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