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Anesthetic Management of Craniotomy for Supratentorial Tumor Resection in a Patient with Femoral-Popliteal Deep Vein Thrombosis: Case Report Saputra, Tengku Addi; Halimi, Radian Ahmad; Hamzah, Hamzah
Jurnal Neuroanestesi Indonesia Vol 13, No 3 (2024)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v13i3.606

Patients with brain tumors are highly susceptible to venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Approximately 2030% of those with intracranial tumors experience VTE, with factors such as neurological deficits, tissue factor secretion, genetic predispositions, advanced age, and hypertension contributing to the risk. In this case, a 61year woman with Space Occupying Lesion (SOL) Supratentorial at Midfrontal, Hypertension Stage II, Diabetes Mellitus (DM) type 2, and femoral-popliteal DVT undergoes craniotomy in general anesthesia. A thorough preoperative assessment is carried out to increase the success of anesthesia, including Doppler ultrasound assessment, administering anticoagulants up to 24 hours before surgery, and monitoring platelet levels and coagulation profiles. Managing VTE in these patients typically involves anticoagulants, thrombolytics, and thrombectomy tailored to the clinical situation. However, the use of anticoagulants, like heparin, poses a risk of severe bleeding during surgical procedures such as craniotomy. A craniotomy is associated with an increased risk of VTE due to endothelial damage, thromboplastin release, and post-operative immobilization, all contributing to Virchows Triad (venous stasis, endothelial injury, and hypercoagulability). Anesthesiologists must provide meticulous perioperative care, incorporating preoperative and post-operative anticoagulant prophylaxis and being aware of intraoperative bleeding. While VTE is recognized as a common post-operative complication, its impact during surgery and the strategies needed to mitigate related risks are still underexplored. Understanding and addressing these challenges are essential, particularly in patients undergoing craniotomy for intracranial tumors, to improve surgical outcomes and reduce mortality.

Dexmedetomidine as an Adjunct in Anesthesia for Adolescent Idiopathic Scoliosis (AIS) Surgery: A Case Series Nofiyanto, Eko; Halimi, Radian Ahmad; Fuadi, Iwan; Abdul rachman, Iwan
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.682

Scoliosis is a spinal curvature deformity 10, with Adolescent Idiopathic Scoliosis (AIS) affecting those aged 10-18 years. The global prevalence of AIS is between 1%-2%, while in Indonesia, it stands at 2,93%, with a female-to-male ratio of 4.7:1. Perioperative challenges include nerve damage, bleeding, and postoperative pain. Neuromonitoring (MEP and SSEP) helps prevent injury, while careful drug selection supports spinal protection. Three female patients scoliosis reconstructions were performed under general anesthesia. All received target- controlled infusion (TCI) propofol, dexmedetomidine, and fentanyl, with stable hemodynamics and no neurological changes post-surgery. Epidemiological data showed that AIS predominantly affects females. The study included patients with curve progression impacting activity, with no motor or sensory abnormalities observed. Anesthesia was induced with propofol TCI (4 ?g/mL) and dexmedetomidine (0.3-0.7 mcg/kg/hr), reducing propofol and opioid use. Dexmedetomidine targets ?2-adrenergic receptors, reducing sympathetic outflow, stabilizing hemodynamics, blocking pain transmission, and improving recovery by reducing blood loss and inflammation. Dexmedetomidine provides sedation, analgesia, and stable hemodynamics in scoliosis surgery, minimizing blood loss and transfusion needs. It supports neurophysiological monitoring, reduces postoperative pain, and enhances recovery.

Tatalaksana Anestesi pada Pasien Anak dengan Cystic Craniopharyngioma yang Menjalani Gamma Knife Radiosurgery Widiastuti, Monika -; Halimi, Radian Ahmad; Fuadi, Iwan; Rahardjo, Sri; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
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Kraniofaringioma merupakan tumor otak jinak dengan karakteristik kistik dan kalsifikasi, yang letaknya dikeliingi oleh stuktur vital sehingga sulit untuk dilakukan reseksi total. Terapi kombinasi dengan Gamma knife radiosurgery (GKRS) merupakan pilihan terapi paling tepat. Prosedur GKRS yang kompleks meliputi banyak tahap dengan durasi 6-10 jam, memerlukan pemberian anestesi pada pasien yang tidak kooperatif. Kasus ini mengenai pasien anak perempuan berusia 4 tahun dengan cystic craniopharyngioma. Pasien dengan keluhan pandangan mata buram, dari pemeriksaan fisik didapatkan papil atrofi bilateral. Hasil magnetic resonance imaging (MRI) menunjukkan massa tumor yang menekan kelenjar hipofise inferior. Pasien menjalani prosedur GKRS selama 6 jam dengan anestesi sedasi sedang menggunakan Propofol 75 mcg/kg/menit. Hemodinamika selama prosedur stabil, tidak terjadi komplikasi. Pemilihan teknik anestesi dapat berupa anestesi umum atau sedasi, tergantung pada kondisi pasien, dokter anestesi, operator, dan fasilitas. Pertimbangan anestesi pada GKRS antara lain prosedur dilakukan di luar kamar operasi, durasi panjang, transportasi ke beberapa tempat seperti radiologi dan cathlab, imobilisasi kepala untuk mencegah pergeseran frame stereotaktik, pasien sendiri di dalam ruang radiasi, prinsip neuroanestesi pediatrik.Anesthetic Management of Pediatric Patient with Cystic Craniopharyngioma Underwent Gamma Knife RadiosurgeryAbstractCraniopharyngioma is a benign tumor characterized by cystic and calcification, surrounded by vital structures therefor it is difficult to perform total tumor resection. Combination with Gamma knife radiosurgery (GKRS) is the best treatment option. The complexities of GKRS consisting of several phases lasts for 6-10 hours. Anesthesia is needed for uncooperative patients. This is a case of a 4-year-old girl with cystic craniopharyngioma. The patient had chief complaint of blurry vision, physical examinations revealed bilateral papil atrophy. Result of MRI showed tumor mass compressing inferior hypophyse. Patient underwent the procedure under moderate sedation with Propofol at 75 mcg/kg/min for 6 hours. Intraoperative hemodynamic condition was stable without adverse events. Choice of anesthesia either general anesthesia or sedation, depends on the condition of patient, considerations from anesthesiologist dan neurosurgeon, dan availability of facilities. Unique considerations for GKRS are; a non-operating room anesthesia, long duration, transportation to other units such as radiology and cathlab, head of the patients need to be immobilized to prevent frame displacement, the patient will be alone in the treatment room, and principles of pediatric anesthesia and neuroanesthesia.

Manajemen Anestesi pada Penderita Sindroma Pfeiffer dengan Posisi Sphinx Halimi, Radian Ahmad; Bisri, Dewi Yulianti; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 7, No 3 (2018)
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Sindroma pfeiffer adalah kelainan genetik autosomal dominan berupa fusi prematur tulang kepala dan tubuh lainnya. Operasi rekonstruksi kraniofasial pada pasien dengan sindrom pfeiffer memberikan tantangan tersendiri bagi ahli anestesi. Pada laporan kasus ini, seorang anak perempuan berusia 18 bulan datang ke rumah sakit Hasan Sadikin Bandung dengan keluhan kelainan bentuk kepala sejak lahir. Kelainan tersebut disertai dengan proptosis mata, hipoplasia maksila bilateral, high arc palate, hipotelorisme dan hidrosefalus, namun tidak terdapat riwayat obstruksi jalan nafas. Pasien direncanakan dilakukan prosedur rekonstruksi kraniofasial dan tarsorhaphy dengan posisi modifikasi prone (posisi sphinx). Permasalahan yang terjadi selama operasi adalah obstruksi vena juguler, perdarahan dan kebocoran cairan serebrospinal pascaoperasi. Operasi berlangsung selama 19 jam. Pascaoperasi pasien dirawat di PICU dan dipindahkan ke ruangan perawatan biasa pada hari ke 4. Penanganan perioperatif pasien dengan sindroma pfeiffer yang akan menjalani prosedur operasi kraniofasial membutuhkan penanganan secara multidisiplin dan dibutuhkan pemahaman yang mendalam mengenai fisiologi, potensi permasalahan intraoperasi, resiko dan komplikasi pascaoperasi untuk mencapai hasil luaran yang baikAnesthesia Management in Patients with Pfeiffer Syndrome with Sphinx PositionPfeiffer syndrome is a dominant autosomal genetic disorder characterized by premature fusion of head and other body bones. Craniofacial reconstruction surgery in patients with Pfeiffer syndrome presents a challenge for an anaesthesiologist. This case report discusses about 18 month old girl came to the Hasan Sadikin hospital in Bandung with complaints of clover head shape from birth. The other abnormalities consist of eye proptosis, bilateral maxilla hypophlasia, high arc palate, hypotelorism and hydrocephalus. There was no history of obstructive sleep apneau (OSA). The patient underwent craniofacial vault reconstruction procedure and a tarrsorhaphy with modified prone position (sphinx position). During the operation, there were problems occured such as jugular venous obstruction, bleeding and postoperative cerebrospinal fluid leakage. The procedure takes 19 hours long, and after the operation, the patient admitted to the PICU and being transferred to the ward on day-4. The perioperative treatment of patients undergoing craniofacial surgery requires a multidisciplinary treatment approach, and deep understanding of the physiology, potential intraoperative problems, risks and postoperative complications to achieve better outcomes.

Pemanjangan Ventilasi Mekanik di Intensive Care Unit (ICU) pada Pasien dengan Tumor Glioma Batang Otak yang menjalani Kraniotomi Pengangkatan Tumor Halimi, Radian Ahmad; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 2, No 3 (2013)
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Kekerapan glioma batang otak mencapai 1020% dari semua tumor primer sistem saraf pusat dan biasanya terdiagnosa pada usia muda. Pada penanganan perioperatif perlu dipertimbangkan cara pengangkatan tumornya, pemakaian steroid perioperatif, perencanaan ventilasi mekanik pascabedah dan fisioterapi. Seorang anak berumur 11 tahun dengan diagnosa tumor batang otak, mengeluh tidak dapat berdiri, penglihatan ganda, afasia, gangguan menelan. Pasien telah menggunakan kortikosteroid dalam waktu yang lama. Dilakukan operasi pengangkatan massa tumor otak dengan lama operasi 10 jam. Pascabedah terjadi pemanjangan ventilasi mekanik, Ventilator Associated Pneumonia (VAP) pada hari ke-4 dan perdarahan lambung pada hari ke-6 di ICU. Teknik operasi sulit karena tumor berada di daerah yang sangat dekat dengan pusat pernapasan dan hemodinamik. Diperlukan perencanaan yang matang mengenai penilaian kondisi pasien saat preoperatif, pemantauan hemodinamik dan tekanan intrakranial, strategi perlindungan terhadap lambung, perencanaan ventilasi mekanik, penilaian cepat perlunya trakheostomi, pemberian antibiotik untuk meningkatkan keluaran yang lebih baik. Prolonged Mechanical Ventilation on Postcraniotomy Tumor Removal on Brainstem Glioma in the Intensive Care Unit Brain stem glioma makes 1020% of primary central nervous system tumor and is diagnosed primarily in children. In perioperative management, approach of tumor removal, steroid usage, mechanical ventilation planning, good nursing care, and physioterapy, should be considered. The aim of this case report is to discuss complications that may occur with prolonged mechanical ventilation after surgery. An 11-year old boy, diagnosed with brain tumor, was admitted to hospital due to inability to stand, double-vision, aphasia, swallowing disorder, with longterm corticosteroid treatment. He underwent a brain tumor removal surgery. Surgery was conducted within 10 hours. After the surgery, he had prolonged mechanical ventilation in ICU. On the fourth day, he suffered from ventilator associated pneumonia (VAP) and gastrointestinal bleeding on the sixth day care in ICU. Patient presented to hospital with late onset symptoms of his condition. Operation technique was difficult as the tumor is located within close proximity to the breathing and haemodynamic centers. There are necessity for detailed perioperative assessment and planning, hemodynamic and intracranial pressure monitoring, gastric protection strategy, mechanichal ventilation planning, quick assessment of tracheostomy installment need and usage of proper antibiotic for a better outcome.

Blokade Peribulbar dengan Adjuvan Fentanil: Efek Hemodinamik dan Analgetik pada Vitrektomi Yadi, Dedi Fitri; Nadya, Siti Fairuz; Halimi, Radian Ahmad; Tavianto, Doddy; Pradian, Erwin; Fuadi, Iwan
Jurnal Anestesi Perioperatif Vol 13, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n2.4413

Operasi vitrektomi membutuhkan analgesia adekuat dan stabilitas hemodinamik, terutama pada pasien usia lanjut dengan komorbiditas. Ropivakain adalah anestesi lokal yang umum digunakan untuk blokade peribulbar, namun kualitas bloknya dapat ditingkatkan dengan penambahan opioid seperti fentanil. Studi ini merupakan penelitian pertama yang membandingkan efektivitas ropivakain 0,75% dengan kombinasi ropivakain 0,75% dan fentanil 3 μg/mL pada tekanan darah dan kualitas analgesia pada operasi vitrektomi. Desain penelitian ini adalah single blind randomized controlled trial yang melibatkan 54 pasien yang menjalani vitrektomi. Penelitian dibagi menjadi dua kelompok yang masing-masing terdiri 27 pasien: kelompok R yang menerima ropivakain 0,75% dan kelompok RF yang menerima ropivakain 0,75% dan fentanil 3 μg/ml. Tekanan darah sistolik, diastolik, MAP, serta kualitas analgesia (NRS) diukur pada tiga waktu yaitu sebelum, selama dan setelah operasi. Analisis statistik menggunakan uji t tidak berpasangan, Mann Whitney dan Chi-Square. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan bermakna dalam perubahan tekanan darah sistolik, diastolik, dan MAP antara kedua kelompok (p>0,05). Kualitas analgesia yang dinilai menggunakan NRS juga tidak menunjukkan perbedaan signifikan (p>0,05). Kesimpulan penelitian ini adalah kombinasi ropivakain 0,75 % dan fentanil 3 mcg/ml memberikan hasil yang sebanding dengan ropivakain 0,75 % saja dalam hal stabilitas hemodinamik dan kualitas analgesia pada operasi vitrektomi.

Penanganan Perioperatif Pasien Pediatrik dengan Cedera Kepala Berat Halimi, Radian Ahmad; Umar, Nazaruddin; Saleh, Siti Chasnak; Rehatta, Nancy Margareta
Jurnal Neuroanestesi Indonesia Vol 5, No 2 (2016)
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Cedera otak traumatika (COT) merupakan penyebab kematian dan kecacatan terbesar di Amerika dan negara industri lainnya di dunia. Anak dari usia balita hingga remaja yang mengalami cedera otak berat biasanya akan dapat menghadapi kecacatan yang signifikan selama beberapa dekade. Seorang anak laki-laki berumur 3 tahun dengan diagnosa cedera kepala berat akibat perdarahan subdural di temporo occipital kiri dan fraktur terdepresi yang disebabkan karena jatuh dari ketinggian tiga meter, direncanakan dilakukan kraniektomi dekompresi karena terjadi penurunan kesadaran signifikan. Berbagai komplikasi dan permasalahan terjadi yakni perdarahan masif intraoperatif, edema otak kongestif disertai demam pascaoperasi di ruang perawatan intensif, hingga akhirnya pasien dapat pindah ke ruang perawatan biasa dan dilakukan rawat jalan. Penanganan COT berat memerlukan kemampuan seorang ahli anestesi dalam melakukan resusitasi otak dengan ABCDE neuroanestesi, kontrol terhadap hipertensi intrakranial, neuroproteksi dan neurorestorasi.Perioperative Treatment Pediatric Patients with Head InjuriesTraumatic brain injury (TBI) is the largest cause of death and disability in the United States and other industrialized countries in the world. Young age patient who suffered severe TBI typically face significant disability for decades. A 3 years old boy with diagnosis of severe TBI as a result of subdural hemorrhage in the left temporo occipital and fracture depressed due to fall from a height of three meters, was planed to perform decompresive craniectomy because decreased conciouseness significantly.Various complications and problems occur, intraoperative masive bleeding, postoperative diffuse brain edema with persistent hyperthermia on the intensive care unit, until the patient can be moved to a regular ward and can be done outpatient. The management of severe head injury requires the ability of an anesthesiologist in performing brain resuscitation with ABCDE neuroanesthesia, control of intracranial hypertension and neurorestoration.

Korelasi antara Rentang Waktu Cedera Otak Traumatik dengan Dimulainya Terapi Pembedahan Kraniotomi terhadap Kejadian dan Beratnya Post Traumatic Headache (PTH) Halimi, Radian Ahmad; Fuadi, Iwan; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 3, No 3 (2014)
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Latar Belakang dan Tujuan: Keluhan nyeri kepala setelah terjadinya Cedera Otak Traumatik (COT) dikenal sebagai Post Traumatic Headache (PTH) yang dapat terjadi setelah cedera kepala ringan, sedang, atau berat. Tujuan penelitian ini adalah mencari apakah ada korelasi antara rentang waktu kejadian COT hingga dilakukannya terapi pembedahan kraniotomi terhadap angka kejadian dan beratnya PTH. Subjek dan Metode: Penelitian observasional kohort prospektif pada 33 orang pasien COT derajat ringan atau sedang dengan pengambilan data secara consequetif sampling. Parameter yang dicatat dalam penelitian ini antara lain usia, jenis kelamin, berat badan, GCS, rentang waktu dari kejadian COT hingga dilakukannya terapi pembedahan kraniotomi, angka kejadian PTH, derajat berat nyeri dengan menggunakan sistem penilaian Numeric Rating Scale (NRS). Analisis korelasi linear dua variabel dihitung berdasarkan analisis korelasi Spearman. Hubungan korelasi bermakna bila koefisien korelasi (R) 0,4 dan nilai p0,05. Hasil: Hasil penelitian menunjukkan adanya korelasi yang kuat antara rentang waktu terhadap kejadian PTH (r = 0,75) dengan korelasi searah dan bermakna (p0,05). Terdapat korelasi yang kuat antara rentang waktu terhadap derajat beratnya PTH (r = 0,82) dengan korelasi searah dan bermakna (p0,05). Simpulan: semakin lama rentang waktu dari kejadian COT hingga dilakukannya terapi pembedahan kraniotomi maka akan semakin banyak angka kejadian dan semakin berat PTH.The Correlation between The Interval of Traumatic Brain Injury with Craniotomy Surgery Start on The Incidence and Severity of Post Traumatic Headache (PTH)Background and Objective: Complaints of headache in the aftermath of Traumatic Brain Injury (TBI) is known as Post Traumatic Headache (PTH), which can occur after mild, moderate, or severe head injury. The purpose of this study is to find a correlation between the time span from the TBI events until the craniotomy surgical therapy was performed with the incidence and severity of PTH.Subject and Method: Prospective observational cohort study in 33 patients with mild or moderate TBI with data retrieval consequetif sampling. The parameters recorded in this study including age, gender, weight, GCS, time interval between the events of TBI until the craniotomy surgical therapy was performed, the incidence of PTH, severity of pain using NRS score. Analysis of linear correlation of two variables calculated by Spearman correlation analysis. Significant correlation when the correlation coefficient (R) 0.4 and p 0.05.Result: The results showed a strong correlation between the interval of the incidence with the incidence of PTH (r = 0.75) with unidirectional and significant correlation (p 0.05). There is a strong correlation between the time span from TBI events until the craniotomy surgical therapy with the severity of PTH (r = 0.82) with unidirectional and significant correlation ( p 0.05).Conclusions: the longer of interval between the TBI events to craniotomy surgical treatment, the more of the incidence and severity of PTH.

Manajemen Pasien Stroke Perdarahan Spontan dengan Komorbid Penyakit Paru Obstruktif Kronik yang Terjadi Bronkhospasme Intraoperasi Halimi, Radian Ahmad; Bisri, Dewi Yulianti
Jurnal Neuroanestesi Indonesia Vol 8, No 2 (2019)
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Stroke perdarahan spontan dan penyakit paru obstruktif kronik (chronic obstructive pulmonary disease/COPD) merupakan dua penyakit yang memiliki angka morbiditas dan mortalitas yang paling tinggi di dunia. Kondisi COPD akan meningkatkan resiko terjadinya stroke, selain itu dapat mengakibatkan terjadinya hipoksemia dan hiperkapnia. Seorang pria berusia 62 tahun datang ke unit gawat darurat karena mengalami penurunan kesadaran dan tidak dapat menggerakkan anggota tubuh sebelah kiri sejak 1 hari, pasien memiliki riwayat hipertensi namun tidak rutin meminum obat, pasien memiliki riwayat sering sesak, dan berdasarkan pemeriksaan fisik didapatkan kondisi barrel chest. Berdasarkan pemeriksaan CT-scan kepala didapatkan perdarahan intrakranial spontan pada basal ganglia sinistra. Pasien dilakukan tindakan kraniotomi evakuasi, namun 2 jam setelah dilakukan induksi anestesi terjadi kondisi desaturasi, hiperkapnia, peningkatan tekanan jalan nafas, dan ditemukan wheezing pada kedua lapang paru, kemudian diberikan terapi farmakologis dan non farmakologis untuk mengatasi kondisi bronkospasme. Pascabedah dilakukan pemanjangan ventilasi mekanik hingga pasien memenuhi kriteria untuk dilakukan ekstubasi. Penanganan pasien stroke dengan komorbid COPD membutuhkan pemahaman yang lebih mendalam mengenai interaksi otak dengan fungsi pernafasan akibat perubahan fisiologi dan patofisiologi pasien COPD.Management of Spontaneous Intracranial haemorhage with Comorbids Chronic Obstructive Pulmonary Disease Occurring Intraoperative BronchospasmAbstractStroke and chronic obstructive pulmonary disease (COPD) are the two diseases that have the highest morbidity and mortality rates in the world. COPD conditions will increase the risk of stroke, but it can lead to hypoxemia and hypercapnia. A 62-year-old man came to the emergency room because of a decreased consciousness and was unable to move the left limb since 1 day, the patient had a history of hypertension but did not regularly take medication, the patient had a history of frequent tightness, and based on physical examination was obtained barrel chest condition. Based on a head CT scan, spontaneous intracranial hemorrhage occurs in the left basal ganglia. Evacuation craniotomy was performed, but 2 hours after anesthesia induction occurred conditions of desaturation, hypercapnia, increased airway pressure, and wheezing was found in both lung fields, then given pharmacological and non-pharmacological therapy to overcome the condition of bronchospasm. After surgery, lengthening of mechanical ventilation is done until the patient meets the criteria for extubation. The treatment of stroke patients with co-morbid COPD requires a deeper understanding of brain interactions with respiratory function due to changes in physiology and pathophysiology of COPD patients.

Korelasi antara Tipe Hematoma Intrakranial dengan Kejadian dan Beratnya Post Traumatic Headache (PTH) Halimi, Radian Ahmad; Fuadi, Iwan; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 4, No 1 (2015)
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Latar Belakang dan Tujuan: Keluhan sakit kepala setelah cedera otak traumatik (COT) disebut sebagai Post Traumatic Headache (PTH), yang dapat terjadi setelah cedera otak ringan, sedang atau berat. Tujuan penelitian ini untuk menemukan korelasi antara tipe hematoma intrakranial dengan kejadian dan beratnya PTH.Subjek dan Metode: Penelitian observasional cohort prospektif pada 31 pasien, umur1359 tahun, laki-laki dan perempuan, yang mengalami COT ringan atau sedang. Pengambilan sampel secara consequetive sampling. Parameter yang dicatat adalah umur, jenis kelamin, berta badan, Glasgow Coma Scale (GCS), tipe hematoma intrakranial, kejadian PTH dan beratnya PTH dengan menggunakan skor numeric rating scale (NRS). Analisis korelasi linier dengan dua variable dengan analisis korelasi Spearman. Korelasi dianggap signifikan bila koefisien korelasi (R) 0,4 dan p0,05.Hasil: Seratus persen pasien subdural hematoma (SDH) dan Intracerebral Hematoma (ICH) mengalami post traumatic headache dan hanya 70,6% pada pasien EDH. Pasien dengan depressed fractur tanpa perdarahan intrakranial mengalami PTH sebanyak 33,3%.Simpulan: Perdarahan yang terjadi dibawah duramater menunjukkan kejadian PTH yang paling tinggi.The Correlation between Type of Intracranial Hematoma with The Incidence and Severity of Post Traumatic Headache (PTH)Background and Objective: Headache occurs after Traumatic Brain Injury (TBI) is known as Post Traumatic Headache (PTH), which could manifest after a mild, moderate, or severe head injury. The aim of this study is to evaluate the correlation between type of intracranial hematoma with the incidence and severity of PTH.Subject and Method: This prospective observational cohort study was performed in 31 patients aged from 1359 years old with mild or moderate TBI usig a consequetive sampling retrieval. Parameters recorded in this study were age, gender, weight, GCS, type of hematoma intracranial, the incidence of PTH, and severity of pain of PTH using the numeric rating score (NRS) score. Linear correlation analysis of two variables was calculated using Spearman correlation analysis. The correlation is significant if the correlation coefficient (R) 0.4 and p 0.05.Result: One hundred percent of subdural hematoma (SDH) and intracerebral hematoma (ICH) patients were experienced PTH and only 70,6% in epidural hematoma (EDH) patients. PTH also found in 33.3% of patient with depressed fracture without intracranial bleeding.Conclusion: Hematoma under duramater causes the highest incidence of PTH

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