Highlights Epidural hematoma in pediatric cases due to head fixation pins are rarely reported. The use of pin-type head fixation in pediatric has several different risk factors compared to adult patients. By knowing pre-operative risk factors and early treatment, the outcome will be better.

BACKGROUND: Cranioplasty is aimed to restore the structure and function of the lost portion of the skull defect. Many materials can be used for cranioplasty, such as the bones of the patient (autograft), the bones of other patients (allograft), bones of animals (xenograft), or synthetic materials such as acrylic or titanium mesh. These materials are quite expensive and sometimes require complex processes. Manual shaping of material for cranioplasty is also quite time-consuming and prone to cause esthetic dissatisfaction. The author will discuss the case of using polylactic acid (PLA) implant with 3-dimensional (3D) printing customization as a cheap and accurate cosmetic solution for cranioplasty procedures. CASE REPORT: We report 2 cases of skull defect underwent cranioplasty. The first case, female, 20-year-old, had a history of severe traumatic brain injury (TBI) and epidural hematoma. She underwent decompression craniotomy on the left frontotemporoparietal region of her skull. The second case, male, 46-year-old, had a history of spontaneous intracerebral hemorrhage due to arteriovenous malformation (AVM). He underwent decompression craniotomy on the right frontotemporoparietal region of her skull. Both the data of computerized tomography (CT) scan were reconstructed to get 3D model of skull defect. Prosthesis was made by 3D printer accordingly using PLA as material. There was no complication reported postoperatively and cosmetic satisfaction was obtained on both cases. CONCLUSION: The use of PLA implant with 3D printing customization was proved to be cost-effective and good cosmetic satisfaction with no complication reported following cranioplasty procedure.

Traumatic brain injury (TBI) following increased intracranial pressure (ICP) is a neuroemergency case which should be managed promptly to prevent secondary brain injury. This will lead to a condition called cerebral energy dysfunction which is an important determinant factor toward worse outcome. Lactate, which was historically known as an end waste product, now is considered as an alternative cerebral energetic fuel. Hypertonic sodium lactate (HSL) is a promising hyperosmolar fluid which serves not only to decrease ICP but also to readily supply exogenous lactate to fulfill increased cerebral energy demand. Pioneer studies have shown the harmlessness and usefulness of HSL in treating pathological condition including TBI.

BACKGROUND: The World Health Organization declared the novel coronavirus disease 2019 (COVID-19) a global pandemic, which classifies the outbreak as an international emergency. This disease has been confirmed as the first pandemic in 21st century. Healthcare workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of being stigmatized. AIM: This study was a review. METHODS: This study was conducted by conducting analytic appraisal using published journals and sources through an electronic database. RESULTS: From cases in Indonesia and other countries, there’s bunch of examples that healthcare workers being negatively stigmatized in case of COVID-19. They lost their rights to have a normal life in this pandemic era. DISCUSSION: The government itself has actually promoted socialization about COVID-19, including the importance of mutual support and assistance including morally and psychosocially for the sufferers and health workers involved. However, negative stigma for health workers and patients and their families suffering from COVID-19 remains strongly attached until nowadays. Synergy between the central government, regional governments, community leaders, and referral hospital officials are certainly important to overcome this stigma problem, in addition to promoting education in the community. CONCLUSION: Synergy among the central government, regional governments, community leaders, and referral hospital officials is certainly important to overcome this stigma problem, in addition to promoting education in the communit