The authors present the case of a 46-year-old woman who was admitted to their institution after suffering acute intratumoral hemorrhage. There was no history and evidence of neoplasms, trauma, seizures and coagulopathy in the patient. Surgery was performed for evacuation of the hematoma and tumor excision after brain CT scan. Post operative results her neurologic function recovered completely. The pathology reports revealed angioblastic meningioma. The key to make an early and accurate diagnosis is good radiological examination, and definitive surgery can bring a more favorable outcome, lowering the morbidity and mortality rate.

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Stroke umumnya didasari suatu faktor risiko seperti hipertensi atau diabetes, dan pasien stroke akan memerlukan rawat inap di rumah sakit. Terapi stroke serta faktor risikonya akan berdampak pada outcome pasien. Penelitian ini bertujuan untuk menilai hubungan antara faktor risiko dengan masa perawatan serta outcome pasien stroke iskemik. Penelitian retrospektif ini mengevaluasi faktor risiko, kesadaran, masa perawatan, serta outcome pasien berdasarkan data rekam medis pasien stroke iskemik yang dirawat tahun 2019-2020 di Rumah Sakit Universitas Kristen Indonesia dengan kriteria pasien dirawat lebih dari 24 jam. Data kesadaran pasien diuji dengan uji t berpasangan, sementara hubungan antara faktor risiko dengan masa perawatan dan outcome diuji dengan Chi-square. Hasil penelitian menunjukkan sebagian besar pasien adalah laki-laki yaitu 63 (63,64%) dari 99 orang, dan terbanyak berusia 61-70 tahun yaitu 37 (37,37%) pasien. Hipertensi didapatkan pada 52 (52,53%) pasien dan masa rawat inap rata-rata 5,7 hari, namun pasien dengan penyakit jantung sampai 8,4 hari. Tingkat kesadaran berdasarkan Glasgow Coma Scale menunjukkan sebagian besar pasien adalah 15, dan hasil uji t tidak menunjukkan perbedaan antara saat masuk dan keluar rumah sakit (p > 0,05). Pada 58 (58,9%) pasien didapatkan defisit neurologis moderate atau moderate-severe, sembuh total 10 (10,10%) pasien, dan 3 (3,03%) pasien meninggal. Hasil uji Chi-square menunjukkan hubungan tidak bermakna antara faktor risiko dengan masa perawatan serta outcome (p > 0,05). Penelitian menyimpulkan hubungan faktor risiko dengan masa perawatan serta outcome pasien stroke iskemik tidak bermakna, namun bila memiliki faktor risiko penyakit jantung maka perawatan akan lebih lama.

The mortality rate of spontaneous supratentorial intracerebral hemorrhage evacuation is still high and varies in all neurosurgical centers. Currently, minimally invasive surgery to evacuate bleeding has become an option, but not all neurosurgical centers can perform the procedures due to limited resources. In addition, there are several guidelines for determining which patients will undergo a surgery. This study assessed the outcome of selected patients who were operated on using micro neurosurgical procedures or external ventricular drainage for intraventricular hemorrhage between 2016 and 2021. Patients included in this study were recruited from a hospital in Jakarta, Indonesia and selected based on the guideline of the 2015 American Heart Association/American Stroke Association (AHA/ASA). The outcome was assessed by a modified Rankin scale (mRS). There were 301 patients with hemorrhagic stroke but only fifty patients were matched the criteria in the guideline. Male patients constituted the majority of the patients (n=28, 56%) and hypertension has occurred in 37 (74%) patients. The hematoma was mostly located in the intracerebral with intraventricular extension (n=27, 54%) patients. The pre-operative Glasgow Coma Scale (GCS) of 23 (46%) patients were comatose and the other was 9–13. Postoperatively, there were 37 (74%) patients with a scale of 13–15, but 10 (20%) patients died. Pair t-test of the preoperative and postoperative scales showed a significant difference, p < 0.01. The outcome of 40 (80%) patients was good (modified Rankin scale of 0–3), and the Spearman’s rank correlation coefficient was -0.739 with the Sig.2-tailed was <0.01. The outcome of spontaneous supratentorial intracerebral hemorrhage evacuation is good when selecting patients following the 2015 AHA/ASA guideline and there is a strong correlation between postoperative GCS with 3-month mRS results.

Background:To relieve the onset of new clinical symptoms, it is important to recognize and treat previously neglected odontoid fractures. However, many hospitals in developing countries do not have the equipment or surgical expertise to adequately manage these lesions.Case Description:A 31-year-old male presented with paresthesias/quadriparesis attributed to an accident sustained 6 months earlier. The cervical magnetic resonance image revealed atlantoaxial subluxation type 2. Following a laminectomy and occipitocervical fusion with a Ransford loop, the patient’s symptoms significantly improved.Conclusion:Straight forward laminectomy and occipitocervical fusion with a Ransford loop may adequately treat selected cases of neglected atlantoaxial subluxation in a developing country.