Background: A decrease in hospital visits including neurosurgery cases during the coronavirus disease 2019 (COVID-19) pandemic has been reported by many countries. This study aims to reveal important data regarding the effect that the COVID-19 pandemic has on services, neurosurgical surgery, and inpatients before and during the COVID-19 pandemic. Methods: This comparative study compares neurosurgical services, neurosurgical patients, outpatient visits, and monthly inpatients assessed from January to December 2020 (onset of the pandemic) with those of the same period in 2019. Results: The average number of outpatient visits per month during the pandemic (January to December 2020) was 369 visits per month, compared to 397 visits in the same period in the previous year. The lowest outpatient visits occurred in May 2020 with 227 outpatient visits. There was a decrease in the number of neurosurgical patients in January-December during the pandemic period compared to the same period in 2019. A significant decrease in outpatients during and before the pandemic was noted with P = 0.046 (P < 0.05). Conclusion: There are differences in the number of visits by outpatients, neurosurgical patients, and inpatients during the pandemic compared to the period before the onset of the pandemic.

Background: Mild traumatic brain injury (mTBI) is a health problem with an increasing incidence in many developed countries. The standard for examining mTBI is a CT scan, but it is costly, is not always available in all hospitals, and carries a risk of radiation. Meanwhile, S100β is a protein component produced by central nervous system cells. This study aims to determine the presence of changes in S100β protein in adult patients with mTBI during treatment as an alternative to examination. Methods: This research is an analytic observational quantitative study with a cross-sectional study approach to investigate changes in S100β protein levels in blood serum using the ELISA method of mTBI patients in the first 3 h posttrauma (pretest) and treatment on day 1 (27 h posttrauma/posttest). The research sample consisted of 22 people. This research was conducted in the Surgery Section, Sub-Division of Neurosurgery, Dr. Moewardi Public Hospital, during September–December 2019. The data were then analyzed using a discrimination test (comparing t-test means) and a nonparametric test (Wilcoxon). Results: There was a significant difference in mean S100β change between the pretest and posttest treatments. The S100β examination results at posttest decreased to 0.0223 + 0.0029 μg/l or decreased S100β by 21.7% after treatment. Previously, it was known that the mean of S100β at pretest was 0.0285 + 0.0137 μg/l. Conclusion: There was a significant change in S100β protein levels at each examination time. Changes in S100β levels that occurred were in the form of decreased levels from 3 h to 27 h posttrauma. Thus, S100β protein can be used as a parameter to assess the clinical development of adult patients with mTBI. Moreover, none of the patients with an S100β value >0.1 μg/l was found to be the cutoff value set by SNC in adult patients with mTBI for head CT scan.

BACKGROUND: Penetrating head injuries are a significant public health problem in worldwide, with an estimated 35.000 civilian deaths annually. Patients that survive to reach the hospital require rapid triage and imaging evaluation. This case report describes a patient with late-onset seizures and left hemiparesis after unusual craniocerebral penetrating injury by a rusty sickle. CASE PRESENTATION: A 26-year-old man reported that he had a sickle stabbed into the right-side parietal area. On admission, he had no neurological deficits. The rusty sickle was broken off just above the skull and did not protrude from the scalp. Computed tomography showed that the knife blade was in the parenchyma without underlying tract hematoma. Surgery was performed after 2 h of admission. Post-operatively, he recovered with no neurological deficit. After 16th days postoperatively, he was complaining of seizure and left hemiparesis. CT scan with contras showed edema and hypodense lesion at the right side of hemisphere. A course of intravenous phenytoin 100 mg/8 h and ceftriaxone 2 g/day was initiated. Physical therapy was done on the patient for 2 weeks. CONCLUSION: Traumatic brain injury (TBI) is the result of energy being transferred from an object to the human skull and underlying brain. Post-traumatic epilepsy is a common complication and can occur as early or late manifestations related to penetrating TBI. Prophylactic treatment of post-traumatic seizures (PTS) is currently not routinely recommended beyond 1 week following head injury (role of antiseizure prophylaxis). Phenytoin is the most rigorously tested AED for PTS.