Cerebellum cavernous also known as cavernous hemangioma is a vascular malformation of the cerebel... more Cerebellum cavernous also known as cavernous hemangioma is a vascular malformation of the cerebellum, usually with characteristics that appear on the magnetic resonance image (MRI). Cerebellum cavernous is the third most malformation of the cerebellum after venous anomalies and capillary telangiectasis with an incidence of 0.5% of the General population usually not noticed until a hemorrhagic event occurs. Cavernomas can be seen in conjunction with developmental venous anomaly (DVAs) in 20% (range 20%-40%) cases, in which case they are known as mixed vascular malformations. We describe anaesthetic management in a 28-year-old woman with cerebellum cavern with developmental venous anomaly (DVAs) that causes acute bleeding. Occipital craniectomy for cerebellar tumor resection is performed using neuronavigation under total intravenous anesthesia and scalp block using 0.5% ropivacaine without complications. The surgery lasts for six hours and the cavernomas can be removed completely. The...
Introduction The COVID-19 pandemic have a negative impact on sleep in people with diabetes mellit... more Introduction The COVID-19 pandemic have a negative impact on sleep in people with diabetes mellitus, which can lead to other health problems. The aimed of this study is to synthesize the available evidence regarding sleep problems in people with diabetes mellitus during the COVID-19 epidemic. Methods: We performed a systematic search of five databases: Science Direct, EBSCO, Scopus, Sage, and ProQuest, to identify previous studies. Studies that enrolled adults with diabetes mellitus, sleep problems, and COVID-19 were published between 2019 and 2021, and used English or Indonesian were included. Results: We identified 819 articles, and fourteen studies met the review's inclusion criteria. The prevalence of sleep disorders ranged from 19.2% to 74.2%. Sleep disturbances have been shown in the majority of studies to have an effect on glycemic control in people with diabetes during COVID-19 pandemic. Conclusions: Sleep disorders in people with diabetes during the COVID-19 pandemic we...
Congenital heart disease (CHD) is one of the leading congenital disease with the incidence of 8 p... more Congenital heart disease (CHD) is one of the leading congenital disease with the incidence of 8 patients of 1000 livebirth. Around 85% of patients with CHD is expected to reach adult age in United States of America. Management of traumatic brain injury in patients with CHD requires combination of fine understanding on pathophysiology of CHD and neuroanesthesia technique. A male patient, 17 years of age had a motor vehicle accident and was diagnosed with moderate traumatic brain injury, intracerebral hemorrhage, epidural hemorrhage and cerebral edema with Tetralogy of Fallot, underwent an emergency craniotomy for ICH evacuation. Surgery was done under general anesthesia and lasted for approximately 3 hours. Challenges during anesthesia and surgery include maintaining optimal oxygen delivery, avoiding increase in oxygen demand and preventing catecholamine release which may trigger hypercyanotic tet spell. Patient was observed and ventilator supported in Intensive Observation Ward and ...
The ideal consciousness scoring scale must be linear, reliable, valid, and user-friendly. There i... more The ideal consciousness scoring scale must be linear, reliable, valid, and user-friendly. There is a need to develop and validate a scale to quickly evaluate the level of consciousness, the severity of the disease, and the prognosis of morbidity and mortality. Glasgow Coma Scale (GCS) is the most commonly used tool to assess the level of consciousness and is considered the gold standard. However, GCS has several limitations, such as inability to evaluate verbal components in intubated patients. To overcome these challenges, researchers developed the Full Outline of UnResponsiveness (FOUR) score. FOUR scores is a clinical grading scale to assess the altered state of consciousness. FOUR scores is simpler and able to provide better information, especially in intubated-traumatic brain injury (TBI) patients. Some studies showed that GCS and FOUR scores have the high predictive value in predicting not only the mortality of trauma patients but also the outcome of discharged patients. A mul...
Electrolyte imbalance is an often incident in patients underwent neurosurgery and it potentially ... more Electrolyte imbalance is an often incident in patients underwent neurosurgery and it potentially induces secondary brain injury, leading to a worse outcome, despite successful surgery. Diabetes insipidus is a frequent hypernatremic condition, commonly caused by abnormalities in the hypophysis; but rarely happens due to pineal tumor. A 21-year-old male with preoperative diabetes insipidus experienced episodes of diabetes insipidus complicated by cerebral salt wasting syndrome and tension pneumocephalus after a successful pineal tumor removal surgery. Closed observation on volume status, plasma glucose and electrolyte, along with optimal dose of desmopressin were keys of successful postoperative management in this patient in order to avoid the patient from secondary brain injury. An intensivist plays a key role, mainly in the understanding of intracranial pathophysiology and its implications to fluid and electrolyte balance.
Cerebellum cavernous also known as cavernous hemangioma is a vascular malformation of the cerebel... more Cerebellum cavernous also known as cavernous hemangioma is a vascular malformation of the cerebellum, usually with characteristics that appear on the magnetic resonance image (MRI). Cerebellum cavernous is the third most malformation of the cerebellum after venous anomalies and capillary telangiectasis with an incidence of 0.5% of the General population usually not noticed until a hemorrhagic event occurs. Cavernomas can be seen in conjunction with developmental venous anomaly (DVAs) in 20% (range 20%-40%) cases, in which case they are known as mixed vascular malformations. We describe anaesthetic management in a 28-year-old woman with cerebellum cavern with developmental venous anomaly (DVAs) that causes acute bleeding. Occipital craniectomy for cerebellar tumor resection is performed using neuronavigation under total intravenous anesthesia and scalp block using 0.5% ropivacaine without complications. The surgery lasts for six hours and the cavernomas can be removed completely. The...
Introduction The COVID-19 pandemic have a negative impact on sleep in people with diabetes mellit... more Introduction The COVID-19 pandemic have a negative impact on sleep in people with diabetes mellitus, which can lead to other health problems. The aimed of this study is to synthesize the available evidence regarding sleep problems in people with diabetes mellitus during the COVID-19 epidemic. Methods: We performed a systematic search of five databases: Science Direct, EBSCO, Scopus, Sage, and ProQuest, to identify previous studies. Studies that enrolled adults with diabetes mellitus, sleep problems, and COVID-19 were published between 2019 and 2021, and used English or Indonesian were included. Results: We identified 819 articles, and fourteen studies met the review's inclusion criteria. The prevalence of sleep disorders ranged from 19.2% to 74.2%. Sleep disturbances have been shown in the majority of studies to have an effect on glycemic control in people with diabetes during COVID-19 pandemic. Conclusions: Sleep disorders in people with diabetes during the COVID-19 pandemic we...
Congenital heart disease (CHD) is one of the leading congenital disease with the incidence of 8 p... more Congenital heart disease (CHD) is one of the leading congenital disease with the incidence of 8 patients of 1000 livebirth. Around 85% of patients with CHD is expected to reach adult age in United States of America. Management of traumatic brain injury in patients with CHD requires combination of fine understanding on pathophysiology of CHD and neuroanesthesia technique. A male patient, 17 years of age had a motor vehicle accident and was diagnosed with moderate traumatic brain injury, intracerebral hemorrhage, epidural hemorrhage and cerebral edema with Tetralogy of Fallot, underwent an emergency craniotomy for ICH evacuation. Surgery was done under general anesthesia and lasted for approximately 3 hours. Challenges during anesthesia and surgery include maintaining optimal oxygen delivery, avoiding increase in oxygen demand and preventing catecholamine release which may trigger hypercyanotic tet spell. Patient was observed and ventilator supported in Intensive Observation Ward and ...
The ideal consciousness scoring scale must be linear, reliable, valid, and user-friendly. There i... more The ideal consciousness scoring scale must be linear, reliable, valid, and user-friendly. There is a need to develop and validate a scale to quickly evaluate the level of consciousness, the severity of the disease, and the prognosis of morbidity and mortality. Glasgow Coma Scale (GCS) is the most commonly used tool to assess the level of consciousness and is considered the gold standard. However, GCS has several limitations, such as inability to evaluate verbal components in intubated patients. To overcome these challenges, researchers developed the Full Outline of UnResponsiveness (FOUR) score. FOUR scores is a clinical grading scale to assess the altered state of consciousness. FOUR scores is simpler and able to provide better information, especially in intubated-traumatic brain injury (TBI) patients. Some studies showed that GCS and FOUR scores have the high predictive value in predicting not only the mortality of trauma patients but also the outcome of discharged patients. A mul...
Electrolyte imbalance is an often incident in patients underwent neurosurgery and it potentially ... more Electrolyte imbalance is an often incident in patients underwent neurosurgery and it potentially induces secondary brain injury, leading to a worse outcome, despite successful surgery. Diabetes insipidus is a frequent hypernatremic condition, commonly caused by abnormalities in the hypophysis; but rarely happens due to pineal tumor. A 21-year-old male with preoperative diabetes insipidus experienced episodes of diabetes insipidus complicated by cerebral salt wasting syndrome and tension pneumocephalus after a successful pineal tumor removal surgery. Closed observation on volume status, plasma glucose and electrolyte, along with optimal dose of desmopressin were keys of successful postoperative management in this patient in order to avoid the patient from secondary brain injury. An intensivist plays a key role, mainly in the understanding of intracranial pathophysiology and its implications to fluid and electrolyte balance.
Uploads
Papers by Dhania Santosa