Curriculum vitae

NAMA : Jan Izaac Ferdinandus, dr., Sp.S

TEMPAT/TGL LAHIR : Ambon, 10 Agustus 1973
JABATAN : Ketua Komite Medik RSUD Piru
ALAMAT RUMAH : Waimital - Gemba
PENDIDIKAN : 1. Fakultas Kedokteran Universitas Kristen
Maranatha Bandung
2. Spesialis Ilmu Penyakit Saraf
FK.Universitas Padjadjaran Bandung

RIWAYAT PEKERJAAN: :
Team Leader MSF-Belgium (NGO) (2005-2007)

Kepala Puskesmas Taniwel (2006-2008)

Staf di RSUD Piru (2014 skrg)

Staf ahli Bagian (SMF) Ilmu Penyakit Saraf RSUD Piru

ORGANISASI :
Anggota PERDOSSI
 MANIFESTATION
HYPERTENSION TO CVD

Jan Izaac Ferdinandus, dr., Sp.S

PIRU
2016
INTRODUCTION

STROKE
Definition :
Stroke is brain dysfunction, sadden and very rapid
development of symptoms, focal or global, caused
by only primary cerebrovascular disease which
persistence of the neurologic deficit for longer than
24 hours or die.
Primary cerebrovascular disease is refere to the
risk factors
Global brain dysfunction is refere to
unconsciousness status
 STROKE SUBTYPES

I s c h e m ic H e m o r r h a g ic
85% 15%

L a rg e V e s s e l C a r d io e m b o lic Lacunar O th e r IC H SAH

35% 25% 20% 5% 10% 5%
 Stroke ranks as the first leading
caused of death in Indonesia
RisKesDas, 2008
158,000 deaths due to stroke per
year.
Stroke-related death every 3.3
minutes.
1/3 of hemorrhagic stroke lead to
Update, from 1997 to 2007 the annual
death.
stroke death rate decreased 34.3% and
the actual number of stroke deaths
1/9 of
declined 18.8%ischemic
**** strokes lead to
death.
 Kejadian terbanyak adalah penyakit stroke, yang merupakan penyebab
kematian utama di hampir seluruh RS di Indonesia, sekitar 15,4%.

Hasil Riset Kesehatan Dasar (Riskesdas) Kemenkes RI tahun 2013

menunjukkan telah terjadi peningkatan prevalensi stroke di Indonesia dari
8,3 per mil (tahun 2007) menjadi 12,1 per mil (tahun 2013).

Prevalensi penyakit Stroke tertinggi di Sulawesi Utara (10,8per mil),

Yogyakarta (10,3 per mil), Bangka Belitung (9,7 per mil) dan DKI Jakarta
(9,7 per mil).

Prevalensi penderita Stroke cenderung lebih tinggi pada masyarakat dengan

pendidikan rendah dan masyarakat yang tinggal perkotaan.

Ke depan, prevalensi penderita Stroke dipresiksi akan meningkat menjadi

25-30 per mil. Di samping itu, sebagian dari pasien yang mengalami Stroke
akan berakhir dengan kecacatan. Berdasarkan beberapa penelitian
didapatkan tingkat kecacatan Stroke mencapai 65%.

UHH penduduk Indonesia mencapai 70,7 tahun pada 2008 dan jumlah
populasi usia lanjut diperkirakan mencapai 38% dari jumlah penduduk pada
tahun 2025.
 Human Cost of Stroke
31% die within 6 months of
occurrence among long-term
survivors.
31% require daily assistence.
20% need help walking.
16% live permanently in nursing
homes.
71% are work-impaired.
Sources: National Stroke Association, American Stroke Association,
2011
Sign And Symptoms of Stroke
 VASCULAR DIFFERENCES
A. CAROTID SYSTEM B. VERTEBROBASILER SYSTEM
. Motor dysfunction . Motor dysfunction
Contralateral hemiparesis Alternating hemiparesis
Motor cranial nerves and Motor cranial nerves and
extrimities paresis is
extrimities paresis ipsilateral
contralateral
Dysarthria
Dysarthria
. Sensory dysfunction
. Sensory dysfunction
Contralateral hemihypesthesia
Alternating hemihypesthesia
Cranial nerves and
Cranial nerves and extremities
extrimitiesypesthesia is ipsilateral
hypesthesia is contralateral
. Visual disturbances
. Visual disturbances
Contralateral homonymous
Homonymous hemianopsia
hemiamianopsia
Cortical blindness
Amaurosis fugax ( TIA )
. Higher cortical dysfunction ( TIA : blackout )
. Others: Loss of balance, Vertigo,
Aphasia
Diplopia
Agnosia
 RISK FACTORS AND PREDICTORS OF
STROKE

NON-MODIFIABLE RISK FACTORS MODIFIABLE RISK FACTORS

Older age Elevated blood pressure
Male gender Diabetes mellitus
Non-white ethnicity Atrial fibrillation
Family history Carotid artery disease
Hyperlipidaemia
Cigarette smoking
Obesity
High alcohol consumption

Previous stroke is the single most

important
risk factor for stroke

GJ Hankey Cerebrovasc Dis; 16(Suppl 1):14-19.

Wolf PA. Adv Neurol. 2003; 92:165-72.
Sacco RL et al. Stroke. 1997; 28(7):1507-17.
RISK FACTORS
A. Major risk factors
1. Hypertension
2. Cardiac diseases
3. Diabetes mellitus
B. Minor risk factors
1. Dyslipidemia
2. Smoking
3. Increase hematocrit, hyperfibrinogenemia, drug
abuse, contraceptive pill, obesity.
 CLINICAL ASPECT OF STROKE
Approach to the Stroke Patient

WHERE Neuroanatomic
Localization
WHERE Vascular Localization
WHEN Profile of Onset
HOW Vascular Mechanism
 BRAIN HEMORRHAGE
BRAIN INFARCTON
COMPLICATIONS
A. Neurologic complications
Brain edema
Hemorrhage infarction
Vasospasm
Hydrocephalus
Hygroma
COMPLICATIONS ( cont )
B. Non neurologic complication
1. Due to intracranial process
Increase blood presure
Hyperglicemia
Pulmonary edema
Cardiac disorders
2. Due to immobilitation
Bronchopneumonia
Thrombophlebitis
Bladder infection
Decubitus
Contracture
STROKE

serangan otak
kegawat - daruratan saraf

kematian
kecacatan
hendaya ( handicap)

dampak pada kualitas hidup &

kehidupan sosial
Apa yang dapat dilakukan ?

Skema pencegahan stroke dan mengurangi

kecacatan.
PERBAIKAN
SEMPURNA

FAKTOR KECACATAN
STROKE HENDAYA
RESIKO (DISABILITAS) (HANDICAP)

MENINGGAL

MENINGKATKAN
MODIFIKASI PENGOBATAN KEPEDULIAN
MASYARAKAT
FAKTOR STROKE AKUT & REHABILITASI
REHABILITASI SISTEM
RESIKO
PENDUKUNG
 Jadi Apa Yang Harus Dilakukan
bila seseorang terkena Stroke ...?
 Time is Brain

THANK YOU