Background: Hydrocephalus is a multifactorial abnormal condition characterized by the accumulation of cerebrospinal fluid (CSF) and an enlarged head and classified into numerous types based on its etiology, examination results, and management. This study aimed to obtain the profile of pediatric hydrocephalus patients with the ventriculoatrial shunt.

Methods: This study was a retrospective descriptive study using secondary data from the medical records of pediatric hydrocephalus patients during 2019 – 2020.

Results: The research results obtained from 15 patients were dominated by patients with an age range of 12 months – 2 years (46.7%) and male (66.7%). The majority of patients had undergone shunt or drainage surgery (53.3%). Most of the patients had a total GCS of 14 – 15 (66.7%), the majority of patients experienced two clinical symptoms (40%) and experienced shunt malfunction (53.3%) while only a few patients experienced shunt malposition (13.3%). Vomiting was the most common symptom (53.3%), while abdominal enlargement and nausea were experienced by a small proportion of patients (20%). The majority of result in the CSF examination was colorless CSF (46.7%), clear (86.7%), no clots (100%), and positive Nonne Pandy examination (80%). The average total cells in the CSF were 56,303, the average polymorphonuclear cell was 25,593; the average mononuclear cell was 73.37; the average glucose concentration was 41.86; and the average protein concentration was 846.32.

Conclusion: The decision to insert a ventriculoatrial shunt in a pediatric hydrocephalus patient varies considerably. Some patients report complaints of abdominal pain, nausea, and bloating, while others report mechanical shunt failure and shunt malposition. Furthermore, there are discrepancies in the CSF examination results.

Keywords: child well-being, hydrocephalus, pediatric, ventriculoatrial shunt

Background: Traumatic brain injury (TBI) is an emergency condition for children. TBI affects more than three million children worldwide each year. It is a common cause of death and disability in children. Knowing the profile of pediatric TBI is important because it can help provide more effective treatment management and increase public awareness of child safety. However, pediatric TBI has not been widely studied in Indonesia. This study aimed to ascertain the profile of pediatric TBI at Dr. Soetomo General Hospital.

Methods: A retrospective study was conducted using medical records of pediatric TBI patients aged < 18 years old who met the inclusion and exclusion criteria at Dr. Soetomo General Hospital from January 2016 to December 2020. Data were processed in the form of descriptive analysis and distributed into frequency tables.

Results: This study included 124 patients. The highest incidence occurred in the age range of 12 – 18 years old (33.87%). Males suffered from TBI more commonly (74.19%) than females with a ratio of 3:1. Accidents were the most common cause of pediatric TBI (66.94%). Most patients came with decreased consciousness (40.55%) and were diagnosed with intracranial injury (52.22%) with epidural hematoma (21.28%) as the most common type. The majority of patients were moderate TBI (41.93%) and received operative management (66.94%) with a percentage of 95.16% of cases being discharged after their condition improved.

Conclusion: Pediatric TBI predominantly occurred in males with an age range of 12 – 18 years old. Traffic accidents were the main cause of pediatric TBI, so it is important to pay attention to child safety, especially when driving.

Keywords: pediatric, profile, traffic accidents, traumatic brain injury

Background: Acquired prothrombin complex deficiency (APCD) is a spontaneous bleeding disorder caused by decreased activity of vitamin K-dependent coagulation factors that can be found in newborns up to six months of age. We would like to report a case of APCD with intracranial hemorrhage and its complication that have been found in Dr. Soetomo General Hospital, Surabaya, Indonesia. This study aimed to identify complications that can be found in patients with APCD.

Case presentation: A 43-day-old child came to the hospital with a chief complaint of fever 11 days before with a history of a general seizure lasting more than 15 minutes. The patient experienced bleeding in the injection site and got the treatment injection of vitamin K and a fresh frozen plasma (FFP) transfusion as the initial treatment of APCD. The physical examination showed the baby was compos mentis with a Glasgow Coma Scale (GCS) of 15 (E4V5M6). Laboratory examination showed hemoglobin levels of 8.7g/dL, prothrombin time (PT) of 13 seconds, activated partial thromboplastin time (APTT) was extended by 112 seconds, and platelet showed a normal value of 279 x 10^3µL. Head computed tomography (CT) scan examination showed bleeding and hydrocephalus. The patient was treated with non-operative and operative management.

Conclusion: Patients with APCD should be treated not only with non-surgical treatment but also with surgical treatment also.

Keywords: acquired prothrombin complex deficiency, case report, hydrocephalus, vitamin K deficiency