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Carotid Artery Stenosis as a Risk Factor for Crescendo Transient Ischemic Attack: Case Report Amry, Carissa Maharani; Imran, Yudhisman; Rahmansyah, Mulia; Rachmiyani, Irmiya; Khusfiani, Triasti
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.758

Abstract

Background A Transient Ischemic Attack (TIA) is an indicator of ischemic stroke. When the frequency, duration, and severity of TIAs increase, they are known as a Crescendo Transient Ischemic Attack (cTIA). Several risk factors, including carotid artery stenosis, can contribute to cTIA. Case Description A 49-year-old man presented to the Emergency Department (ED) after being referred from another hospital, complaining of sudden weakness on the left side of his body that started three days ago. The weakness on his left side was noted to be intermittent. The patient initially experienced sudden weakness on the left side of his body five days before his hospital admission at 2:00 PM, after which his condition improved. That evening, at 8:00 PM, the patient again experienced sudden weakness on the left side, but it improved to normal afterward. Four days before admission, at 12:00 PM, the patient experienced weakness on the left side along with slurred speech, which also improved. Before being referred, the patient underwent a non-contrast head computed tomography (NCCT), revealing no bleeding. The neurological physical examination was within normal limits. The patient was hospitalized and received dual antiplatelet therapy (Aspilet and Clopidogrel), Ranitidine, Citicoline, Mecobalamin, and Atorvastatin. He was discharged on the second day, with no neurological deficits observed during treatment. The patient was evaluated at the neurology clinic and underwent CT angiography of the carotid arteries, revealing moderate stenosis (50 - 69% NASCET Scale stenosis) in the right internal carotid artery and mild stenosis (<50% NASCET scale stenosis) in the left internal carotid artery. Conclusions Crescendo Transient Ischemic Attack (cTIA) is an important indicator of ischemic stroke requiring hospitalization. In cTIA, a supporting examination is needed, typically computed tomography angiography (CTA). This imaging technique has high sensitivity for detecting intracranial stenosis and occlusion, which are significant risk factors for recurrent TIA. In high-risk TIA patients, DAPT (aspirin and clopidogrel) should be started early to reduce the risk of recurrent ischemic stroke. Keywords: Transient Ischemic Attack, Crescendo Transient Ischemic Attack, computed tomography angiography
Penyuluhan Faktor Risiko Dan Gejala Stroke Imran, Yudhisman; Rachmiyani, Irmiya; Adriani, Donna; Anggiane Putri, Mustika; Amani, Patwa; Putri Nasution, Dina
AMMA : Jurnal Pengabdian Masyarakat Vol. 2 No. 12 : Januari (2024): AMMA : Jurnal Pengabdian Masyarakat
Publisher : CV. Multi Kreasi Media

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Abstract

Stroke is an emergency disease in the field of neurology. Stroke is acute and one of the highest causes of disability and death in various countries in the world. There has been an increase in the incidence of stroke in various countries. Stroke may occur due to risk factors. Stroke risk factors are divided into modifiable (hypertension, diabetes mellitus, smoking, dyslipidemia) and non-modifiable risk factors (age, gender, ethnicity). Based on the pathophysiology, stroke is divided into two, namely ischemic stroke (blockage) and hemorrhagic stroke (bleeding). Stroke symptoms are characterized by sudden neurological deficits. Examples of neurological deficits are mouth, mumbling, slurred speech, weakness on one side of the body, and numbness on one side of the body. This education aims to increase public knowledge about the risk factors and symptoms of stroke so that they can prevent disability and death as a result of stroke. The education method is to fill out a questionnaire by 30 participants before and after online education via Zoom video conference meeting. Education was held in Duren Sawit Subdistrict RT 002/04 because many residents had experienced strokes, some even had repeat ones. The results of the level of knowledge before education were 66.25% correct answers. The results of the level of knowledge after education were 71.88% correct answers. Based on the results above, it can be concluded that education could increase public knowledge.