Penyakit Serebrovaskuler pada Preeklampsia

  • Dewi Yulianti Bisri Faculty of Medicine Universitas Padjadjaran Bandung
  • Tatang Bisri Faculty of Medicine Universitas Jend. Ahmad Yani Cimahi Bandung, Indonesia
Keywords: Preeklampsia, Wanita hamil, penyakit serebrovaskular, Stroke

Abstract

Preeklamsia, penyakit hipertensi yang mempengaruhi 5% hingga 8% kehamilan, adalah gangguan multisistem, dengan disfungsi pembuluh darah menjadi pusat penyakit. Pembuluh darah otak ibu sangat rentan terhadap efek samping preeklampsia. Komplikasi serebrovaskular jangka pendek dan jangka panjang dari preeklampsi termasuk sindrom ensefalopati reversibel posterior (posterior reversible encephalopathy syndrome/PRES), sindrom vasokonstriksi serebral reversibel (reversible cerebral vasoconstriction syndrome/RCVS), stroke hemoragik dan iskemik, penyakit vasokonstriksi serebral, dan demensia vaskular. Gangguan serebrovaskular akut, termasuk PRES, RCVS, stroke iskemik dan hemoragik, dan trombosis sinus vena serebral (cerebral venous sinus thrombosis/CVST), adalah komplikasi preeklampsia yang ditakuti yang dapat mengakibatkan kecacatan ibu permanen atau kematian. Risiko penyakit serebrovaskular akut pada kehamilan yang dipersulit oleh preeklampsi sebesar 1 dari 500 persalinan; sebagai perbandingan, risiko keseluruhan penyakit serebrovaskular akut terkait kehamilan adalah ≈30 per 100.000 persalinan. PRES adalah sindrom edema vasogenik dan kerusakan sawar darah otak, yang mempengaruhi struktur kortikal dan subkortikal dan semua daerah otak. Ada kecenderungan pada lobus parietal dan oksipital, kadang-kadang mengakibatkan gangguan penglihatan atau kebutaan kortikal. Hadir dengan keluhan sakit kepala thunderclap yang parah, RCVS menyebabkan vasospasme arteri sirkulus Willisi dan dapat dikaitkan dengan stroke iskemik dan subarachnoid hemorrhagic (SAH) nonaneurisma, biasanya di atas convexitas serebral.

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Author Biographies

Dewi Yulianti Bisri, Faculty of Medicine Universitas Padjadjaran Bandung

Department Anesthesiology and Intensive Care Dr. Hasan Sadikin General Hospital Bandung

Tatang Bisri, Faculty of Medicine Universitas Jend. Ahmad Yani Cimahi Bandung, Indonesia

Department of Anesthesiology and Intensive Care Melinda Hospital Bandung

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Published
2024-03-21
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Literature Review