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Abstrak :
Latar Belakang: Perdarahan intraserebral spontan (PISS) berkaitan dengan luaran yang buruk dibandingkan dengan infark serebral, dapat menyebabkan disabilitas berat, yaitu menyebabkan kecacatan fisik, psikologis, dan fungsi sosial. Pada pasien yang secara CT scan terbukti terdapat hematom intraserebral supratentorial, pembedahan dan perawatan neurointensif mengurangi angka kematian atau kecacatan dibandingkan hanya dengan terapi medis saja. Pembedahan yang dilakukan dapat meningkatkan luaran pasien dengan PISS yang selektif. Tujuan: Menilai luaran 6 bulan pasca operasi penderita perdarahan intraserebral spontan supratentorial yang di kelola Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2013-Agustus 2014 serta faktor-faktor yang mempengaruhi luaran tersebut. Metode: Penelitian ini merupakan penelitian potong lintang terhadap pasien perdarahan intra serebral spontan supratentorial yang dilakukan operasi evakuasi hematom di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2013-Agustus 2014 menggunakan modified Rankin Scale (mRS). Data penelitian ini diperoleh melalui catatan rekam medis. Hasil: Luaran 6 bulan setelah dilakukan operasi didapatkan luaran independent 7 pasien (38,9%) dan dependent 11 pasien (61,1%). Tidak didapatkan pasien meninggal selama follow up 6 bulan setelah operasi dari data ini. Berdasarkan lokasi perdarahan supratentorial, perdarahan lobar dengan luaran lebih baik dimana luaran independent 50% dibandingkan perdarahan deep seated dengan luaran independent 16,7%. Faktor faktor yang mempengaruhi seperti jenis kelamin, GCS, volume hematom, komorbiditas hipertensi serta diabetes melitus dan jenis tindakan tidak dapat dilakukan uji kemaknaan karena jumlah sampel yang sedikit. Kesimpulan: Luaran 6 bulan PISS supratentorial pasca operasi evakuasi hematom secara keseluruhan didapatkan lebih banyak dependent dibandingkan independent, dimana pasien perdarahan intraserebral spontan supratentorial lobar lebih baik dibandingkan dengan deep seated. ...... Background: Spontaneous intracerebral hemorrhage associated with poor outcomes compared with cerebral infarction, can cause severe disability, that causes physical disability, psychological, and social functioning. In patients who are the CT scan proved there supratentorial intracerebral hematoma, surgery and neurointensive care reduce mortality or disability compared only with medical therapy alone. Surgery can improve the outcome of patients with selective spontaneous intracerebral hemorrhage. Purpose: Assessing outcomes 6 months postoperatively supratentorial spontaneous intracerebral hemorrhage patients who managed the Department of Neurosurgery Dr. Cipto Mangunkusumo Hospital, the period January 2013-August 2014 and the factors that affect these outcomes. Method: A cross sectional study on patients with supratentorial spontaneous intracerebral hemorrhage and evacuation operation conducted in the Department of Neurosurgery Dr. Cipto Mangunkusumo Hospital the period January 2013-August 2014. Evaluate outcomes using the modified Rankin Scale (mRS). The research data was obtained through medical record. Result: Outcome 6 months after surgery obtained independent outcomes 7 patients (38.9%) and dependent 11 patients (61.1%). There were no patients died during the follow-up 6 months after surgery of this data. Based on the location supratentorial hemorrhage, lobar hemorrhage with better outcomes in which the outcome of the independent 50% compared to the deep-seated bleeding with independent outputs of 16.7%. Factors influencing such as sex, GCS, hematoma volume, comorbid hypertension and diabetes mellitus and type of action can not be performed because of the significance of test sample size slightly. Conclusion: Outputs 6 months postoperatively PISS supratentorial hematoma evacuation as a whole gained more dependent than independent, which supratentorial spontaneous intracerebral hemorrhage patients with lobar better than the deep-seated.

Abstrak :
Latar Belakang. Oleh karena tingginya angka kecacatan dan kematian pada penderita stroke hemoragik, beberapa peneliti mendapatkan adanya hiperglikemia pada perdarahan intraserebral menyebabkan kerusakan otak yang luas kerusakan otak. Untuk mencegah kerusakan tersebut, sangat penting untuk mengetahui dan mengantisipasi peningkatan kadar gula darah sewaktu pada perdarahan intraserebral fase akut. Metod e. Penelitian ini merupakan analitik observasional secara potong lintang pada 50 penderita stroke hemoragik dengan riwayat hipertensi yang dirawat di rurnah sakit Cipto Mangunkusumo dipilih secara consecutive sampling berdasarkan kriteria inklusi yaitu onset stroke kurang dari 72 jam, riwayat diabetes melitus, usia 45 - 65 tahun. Kriteria eksklusi yaitu stroke iskemik dan berulang. Dilakukan diagnosis dengan pemeriksaan fisik, pemeriksaan neurologis dan Cf Scan, volume perdarahan dihitung dengan menggunakan rumus elipsoid 4/3 X n X Y2 p X Y2 1 X Y2 t. Defisit neurologis diukur dengan menggunakan skala NIHSS. Pemeriksaan gula darah sewaktu, HbA1c diukur setelah dihitung volume perdarahan, kemudian dianalisis dengan uji statistik korelasi regresi, analisis multi regresi (p < 0,05). Hasil. Usia rata-rata penderita perdarahan intraserebral hemoragik adalah 55,5 ± 6,2 tahun. Peningkatari tekanan darah sistolik (rerata 190,0 ± 21,0 mmHg) berhubungan bermakna dengan peningkatan kadar gula darah sewaktu (p = 0,032, p < 0,05). Rerata kadar gula darah sewaktu 155 ± 56,7 mg/dl. Besamya volume perdarahan (rerata 32,0 ± 31,4 cm3) berhubungan berrnakna dengan peningkatan kadar gula darah sewaktu (p = 0,032, p < 0,05). Peningkatan HbA1c berhubungan bermakna dengan volume perdarahan (p = 0,000, p < 0,05). Kesimpulan. M~ tinggi tekanan darah sistolik akan makin besar volume perdarahan intraserebral. Makin besar volume perdarahan intraserebral akan makin tinggi kadar gula darah. Adanya riwayat diabetes melitus akan menambah besarnya volume perdarahan. ......Background Regarding of the hight disability and mortality rates on hemorrhage stroke patients, many authors found that hyperglicemia in intracerebral hemorrhage leading to severe brain damage. To prevent such effect, the anticipation of increasing random blood glucose consentration in acute phase intracerebral hemorrhage is crucial. Method This is a cross sectional analytic observational study on 50 consecutive sampling of stroke hemorrhage patients with history of hypertension at Cipto Mangunkusumo Hospital, with onset of stroke before 72 hours, history of diabetes mellitus, age range of 45 - 65 years as primary inclusion criteria. Patients with multiple stroke were excluded. Diagnostic on admission were screened by clinical examinations, clinical neurologic computed tomographic scans (CT Scans). Volume of intracerebral hemorrhage was then estimated using the formula for an ellipsoid 4/3 x 1t x ~ p x ~ 1 x ~ t. Neurological deficit was measured by NIHSS (National Institutes of Health Stroke Scale). Blood glucose level, HbA1c were measured after estimated the hemorrhage volume at the time of admission. Data were taken statistical method with univariate logistic regression analysis values of p < 0,05. Results The mean age of acute stroke hemorrhage patients is 55,5 ± 6,2 years old. Elevation of systolic blood pressure (mean 190,0 ± 21,0 mmHg) was significantly correlated with the height of blood glucose level (p = 0,020, p < 0,05). Mean blood glucose level155 ± 56,7 mg/dl. Elevation of intracerebral hemorrhage volume was significantly correlated with the height of blood glucose level (p = 0,032, p < 0,05). Elevation of the HbA1c was significantly correlated with the height volume of intracranial hemorrhage (p = 0,000, p < 0,05). Conclusion The higher the systolic blood pressure larger the intracerebral hemorrhage volume. Elevation of systolic blood pressure will raising the volume of intracerebral hemorrhage. The larger the intracerebral hemorrhage the higher the blood glucose consentration. History of diabetes mellitus will increase the hemorrhage volume.