Patients: A Literature Review 2022-06-29T06:16:26+00:00 Putri Winanda Natasya Putri <p><strong>Highlight:</strong></p> <ol> <li>The ongoing Coronavirus disease 2019 also affects multiorgan, including cardiovascular disease with several factors.</li> <li>Mechanism of thrombus in the patient that induces the subject such as obesity with increased BMI, thrombotic pathway modulator and pathophysiologist.</li> <li>An increase in acute CVD incidence, including ischemic stroke in COVID-19 patients, has been a new concern in the ongoing pandemic.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p>Coronavirus disease 2019 (COVID-19), <em>despite being a respiratory infection, </em>also causes neurological manifestations such as stroke due to thrombosis formation. Prior investigations have examined the correlation between COVID-19 and ischemic stroke, as well as COVID-19 and obesity. However, the mechanism of thrombosis in obese COVID-19 patients remains elusive. This review aims to examine the mechanism of thrombosis in COVID-19 patients with ischemic stroke and obesity. Chronic inflammation and impaired fibrinolysis are two major pathways responsible for thrombosis in people with obesity. Chronic inflammation activates prothrombic signaling pathways in vascular cells, resulting in procoagulant factors and adhesion molecules upregulation, anticoagulant proteins downregulation, platelet activation enhancement, and increased thrombin generation. SARS-CoV-2 enters human cells utilizing the angiotensin-converting enzyme 2 (ACE-2) receptors, which results in inflammation, which has been suggested as one of the factors contributing to thrombotic complications in COVID-19 patients. The infection also causes cytokine storm that induces atherosclerosis, plaque rupture, and superimposed thrombosis leading to brain damage. Together with endothelial injury, the cytokine storm might increase the expression of tissue factors and further promote a prothrombic state. In conclusion, the mechanisms of thrombosis in COVID-19 patients are related to direct infection of SARS-CoV-2 into the ACE-2 receptor and the cytokine storm that results in chronic inflammation and thrombosis formation. Obesity will further boost the inflammation process that leads to the formation of thrombosis and increase the risk of ischemic stroke among individuals with COVID-19 with obesity<em>.</em></p> 2022-07-31T00:00:00+00:00 Copyright (c) 2022 Putri Winanda, Natasya Putri