Faktor risiko transformasi hemoragik pada pasien stroke infark
https://doi.org/10.22146/bns.v18i2.54994 Adika Mianoki(1), Ismail Setyopranoto(2*), Mochammad Was’an(3)
(1) KSM Saraf RSUP Soeradji Tirtonegoro, Klaten
(2) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author
Abstract
Transformasi hemoragik dari infark serebral merupakan kejadian yang umum dan berpotensi serius terjadi setelah stroke iskemia akut. Tingkat keparahan perdarahan dapat berkisar dari beberapa petekia sampai hematoma ukuran besar yang menimbulkan efek desak ruang. Patogenesis transformasi hemoragik belum begitu jelas, meskipun iskemia dan reperfusi telah dianggap menyebabkan gangguan sawar darah otak yang menyebabkan ekstravasasi darah. Pada tingkat molekuler, radikal bebas dan enzim proteolitik (metaloproteinase) dapat menyebabkan kerusakan jaringan.
Beberapa kondisi merupakan faktor risiko terjadinya transformassi hemoragik. Faktor-faktor yang telah diketahui merupakan prediktor potensial untuk trombolisis yang berkaitan dengan transformasi hemoragik dapat dikategorikan menjadi faktor klinik, biokimiawi, dan radiologis. Dengan mengendalikan atau memonitor faktor-faktor tersebut sedini mungkin diharapkan bisa menurunkan kejadian transformasi hemoragik pada pasien stroke infark.
Telah terdapat algoritma yang disarankan untuk pengelolaan perdarahan intraserebral spontan setelah trombolisis intravena untuk stroke iskemia akut, akan tetapi algoritma ini hanya berbasis empiris bukan data. Penelitian lebih lanjut diperlukan untuk menentukan strategi pengelolaan yang optimal.
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DOI: https://doi.org/10.22146/bns.v18i2.54994
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