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STEP 7
PENYAKIT SEREBROVASKULER
1. Defnisi
2. Etiologi3. Jenis !enis "en#$%itn#$&en'('t Kl$sif%$si Pen#$%it Se(e)(o*$s%'l$( III +1,,- / 0$(i N$tion$lInstit'0e o Ne'(ologi $l Diso(0e(s 0$n St(o%e/N$tion$l Instit'0e o
e$lt4/ Bet4es0$/ &$(#l$n0/ USA5$. Pe(0$($4$n se(e)($l). Pe(0$($4$n s')$($ 4noi0
. Pe(0$($4$n Int($%($ni$l 0$(i AV& +$(te(io*enos's&$l o(6$tion
0. In $(% Ot$%
St(o%e/Pengelol$$n &'t$%4i(/D(. .Soe0o6o $0inoto 7K Un0i"8. P$togenesis
STROKE
1. Defnisi
&en'('t 9 O5
St(o%e $0$l$4 6$ni est$si %lini% 0$n g$ngg'$n 'ngsi se(e)($l/ )$i%
o%$l 6$'"'n (nen#el'('4 +glo)$l / #$ng )e(l$ngs'ng 0eng$n e"$t.
)e(l$ngs'ng le)i4 0$n 28 !$6. $t$' )e($%4i( 0eng$n 6$'t/ t$n"$
0ite6'%$nn#$ "en#e)$) sel$in 0$(i"$0$ g$ngg'$n *$s%'l$(.
K$"it$ Sele%t$ Ne'(ologi
2. E"i0e6iologi3. Etiologi8. Kl$sif%$si
Kl$sif%$si 't$6$ st(o%e51. Is%e6i% In $(% Se(e)('6
$. O%l'si t(o6)oti%i. L$%'n$(
). O%l'si e6)oli%i. K$(0iogeni%
ii. A(te(i %e $(te(i2. Pe(0$($4$n Int($%($ni'6
$. Int($se(e)('6 +"$(en%i6:PIS). S')$($ 4noi0 +PSA
. S')0'($l +)i$s$n#$ t($'6$ti%0. E"i0'($l +t($'6$ti%
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P$tofsiologi/Konse" Klinis P(oses2 Pen#$%it/Vol'6e 2/E0isi ;/2--;
&en'('t 9 O I 4$(i
iii. S')%(onis/)il$ %(isisn#$ > 4$(i
. Pe(0$($4$n Int($%($ni$l nons"esif% 0$n #$ng l$in6is$ln#$/"e(0$($4$n e%st($0'($l $t$' e"i0'($l nont($'6$ti%/"e(0$($4$n $t$' 4e6$to6$ s')0'($l nont($'6$ti% 0$n"e(0$($4$n int($%($ni$l nons"esif%.
St(o%e/Pengelol$$n &'t$%4i(/D(. .Soe0o6o $0inoto 7K Un0i"
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Unit St(o%e/&$n$!e6en St(o%e Se $($ Ko6"(e4ensi /D(. Al R$s#i0S".S /D(.L#n$ Soe(ti0e=i S".S+K /&.E"i0/ 7KUI/ 2-->
?. 7$ to( (esi%o
;. P$tofsiologi7$%to( $%to( #$ng 6e6"eng$('4i ADO
1. 7$%to( e%st(insi%$. Te%$n$n D$($4 siste6i%). Di$6ete( Pe6)'l'4 D$($4
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. K'$lit$s D$($4i. Vis%osit$s D$($4 +$"$)il$ n$i%/6$%$ (esistensi
se(e)(o*$s%'l$( !'g$ n$i%/se4ingg$ ADO 6en'('nii. E(it(osit +"ening%$t$n $g(eg$si e(it(osit 0$n
"en'('n$n 0e o(6it$s e(it(osist %$(en$"ening%$t$n t/"ening%$t$n f)(inogen 0$n"en'('n$n te%$n$n "e( 'si
iii. Pl$telet+6ele"$s 2 6$ $6 6e0i$to(*$so$%ti /$s$6 $($ 4i0on$t 0$n )iogeni% $6in s"tno(e"ine"4(ine/0o"$6in/$0(en$lin.Pl$telet
en0e('ng )e($g(eg$si se $($ s"ont$n $t$' $t$sin0'%si ADP/%ol$gen 0$n t(o6)o@$n A2
2. 7$%to( inst(insi%$. A'to(eg'l$si/6el$l'i (e e%s 6iogeni% inst(insi% 0$(i
0in0ing $(te(iol 0$n "e($n$n siste6 $'tono6). 7$%to( Bio%i6i$=ii.
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Unit St(o%e/&$n$!e6en St(o%e Se $($ Ko6"(e4ensi /D(. Al R$s#i0S".S /D(.L#n$ Soe(ti0e=i S".S+K /&.E"i0/ 7KUI/ 2-->
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St(o%e e6o($gi%1. Pe(0$($4$n Int($ Se(e)($l +PIS
$. Ken$i%$n A%'t 0$(i Te%$n$n D$($4 Siste6i%). Ken$i%$n A%'t 0$(i ADO se $($ 0i 's $t$' o%$l setel$4
"e()$i%$n 0$(i o)st('%si $(te(i$l +(e"e( 'si. Ke)o o($n $t$' Ke('s$%$n Din0ing Pe6)'l'4 D$($4
$%i)$t (e"e( 'si 0$(i !$(ing$n is%e6i% $t$' l'%$Sin0(o62 %linis PIS
$. Pe(0$($4$n Se(e)($l Lo)e( 0i s')s.$l)$s'"($tento(i$l/$%i)$t $ngio6$ +$ngio"$ti $6iloi0se(e)($l 0$n %o$glo"$ti
). Pe(0$($4$n P't$6en +st(i$t$ te(se(ing. Pe(0$($4$n T$l$6's
0. Pe(0$($4$n Ponse. Pe(0$($4$n
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>. &$ni est$si %linisBA&7ORD
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i. Dis 'ngsi s$($ ot$% s$t' $t$' le)i4 i"sil$te($l 0$n $t$'g$ngg'$n 6oto(i%:senso(i% %ont($l$te($l
ii. $ngg'$n 6oto(i%:senso(i% )il$te($liii. $ngg'$n ge($%$n %on!'g$si )ol$6$t$ +4o(iCont$l et
*e(ti $li*. Dis 'ngsi e(e)el$( t$n"$ g$ngg'$n long t($ t i"sil$te($l*. Isol$te0 4e6i$no"i$ $t$' )'t$ %o(ti%$l
*i. Pen'('n$n%es$0$($n g$ngg'$n t($%t's (eti%'l$(isSt(o%e/Pengelol$$n &'t$%4i(/D(. .Soe0o6o $0inoto 7K Un0i"
Unit St(o %e/&$n$!e6en St(o%e Se $($ Ko6"(e4ensi /D(. Al R$s#i0S".S /D(.L#n$ Soe(ti0e=i S".S+K /&.E"i0/ 7KUI/ 2-->
. Di$gnosis )$n0ing
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K$"it$ Sele%t$ Ne'(ologi,. Peneg$%$n 0i$gnosis
st(o%e non4e6o($gi%
Di$gnosis 0i0$s$(%$n $t$s 4$sil 5
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1. Pene6'$n %linis5
Anamnesis :
- te('t$6$ te(!$0in#$ %el'4$n:ge!$l$ 0elisit ne'(ologi% #$ng
6en0$0$%- t$n"$ t($'6$ %e"$l$.- $0$n#$ $%to( (isi%o PDO
Pemeriksaan sik:
- $0$#$ 0eifsit ne'(ologi% o%$l- 0ite6'%$n $%to( (isi%o +4i"e(tensi. %el$in$n !$nt'ng. 0li- )ising "$0$ $'s%'ltFsi $t$' %el$in$n "e6)'l'4 0$($4
l$inn#$.
2. Pe6e(i%s$n T$6)$4$n L$)o($to(i'6
Pemeriksaon Neuro-radiologik:
- S%en to6og($f% 5 $6$t 6e6)$nt' 0i$gnosis 0$n
6e6)e0$%$nn#$ 0eng$n "e(0$($4$n te('t$6$ "$0$ $se
$%'t.
- Angiog($f se(e)($l +%$(otis/ $t$' *e(te)($l 'nt'%6en0$"$t%$n g$6)$($n #$ng !el$s tent$ng "e6)'l'4
0$($4 #$ng te(g$ngg'/ $t$' )il$ s%en t$% !el$s.- Pe6e(i%s$$n li%'o( se(e)(os"in$lis 5 se(lng%$li 0$"$t
6e6)$nt' 6e6)e0$%$n In $(%/ "e(0$($4$n ot$%. )$l% PIS
+"e(0$($4$n Int($se(e)($l 6$'"'n PSA+"e(0$($4$n
s')$($%noi0$l .
3. Pe6e(i%s$$n l$in l$in5- "e6e(i%s$$n 'nt'% 6ene6'%$n $%to( (isi%o. se"e(ti5
0$($4 ('tin + ). 4e6$to%(lt/ le'%osit. e(it(osit. LED . 4it'ng
!enis 0$n )il$ "e(l' g$6)$($n 0$($4- %o(n"onen %i6i$ 0$($4/ g$s. Ele%t(olit- 0o""le(. EKO/ E%4o%$(0iog($f/ 0ll.
K$"it$ Sele%t$ Ne'(ologi
Pe6e(i%s$$n St(o%e
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Pe6e(i%s$$n Pe(0$($4$n In $(%
B($0i%$(0i D$(i "e(6'l$$n 4$(i %e8
U0e6 P$"il
K$%' K'0'%
T$n0$Ke(nig/B('0Cins%i
7'n0's%o"i Pe(0$($4$n 0i (etin$0$n %o("'s *it(e'6
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$. Pengo)$t$n '6'6?B
i. B(e$t4ing /!$l$n n$ $s )e)$s/ 'ngsi "$('2 )$i%ii. Bloo0/te%$n$n 0$($4 +4i"e(tensi "$0$ $se $%'t !gn
sege($ 0it'('n%$n 0$n %o6"osisi 0$($4iii. Bo=el/0e e%$si 0$n n't(isi 4$('s
0i"e(4$ti%$n/"e6)e(i$n in 's gl'%os$ 4$('s 0i eg$4i*. Bl$00e(/6i%si 0$n )$l$n e $i($n 4$('s
0i"e(4$ti%$n/!$ng$n s$6"$i te(!$0i (etensi '(in*. B($in/!$ng$n s$6"$i '0e6 ot$% 0$n %e!$ng2
). Pengo)$t$n K4's's
. 7isiote($"i11. Re4$)ilit$si12. Pen eg$4$n13. P(ognosis18. Ko6"li%$si