stroke,epilepsy & vertigo

8/18/2019 Stroke,Epilepsy & Vertigo

1/27

-Stroke

- Epilepsi

- Vertigo


2/27

Hippocrates (50 years later…….) “Men should know that from theBRAIN alone come to usour pleasure, our joys, our laughter, our jokes, and alsoour pains, our sufferings, our resentments and our tears. Through theBRAIN we think, we see, we understand and

we distinguish the ugly from the beautiful, the bad fromthe good, the pleasant from the unpleasant. I therefore hold the view that theBRAIN is the mostpowerful organ of the human body because when it is ingood health it interprets for us the phenomena of aerialorigin, and it is indeed the air which gives us intelligence.

Eyes, ears, tongue, hands and feet act it in accordance with the discernment of the brain” (cf.Giurgea, 1981)


3/27

IGD

• Gawat darurat :

- mendadak dlm keadaan GAWAT

- bila tidak segera ditolong akanmenjadi GAWAT & MENGANCAM IWA

• !eluru" #ersonil IGD $dokter%#aramedis% non medis

!EN!E o' EME(GENC)


4/27

• *erat +, dari **erlu ./, C0 $Cardia1 0ut ut

erlu +2, konsumsi 0+


5/27


6/27

STROKE

Wolrd Stroke Day:29 Oktober

De3nisi:- De3sit neurologis 405A6 7 G60*A6

- berlangsung 8 +9 jam

5ECACATAN 7 5EMATIAN Gangguan #umbulu" dara" di 0TA5


7/27

5oreksi istila"

Mini stroke 7 !troke 6AC;NA(:

- #ure motorik

- #ure sensorik - 1lums< "and7ata=i1 "emi#legia

- >>>>>>??

@ !troke ringan

!T(05E is !T(05E


8/27

4aktor (isiko


9/27


10/27


11/27

anterior

B #osterior


12/27


13/27

5lasi3kasi !troke

- AT060GI! : - NON HEMOR!"K 7 In'ark 1erebri

#Tro$bosis % E$boli& - EM0(AGI5 $IC & !A

- A!5;6A(I!A!I : - 'ROT"S $ ant? - E(TE*(0*A!I6A( $B

#ost?

- !TADI;M WA5T; : - $TIA

- (IND

- !troke in eolution

- Com#lete !troke


14/27


15/27


16/27

engenalan tanda+ !T(05E

Ada (OK)"TS $#aresis motorik7Nn1ranialis7

de3sitmotorik7sensorik7gangg?keseimbangan

dll

disertai % tidak disertai

!N!!*N pada +,gsiOTK $F5E!ADA(AN


17/27

Ins#eksi

- Cara #= datang $mandiri 7 tidakmandiri

- 5linis !E5I6A! : - 1ara bi1ara$disartria7a'asia7N

- #osisi bola mata$#aresis 797H

- waja" $asimetri

- sika# motorik

tindakan EME(GENC) : .'


18/27

Anamnesis

!ingkat te#at to t"e #oint 9 W J.

- 5elu"an ;TAMA $Fkesadaran7lum#u"7tidak

bisa bi1ara7kejang7sakitke#alaJmunta"+

Menggiring ke ara" jenis stroke$!N7 !K

- 5elu"an tamba"an melengka#i


19/27

emeriksaan 4isikNeurologis

-5esadaran : Normal

bila ada F dengan GC!

8L. -.+ O

rePeks+ *ATANG 0TA5:

$rePeks 1a"a


20/27

- tanda+ S TI5 su#ratentorial$kesadaran F% ( J .sisi atau + sisi% #ola res# C!

in'ratentorial$kesadaran F% #u#il anisokoria% #olares# CN!7A#n brt7Clstr br7 At= brt

- Nn 1ranialis7motorik7(47(

emeriksaan 4isikNeurologis


21/27

Diagnosis

!esuai 5lasi3kasi TIA ATA;!T(05E KK

(IN!I : 5IE tentang D= !olde /eriode : O H jam #ertama

TIA : e=#lorasi 4( % A(;! dikontrol% (ujuk

!T(05E 'ase A5;T $s7d "ari ke onsetA(;! dirawat untuk e=#lorasi 4( (ujuk

Atasi 5egawat daruratan (ujuk


22/27

E/")E/S"

De0isi : - .agkita epilepsi (epileptic sei1,re )

ber,lag

- 23 4a$5 TN/ pro6okasi

----------------------------------------------------------------

.? Engel % edle< TA?E#ile#s


23/27

!indrom E#ile#si

- kum#ulan gejala 7 tanda klinis


24/27

edoman ;mum

.? A!TI5AN bangkitan #aroksismal


25/27

emeriksaan #enunjang

!esuai indikasi :

- 6ab : D6% 'ungsi "ati% ur71r $sebelummemulai T=

4ungsional : EEG

!truktural :- CT s1an 7 M(I

- ET7!ECT7M(!


26/27

rinsi# Tera#i 0AE

- Tujuan : kawalitas "idu# o#timal

V *E*A! *ANG5ITAN TANA E4E5!AMING V

- D= E#ile#si J 5IE J

- 6ongTerm T= M0N0 T= sesuai jenisbangkitan

!E obat

ke#atu"an #=


27/27

6ini . di Indonesia : T%A%C*?$*

- Mulai dosis ke1il d#t S berta"a#sam#ai dosis

rinsi# Tera#i 0AE

stroke,epilepsy & vertigo

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