Background: Conus medullaris syndrome (CMS) and cauda equina syndrome (CES) are complex neurological disorders with varying symptoms. Patients often complain of weakness in both legs, walking problems, numbness in the legs, bowel movements, and urination problems. The causes also vary, such as trauma, tumors, infections, and degenerative processes. This study aimed to evaluate the clinical outcome in patients with CMS and CES after surgical procedures.

Methods: We included 37 subjects with CMS/CES treated with decompression with posterior stabilization surgery. A detailed visual analog scale (VAS) score of Low Back Pain (LBP) and Oswestry Disability Index (ODI) were used to quantify the clinical improvement at the final follow-up.

Results: Thirty-seven subjects enrolled in this study. VAS scores before surgery at six months and nine months were 7.62 ± 0.6, 3.16 ± 0.7, and 2.67 ± 0.5, respectively. ODI from baseline, six months, and nine months were 49.73 ± 10, 28.11 ± 6.51, and 12.6 ± 6.65 which demonstrated significant improvement in VAS and ODI scores (p < 0.001). The Mc-Nab criteria was excellent in 8.1%, good in 72.9%, fair in  5.49%, and poor in 13.5% of subjects. No complication was found after surgery.

Conclusion: Decompression and stabilization surgery may reduce pain and disability, and improve clinical outcomes. Bowel and bladder dysfunction were still felt during six months of postoperative follow-up. A complete preoperative assessment and surgery in a timely manner according to the course of the neurological deficit can prevent the disease from progressing to a chronic condition.

Keywords: cauda equina syndrome; clinical outcome; conus medullaris syndrome

Background: Meningioma was found in one-third of all brain tumors. Clinical manifestation differed according to location. This tumor is mostly benign and may be treated surgically or conservatively. A description of the characteristics of meningioma patients in Hasan Sadikin hospital is needed. This study aimed to describe the characteristics of meningioma patients in Hasan Sadikin hospital in the last 10 years.

Methods: This was a retrospective study of patients diagnosed with meningioma hospitalized in Hasan Sadikin Hospital, Bandung, from 2012 – 2021. Patients diagnosed with brain tumors other than meningioma were excluded. Demographic and clinical data were analyzed using Statistical Package for Social Sciences for Windows version 26.0.

Results. A total of 936 subjects were hospitalized due to meningioma in Hasan Sadikin Hospital in the last 10 years, with the highest in 2014 (13.4%) and the lowest both in 2020 and 2021 (4.6% each). Most patients were female (88.0%). The mean age was 44.16 ± 9.29. Most patients were between 38 – 47 years old (43.4%). Visual disturbance (26.9%), headache (24.0%), and protrusion of the eye (23.5%) were three of the most commonly reported complaints. Twenty-three percent of meningioma were diagnosed as sphenoorbita and 21.7% were diagnosed as convexity meningioma. Three patients were diagnosed with meningioma in more than one location. Meningiomas in Hasan Sadikin Hospital were mostly managed with craniotomy tumor removal (90.9%), followed by craniectomy tumor removal (4.8%). Sixteen patients (1.7%) were managed conservatively.

Conclusions: The number of meningioma patients were decreasing in the last two years. Most patients were females aged between 38 – 47 years old. Visual disturbance and headaches were commonly reported. The most frequent diagnosis was sphenoorbita meningioma. Almost all patients were treated surgically with craniotomy tumor removal being the most common procedure performed.

Keywords: benign intracranial neoplasm, characteristics, meningioma

Background: Vestibular schwannoma is the most common lesion of the cerebellopontine angle and accounts for 90% of all conditions affecting the cerebellopontine angle and 8% of all intracranial primary neoplasm. It is a benign, slow-growing tumor of Schwann cell origin.

Case presentation: A 30-year-old lady, with no significant medical history presented with chief complaints of progressive visual deterioration in both eyes for the past month, which was insidious in onset gradually progressive, and not associated with headache, vomiting, giddiness, or diplopia. There was no history of floaters, narrowing of the visual field, pain, or redness in the eyes.

Conclusion: Vestibular schwannoma presenting as severe vision loss is rare. There are different causes for papilledema in vestibular schwannoma. Early detection and treatment of papilledema will help to restore vision.

Keywords: case report; treatment of papilledema; vestibular schwannoma; visual deterioration