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Jurnal Neuroanestesi Indonesia

jni
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Published by Indonesian Society of Neuroanesthesia & Critical Care

ISSN : 20889674 EISSN : 24602302 DOI : https://doi.org/10.24244/jni

Core Subject : Health, Science, Education,

Biochemistry, Genetics & Molecular Biology Education Medicine & Pharmacology Neuroscience Public Health

Editor of the magazine Journal of Neuroanestesi Indonesia receives neuroscientific articles in the form of research reports, case reports, literature review, either clinically or to the biomolecular level, as well as letters to the editor. Manuscript under consideration that may be uploaded is a full text of article which has not been published in other national magazines. The manuscript which has been published in proceedings of scientific meetings is acceptable with written permission from the organizers. Our motto as written in orphanet: www.orpha.net is that medicine in progress, perhaps new knowledge, every patient is unique, perhaps the diagnostic is wrong, so that by reading JNI we will be faced with appropriate knowledge of the above motto. This journal is published every 4 months with 8-10 articles (February, June, October) by Indonesian Society of Neuroanesthesia & Critical Care (INA-SNACC). INA-SNACC is associtation of Neuroanesthesia Consultant Anesthesiology and Critical Care (SpAnKNA) and trainees who are following the NACC education. After becoming a Specialist Anesthesiology (SpAn), a SpAn will take another (two) years for NACC education and training in addition to learning from teachers in Indonesia KNA trainee receive education of teachers/ experts in the field of NACC from Singapore.

Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine

Articles 8 Documents

Search results for , issue "Vol 7, No 1 (2018)" : 8 Documents clear

Pengelolaan Perioperatif Cedera Medula Spinalis Servikal karena Trauma dengan Tetraparesis Frankle C Asia Basuki, Wahyu Sunaryo; Bisri, Dewi Yulianti; Saleh, Siti Chasnak; Wargahadibrata, A. Hmendra
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Cedera medula spinalis akut relatif jarang namun menjadi salah satu kejadian trauma yang berakibat fatal. Kejadian ini sering terjadi pada laki-laki dewasa muda. Kecelakaan lalu lintas merupakan penyebab utama dari kejadian ini, disusul oleh kejadian trauma di rumah, industri dan olahraga. Tujuan utama dari pengelolaan cedera medula spinalis akut adalah mencegah medula spinalis dari cedera sekunder dan memperbaiki fungsi neurologis, mencegah perubahan alignment dan menjaga stabilitas columna vertebralis untuk mendapatkan hasil pemulihan neurologis dan rehabilitasi yang maksimal. Ahli anestesi berperan besar mulai awal pengelolaan secara optimal cedera medula spinalis akut ini. Seorang laki-laki, 57 tahun, dibawa kerumah sakit karena kecelakaan sepeda motor. Pada pemeriksaan fisis, didapatkan laju nafas 24x/menit, nadi 70x/menit, tekanan darah 110/61 mmHg, perfusi baik, GCS 15, dan tetraparesis. Dalam perawatan selanjutnya, terjadi bradikardia (nadi 50-61 x/menit) dan hipotensi (tekanan darah 80-90/40-60 mmHg). Dilakukan laminoplasti dekompresi stabilisasi segera.Perioperative Management Traumatic Cervical Spinal Cord Injury with Tetraparesis Frankle C AsiaAcute spinalis cord injury (SCI) is relatively rare but can be a fatal trauma event. Young adult men are most commonly affected. Traffic accident is a frequent cause, followed by accidents at homes, industries, and in sports. The primary goals of the management of acute SCI are to prevent secondary injury of the spinal cord, improve neurological functions, prevent disruption in alignment, and maintain the stability of the vertebral columns. These serve to achieve neurological recovery and maximal rehabilitation. Anesthesiologists play an important role in the optimal management of acute SCI. A 57-year-old man was brought to the hospital due to a motorcycle accident. Physical examination revealed respiratory rate 24 x/minutes, heart rate 70 x/minutes, blood pressure 110/61 mmHg, good perfusion, GCS 15, and tetraparesis. During hospitalization, the patient developed bradycardia (heart rate 50-61 x/minutes) and hypotension (blood pressure 80-90/40-60 mmHg). Immediate decompressive laminoplasty stabilisation was performed.

Talaksana Perioperatif Pasien dengan Reseksi Arteriovenous Malformation Intrakranial Permatasari, Endah; Oetoro, Bambang J.; Gaus, Syafruddin
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Tindakan pembedahan eksisi arteriovenous malformation (AVM) merupakan salah satu prosedur yang menantang di bidang neuroanestesia. Diagnosis AVM ditegakkan berdasarkan gejala klinis didukung pemeriksaan neuroradiologis. Untuk persiapan perioperatif pasien AVM yang optimal, ahli anestesi harus memahami patofisiologi AVM dan tatalaksananya. Terapi pada pasien AVM sangat tergantung pada ukuran diameter AVM dan lokasinya. Target utama dari operasi adalah memotong pasokan aliran darah ke AVM. Dengan tindakan reseksi AVM, bila AVM sudah dapat diidentifikasi maka pasokan aliran darah akan dihentikan dan dilakukan pengangkatan nidus. Pada kasus ini dilaporkan seorang wanita usia 19 tahun dengan nilai GCS 15, BB 59 kg, datang dengan keluhan sering sakit kepala semenjak 1 tahun sebelum masuk RS. Hasil angiografi otak menunjukan adanya gambaran AVM di lobus parietal kanan. Dilakukan tindakan reseksi AVM dan pembedahan berhasil dengan baik. Tidak timbul defisit neurologis pascabedah. Pascabedah pasien dirawat di ICU dan pindah keperawatan keesokan harinya.Perioperative Management Patient with Intracranial Arteriovenous Malformation ResectionArteriovenous malformation (AVM) resection is one of the most challenging procedures in neuroanesthesia. Right now, cerebrovascular surgery is frequently done. The diagnosis of intracranial AVM is based on clinical symptoms and is supported by neuroradiological examination. For optimal perioperative management of patients with intracranial AVM abnormalities, anaesthetist should understand the pathophysiology of the AVM disorder and its management. Therapy in AVM patients is highly dependent on the size of the AVM diameter and its location. The main target of surgery is to cut the blood supply to the AVM. In AVM resection, as soon as AVM can be identified, the blood supply will be stop anf the nidus will be remove. In this case report: a 19 year old woman, score GCS 15, 59 kg in weight cames with frequent headache since the previous years before entered the hospital. Brain angiographic results showed intracranial AVM features in the right parietal lobe. The patient underwent the AVM resection action and the operation was done successfully. No neurological deficit was found. Postoperative patients were admitted to the ICU and moved to the ward the next day.

Pengelolaan Kadar Gula Darah Perioperatif pada Pasien Diabetes Mellitus dengan Tumor Cerebellopontine Angle Santosa, Dhania Anindita; Gaus, Syafruddin; Oetoro, Bambang J.; Saleh, Siti Chasnak
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Prevalensi penyakit diabetes mellitus (DM) meningkat sangat cepat pada abad ke-21, terutama karena obesitas, penuaan dan kurangnya aktivitas fisik. International Diabetes Federation (IDF) menyatakan diperkirakan penderita DM menjadi 380 juta pada tahun 2025. Pasien dengan DM yang menjalani pembedahan mungkin sudah disertai dengan penyakit lain akibat DM. Episode hipoglikemia, hiperglikemia dan variabilitas kadar gula darah yang tinggi perioperatif memberikan risiko tingginya komplikasi perioperatif pada pasien. Seorang ahli anestesi memegang peranan penting dalam pengelolaan perioperatif pasien-pasien seperti ini, terutama pasien bedah saraf di mana otak sangat bergantung pada glukosa sebagai bahan bakar. Seorang wanita usia 46 tahun dengan DM dan tumor cerebellopontine angle (CPA) menjalani pembedahan elektif eksisi tumor. Pembedahan dilakukan dengan anestesi umum intubasi endotrakeal dan berjalan kurang lebih sembilan jam. Tantangan selama periode perioperatif adalah menjaga kadar gula darah tetap dalam rentang target yang diinginkan untuk meminimalisir cedera sekunder pada otak yang dapat mempengaruhi luaran kognitif serta komplikasi perioperatif yang mungkin terjadi. Pascabedah pasien dirawat di ICU dengan bantuan ventilator dan dilakukan ekstubasi tiga jam pascabedah dengan kadar gula darah stabil dan tanpa sequelaePerioperative Glucose Control in Diabetic Patients with Cerebellopontine Angle TumorPrevalence of patients with diabetes mellitus (DM) increases rapidly in the 21st century, mainly due to obesity, aging and lack of physical activity. International Diabetes Federation (IDF) predicted that by the year of 2025, 380 million people will suffer from DM. Diabetic patients undergoing surgery might have other diseases caused by DM. Episodes of hypoglycemia, hyperglycemia and high perioperative glucose level put the patients into higher perioperative risks. Anesthesiologists play a key role in perioperative management in these patients, moreover in neurosurgery pastients, as brain is very glucose-dependent. A 46 year old diabetic woman with cerebellopontine angle (CPA) tumor underwent elective surgery of tumor removal. Surgery was done under general endotracheal anesthesia and lasted for nine hours. Challenges during perioperative period are to maintain glucose level within target range to minimize secondary injury to the brain which may influence cognitive outcome and other possible perioperative complications. Patient was taken care at the ICU post operatively with ventilator. Patient was weaned and extubated three hours later with stable glucose control and no sequelae.

Tatalaksana Cerebral Venous Sinus Thrombosis dengan Alkoholik dan Perdarahan Intraserebral Fitri Sepviyanti Sumardi; Rose Mafiana; Eri Surachman
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Cerebral venous sinus thrombosis (CVST) adalah suatu sindrom seperti stroke, angka kejadiannya sangat jarang, sehingga dapat menjadi dilema bagi dokter di instalasi gawat darurat dalam menegakkan diagnosis. Seorang lelaki 25 tahun, 50 kg, tinggi badan 165 cm, mengeluh lemah anggota badan sebelah kanan sejak 12 jam sebelum masuk rumah sakit. Keluhan disertai dengan sukar berbicara. Satu hari sebelum masuk rumah sakit, pasien mabuk-mabukan dan mengalami muntah-muntah ± 3–5 x/hari. Riwayat kejang, konsumsi obat-obatan dan trauma sebelumnya disangkal. Tidak ada riwayat demam, hipertensi, diabetes mellitus dan penyakit penyerta lainnya. Dilakukan dekompresi evakuasi perdarahan sebagai tindakan penyelamatan jiwa setelah pasien terehidrasi, operasi dilakukan dalam anestesi umum. Lama operasi selama 2 jam dan lama pasien teranestesi 2 jam 15 menit. Pasien dirawat di ICU selama 2 hari, lalu dipindahkan ke ruang HCU. Pada hari ke-5 pascabedah mulai diberikan enoxaparin sodium 50 mg subcutan selama 6 hari. Lalu pasien dipindahkan ke ruang rawat inap dan pulang ke rumah pada hari ke-15 perawatan. Target pencapaian utama pada pasien CVST adalah untuk rekanalisasi penyumbatan, menjaga venous return, mengurangi risiko hipertensi vena, infark serebral dan emboli paru. Algoritma tatalaksana pasien CVST terkadang harus disesuaikan dengan kondisi klinis pasien saat tiba di rumah sakit. Pemberian low-weightmoleculer heparin (LWMH) tetap diberikan selama tidak terjadi peningkatan tekanan darah yang bermaknaCerebral Venous Sinus Thrombosis Management with Alkoholic and Intracerebral HemorrhageCerebral venous sinus thrombosis (CVST) is a syndrome similar a stroke, the incidence is very rare, so it can be a dilemma for doctors at emergency departments to make the diagnosis. A 25 year old male weighing 50 kg and height 165 cm. Patients complained of right limb wekness since 12 hours before admission. Complaints are accompanied by difficulty speaking. One day before entering the hospital, the patient got drunk and experienced vomiting ± 3–5 times a day. History of seizures, previous consumption of drugs and trauma was denied. No history of fever, hypertension, diabetes mellitus and other comorbidities. Decompression by hematoma evacuation was performed as a life-saving action after the patient was hydrated, surgery was performed under general anesthesia. Operation duration was 2 hours and anesthesia duration was 2 hours 15 minutes. The patient was admitted to the ICU for 2 days, then transferred to the HCU room. On the 5th day post-surgery patient got 50 mg subcutaneous enoxaparin for 6 days. Then the patient was transferred to the ward and returned home on the 15th day of treatment. The main achievement targets in CVST patients were for clotting recanalization, maintaining venous return, reducing the risk of venous hypertension, cerebral infarction and pulmonary embolism. The CVST patient management algorithm sometimes has to be adjusted to the patient's clinical condition upon arrival at the hospital. Provision of LWMH is still given as long as the blood pressure does not increase significantly.

Tata Kelola Edem Paru Neurogenik Riyadh Firdaus; Syafruddin Gaus; Bambang J. Oetoro; Tatang Bisri
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Edem paru neurogenik merupakan salah satu komplikasi pernafasan yang dapat muncul setelah cedera/trauma susunan saraf pusat. Bervariasinya laporan epidemiologi dan patofisiologi edem paru neurogenik dapat menyebabkan misdiagnosis yang dapat memperburuk prognosis pada pasien yang mengalami edem paru neurogenik. Patofisiologi edem paru neurogenik diduga dimulai dari kerusakan pada persarafan autonom pembuluh darah pulmonal dan stimulasi berlebihan dari pusat vasomotor susunan saraf pusat, yang kemudian menyebabkan berbagai perubahan yang terjadi pada pembuluh darah pulmonal hingga disfungsi jantung. Investigasi klinis harus dilakukan hati-hati karena manifestasi klinis yang dapat menyerupai edem paru kardiogenik dan non-kardiogenik lainnya, hasil pemeriksaan yang tidak spesifik, dan tidak adanya kriteria diagnosis. Saat ini belum ada pedoman tata kelola edem paru neurogenik yang dapat diterima secara luas, namun berbagai studi dan literatur menyebutkan tata kelola edem paru neurogenik berupa tata kelola suportif airway, breathing, circulation, di samping tata kelola penyebab cedera/trauma susunan saraf pusat memiliki prognosis yang baik, oleh karena itu identifikasi, investigasi, dan tata kelola edem paru neurogenik harus dilakukan secepatnya. Edem paru neurogenik dapat beresolusi dengan baik dalam 48–72 jam setelah mendapatkan tata kelola yang adekuat.Management of Neurogenic Pulmonary EdemaNeurogenic pulmonary edema is one of respiration complication caused by injury of central nervous system. Due to the vary of neurogenic pulmonary edema epidemiology and pathophysiology leads to misdiagnosed of neurogenic pulmonary edema, which could worsen the clinical condition patients. The pathophysiology of neurogenic pulmonary edema is believed caused by lesion on the autonomic central of vascular pulmonary bed and overactivation of central vasomotor system, which leads to alteration of vascular pulmonary conditions and cardiac dysfunction. Clinical investigation should be done carefully, because the clinical manifestations of neurogenic pulmonary edema mimicking the cardiogenic and non-cardiogenic pulmonary edema, non-spesific diagnostic modalities, and none diagnostic criteria in neurogenic pulmonary edema. Although nowadays none of management guidelines of neurogenic pulmonary edema accepted widely, many study reported the good outcome of supportive management of airway, breathing, and circulation besides the primary management of central nervous system injury. Hence, clinical identifications, investigations, and management of neurogenic pulmonary edema should be done immediately, because of good clinical outcome in 48 – 72 hours with adequate management.

Hubungan antara Volume Residu Gaster dan Skor Glasgow Coma Scale (GCS) pada Pasien Cedera Otak Traumatik Sedang dan Berat Giovanni, Cindy; Bisri, Dewi Yulianti; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Cedera Otak Traumatik (COT) berhubungan dengan disfungsi gastrointestinal berupa perlambatan pengosongan lambung. Belum jelas adakah hubungan antara skor Glasgow Coma Scale (GCS) dan derajat gangguan pengosongan lambung yang terjadi. Penelitian ini bertujuan untuk membandingkan volume residu gaster pada pasien COT sedang dan berat serta mengkaji hubungan antara skor GCS dan volume residu gaster pada pasien COT.Subjek dan Metode: Penelitian observasional analitik cross-sectional ini dilakukan pada 42 pasien COT sedang dan berat yang dirawat di RSUP Dr. Hasan Sadikin dari bulan Desember 2016 hingga Juni 2017. Pengukuran volume residu gaster, skor GCS, dan tanda vital dilakukan tiap 6 jam selama 48 jam. Data hasil penelitian diuji dengan uji t tidak berpasangan, Chi Square, dan uji korelasi Pearson. Hasil: Hasil penelitian menyatakan bahwa rerata volume residu gaster pada kelompok COT sedang dan berat adalah 10,83 8,15 ml dan 50,59 18,23 ml (p 0,000). Korelasi antara skor GCS dan volume residu gaster menunjukkan adanya korelasi negatif yang bermakna dan sangat kuat (r=-0,745 hingga -,974;p=0,000).Simpulan: Volume residu gaster pada COT berat lebih banyak dari COT sedang dan terdapat hubungan antara skor GCS dan volume residu gaster pada pasien COT.Correlation between Gastric Residual Volume and Glasgow Coma Scale (GCS) Score in Patient with Moderate and Severe Traumatic Brain InjuryBackground and Objective: Traumatic Brain Injury (TBI) is associated with gastrointestinal dysfunction in the form of delayed gastric emptying. It is not clear whether there is a relationship between Glasgow Coma Scale (GCS) score and the degree of gastric emptying that occurs. This study aimed to compare gastric residual volume in moderate and severe TBI patients and to examine the relationship between GCS score and gastric residual volume in TBI patients.Subject and Methods: This cross-sectional analytical observational study was conducted on 42 moderate and severe TBI patients who were admitted to Dr. Hasan Sadikin from December 2016 to June 2017. Measurement of gastric residual volume, GCS score, and vital signs were performed every 6 hours for 48 hours. The result data were tested with unpaired t-test, Chi Square, and Pearson correlation test. Results: The results showed that the mean gastric residual volume in moderate and severe TBI groups was 10.83 8.15 ml and 50.59 18.23 ml (p 0.000). The correlation between GCS and gastric residual volume showed a very strong negative correlation (r=-0,745 to -,974;p=0,000).Conclusion: Gastric residual volume in patient with severe TBI is more than gastric residual volume in moderate TBI and there was a relationship between GCS score and gastric residual volume in TBI patients.

Perbandingan Mannitol 20%, NaCl 3% dan Natrium Laktat Hipertonik terhadap Osmolaritas dan Brain Relaxation Score Pasien Tumor Otak yang menjalani Kraniotomi Pengangkatan Tumor Wirawijaya, Dear Mohtar; Sitanggang, Ruli Herman; Bisri, Tatang
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Latar Belakang dan Tujuan: Mannitol membuat relaksasi otak, namun memiliki efek samping berkurangnya volume intravaskuler, peningkatan kembali tekanan intrakranial (rebound) dan gagal ginjal. Penggunaan NaCl 3% dan natrium laktat hipertonik dapat memberikan relaksasi otak yang baik. Tujuan penelitian ini untuk mengetahui peningkatan osmolaritas dan brain relaxation score (BRS) pada pasien yang menjalani kraniotomi pengangkatan tumor dengan menggunakan mannitol 20%, NaCl 3%, dan matrium laktat hipertonik.Subjek dan Metode: Penelitian merupakan uji klinik terkontrol secara acak terhadap 39 pasien tumor otak yang masing-masing mendapatkan 2,5cc/kgBB mannitol 20%, NaCl 3%, dan natrium laktat hipertonik. Hasil: Tidak ada perbedaan peningkatan osmolaritas yang signifikan antara ketiga kelompok 1 jam setelah pemberian osmoterapi dan saat durameter dibuka (p0,05). BRS pada ketiga kelompok memiliki nilai median yang sama besar (2,00), artinya tidak ada perbedaan BRS yang bermakna (p0,05). Terdapat peningkatan diuresis yang signifikan pada pemberian mannitol 20%, peningkatan klorida pada NaCl 3% dan peningkatan glukosa signifikan pada natrium laktat hipertonik. Simpulan: Mannitol 20%, NaCl 3%, dan natrium laktat hipertonik memberikan relaksasi otak yang sama dan tidak mengakibatkan perbedaan osmolaritas yang signifikan.Comparison Between 20% Mannitol, 3% NaCl and Hypertonic Sodium Lactate on Osmolarity and Brain Relaxation Score Brain Tumor Patient underwent Craniotomy Tumor RemovalBackground and Objective: Mannitol produce brain relaxation but associated with several side effects such as reduced intravascular volume, rebound in intracranial pressure and kidney failure. The use of 3% NaCl and hypertonic sodium lactate (HSL) may provide brain relaxation. Aim of this study is to examine increased osmolarity and brain relaxation score (BRS) in patient underwent craniotomy using 20% mannitol, 3% NaCl, and hypertonic sodium lactate.Subject and Method: This is a randomized control study of 39 brain tumor patients divided into three groups each obtained 2.5cc/kg 20% mannitol, 3% NaCl, and HSL. Result: there is no significant difference of osmolarity between the three groups 1 hour after administration of osmotherapy and during the opening of durameter (p0,05). BRS between the three groups have an equivalent median score (2,00), it means no significant difference in BRS (p0,05). A significantly increased diuresis in the administration of 20% mannitol, increased chloride to 3% NaCl and significant glucose increase in HSL. Conclusion: Administration of 20% mannitol, 3% NaCl and HSL produce the same brain relaxation and resulted in insignificant osmolarity differences.

Manajemen Anestesi Stroke Perioperatif Permatasari, Endah; Bisri, Dewi Yulianti; Saleh, Siti Chasnak; Wargahadibrata, A. Hmendra
Jurnal Neuroanestesi Indonesia Vol 7, No 1 (2018)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Stroke perioperatif merupakan suatu kejadian katastropik yang meningkatkan mortalitas dan morbiditas, terutama pada usia di atas 65 tahun. Stroke perioperatif merupakan suatu momok (kejadian yang tidak diharapkan) bagi keluarga dan rekan sejawat yang merawat. Stroke perioperatif dapat bersifat iskemik atau hemoragik yang terjadi selama masa intraoperatif hingga 30 hari pascaoperasi. Faktor risiko terjadinya stroke perioperatif diantaranya adalah: usia lanjut, riwayat stroke dan Transient Ischemic Attack (TIA) sebelumnya, atrial fibrilasi, kelainan pembuluh darah dan metabolik. Umumnya stroke perioperatif tidak terjadi selama masa pembedahan atau saat pulih sadar, tetapi terjadi dalam 24 jam pertama pascabedah. Penanganan stroke perioperatif membutuhkan manajemen yang menyeluruh dan suatu kerjasama tim yang baik. Walaupun kejadiannya tidak banyak namun membutuhkan penanganan tepat karena tingkat morbiditas dan mortalitas yang tinggi serta mengakibatkan lama perawatan memanjang. Identifikasi awal pasien dan manajemen terpadu lintas keilmuan harus dilakukan untuk mencegah luaran yang buruk setelah terjadinya stroke perioperatif.Anesthetic Management of Perioperative StrokePerioperative stroke can be a catastrophic outcome for surgical patients and is associated with increased morbidity and mortality, especially in the age above 65. A perioperative stroke is an unexpected event for families and caring colleagues. A perioperative stroke may be an ischemic or haemorrhagic disorder that occurs intraoperatively or up to 30 days postoperatively. Risk factors for perioperative stroke include elderly, history of previous stroke and transient ischemic attack (TIA), atrial fibrillation, vascular and metabolic disorder. Most perioperative stroke generally does not occur during the intraoperative period or soon after recovering period but within the first 24 hours. Handling perioperative stroke requires a thorough management and a good teamwork. Perioperative stroke can be devastating, as they not only result in death but also prolong the length of hospital stay, increasing cost and greater likelihood of discharge to long term care facilities. Although the incidence is not much but this requires appropriate treatment because of high morbidity and mortality and also result in prolong length of hospital stay. Early identification and expeditious management involving a multidisciplinary approach is the key to avoid a poor outcome following perioperative stroke.

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Home Page

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Contact Name Agni Susanti

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Editorial Address Jl. Prof. Eijkman No. 38 Bandung 40161, Indonesia Lt 4 Ruang JNI

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Abstract

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Agni Susanti

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jurnalneuroanestesi@gmail.com

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+6287722631615

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jni@inasnacc.org

Editorial Address
Jl. Prof. Eijkman No. 38 Bandung 40161, Indonesia Lt 4 Ruang JNI

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INDONESIA