STROKE
Definisi ( WHO )- Def. Neuro Fokal / Global- Akut- > 24 Jam / Meninggal- Kelainan Pemb. Darah Otak
Klasifikasi Patologi : Stroke Iskemik :
- Atherotrombotik
- Kardioemboli
Stroke Perdarahan :
- PIS
- PSA
Different Types of Stroke, 2000
American Heart Association (AHA). Heart Disease and Stroke Statistics — 2003 Update. 2003. Available at: http://www.americanheart.org/downloadable/heart/10590179711482003HDSStatsBookREV7-03.pdf. Accessed October 13, 2003.
Ischemic Stroke
85% Cerebral Thrombosis
61%
TIA 3%
Cerebral Embolus
24%
Intracerebral Hemorrhage
9%
Subarachnoid Hemorrhage 3%
HemorrhagicStroke
12%
Klasifikasi Anatomi P. Darah
Sist. Karotis
Sist. Vertebrobasiler
FOKUS
Proses Atherotrombotik
Stroke KE
Stroke Usia Muda
Atherosklerosis
Atherosclerosis Process
Atherosclerosis Process
"response-to-injury" hypothesis : endothel Chronic injury Monocyte, lipoprotein, platelet, lymphocyte, and smooth muscle cells
interactions. The main "battleground" : the intima Complex lipids + protein + carbohydrates + cell proliferation accumulation
in the intima . Type I : chronic minimal injury, endothelial cells functional alterations w.o
significant morphologic changes caused by turbulence of blood flow. Other factors : hypertension, hyperchol, vasoactive amines, viral, tobacco,
immunocomplexes.
Type II : denuding of endothel and superficial intima . result of toxic released by macrophages in the intima + platelet deposition w/w.o thrombus formation.
Type III : deep intima and medial damage + platelet aggregation + mural thrombosis. Vascular injury seen following plaque rupture.
STROKE KE Resource : jantung Turbulensi darah Kelainan : Irama ( AF) , anatomi ( dinding :
AMI, OMI, katup : MI – MS )
Fungsi Red Trombus : Eritrosit dominan, unstable TH/ : Trombolitik ( rTPA )
STROKE KE
Khas :
Infark luas, Maximal at onset
Infark berdarah ( Akibat reperfusi )- Hari 2 -4- TTIK- CT Scan : Salt & Pepper
STROKE USIA MUDA
Insidensi Meningkat
A VM – ANOMALY VASCULER B LOOD DYSCRASIA C ARDIOVASKULER D RUGS
STROKE USIA MUDA AVM
- Nyeri kepala , satu sisi, berdenyut
- Bila pecah : Nyeri kepala hebat, KK,
TTIK, LB : Bloody
- D/ : MRA
- Th/ : Operatif
Stroke usia muda
Drugs : Amphetamine, Coccaine, Smoking, Alcohol.
Life style
Economic Burden