PEMBAHASAN

KASUS STROKE
 “
Stroke is the rapid loss of brain function due to a
disturbance in the blood supply to the brain

”
 STROKE

• Stroke Iskemik

• Stroke perdarahan

• Transient Ischemic Attack (TIA) or Minor Stroke

 STROKE ISKEMIK
• Berdasarkan patofisiologi, terbagi menjadi 2:

1. Stroke Thrombotik, berasal dari rupturnya plak aterosklerosis

2. Stroke Emboli, berasal dari cardiogenic emboli (pada kondisi

mitral stenosis, atrial fibrillation, severe heart failure, penggunaan
prosthetic valve)

3. Global ischemia (hypotensive) stroke, akibat dari hipoperfusi

sistemik
TREATMENT OF ACUTE ISCHEMIC STROKE (AIS)

TROMBOLITIK

ALTEPLASE

TIME WINDOW

INDICATION &
CONTRAINDICATION
CRITERIA

•
TREATMENT OF TREATMENT OF ACUTE ISCHEMIC STROKE (AIS)

ANTIPLATELET

Administration of aspirin is recommended in patients with

AIS within 24-48 hours of stroke. If patients treated IV
alteplase, aspirin must be delayed until 24 hours of alteplase
(Grade 1A)

ANTIHYPERTENSIVE
• In patients with AIS, early treatment of hypertension is indicated when required by comorbid
conditions (eg, concomitant acute coronary event, acute heart failure, aortic dissection,
postthrombolysis sICH, or preeclampsia/eclampsia). Lowering BP initially by 15% is probably safe
(Grade 1C)
• BP should be maintained <180/105 mm Hg for at least the first 24 hours after IV alteplase treatment
(Grade 1B)
• Starting or restarting antihypertensive therapy during hospitalization in patients with BP >140/90
mm Hg who are neurologically stable is safe and is reasonable to improve long-term BP control
unless contraindicated (Grade 1C)
 TREATMENT OF ISCHEMIC STROKE

• Secondary Prevention: Mencegah terjadinya recurrent stroke

• The Essential part of treatment for secondary prevention:

1. Antiplatelet

2. Antikoagulan

3. Anti hipertensi

4. Anti diabetic

5. Statin