Meningioma is uncommonly found in extracranial. Extracranial meningioma can be extension from primary intracranial tumors that accompany osteolytic changes in the skull or causes bone destruction. In this article, we report about intracranial meningioma in the frontal region that extend to the sinonasal bone causes bone destruction and being predisposing factor for respiratory tract infection. A 47-years old female brought to the emergency department due to dyspnea and fever since a week ago and there was found a lump in the frontal region. During the surgical procedure, there was invasion of tumor and caused sinonasal bone destruction. The endotracheal tube (ETT) can be seen from the surgical field. In this case the patient was threated pneumonia infection, it can be related as complication of sinonasal bone destruction that caused by invasion of meningioma to extracranial manifestation. The clinical important that must be informed to the patient the possibility of recurrent respiratory tract infection incidents.
Phenytoin is an antiepileptic drug used as monotherapy for partial and generalized tonic-clonic seizures for more than 50 years. Pyridoxine is a water-soluble vitamin widely used for seizure patients unresponsive to standard treatment regimens. This study was conducted to determine the effect of pyridoxine as adjuvant therapy in epilepsy patients receiving phenytoin and to determine the relationship between age, gender, type of epilepsy, and duration of therapy on the incidence of seizures in epilepsy patients at Soebandi Regional Hospital Jember. This research is an observational analytic study with a cross sectional design. The data was taken from the patient's medical record at Soebandi Hospital Jember. The number of samples in each treatment group was 18 samples so the total number of samples in this study was 36 samples. Samples were taken using total sampling technique. Data analysis was performed using Chi-Square test on bivariate analysis and The Logistic test on multivariate analysis. The sample in this study was dominated by male patients (52.8%), aged 19-59 years (52.8%), had epilepsy with generalized seizure type (86.1%), and received therapy for < 3 years (77.8%). The results of bivariate and multivariate analysis showed correlation between the administration of pyridoxine and the incidence of seizures, indicating that phenytoin therapy with pyridoxine adjuvants was more effective than monotherapy phenytoin. Other factors such as gender, age, type of epilepsy, and duration of therapy were not proven to have a correlation with the incidence of seizures in epilepsy patients at Soebandi Hospital Jember.
Cerebral venous sinus thrombosis (CVT) is a rare cause of stroke, a life-threatening disorder that occurs in approximately 0,5-1% of all stroke incidents. Various clinical presentations, risk factors, and neuroimaging findings of this disease may cause a delay in the early diagnosis and treatment of CVT. We discuss a case of a 34-year-old female who was admitted to the emergency room (ER) with the onset of a generalized tonic-clonic seizure with a progressive headache in the occipitotemporal region. Based on head CT, there was multiple hyperdense and cerebral venous infarction in the posterior left parietal lobe. D-dimer evaluation, there was an increasing level of D-dimer (>10.000 ng/mL). The patient was treated with the primary therapy heparin. After 15 days of being hospitalized, the patient was discharged without any sequelae.
Keywords: CVT, heparin, stroke
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