Defisit Serebelum Murni akibat Stenosis Arteri Serebri Posterior - Widyantara, I Wayan; Kondra, I Wayan (PT. Kalbe Farma Tbk., 2015)
Latar Belakang: Stroke merupakan penyebab kematian utama nomor 2 di dunia dan berkontribusi besar dalam penyakit global. Stroke arteri serebri posterior/posterior cerebral artery (PCA) terjadi pada sekitar 26,5% stroke iskemik dan disabilitas yang disebabkannya berupa defek lapang pandang, hemiparesis, gangguan sensibilitas, gangguan kognisi dan perilaku. Sedikit laporan yang menyatakan infark PCA menyebabkan ataksia atau gangguan koordinasi. Laporan kasus: Seorang laki-laki 43 tahun, datang dengan kondisi sadar mengeluh pusing berputar mendadak saat aktivitas sejak 3 hari sebelum masuk rumah sakit. Keluhan pusing menetap, tidak memberat pada perubahan posisi dan tidak membaik saat istirahat; disertai sulit mengendalikan gerakan diikuti kurang tangkasnya tungkai kiri sehingga pasien tidak mampu berdiri dan berjalan. Didapatkan vertigo tipe sentral, kekuatan keempat ekstremitas dalam batas normal, gangguan koordinasi lebih berat pada sisi kiri tubuh, asinergia serebelar, proprioseptif normal. Pemeriksaan MRA Magnetic Resonance Angiography) mendapatkan gambaran stenosis PCA dekstra. Simpulan: Gambaran klinis gangguan serebelum murni kedua sisi dapat akibat stenosis arteri serebri posterior kanan yang memberikan percabangan pada kedua sisi arteri thalamoperforate.Background: Stroke is the second leading cause of death in the world and contributed the majority of global illness. The incidence of posterior circulation stroke is about 26.5% causing disabilities such as visual fi eld defect, hemiparesis, sensibility disorder, cognition and behavior disorders. There was a report that infarc of PCA cause ataxia or coordination disorder. Case Report: A 43-year old male, alert, presented with chief complain of sudden spinning sensation during activity 3 days prior to admission. The symptom was continues and settle, not get worsen by changing position and not improving by resting. It was accompanied with diffi culty to control movement followed by left leg weakening resulting in inability to stand up and walk. Neurological examination found central type of vertigo, normal strength with coordination defect on both sides but more severe on the left, cerebral asynergy, normal proprioception. MRA (Magnetic Resonance Angiography) showed stenosis of the right posterior cerebral artery (PCA). Conclusion: Pure cerebellum defi cit on both sides can be caused by stenosis of the right posterior cerebral artery which supplied both thalamoperforate arteries.