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Peningkatan glasgow coma scale yang signifikan pada pasien epidural hematome post operasi trepanasi evakuasi klot

Abstract

Epidural hematoma (EDH) is a major traumatic brain injury and a potentially life-threatening condition. Nearly 81% of EDH cases were caused by accidental incident, 17% due to assault, and the rest due to self harm and suicidal intent. The epidural hematome occurs due to fracture of the skull in the space between the internal tabula cranii and duramater. Epidural hematoma is a serious sequela of head injury and causes a mortality rate of about 50%. Surgery is performed in 40% of cases of EDH. A 17-year-old man was diagnosed moderate head injury and right temporoparietal epidural hemorrhagic with cerebral odema and base skull fracture and closed fracture of the right lower extremity with GCS (Glasgow Coma Scale) E1 V 1 M3 and underwent trepanation, clot evacuation and debridement elevation, reconstruction. The surgery was under general anesthesia with the neuroanesthesia's technique. Hemodynamics was stable during the 3 hours 40 minutes surgery. Management of neuroanesthesia for head injuries aims to optimize brain perfusion, facilitate surgery and prevent secondary brain injury.

 

Epidural Hematom (EDH) adalah cedera otak traumatik utama dan kondisi yang berpotensi mengancam jiwa. Hampir 81 % dari kasus EDH disebabkan oleh kecelakaan yang tidak disengaja, 17 % karena penyerangan, dan sisanya karena merugikan diri sendiri dan niat untuk bunuh diri. Operasi bedah saraf dilakukan pada 40% kasus EDH. Seorang laki- laki berusia 17 tahun dengan diagnosa cedera kepala sedang dengan epidural hemoragik temporoparietal dekstra dengan odema serebri dengan fraktur basis kranii dan fraktur tertutup cruris dekstra dengan GCS ( Glasgow Coma Scale) E1 V 1 M3 dan akan dilakukan tindakan trepanasi evakuasi klot dan debridement elevasi rekontruksi. Selama operasi pasien di berikan teknik anestesi umum dengan konsep neuroanestesi. Hemodinamik stabil selama operasi 3 jam 40 menit berlangsung. Epidural Hematom adalah perdarahan intrakranial yang terjadi karena fraktur tulang tengkorak dalam ruang antara tabula interna kranii dengan duramater. Epidural hematoma merupakan gejala sisa yang serius akibat cedera kepala dan menyebabkan angka mortalitas sekitar 50%. Manajemen neuroanestesia untuk cedera kepala bertujuan untuk mengoptimalkan perfusi otak, memfasilitasi pembedahan dan mencegah cedera otak sekunder. 

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How to Cite

Pratiwi, D. A. N. I., & Sutawan, I. B. K. J. (2021). Peningkatan glasgow coma scale yang signifikan pada pasien epidural hematome post operasi trepanasi evakuasi klot. Medicina, 52(1), 44–47. https://doi.org/10.15562/medicina.v52i1.1049

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Dewa Ayu Nyoman Isma Pratiwi
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Ida Bagus Krisna Jaya Sutawan
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