Publications by authors named "Achmad Fahmi"

10 Publications

  • Page 1 of 1

Chronic subdural hematoma-induced parkinsonism: A systematic review.

Clin Neurol Neurosurg 2021 Sep 21;208:106826. Epub 2021 Jul 21.

Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Background: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical cases, especially in elderly individuals. Secondary parkinsonism due to CSDH is a rare entity. The mechanism of parkinsonism symptoms in chronic subdural hematoma has been suggested to include direct mechanical compression of the basal ganglia due to hematoma or indirectly through brain structure changes due to space lesions and vascular disorders. Surgery on the subdural hematoma provides a favorable outcome for parkinsonism symptoms.

Objectives: To systematically review the literature on CSDH-induced parkinsonism.

Search Methods: This is a systematic review on case reports. Literature search was performed using the predefined keywords on PubMed, ProQuest, and Google Scholar. We also provided our own case report and compared it with published studies.

Result: Sixteen cases from 13 case reports/series were identified, predominantly consisting of male patients with the mean age of 66.5 ± 9.73 years. The most common symptoms were rigidity, gait disturbance, and bradykinesia, observed in 12 (75%) cases each. The second and third most common symptoms were tremor (11; 68.75%) and facial masking (8; 50%), respectively. Other reported symptoms were dysphasia (3; 18.75%), dysarthria (3; 18.75%), and urinary incontinence (2; 12. 5%). Time gap between the symptom onset and CSDH diagnosis and unilateral location seemed to influence the outcome.

Conclusion: Only 16 CSDH-induced parkinsonism were identified since the 1960s. This condition is thought to occur due to basal ganglia compression. Surgery on the subdural hematoma provides a favorable outcome for parkinsonism symptoms. Timely CSDH diagnosis might yield better outcome. However, further research on CSDH-induced parkinsonism is needed, especially in the mechanisms and treatment outcomes.
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http://dx.doi.org/10.1016/j.clineuro.2021.106826DOI Listing
September 2021

Commentary: Percutaneous Full-Endoscopic C2 Ganglionectomy for the Treatment of Intractable Occipital Neuralgia: Technical Note.

Oper Neurosurg (Hagerstown) 2021 Sep;21(4):E397-E398

Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

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http://dx.doi.org/10.1093/ons/opab248DOI Listing
September 2021

VIM Line Technique for Determining the Ventral Intermediate Location.

Turk Neurosurg 2021 ;31(4):601-606

Universitas Airlangga, Faculty of Medicine, Post Graduate Doctoral Program, Surabaya, Indonesia.

Aim: To prove that VIM line technique created by using a mathematical model, can be used to identify the location of the ventral intermediate nucleus of the thalamus (VIM) MATERIAL and METHODS: Eleven patients with Parkinson?s disease (PD) were assessed. To determine the VIM location, 3-T magnetic resonance imaging and stereotactic protocol 128-slice computed tomography were used. The VIM line technique was performed by drawing a line from the end-point of the right external globus pallidus to that of the left external globus pallidus in the intercommissural plane. PD severity was measured using the Unified Parkinson?s Disease Rating Scale (UPDRS).

Results: A mathematical model was constructed to describe the VIM line technique for determining the VIM location. UPDRS scores before and after thalamotomy showed a significant decreasing trend (p=0.003).

Conclusion: The VIM line technique using the mathematical model can be considered a referential method to determine the VIM location. Its effectiveness was demonstrated by decreased UPDRS scores in patients after VIM thalamotomy.
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http://dx.doi.org/10.5137/1019-5149.JTN.31961-20.2DOI Listing
July 2021

Complete resolution of recurrent piriformis syndrome after piriformis resection with 3 years' follow up: A case report.

Int J Surg Case Rep 2020 20;77:576-579. Epub 2020 Nov 20.

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Neurosurgery, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Introduction: Piriformis syndrome (PS) is an uncommon neuromuscular condition characterized by buttock pain radiating to the leg. Although the goal of PS treatment is symptom relief, it is difficult in some patients using conservative treatment alone.

Presentation Of Case: A 72-year-old male underwent piriformis resection after failed sequential steroid injection of the piriformis. The patient ultimately underwent surgery for resection of the piriformis muscle and experienced satisfactory pain relief (pain reduction > 75% according to visual analog scale for at least 12 months) following surgery and in the 3-year follow-up period.

Discussion: Conservative treatment is first-choice treatment for managing PS. Surgery was indicated when the patient did not achieve satisfactory pain relief with conservative treatment. Surgical resection of the piriformis muscle has been shown to be effective and feasible.

Conclusion: Piriformis resection is effective and can be a feasible option for the treatment of PS following failure of appropriate conservative treatment(s).
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http://dx.doi.org/10.1016/j.ijscr.2020.11.099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708764PMC
November 2020

Vim line technique thalamotomy for Parkinson tremor: Case series.

Int J Surg Case Rep 2020 20;77:573-575. Epub 2020 Nov 20.

Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Introduction: The ventral intermediate (Vim) nucleus of the thalamus is difficult to identify even with 3 T magnetic resonance imaging. Stereotactic Vim thalamotomy is a usual procedure to control Parkinson tremor. Successful relieving of the tremor depends on the accuracy of defining the Vim location.

Presentation Of Cases: Three patients with Parkinson tremor were subjected to stereotactic thalamotomy using the Vim line technique (VLT) so as to precisely determine the Vim location. All patients showed good results, with improved tremors, as indicated by the UPDRS score, without any complications.

Discussion: The precise targeting of the Vim nucleus is crucial importance for the successful Vim thalamotomy. Various method has been developed to determine Vim location. Atlas based and Guiot's technique routinely used by neurosurgeon. VLT is a new technique that has been developed to determine the Vim location on MRI.

Conclusion: VLT is useful for the determination of the Vim location. However, further research is warranted to prove its effectiveness.
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http://dx.doi.org/10.1016/j.ijscr.2020.11.096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708753PMC
November 2020

Successful Relief of Abdominal Dystonia After Sequential GPi Pallidotomy with 2-Year Follow-Up.

World Neurosurg 2020 12 1;144:68-70. Epub 2020 Sep 1.

Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Background: Abdominal dystonia is very rare. To our knowledge, no clinical study has reported its specific treatment. Stereotactic therapy has been used to treat several movement disorders, including focal and general dystonia. We investigated the use of internal globus pallidum (GPi) pallidotomy for abdominal dystonia after failed oral medication.

Case Description: A 48-year-old man presented with abdominal dystonia and complaints of involuntary undulating and contraction movements of his left abdominal wall for 5 years. Treatment with oral medication for 4 years was ineffective. Lesioning of the right GPi successfully relieved his symptoms. The symptoms recurred at 3 months and right GPi pallidotomy was repeated with complete resolution of symptoms after the second procedure. There was no recurrence or focal deficit at the 2-year follow-up.

Conclusions: GPi pallidotomy is feasible and effective for the treatment of abdominal dystonia that is resistant to standard medical therapy.
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http://dx.doi.org/10.1016/j.wneu.2020.08.152DOI Listing
December 2020

Stereotactic aspiration of spontaneous intracerebral hematoma: Case series.

Int J Surg Case Rep 2020 11;72:229-232. Epub 2020 Jun 11.

Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Indonesia.

Introduction: Minimally invasive techniques such as stereotactic aspiration of spontaneous intracerebral hematoma (SICH) evacuation can minimize brain tissue damage due to surgery. We share our experience of adopting stereotactic aspiration of SICH in our center without compromising safety.

Presentation Of Cases: Three stereotactic aspiration procedures for SICH immediately after 24 h of onset are reported. All cases showed good results. Level of consciousness of all the patient returned to normal. Two patients could carry out routine activities independently. One patient has left hemiparesis.

Discussion: Stereotactic aspiration of SICH has been newly implemented at our center with acceptable results achieved. Patient selection has an important role in determining the choice of technique. The procedures were done without anticoagulant agent. Stereotactic aspiration of SICH is associated with limited brain tissue damage, shorter duration of surgery, reduced length of stay, faster postoperative healing, and better functional improvement.

Conclusion: Stereotactic aspiration of SICH is a minimally invasive defined strategy for hematoma evacuation without compromising safety.
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http://dx.doi.org/10.1016/j.ijscr.2020.06.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298528PMC
June 2020

Commentary: Pre- and Postoperative Gait Analysis and Video for Selective Dorsal Rhizotomy in Spastic Diplegia: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2019 09;17(3):E105-E106

Faculty of Medicine, Universitas Airlangga Dr. Soetomo General Academic Hospital, Surabaya Indonesia.

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http://dx.doi.org/10.1093/ons/opz044DOI Listing
September 2019

Impar Ganglion Block with Combination of Neurolysis Drugs and Radiofrequency Thermocoagulation for Perineal Pain.

Asian J Neurosurg 2018 Jul-Sep;13(3):838-841

Department of Neurosurgery, Division of Stereotactic and Functional Neurosurgery, Faculty of Medicine, Airlangga University/Dr. Soetomo General Hospital, Surabaya, Indonesia.

Since it was first introduced, a variety of modification techniques to block the impar ganglion appear such as transsacrococcygeal ligament technique, sacrococcygeal transdiscal approach, paramedian approach, and a two-needle technique using fluoroscopy or computed tomography scan. For therapeutic purposes, a combination of steroid and local anesthetic, neurolysis agents such as alcohol, phenol, cryolesioning, and heat lesioning using radiofrequency thermocoagulation could be used. Here, we reported a successful outcome in treating chronic perineal pain in a 65-year-old patient using combination of neurolysis agent which was alcohol 96% and radiofrequency thermocoagulation.
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http://dx.doi.org/10.4103/ajns.AJNS_306_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159014PMC
October 2018

Bilateral platysma dystonia.

Asian J Neurosurg 2017 Apr-Jun;12(2):244-246

Tokyo Women's Medical University Hospital, Tokyo, Japan.

Platysma dystonia is an involuntary movement of platysma muscle. It is a rare form of dystonia. In this case report, we would like to report a good result of peripheral nerve denervation for bilateral platysma dystonia case. A 58-years-old woman presented with an 8-years history of involuntary jerking movement of her bilateral platysma muscles. Oral medication was not effective. Microsurgical denervation of the facial nerves and its terminal branches to the platysma muscles were performed. Immediately after surgery, the patient showed considerable improvement. There were no complications. Selective peripheral denervation is useful for dystonia of the platysma muscles.
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http://dx.doi.org/10.4103/1793-5482.144152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409377PMC
May 2017
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