Professional Documents
Culture Documents
S
Bagian Ilmu Penyakit Saraf
Fakultas Kedokteran Universitas YARSI
Stroke
A syndrome characterized by rapidly developing clinical symptoms and/or
signs of focal, and at times global (applied to patients in deep coma and
those with subarachnoid haemorrhage), loss of cerebral functions, with
symptoms lasting more than 24 h or leading to death, with no apparent
cause other than of vascular origin (Bull World Health Organ 1976;54(5):541-53)
TIA
Clinical syndrome characterized by an acute loss of focal cerebral or
monocular function with symptoms lasting less than 24 h and which is
thought to be due to inadequate cerebral or ocular blood supply as a
result of low blood flow, thrombosis or embolism associated with disease
of the arteries, heart, or blood (J Neurol Neurosurg Psychiatry 1991;54(9):793-802)
Executive Summary: Heart Disease
and Stroke Statistics–2012 Update
A Report From the American Heart Association
(Circulation 2012;125:188-197)
First attacks
610.000
795.000/year
Recurrent attacks
185.000
Leading cause of
functional
Death
Rates
impairment
Therapeutic
Treat Window
ISCHEMIC
rtPA 3 h onset
Refer HEMORRHAGIC
RAF VII 4 h onset
How to Diagnose?
Diagnosis
Cerebral infarction
Intracerebral
hemorrhage
Subarachnoid
hemorrhage
Uncertain
How to differentiate?
Gold Standar
CT/MR brain scanning or postmortem
No clinical
scoring method
can
differentiate,
with absolute
reliability,
ischemic stroke
from ICH
How to
differentiate?
Clinical Syndrome
BAMFORD Classification
TACI
Total Anterior Circulation Infark Occlucion of the mainstem or a branch of the
MCA/ACA/ICA by embolism from the heart,
embolism from proximal arterial sites of
atherothrombosis, and sometimes by
PACI thrombotic occlusion of sever ICA stenosis
Partial Anterior Circulation Infark
Hemodynamic stabilization
Controlled of seizure
Seizure management
Thrombolytic therapy
Neurosurgical intervention
Blood Pressure Management