Asian Australasian Neuro and Health Science Journal (AANHS-J)

A Helmet Use Reduces Injury in Mild Head Trauma with Multiple Injuries: A Case Report

2025-07-30T17:23:34+07:00

Introduction : Patients with head injuries have a high risk of organ trauma. Organ trauma can occur in conjunction with head injuries, especially in cases of accidents involving violent impact. The energy of the impact usually does not affect only one area of the body. The head may be lightly impacted, but other parts of the body may also be injured. Not all parts of the body receive the same severity of impact. The head may suffer minor injuries while other parts of the body may suffer more severe injuries.

Case precentation : A 22-year-old man came to the emergency department of Yogyakarta City Hospital delivered by an ambulance with complaints of lower abdominal pain, the pain felt widespread, the patient complained of not being able to eat and drink, nausea and vomiting, left leg pain when lifted. Physical examination revealed vulnus excoriation. The diagnosis of mild head injury accompanied by multiple trauma can be established by history taking, physical examination, neurological examination, and supporting examinations such as laboratory, X-ray, and abdominal ultrasonography.

Discussion : Non-helmeted riders experience more severe head and facial injuries than helmeted riders. Riders who did not wear helmets had poorer mental status than those who did, and their mean GCS scores were usually lower than those who wore helmets. This suggests that there is a relationship between head protection, or helmets, and the severity of motorcyclists' injuries, and that when motorcyclists do not wear helmets, injuries and the risk of injury are greater.

Conclusion : The patient suffered a mild head injury with multiple organ trauma after physical and supporting examinations. The patient's head injury can be minimized because the patient was still wearing a helmet at the time of the accident.

Efficacy of Endoscopic Lumbar Discectomy in Motor Deficit Recovery: A Meta-Analysis of Neurological and Functional Outcomes

2025-07-02T02:00:11+07:00

Background: Endoscopic Lumbar Discectomy (ELD) has gained popularity as a minimally invasive alternative for treating lumbar disc herniation. However, its safety and efficacy in patients with preoperative motor deficits remain under debate due to concerns about limited decompression and neurological recovery. This study aimed to evaluate neurological and functional outcomes following ELD in patients presenting with motor weakness.

Methods: A meta-analysis were conducted on studies published between 2015 and 2025. Databases searched included PubMed, Scopus, Web of Science, and Cochrane Library. Eligible studies reported pre- and postoperative motor function (MRC scale) and/or functional disability (Oswestry Disability Index, ODI) in patients undergoing ELD. Pooled mean changes in MRC and ODI were calculated, and subgroup analysis was performed based on baseline motor strength.

Results: Eight studies comprising 613 patients met inclusion criteria. The pooled mean improvement in motor strength was +1.44 on the MRC scale. Functional outcomes improved significantly, with a mean ODI reduction of −37.3 points. Patients with severe baseline deficits (MRC ≤3) demonstrated greater neurological recovery. No study reported postoperative motor deterioration, and complication rates were low.

Conclusion: ELD is associated with favorable neurological and functional outcomes in patients with preoperative motor deficits. These findings suggest that motor weakness should not be considered a contraindication to ELD, and with appropriate selection and expertise, ELD offers a safe and effective surgical option.

Literatur Review: Intraoperative MRI (iMRI)

2025-04-09T19:45:43+07:00

Intraoperative Magnetic Resonance Imaging (iMRI) is a medical imaging technology used during surgical procedures to provide real-time visualization of a patient’s anatomy. By utilizing iMRI, surgeons can immediately evaluate the surgical outcome and make necessary adjustments, ultimately improving the success rate of the operation and reducing the risk of postoperative complications.

The purpose of this literature review is to explain the fundamental concept of iMRI (Intraoperative Magnetic Resonance Imaging) and analyze its benefits in enhancing surgical accuracy, particularly in neurosurgery and tumor resection.This study employs a literature review method, utilizing references from previous research articles and scientific journals.This review covers various aspects of iMRI, including its definition, working mechanism, image interpretation, clinical applications, comparison with other imaging modalities, cost and time efficiency, and future innovations in iMRI technology. Based on the review findings, intraoperative MRI (iMRI) has been proven to be a highly effective imaging tool in improving the precision of brain tumor resection, particularly for gliomas, pituitary adenomas, and brain metastases. Additionally, iMRI is beneficial in epilepsy surgery and pediatric neurosurgery. It provides higher resolution imaging, enabling better anatomical visualization compared to other modalities such as intraoperative ultrasound (iUS) and 5-ALA fluorescence-guided surgery. Furthermore, the latest iMRI systems have been developed with automated imaging data processing features, allowing rapid analysis of tumor volume changes during the procedure. Overall, while iMRI involves higher costs and longer surgical duration compared to conventional methods, it significantly reduces recurrence rates.

The Arteriovenous Malformation Rupture on Posterior Cranial Fossa:Management and Treatment of 9 Children Patients at Morozovskaya Children's Hospital

2025-08-25T09:31:16+07:00

Abstract

Background

Posterior cranial fossa (PCF) arteriovenous malformations (AVM) in children are the least studied among vascular malformations. Mortality rates after hemorrhages from ruptured PCF AVM reach the range of up to 21-67%. The aim of this Evaluation of the treatment tactics of the arteriovenous malformation rupture in an area of the posterior cranial fossa in children.

Materials and Methods

The study includes 9 children admitted to the Morozovskaya Children’s City Clinical Hospital Moscow Healthcare department, Moscow, Russia, with PCF, AVM intracranial hemorrhage (ICH) during the period of 2015-2022. The age varies from 7 to 17 years old. All patients underwent clinical and neurological examination, CT, and MRI of the brain, as well as cerebral angiography. The volume of intracranial hematoma ranges from 5 to 41.1 mL. To decide on the further extent of surgical intervention, GCS, Greab, PedNIHSS, and H-H scales were used.

Results

The extent of surgical intervention was based on the time of the admission to the hospital, the severity of the patients’ condition, the size and location of the ICH, and its relationship to the med-stem structures. Type of operation: microsurgical intervention in 3 cases (33.3 %), endovascular embolization in 2 cases (22.2 %), combined treatment in 4 cases (44.5 %). Surgery was performed in the acute period in all patients.

Conclusion

Modern microsurgical and endovascular PCF AVM treatment methods allow for positive results in complete neurological symptom regression form. This considerably decreases disability rates and increases patients’ quality of life.

Painful Neuralgia in Ramsay Hunt Syndrome: A Case Report

2025-06-06T13:39:44+07:00

Ramsay Hunt Syndrome rarely presents with severe neuralgia, but when it does, it can lead to significant complications. One common manifestation is facial paralysis accompanied by skin lesions. In this report, we describe the case of a 64-year-old man referred to the neurology clinic with intense neuropathic pain due to herpetic neuralgia affecting the third branch of the trigeminal nerve. The patient had been undergoing antiviral and steroid treatment for skin lesions that appeared two weeks prior to the onset of facial paralysis, which gradually improved. He then experienced left-sided peripheral facial palsy. Treatment for neuropathic pain, along with physical therapy, lead to improvement in his painful neuralgia.