stroke hemoragik.pptx

7/23/2019 STROKE HEMORAGIK.pptx

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STROKE HEMORAGIK

dr. Selly Marisdina, Sp.S


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EPIDEMIOLOGI STROKEPenyebab kematian kedua di dunia

penyebab kematian ketiga di merika Serikat

Ind!nesia" angka kematian tertinggi #$%,&'(


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PRE)LE*SI

Keseluru+an ,-' #Circulation. 2014)

Ind!nesia" #Riskesdas,$/(

Diagnosis 7 per mil

Terdiagnosis atau gejala 12,1 per mil

Sumatera Selatan" #Riskersdas,$/(

Diagnosis: 5,2 per mil

Terdiagnosis atau gejala 7,8


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I*SIDE*SI

Dunia" 0.. kasus #dams,1(

merika Serikat" 20%. kasus #3ir4ulati!n,$&(

RS5P Dr. M!+.6!esin

2011 = 763 kasus

2012 = 671 kasus

2013 = 586 kasus


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5sia

- RS di Ind!nesia" %-,- ta+un7$/,/ ta+un, dengan kisaran $-80

9anita" 1,&7$/,- ta+un

pria " %2,%7$,2 ta+un

kurang dari &% ta+un" $,0'

Lebi+ dari 1% ta+un" /%,-'.

MISBACH J.2011


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DE:I*ISIStroke

Sindr!ma neur!l!gik ;!kal yang mendadak yang k+usus disebab

ere!ro"asular disease#

ere!ro"asular disease :

$!normalitas pada otak aki!at proses patologi pem!ulu% dara%

Str!ke perdara+an"

Perdara+an intraserebral

Perdara+an subarak+n!id

1. ROPPER AH, BROWN AH. ADAM AND VICTOR'S.THE PRINCIPLES OF NEUROLOGY. 8TH EDITION. MCGRAW HILLYORK.200


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Perdara+an intraserebral

Kumpulan ;!kal dara+ didalam parenkim !tak atau sistem


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Perdara+an Subarak+n!id

Perdara+an di dalam ruang subarak+n!id #ruang antara membra

arak+n!id dan piamatter dari !tak atau medula spinalis(

Str!ke yang disebabkan Perdara+anSubarak+n!id

Ge=ala dis;ungsi neur!l!gi yang berkembang 4epat dan atau nyeyang disebabkan perdara+an subarak+n!id yang bukan disebab

trauma.

AN UPDATE DEFINITION OF STROKE FOR THE 21STCENTURY. AMERICAN HEART ASSOCIATION.201!


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ICH

SA

H


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PERDR6* I*TRSERE>RL

Pe4a+nya mikr!aneurisma #&err' aneur'sm(akibat +ipertensi ma

6ipertensi kr!nikperuba+an pat!l!gi pada dinding pembulu+ daberdiameter $8& mikr!meter berupa +ip!+ialin!sis, nekr!sis ;serta timbulnya aneurisma tipe >!u4+ard.

Kenaikan tekanan dara+ yang mendadak atau kenaikan dalam =umsangat men4!l!kpe4a+nya pembulu+ dara+.


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"FROM #URESHI AI, TUHRIM S, BRODERICK JP, ET AL$ SPONTANEOUS INTRACEREBRAL HEMORRHAGE. N ENGL J MED2001%!&&$1&01&(0

#( t+e 4erebral l!bes and !riginate

penetrating 4!rti4al bran4+es !; t+e

middle, !r p!steri!r 4erebral arterie

#>( t+e basal ganglia and !riginate

as4ending lenti4ul!striate bran4+es

middle 4erebral artery#3(t+e t+alamus and !riginate ;r!m

t+alam!geni4ulate bran4+es !; t+e

4erebral artery

#D( t+e p!ns and !riginate ;r!m pa

bran4+es !; t+e basilar artery

#E( t+e 4erebellum and !riginate ;r!

penetrating bran4+es !; t+e p!ster

anteri!r in;eri!r, !r superi!r 4erebe

Typi4al sites and s!ur4es !;

intra4erebral +em!rr+age.


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PERDR6* S5>RK6*OIDPe4a+nya aneurisma sakuler #-'(

Pr!ses degenerasi


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Major Risk Factors forHemorrhagic Stroke

Obesity

6ypertensi!n

3igarette sm!king

E?4essi


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Symptoms ofHemorrhagic Stroke

6emiparesis

3!n;usi!n

Di@@iness !r l!ss !; balan4e

Di;;i4ulty speaking !r

understanding spee4+

Sudden se


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Diagnostic Tests forHemorrhagic Stroke

6ist!ry and p+ysi4al e?am"

A Rapidity !; sympt!ms

A Time !; !nset

A Pattern !; sympt!ms

A Mental status

A Medi4ati!ns patient is taking

E3G

3!mplete bl!!d 4ell 4!unt,in4luding platelets

3ardia4 en@ymes andtr!p!nin

>l!!d urea nitr!gen

3reatinine

Serum bl!!d glu4!se

Pr!t+r!mbin time, I*Rpartial t+r!mb!plastintime


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Imaging Stuies for !iagnosiHemorrhagic StrokeComputed tomography scan:used t! determine type !; str!ke, sl!4ati!n, and presen4e !; 4erebr!spinal ;luid

Cerebral angiography:used t! 4!n;irm diagn!sis !; 4erebral ane)M

Lumbar puncture:used t! 4!n;irm subara4+n!id +em!rr+age


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Treatment Goals forHemorrhagic Stroke

C)*++-+ ) / )*/-)* ) 34/5 /*4 +67/5 *-3793*-)*+

:W*4); ) )


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Medical Interventions fHemorrhagic Stroke

P/-3*- +?)654 3 )*-)7345)+35= * -?3 ICU

B3473+- ;-? +34/-)* -)


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Surgical Interventions Hemorrhagic Stroke

R3)9/5 ) ?3)77?/3 9/ 7/*)-)= "73)3*434 )7 3737/?3)77?/3 73/-37 -?/* ! * 4/3-37

I* /*367=++ -?/- ?/93*- 76


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Clipping an Aneurysm


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Complications ofHemorrhagic StrokeR35334*

P+=?)5)/5 +=


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Rehailitation AfterHemorrhagic Stroke

B3*+ * -?3 /6-3


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Rehailitation Compone

Pre

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