Trihardi, Rizfan
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Incidence and Risk Factors of Stroke-Associated Pneumonia in Ischemic Stroke with Dysphagia: A Cross-Sectional Study Sukiandra, Riki; Maryanti, Yossi; Sucipto; Juananda, Desby; Trihardi, Rizfan; Risman, Salsa Wiratama; Qadriyyah, Lu’lu’ul; Ashiddiqi, Hafil
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p51-57.2025

Abstract

Background: Stroke-associated pneumonia (SAP) is a common and debilitating complication following stroke, typically occurring within the first 7 days of onset in about one-third of patients with acute ischemic stroke. SAP significantly contributes to increased morbidity, mortality, and healthcare costs due to prolonged hospitalizations. In Riau, the reported prevalence of stroke is 8.3%, which has been rising since 2013, alongside an increase in SAP cases. Dysphagia, defined as difficulty swallowing, is a major risk factor for SAP as it predisposes patients to aspiration, a leading cause of pneumonia. If left untreated, dysphagia can lead to dehydration and electrolyte imbalance. Despite the clinical importance of SAP, local data regarding its incidence and associated risk factors at Arifin Achmad General Hospital in Riau Province is lacking. This study aims to investigate the incidence and risk factors associated with SAP in ischemic stroke patients with dysphagia. The findings are expected to provide evidence-based references to improve neurointensive care and preventive strategies for SAP in this patient population. Methods: This cross-sectional study was conducted at Arifin Achmad General Hospital, Riau Province, from August to November 2023. Ischemic stroke patients who underwent the Water Swallow Test (WST) were included. Dysphagia, electrolyte imbalance, and SAP were the key variables. Data were collected from medical records and observation sheets. Statistical analysis was performed using the Chi-square test (p < 0.05) with SPSS version 25. Results: The study found that 37.5% (15 patients) of ischemic stroke patients developed stroke-associated pneumonia, while 42.5% experienced dysphagia. The majority of these patients were aged 51-60 years (41.2%), male (58.8%), had their first stroke attack (60%), and had multiple risk factors (73.3%). A significant number of dysphagia patients had low electrolyte levels. The most common lesion locations in dysphagia patients were bilateral (66.7%). There was a significant correlation between dysphagia and the incidence of SAP (p=0.000). Patients with dysphagia had 78.75 times higher odds of developing SAP (95% CI: 9.95-622.6) compared to those without dysphagia. Conclusion: SAP is a frequent complication in ischemic stroke patients. Future prospective studies should adopt a unified definition, strict inclusion criteria, and long-term follow-up to better identify the incidence, prognosis, and related factors of SAP.
BRAIN ARTERIOVENOUS MALFORMATION WITH ORBITAL INVOLVEMENT PRESENTING AS PROPTOSIS: A CASE REPORT Trihardi, Rizfan
Journal of Pain, Headache and Vertigo Vol. 7 No. 1 (2026): March
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Brain arteriovenous malformation (AVM) is a rare vascular anomaly of the central nervous system that may present with headache, seizures, or focal neurological deficits. Orbital involvement leading to proptosis is extremely uncommon and may delay the diagnosis if not properly recognized. Case Report: A 35-year-old female presenting with chronic headache, focal seizures, left-sided hemiparesis, hemihypoesthesia, and progressive right eye proptosis. Neurological examination confirmed motor weakness and sensory impairment on the left side. Brain MRI and CT angiography revealed a large cerebral AVM with orbital venous drainage causing orbital congestion and proptosis. Discussion: AVM with orbital involvement is exceedingly rare, with only few cases described in the literature. Proptosis usually results from venous hypertension [A2.1][A2.2]secondary to abnormal arteriovenous shunting and orbital venous drainage. This unusual presentation poses diagnostic challenges, often mimicking orbital or ophthalmologic disorders. Recognition of the clinical spectrum is crucial to avoid misdiagnosis and ensure timely management. Conclusion: This case highlights the importance of considering cerebral AVM in the differential diagnosis of patients presenting with proptosis accompanied by neurological manifestations. Early identification and appropriate referral are essential to improve patient outcomes.