Neuroimaging in Stroke
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Transcript of Neuroimaging in Stroke
8/18/2019 Neuroimaging in Stroke
http://slidepdf.com/reader/full/neuroimaging-in-stroke 1/41
8/18/2019 Neuroimaging in Stroke
http://slidepdf.com/reader/full/neuroimaging-in-stroke 2/41
Tiga Kemungkinan Hasil
• ! "esi stroke non iskemik
• #! Hemoragik• SDH
• $DH
• S#H
• %ntracerebral
&! Non Hemoragik Tumor' #bses
8/18/2019 Neuroimaging in Stroke
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• (! Stroke iskemik
) H*perdense arter* sign
) "oss o+ insular ribbon
) "oss o+ cortica-gra*-,hite matter
di++erentiation
) ass $++ect
.! Normal CT
8/18/2019 Neuroimaging in Stroke
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Time course o+ stroke
• Hiperakut /0 1 2am3
• #kut /1-(4 2am3
• #kut lan2ut /-. hari3• Subakut a,al /4-5 hari3
• Subakut lan2ut /-6 minggu3
• Kronik /7 ( bulan3
8/18/2019 Neuroimaging in Stroke
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Trombolisis
• Han*a untuk hiperakut
• K% pada perdarahan
• %skemik 7 8. C# distribusi' potensialperdarahan setelah trombolitik
8/18/2019 Neuroimaging in Stroke
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$+ek massa pada stroke
• ulai timbul setelah hari
• Tidak tampak lagi setelah 4 minggu
• Pendesakan ?
8/18/2019 Neuroimaging in Stroke
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Trans+ormasi hemoragik
• ulai -. hari
• Puncakn*a -( minggu
8/18/2019 Neuroimaging in Stroke
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$nhancement
• Parenkimal
mulai . hari
Puncak . mingguHilang . bulan
"eptomeningeal 9-9 hari
8/18/2019 Neuroimaging in Stroke
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D:-%
• Pada stroke hiperintens
• ulai mendeteksi stroke setelah .9 menit
•eningkat terus dalam beberapa hari• enghilang setelah -4 minggu /rata-rata5-9 hari3
• Kurang sensiti+ untuk perdarahan
• embedakan lesi lakunar ;s in+ark akut
• T%# han*a <9 = *ang positi+
8/18/2019 Neuroimaging in Stroke
http://slidepdf.com/reader/full/neuroimaging-in-stroke 10/41
Per+usion-:%
• enentukan penumbra
• Seleksi trombolitik terapi
8/18/2019 Neuroimaging in Stroke
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Sistimatika membaca CT
• ! Parenkim
) Simetris ?
) idline ?
) Di+erensiasi gra*-,hite matter
) "esi h*perdens
) &a*i ? >sia lan2ut ?
8/18/2019 Neuroimaging in Stroke
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• (! entrikel dan sisterna ) &asal sisterna
) #simetris sulci in+ark
) Perdarahan pada sulci - S#H
.! Dura dan subdural space
4! TulangFraktur
Sinus paranasal' mastoid' telinga tengah
8/18/2019 Neuroimaging in Stroke
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• <! Kutis dan subkutis
8/18/2019 Neuroimaging in Stroke
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Trauma
• Cek dari tengah ke arah luar
• &agaimana
)Corte@ dan subcotical
) Sulci dan sisterna
) Subdural
) Fraktur
8/18/2019 Neuroimaging in Stroke
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Sakit Kepala
• Cari adan*a
) S#H
) assa
) Sinusitis
8/18/2019 Neuroimaging in Stroke
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Perubahan mental
• Cari
) SDH
) %n+ark
) assa
8/18/2019 Neuroimaging in Stroke
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Ke2ang
• Cari
) $+ek massa
) %n+ark
8/18/2019 Neuroimaging in Stroke
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T$STAAA
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C#S$
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CASE 2
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