Trombosis Vena Otak

Kenanga Marwan, Zafrullah Kany Jasa, Nazaruddin Umar

Abstract


Trombosis vena otak (TVO) adalah trombosis pada vena otak dan sinus mayor duramater. Faktor resiko terjadinya TVO meliputi faktor genetik trombofilia dan penggunaan kontrasepsi hormonal. Manifestasi klinis TVO sangat bervariasi. Timbulnya gejala dan tanda bersifat akut, subakut, atau  kronis. Empat sindrom  utama yang muncul: hipertensi intrakranial terisolasi, kelainan neurologis fokal, kejang, dan ensefalopati. Sindrom ini dapat muncul dalam kombinasi atau terisolasi tergantung pada luas dan lokasi TVO. Tatalaksana fase akut dari TVO berfokus pada antikoagulan, manajemen dari sekuele seperti kejang, peningkatan tekanan intrakranial, dan infark vena.2 Penyebab utama kematian pasien TVO selama fase akut adalah herniasi transtentorial yang kebanyakan disebabkan karena perdarahan vena. Mayoritas pasien mengalami penyembuhan parsial dan sekitar 10% mengalami defisit neurologis permanen hingga 12 pasien terjadi pada bulan ketiga) dan akan terbatas setelahnya. Rekurensi dari TVO termasuk jarang (2,8%).

Cerebral Venous Thrombosis

Cerebral venous thrombosis is a condition of thrombosis in cerebral veins and major sinus duramater. Risk factor of cerebral venous thrombosis include genetic factor like thrombophylia and hormonal contraception. There are variations in clinical manifestation of cerebral venous thrombosis. The sign and symptom could be divided into acute, subacute or chronic onset. There are 4 syndroms of clinical manifestations of cerebral venous thrombosis: isolated intracranial hypertension, focal neurologic deficits, seizure, and encephalopathy. The focus of treatment in cerebral venous thrombosis is anticoagulant therapy, sequele of seizure, to treat intracranial hypertension and venous infract. The main cause of death patient with acute onset cerebral venous thrombosis is transtentorial herniation due to venous bleeding. Partial recovery happens in mostly patient with cerebral venous thrombosis anda about 10% had permanent neurologic deficits untill 12 moths. Recanalisation occurs in the first month after cerebral venous thrmbosis (84% patient in the third month) and limited after that. Cerebral venous thrombosis recurrency is rare (2,8%).


Keywords


trombrosis vena otak; faktor resiko; prognosis; terapi;

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DOI: https://doi.org/10.24244/jni.vol7i2.9

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