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IDENTITAS PASIEN Nama
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IDENTITAS PASIEN Nama
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Riwayat Penyakit Sekarang •
2 minggu sebelum masuk rumah sakit, pasie Sign up to vote on this title Not useful Useful mengeluhkan lemah pada kedua lengan dan tungkai yang makin lama makin bertambah b
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Riwayat Penyakit Sekarang •
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Riwayat Penyakit Sekarang •
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Riwayat Penyakit Keluar •
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RESUME ANAMNESIS •
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PEMERIKSAAN FISIK •
KEADAAN UMUM – –
–
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STATUS NEUROLOGIK •
•
KESADARAN E4M6V5
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SISTEM MOTORIK Kanan
Kiri
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Ekstremitas atas Kekuatan
Keteranga
4
4
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SISTEM MOTORIK Kanan
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Ekstremitas bawah Kekuatan
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SISTEM MOTORIK Sign up to vote on this title
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SISTEM SENSORIK Sign up to vote on this title
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REFLEKS Kanan
Kiri
Fisiologis
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Triseps
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SISTEM OTONOM •
•
Miksi
: retensio urin, terpasang katet
Defekasi : konstipasi
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RESUME PEMERIKSAAN •
Keadaan umum – – –
Kesadaran Tekanan darah Pernafasan
: Composmentis Sign up to vote on this title Useful Not useful : 120/80mmHg : 20 kali/menit You're Reading a Preview
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RESUME PEMERIKSAAN •
Motorik
: ekstremitas atas : 4/3/0 4/3/0 Hipotonus,atro Sign up to vote on this title Useful Not useful Ekstremitas bawah0/0/0 0/0/0 You're Reading a Preview Hipotonus, atro
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USULAN PEMERIKSAAN PENUNJA Darah rutin
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HASIL PEMERIKSAAN PENUNJA •
Darah Rutin ( 8 Desember 2013) Hb : 13,6 gr% Leuko : 7000/mm Sign up to vote on this title Useful Not useful Plt : 441.000 /mm3 Ht : 40 vol% You're Reading a Preview
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RO thorax (18 Desember 2013 Sign up to vote on this title
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MRI dengan kontras (10 Desember 2013) Sign up to vote on this title
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MRI servikal dengan kontras • Alignment baik, tak tampak listhesis.
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• Tampak destruksi corpus C5, C6, C7 terutama C6-C7 yang memben
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PENATALAKSANAAN •
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Hasil konsul bedah orthopedi: Sign up to vote on this title
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atau struktur dari medulla • gangguan fungsi You're Reading a Preview
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Kriteria Diagnosis Mielopati •
Anamnesis –
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Pemeriksaan Penunjang
Lab
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Klasifikasi •
Tumor primer –
Jinak, yang berasal dari •
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tulang; osteoma dan kondroma You're Reading a Preview (Schwannoma ) serabut saraf : neurinoma
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Epidemiologi • 15% dari total tumor SSP
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AS
• Insiden 0,5-2,5 Useful Not useful pendudu kasus/100.000
tahun. You're a Preview 25%Reading servikal, 55% thorakal dan 20%
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Epidemiologi Sign up to vote on this title
Intradural
Intradural
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Patofisiologi Proses desak ruang dalam kanalis spinalis
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Gejala klinis Prephase
• gejala yang tidak jelas Sign up to vote on this title
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Gejala
Tumor ekstrameduler
Tumor intramedul
Nyeri spontan
Mempunyai tipe dan distribusi Mempunyai radikuler dan merupakan gejala tidak dini yang penting
Sensibilitas
Tipe Brown Sequard
tipe
mempunyai
yang jelas. Sign up to vote on this title Terdapat
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Pemeriksaan Penunjang Laboratorium Sign up to vote on this title
LCS
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Pentalaksanaan dexamethasone Sign up to vote on this title
Useful useful % Notmungkin • 100 mg (mengurangi nyeri pada 85 kasus, jug
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Pentalaksanaan Penatalaksanaan darurat Sign up to vote on this title
• bila >80 % blok komplit atau perburukan yang cepat: penatalaksanaan sesegera mun
keesokan harinya dengan 24 (bila merawat dengan radiasi, teruskan deksamethason IV setiap 6 jam selama 2 hari, lalu diturunkan (tappering) selama radiasi, selama 2 You're Reading a Preview minggu. Useful
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Prognosis Gambaran PA yang agresif prognosis yang Sign buruk up to voteterhadap on this title Useful Not useful terapi. You're Reading a Preview
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DASAR DIAGNOSIS diagnosis klinis
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• Didapatkan gangguan motorik berupa nyeri You're Reading a Preview
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DASAR DIAGNOSIS diagnosis etiologik Sign up to vote on this title
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Dasar Usulan Pemeriksaan Penunj darah rutin dan kimia darah
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Dasar Usulan Pemeriksaan Penunj MRI dengan kontras
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Dasar diagnosis Dasar diagnosis akhir
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