AKSONA https://e-journal.unair.ac.id/aksona <p><strong>AKSONA - <a href="https://portal.issn.org/resource/ISSN/2807-7970">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="https://drive.google.com/file/d/12DluFR25YSTC1bs00WXkisT6LR9tRI2_/view?usp=sharing">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="https://scholar.google.com/citations?hl=id&amp;user=qD-06pwAAAAJ" target="_blank" rel="noopener">Google Scholar</a>, <a href="https://www.mendeley.com/search/?page=1&amp;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="https://search.crossref.org/?q=AKSONA&amp;from_ui=yes" target="_blank" rel="noopener">Crossref</a>, <a href="https://garuda.kemdikbud.go.id/journal/view/25702" target="_blank" rel="noopener">Garuda</a>, <a href="https://app.dimensions.ai/discover/publication?search_mode=content&amp;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="https://www.scilit.net/journal/6467111">Scilit</a>. </p> <p>The manuscript should be prepared according to<a href="https://e-journal.unair.ac.id/aksona/guideforauthor" target="_blank" rel="noopener"> the Guidelines for Author</a>, arranged according to its <a href="https://drive.google.com/drive/u/1/folders/16Nq5ax4QyA_8SbUcRrjSttfVhu2LInyU" target="_blank" rel="noopener">respective template</a>, and submitted via the <a href="https://e-journal.unair.ac.id/aksona/submissions1" target="_blank" rel="noopener">Online Submission</a> at the sidebar. All necessary forms, such as <a href="https://drive.google.com/file/d/1o4LxDkAiI8XhqS-YywiyBJHTcjtKmAuZ/view" target="_blank" rel="noopener">Authors' Form</a> should be completed. It is recommended to <a href="https://docs.google.com/document/d/1s9CUS_ugZgVnzM0E3nAFyVmkMXq0n2uH/edit">check the required completeness</a> before submitting. Starting in 2022, AKSONA will only accept submissions and publish article in English.</p> <p>AKSONA has been accredited by the National Journal Accreditation (ARJUNA) by the Ministry of Education, Culture, Research, and Technology of the Republic of Indonesia with the category of <a href="https://sinta.kemdikbud.go.id/journals/profile/10911" target="_blank" rel="noopener"><strong>SINTA 5</strong></a> (based on the Decree of the Director General of Higher Education, Research, and Technology <a href="https://drive.google.com/file/d/1h9Z1jZbyjESDmf2C7Orp8LTkGIryFNwt/view?usp=sharing" target="_blank" rel="noopener">Number 79/E/KPT/2023</a>)</p> en-US aksona@fk.unair.ac.id (Dr. Paulus Sugianto, dr., Sp.N(K), FAAN) aksona@fk.unair.ac.id (Gading Diah Zahara Putri) Wed, 31 Jan 2024 00:00:00 +0700 OJS http://blogs.law.harvard.edu/tech/rss 60 Ischemic Stroke Risk Factor Profile at Prof. Dr. W. Z. Johannes Hospital, Kupang, East Nusa Tenggara https://e-journal.unair.ac.id/aksona/article/view/45403 <p><strong>Highlight:</strong></p> <ol> <li>Ischemic stroke is a major public health issue in Indonesia.</li> <li>Clinical data correlated to an ischemic stroke patient's prognosis.</li> <li>Several clinical factors and laboratory testing describe the tendency of ischemic stroke patients.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> In Indonesia, ischemic stroke is a major public health issue. Clinical data correlates with an ischemic stroke patient’s prognosis. <strong>Objective:</strong> This study aimed to provide an overview of clinical data in ischemic stroke patients from October 2020 to December 2021. <strong>Method</strong><strong>s</strong><strong>:</strong> This was a retrospective, descriptive study using medical records. A non-probability purposive sampling strategy with a total sampling method is used in this study. Age, gender, cardiac comorbidities, diabetes, repeated strokes, blood laboratory exams, electrolyte tests, alcohol consumption, and smoking habits were all observed variables. <strong>Results:</strong> The sample consisted of 242 ischemic stroke patients. The majority of patients (32.23%) were in the 61 to 70 age group, and men (57.4%) made up the majority of the sex group. Then, cardiac comorbidities were dominated by coronary artery disease (CAD), with 33 patients (57.4%) with 4 deaths (12.1%), while 15 patients (6.19%) were found with atrial fibrillation (AF), with 7 deaths (46.67%). Hypertension was found in 81.40% of patients, diabetes in 26.03% of patients, and recurrent stroke in 31.40% of patients. Active smokers make up 52.06% of all patients, and 18.18% are heavy alcohol drinkers. The majority of patients showed blood and electrolyte levels within the normal range, except for an increased leukocyte count and a decreased potassium level. <strong>Conclusion:</strong> The main risk factors obtained sequentially are hypertension, coronary artery diseases, active smokers, diabetes, and excessive alcohol consumption.</p> Indra Pramanasari Copyright (c) 2024 Indra Pramanasari https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/45403 Wed, 31 Jan 2024 00:00:00 +0700 Incidence of Stroke Cases at Blambangan General Hospital of Banyuwangi in January-December 2022: A Descriptive Study https://e-journal.unair.ac.id/aksona/article/view/47492 <p><strong>Highlight:</strong></p> <ol> <li>The majority of stroke cases at Blambangan General Hospital in Banyuwangi are ischemic strokes.</li> <li>The age group that experienced the most strokes was &gt;40 years.</li> <li>The gender that experienced the most strokes was female.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> Stroke is a leading cause of morbidity in Indonesia. It significantly contributes to the overall burden of disease and places a substantial impact on the health of the population in Indonesia. <strong>Objective:</strong> The purpose of this study was to show the incidence of stroke cases in the Blambangan General Hospital in Banyuwangi. Understanding the prevalence of strokes at this particular hospital is critical for identifying patterns, improving patient care, and taking preventive actions to deal with this important health issue. <strong>Methods:</strong> This study used a retrospective cross-sectional sampling method to look at all 342 inpatient stroke cases that were treated in the neurology department of Blambangan General Hospital in Banyuwangi in 2022. All of their data was collected and analyzed. <strong>Results:</strong> Most cases of stroke in this study were ischemic strokes, with a total of 212 cases (62.0% of all cases). The age group that experienced the most strokes was over 40 years old (96.2%) and female (56.4%). More than half of stroke patients had hypertension, and 80.1% had diabetes mellitus. <strong>Conclusion:</strong> This study found that ischemic stroke survivors, mostly female and aged over 40, were frequently associated with diabetes mellitus and hypertension. These findings provide insights into the frequency of these stroke types within the examined population.</p> <p> </p> Riani Dwi Hastuti, Andar Setyawan, Indah Ari Handayani, Putri Nabila Khalisha Copyright (c) 2024 Riani Dwi Hastuti, Andar Setyawan, Indah Ari Handayani, Putri Nabila Khalisha https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/47492 Wed, 31 Jan 2024 00:00:00 +0700 Hypertensive and Non-hypertensive Hospital Admission Blood Pressure Association with Cognitive Function in Stroke Patients https://e-journal.unair.ac.id/aksona/article/view/51720 <p><strong>Highlight:</strong></p> <ol> <li>A comparative study of hypertension and non-hypertension on cognitive function.</li> <li>Hospital admission blood pressure and cognitive function in acute-phase stroke patients.</li> <li>Blood pressure is not associated with cognitive function.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction</strong><strong>: </strong>Cognitive impairment is one of the many stroke effects. White matter damage, microinfarcts, microbleeding, atrophy, and amyloid buildup in the brain due to stroke are all potential causes of this condition. Cognitive impairment studies have yet to provide a definitive explanation for how this condition develops following a stroke. Blood pressure is one of several risk factors for stroke. Meanwhile, few studies have been conducted on the association between blood pressure and cognitive function in stroke patients, and no definitive results have been established. <strong>Objective:</strong> This research was designed to examine and evaluate the difference in the measured cognitive function category between hypertensive and non-hypertensive hospital admission blood pressure stroke patients. <strong>Method</strong><strong>s:</strong> This research used a cross-sectional design with a consecutive sampling method on acute stroke patients at Dr. Soetomo General Academic Hospital. The MMSE (Mini Mental State Examination) was carried out to assess the degree of cognitive function. The blood pressure measured is the hospital admission blood pressure. <strong>Results:</strong> There were 40 patients included in this study. A total of 36 patients (90%) were in the hypertension group (blood pressure ≥ 130/80 mmHg), and 4 patients (10%) were in the non-hypertension group (blood pressure &lt; 130/80 mmHg). The MMSE results showed that 10 patients performed with no cognitive impairment, 12 patients performed with mild cognitive impairment, and 18 patients performed with severe cognitive impairment. Statistical analysis of the Mann-Whitney U test showed that p = 0.561. <strong>Conclusion:</strong> There was no difference in the measured cognitive function category between hypertensive and non-hypertensive hospital admission blood pressure stroke patients.</p> <p> </p> Muhammad Andika Rifqi, Sita Setyowatie, Johanes Nugroho Eko Putranto Copyright (c) 2024 Muhammad Andika Rifqi, Sita Setyowatie, Johanes Nugroho Eko Putranto https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/51720 Wed, 31 Jan 2024 00:00:00 +0700 Comparison of Recurrent Stroke in Patients with First Stroke Ischemic and Hemorrhagic in Soetomo General Academic Hospital Surabaya https://e-journal.unair.ac.id/aksona/article/view/50403 <p><strong>Highlight:</strong></p> <ol> <li>The incidence of recurrent stroke in patients with the first stroke of ischemic type was 2.5-fold higher than that of hemorrhagic type, with the majority of recurrent strokes being the same type as the first stroke.</li> <li>Hypertension is the most common modifiable stroke risk factor in both stroke types, and in 5% of cases, secondary prevention is still not optimal.</li> <li>The average length of hospital stay for patients with the first stroke of hemorrhagic type was 3 days longer, along with a higher average NIHSS score on presentation than patients with ischemic stroke.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> Stroke is the leading cause of mortality and disability in Indonesia, as well as being the major cause of death and disability-adjusted life years (DALY) lost worldwide. Recurrent stroke is one of the most common complications of stroke after discharge, despite being highly preventable. <strong>Objective:</strong> This study aimed to compare the differences in recurrent stroke profiles between patients with first stroke ischemic and hemorrhagic strokes. <strong>Methods:</strong> The study was done by collecting secondary data from medical records and the stroke registry at Dr. Seotomo General Academic Hospital over a period of six months (January–July 2020). <strong>Result: </strong>This study examined 36 samples that met the inclusion criteria. The results revealed that patients who experienced their first stroke of the ischemic type had a 2.5-fold higher incidence of recurrent stroke than those who suffered a hemorrhagic type. Except for one case, the majority of patients had the same type of stroke as the first. The most frequent modifiable risk factors seen in these two types of strokes are hypertension and physical inactivity. It was found that there were still 5% of the risk factors for which secondary prevention had not been carried out optimally with antidyslipidemic, antidiabetic, or antihypertensive drugs. The most common acute treatment for ischemic stroke is antiplatelet therapy, either single or dual therapy. Up to 90% of hemorrhagic strokes were treated conservatively, and in one patient, extraventricular drainage was performed. <strong>Conclusion:</strong> There were more stroke patients with a first stroke of hemorrhagic type that presented with NIHSS scores in the severe to very severe range, and the average length of hospitalization in this group was longer.</p> <p> </p> <p> </p> Marselia Febriyanti Sihotang, Mohammad Saiful Ardhi, Muhammad Arifin Parenrengi Copyright (c) 2024 Marselia Febriyanti Sihotang, Mohammad Saiful Ardhi, Muhammad Arifin Parenrengi https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/50403 Wed, 31 Jan 2024 00:00:00 +0700 The Impact of Chronic Exposure to Organophosphate Pesticides on the Incidence of Primary Brain Tumors in Farmers: A Narrative Review https://e-journal.unair.ac.id/aksona/article/view/51648 <p><strong>Highlight:</strong></p> <ol> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Primary brain tumors have high mortality and morbidity rates.</span></li> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Organophosphate pesticides are commonly used by farmers.</span></li> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Chronic exposure to organophosphate pesticides can increase the incidence of primary brain tumors farmers.</span></li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> Primary brain tumors have high mortality and morbidity rates. Its causes and risk factors have not been explored further. Several studies indicate that exposure to pesticides can be one of the main triggering factors. Organophosphate insecticide is one of the most common pesticides used by farmers. Chronic exposure to organophosphates is known to trigger an imbalance of reactive oxygen species (ROS) in the body by suppressing the acetylcholinesterase enzyme. <strong>Objective:</strong> This study aimed to determine the impact of chronic exposure to organophosphates in terms of the types of organophosphates used by farmers, frequency of usage, and duration of exposure, using a narrative review method. <strong>Methods:</strong> A literature search was conducted with multiple electronic databases, such as PubMed, ScienceDirect, Cochrane Library, and Springer. The keywords will be searched using the boolean operator method, while synonyms will be found in the Medical Subject Heading (MeSH) database. Articles were assessed using the Newcastle-Ottawa Scale (NOS) Questionnaire. <strong>Results:</strong> There were 1071 articles found, but only 14 were selected for review. The studies showed that there was a relationship between the type, frequency, and duration of organophosphate usage and the incidence and risk factors for primary brain tumors. <strong>Conclusion:</strong> Chronic exposure to organophosphate pesticides, either directly or indirectly, can increase the incidence of primary brain tumors in farmers. The influencing factors include the type, frequency, and duration of pesticide exposure. The most influential factor is the duration of chronic pesticide exposure by farmers. Pesticide reduction exposure is beneficial in preventing the incidence of primary brain tumors in farmers.</p> <p> </p> <p> </p> Azham Purwandhono, Jasmine Tartila, Jauhar Firdaus Copyright (c) 2024 Azham Purwandhono, Jasmine Tartila, Jauhar Firdaus https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/51648 Wed, 31 Jan 2024 00:00:00 +0700 Challenging Endovascular Treatment of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm: A Case Report https://e-journal.unair.ac.id/aksona/article/view/44640 <p><strong>Highlight:</strong></p> <ol> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Posterior inferior cerebellar artery (PICA) aneurysms are rare in occurence.</span></li> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">The endovascular management of PICA aneursysms is challenging due to anatomical difficulties in accessing the site.</span></li> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">The rebleeding of PICA aneurysms, although rare than other intracranial anurysms, may still happen and must be considered in their management</span></li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction</strong> Aneurysms of the posterior inferior cerebellar artery (PICA) are rare clinical entities with a lower risk of rupture than other intracranial locations. This makes managing PICA aneurysms challenging and important for neurointerventionists to understand. In this case report, we looked at a rare case of PICA aneurysm with post-coiling rebleeding. <strong>Case:</strong> We reported a 51-year-old female with complaints of dizziness and vomiting. The patient was found to be hypertensive and a neurologic assessment revealed neck stiffness and left hemiparesis. A computed tomography (CT) scan of the head indicated subarachnoid hemorrhage. CT angiography (CTA) showed an aneurysm at the right proximal PICA. Although endovascular coiling was performed, the patient rebleed one month later. Following the insertion of the second coil, successful embolization was achieved, and the patient showed clinical improvement. <strong>Conclusion:</strong> PICA aneurysms require careful endovascular management, considering the difficulty of access due to their anatomical location. An understanding of its proper management is of paramount importance to reducing mortality.</p> <p> </p> Bambang Tri Prasetyo, Ricky Gusanto Kurniawan, Beny Rilianto, Pratiwi Raissa Windiani, Kelvin Theandro Kelvin Copyright (c) 2024 Bambang Tri Prasetyo, Ricky Gusanto Kurniawan, Beny Rilianto, Pratiwi Raissa Windiani, Kelvin Theandro Kelvin https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/44640 Wed, 31 Jan 2024 00:00:00 +0700 Case Report: Meningitis in Postpartum https://e-journal.unair.ac.id/aksona/article/view/45453 <p><strong>Highlight:</strong></p> <ol> <li>Meningitis is an infectious disease of the brain membranes and spinal cord.</li> <li>Bacterial meningitis is a severe infection with high mortality and morbidity rates and can be one of the causes of fever in postpartum patients.</li> <li>The most common pathogen that can cause bacterial meningitis is <em>Streptococcus agalactiae (GBS)</em>, which causes most of the cases.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction:</strong> Meningitis is an infectious disease of the brain membranes and spinal cord. Viruses, bacteria, fungi, parasites, or aseptic actions can all cause meningitis. Bacterial meningitis is a severe infection with high mortality and morbidity rates that can induce fever in postpartum patients. The incidence of invasive <em>Streptococcus agalactiae Group B</em> (SGB) in pregnant women reached 31.58%; the older the pregnant woman, the greater the risk of invasive SGB. <strong>Case: </strong>The patient came to the emergency room with unconsciousness, fever, and shortness of breath. The patient presented with Ronchi +, neck stiffness +, and GCS E1M1V1. A chest X-ray found cardiomegaly as well as pulmonary edema. A full blood count indicated leukocytosis, increased neutrophils, elevated SGOT and SGPT levels, and lymphocytopenia. The patient was then given antipyretics, anticonvulsants, neurotonics, neurotrophics, diuretics, antihypertensives, and antianginals. <strong>Conclusion:</strong> In this study, it can be determined whether infection during pregnancy or labor can cause postpartum meningitis. The most common pathogen that can cause bacterial meningitis is <em>Streptococcus agalactiae Group B</em> (SGB), which causes most cases. Early diagnosis of postpartum meningitis is important in order to begin as soon as possible and achieve the best results for the patient's recovery.</p> <p> </p> Medio Yoga Pratama Copyright (c) 2024 Medio Yoga Pratama https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/45453 Wed, 31 Jan 2024 00:00:00 +0700 Successfully Procedure Endovascular Carotid Angioplasty Stent in a Case of Neck Stab Wound with Pseudoaneurysm, Recurrent Transient Ischemic Attack, and Horner Syndrome: A Case Report https://e-journal.unair.ac.id/aksona/article/view/48951 <p><strong>Highlight:</strong></p> <ol> <li style="font-weight: 400;" aria-level="1"><strong>Uncommon Presentation and Diagnosis: </strong>The case report presents a unique and rare clinical scenario involving a 14-year-old boy who sustained a neck stab wound, leading to the development of a pseudoaneurysm within the common carotid artery.</li> <li style="font-weight: 400;" aria-level="1"><strong>Multidisciplinary Approach to Treatment: </strong>The case highlights the complexity of managing such casesm where a multidisciplinary approach is paramount. The manuscript underscores the significance of involving neurology, interventional neurology, and vascular surgery teams to provide comprehensive and tailored patient care</li> <li style="font-weight: 400;" aria-level="1"><strong>Efficacy of Endovascular Intervention: </strong>The successful outcome of the endovascular carotid angioplasty stent procedure highlights its effectiveness as a treatment option for addresing complex vascular conditions like pseudoaneurysm or dissection of the carotid artery.</li> </ol> <p> </p> <p><strong>ABSTRACT</strong></p> <p><strong>Introduction</strong><strong>: </strong>Neck stab wounds can lead to various vascular complications, including pseudoaneurysm or carotid artery dissection. Proper diagnosis and management can prevent recurrent strokes. <strong>Case</strong><strong>:</strong> We reported a case of a 14-year-old boy with a previous left neck stab wound who developed recurrent transient ischemic attacks (TIAs) accompanied by Horner's syndrome and headache following a traumatic common carotid artery dissection. An angiographic examination revealed a pseudoaneurysm or dissection of the left common carotid artery. The patient was initially treated with oral anticoagulant therapy, but he continued to experience recurrent TIA. The patient was then treated endovascularly with a carotid angioplasty stent to restore the compromised carotid artery. Following the endovascular procedure, the patient experienced no complications, showed improvement in Horner syndrome, and had no headache. During the follow-up period, the patient had no more TIAs. <strong>Conclusion:</strong> Endovascular carotid angioplasty stents are an effective and safe way to treat pseudoaneurysm or dissection of the carotid artery, especially in cases presenting with recurrent TIAs and Horner syndrome. The observed clinical improvement following the procedure indicates significant benefits in enhancing the patient's quality of life and preventing complications from recurrent TIA episodes.</p> Pinto Desti Ramadhoni, Hawari Martanusa Copyright (c) 2024 Pinto Desti Ramadhoni, Hawari Martanusa https://creativecommons.org/licenses/by-sa/4.0 https://e-journal.unair.ac.id/aksona/article/view/48951 Wed, 31 Jan 2024 00:00:00 +0700