Introduction: As COVID-19 has rapidly spread worldwide, it is an urgent health problem. Some evidence suggests that SARS-CoV-2 also affects the central nervous system. Stroke is the most common disease of the central nervous system. In contrast to ischemic stroke, which can occur due to the hypercoagulation effect of COVID-19, the study of Intracerebral Hemorrhage (ICH) associated with COVID-19 is still unclear. Objective: This paper investigated the characteristics of an inflammatory biomarker and compared the outcomes of ICH patients with COVID-19 and ICH patients without COVID-19. Methods: We conducted a retrospective, observational analysis case-control of patients (n = 42) admitted with ICH with positive COVID-19 and ICH with negative COVID-19 at the National Brain Center Hospital Prof.Dr.dr. Mahar Mardjono from March 2020 to August 2021. We took blood samples and COVID-19 swab PCR on the first day of admission, and GOS was measured when the patients were discharged. Results: There were 21 ICH patients with positive COVID-19 who had a significantly procalcitonin (p < 0.05) compared  to control patients. From Spearman’s correlational analysis, there is a significant value between early procalcitonin and the Barthel Index (rs = -0,374, p < 0.05), early CRP and GOS (rs =- 0.329, p < 0.05), which indicates weak-inverse correlation, and between early PCT and GOS (rs = -0.438, p < 0.05) which indicates moderate-inverse correlation. Conclusion: The level of procalcitonin was increased in ICH patients with COVID-19. Maybe PCT could be a predictor of outcome in ICH patients with COVID-19.

BACKGROUND:As the most cause of death in patients with solid extracranial malignancy, brain metastasis (BM) nowadays being studied extensively especially on how to find a reliable laboratory marker that can correlate with its clinical outcome. Leukocyte subtypes, primarily neutrophils and lymphocytes and its ratio known as Neutrophils-Lymphocyte Ratio (NLR) have been known before its relationship with progressivity of BM from other solid tumours.AIM:The objectives of this research to study the correlation of leukocyte subtypes, neutrophil-lymphocyte ratio & functional outcome in brain metastasis.METHODS:The study subjects were recruited consecutively from the study population. Venous blood was taken 5 ml of venous blood samples done in the first day of admission on emergency department and neurology clinic of Neurology Department of Adam Malik General Hospital before any drug injections. Samples were kept in vacutainer tubes containing ethylenediaminetetraacetic acid (EDTA) and sent to Department of Clinical Pathology laboratory of Adam Malik General Hospital, immediately centrifuged at 3100 rpm for 10 minutes in -20°C temperature and analysed using Sysmex XT-2000i. Functional outcome of the patient assessed using Karnofsky performance scale (KPS) in a cross-sectional manner with laboratory analysis.RESULTS:We conduct a mean differences and correlational leukocytes and its subsets analysis of 72 BM patients resulting on significant positive correlation on lymphocyte percentage (r = 0.383, p = 0.001) and lymphocyte absolute (r = 0.265, p = 0.024), also significant negative correlation on neutrophils (r = -0.240, p = 0.042) and NLR (r = -0.432, p < 0.001) with Karnofsky Performance Scale (KPS).CONCLUSION:Increased lymphocyte absolute and lymphocyte percentage correlated significantly (p < 0.05) with better KPS, while elevated neutrophils percentage and increased NLR show significant correlation with worse outcome of BM patients.

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Ischemic stroke is one of stroke subtype often correlated with disturbance of cognitive function. We conduct an observational study with cross-sectional design of 70 ischemic stroke patients. Objective of this study is to evaluate cognitive differences based on hemispheric lateralization lesions. We used Montreal Cognitive Assessment -Indonesian version (MoCA-Ina) to assess cognitive function resulting on 70 patients, consist of 48 subjects (68.57 %) of left hemispheric stroke and 22 subjects (31.43%) of right hemispheric stroke. As much as 68 subjects (97.14 %) are categorized as having cognitive disturbance. Mean differences of MoCA-Ina was assessed using Mann-Whitney test resulting no significant differences between left vs right hemisphere groups (18.94 + 3.26 vs 19.82 + 3.13; p= 0.320). Further study would warrant lesions lateralizations could affects cognitive performance of ischemic stroke patients.

Hypertension is one of the main health problems in Indonesia, which if not controlled will result in health, psychological, social and economic burdens. A common clinical consequence of hypertension is impaired cognitive function, namely dementia and senility, which can be examined through the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina). The service program which is carried out by the Faculty of Medicine, Universitas Sumatera Utara (FK USU) is an examination of cognitive function and blood pressure in Padang Bulan Selayang II region. Examinations are carried out in accordance with the 2017 World Alzheimer Month and are followed by lay seminars on dementia, brain gym exercises (gerak latih otak/GLO) as well as brain teasers. The activity involved 26 participants from integrated development post (pos pembinaan terpadu/Posbindu) with a mean systolic blood pressure (TDS) 131.54 + 18.70 mmHg, mean diastolic blood pressure (TDD) 83.85 + 8.98 mmHg, mean mean arterial pressure 99, 69 + 9.47 mmHg and a mean MoCA-Ina score of22 + 5.03. Blood pressure monitoring, education of community awareness and cognitive stimulation at regular intervals are expected to prevent and reduce the incidence of hypertension, dementia and senility.