Symptoms of Aneurysms

Symptoms of Aneurysms often not recognized

Jakarta, Kompas - the brain aneurysm that has not been broken in general symptoms are difficult to identify. In fact, the introduction of early symptoms is very important so that early treatment and not fatal.

The remark was made by Prof. Dr. Dr. Eka Julianta Wahjoepramono Sp BS, Saturday (17 / 4), the day was confirmed as a Professor of Neurosurgery in the field of Science Faculty of Medicine, University of Pelita Harapan. On that occasion, Prof. Eka read scientific papers "Neurosurgery: from the five senses to the sense of Maya, from the Brain Stem to Operation Giant Aneurysms."

Inaugural speech that explains the journey that previously relied neurosurgical senses merely to show a variety of sophisticated tools that make neurosurgery more developed. The event was attended by Prof. Peter Black's inauguration as President of the World Federation Neurosurgical Societies, the Harvard Medical School.

In his oration by Prof. Eka explained, is to inflate the artery aneurysms of the brain that can occur in any artery in the brain, especially on the branches and most occur in areas of existing willisi sirkulus arteriosus at the base of the skull. Inflate the blood brain that occurs because of muscle layers are not formed in the brain blood vessels so the walls become thin to be bloated due to boost blood flow in a long time. If the aneurysm ruptured, there was bleeding in the brain.

In a small patient symptoms can arise due to the pressure on the giant aneurysm, which is on neural structures in the vicinity. As many as 15-30 percent of patients with giant aneurysms rupture in his brain structure had early warning of some blood seepage from a brain aneurysm. The symptoms include severe headache accompanied by stiff neck.

Aneurysms that are not recognizable symptoms is very dangerous because it could happen again broke out. Broke the second time always result in more fatal and so on. Eka disclose, recognize signs of a mild outbreak of aneurysms while still very important to get the patient immediately on diagnosis and there is immediate action to prevent re-rupture. It is the duty of doctors to educate the neurosurgical community to recognize the signs and symptoms of a brain aneurysm rupture before so fatal.

Therapy to deal with a brain aneurysm usually by clipping or embolization procedures. Micro surgical clipping is aneurysm by clipping the neck so that the aneurysm was no longer teraliri blood from the parent blood vessel. Clamping level reaches 80-90 percent successful. While embolization is penyumpalan, or blockage of aneurysms. These procedures are done by doctors in Indonesia.

He said the handling of aneurysms is still very expensive, especially if patients present with severe conditions should be in the intensive care unit. "We, the doctors, attempt to provide assistance, such as freeing the patient is not capable of physician fees. However, if you've used the room in a hospital intensive care is very expensive because it can reach millions of rupiah per day, "he said. Availability of neurological surgeons also very limited.

Prof Black said, ideally with a neurosurgical physician ratio is the 1:250.000 population. However, in Indonesia, the ratio is still 1:2.000.000. (Ine)




Gejala Aneurisma Kerap Tidak Dikenali

Kompas - Senin, 19 April

Gejala Aneurisma Kerap Tidak Dikenali

Jakarta, Kompas - Aneurisma otak yang belum pecah pada umumnya gejalanya sulit dikenali. Padahal, pengenalan gejala sejak awal menjadi sangat penting agar penanganan lebih dini dan tidak berakibat fatal.

Hal itu dikemukakan Prof Dr dr Eka Julianta Wahjoepramono Sp BS, Sabtu (17/4), yang hari itu dikukuhkan sebagai Guru Besar dalam bidang Ilmu Bedah Saraf Fakultas Kedokteran Universitas Pelita Harapan. Dalam kesempatan itu, Prof Eka membacakan orasi ilmiah ”Bedah Saraf: Dari Panca Indera ke Indera Maya, dari Operasi Batang Otak ke Aneurisma Raksasa”.

Pidato pengukuhan itu menjelaskan perjalanan bedah saraf yang semula mengandalkan pancaindra semata hingga muncul berbagai alat canggih yang membuat bedah saraf semakin berkembang. Acara pengukuhan dihadiri Prof Peter Black selaku Presiden World Federation Neurosurgical Societies, Harvard Medical School.

Dalam orasinya Prof Eka memaparkan, aneurisma ialah penggelembungan pembuluh darah otak yang bisa terjadi di setiap arteri di otak, khususnya pada percabangannya dan paling banyak terjadi pada daerah sirkulus arteriosus willisi yang ada di dasar tengkorak. Penggelembungan darah otak itu terjadi karena tidak terbentuk lapisan otot pada pembuluh darah otak sehingga dinding menjadi tipis yang akan menggelembung karena semburan aliran darah dalam waktu lama. Jika aneurisma pecah, terjadilah pendarahan di otak.

Pada sebagian kecil penderita dapat timbul gejala akibat tekanan pada aneurisma raksasa, yakni pada struktur saraf di sekitarnya. Sebanyak 15-30 persen penderita pecah aneurisma raksasa pada struktur otaknya mengalami peringatan awal berupa sedikit rembesan darah dari aneurisma otak. Gejala yang timbul antara lain nyeri kepala hebat disertai kaku kuduk.

Aneurisma yang tidak dikenali gejalanya amat berbahaya karena bisa terjadi pecah ulang. Pecah kedua kalinya selalu berakibat lebih fatal dan seterusnya. Eka mengungkapkan, mengenal tanda pecahnya aneurisma selagi masih ringan amat penting agar pasien segera di diagnosis dan ada tindakan secepatnya untuk mencegah pecah ulang. Merupakan tugas para dokter bedah saraf untuk mengedukasi masyarakat agar mengenal tanda-tanda dan gejala pecahnya aneurisma otak sebelum jadi fatal.

Terapi guna menangani aneurisma otak biasanya dengan prosedur kliping atau embolisasi. Kliping ialah pembedahan mikro dengan menjepit leher aneurisma sehingga aneurisma tidak lagi teraliri darah dari pembuluh darah induk. Tingkat sukses penjepitan mencapai 80-90 persen. Sementara embolisasi adalah penyumpalan atau penyumbatan aneurisma. Prosedur-prosedur tersebut sudah dapat dilakukan oleh dokter-dokter di Indonesia.

Dia mengatakan, penanganan aneurisma memang masih sangat mahal, apalagi jika pasien datang dengan kondisi berat sehingga harus di ruang rawat intensif. ”Kami, para dokter, berupaya memberikan bantuan, misalnya membebaskan pasien tidak mampu dari biaya dokter. Tetapi, kalau sudah menggunakan ruang perawatan intensif di rumah sakit memang menjadi sangat mahal karena bisa mencapai jutaan rupiah per hari,” ujarnya. Ketersediaan dokter bedah saraf pun sangat terbatas.

Prof Black mengatakan, idealnya rasio dokter bedah saraf dengan populasi adalah 1:250.000. Namun, di Indonesia, rasionya masih 1:2.000.000. (INE)