Husi

dr.Manuel Fátima Gonçalves,S.Ked

Faculdade Medicina Geral

Univercidade Udayana
Denpasar-Bali
HRS:17.10
22.01.16
 Ataka Stroke akontese wainhira urat
(Pembuluh darah) iha kakutak
intupido/nakfera. La iha ran & oksigen
nebe lori/lao diak,parte husi kakutak
hahu mate. Parte husi isin lolon
ne’ebe kontrola husi area kakutak aat
no la servico ho diak

 Kakutak hahu aat ho konta deit ho

minutu,ho ida ne’e mak importante
ba ita hodi ba hatene sintomas/sinal
stroke no lalais hodi salva

 Tratamentu ne’ebe lalais hodi bele

ajuda fahe kakutak nebe aat &
aumenta fali diak lalais husi Stroke.
 Hipertensia/ (Tensaun Aas)
Fabrilasi Atrium (Moras Fuan)
Diabetes Melitus (Ran Midar / Mi Midar)

Hemu Tua (Alkohol) Hiperkolesteromia

Isin Bokur Konsumsi pil kontrasepsi
(Hemu aimoruk KB)
(Han la kontrola)
Fuma Tabako
 Sintoma/ Sinal atu mosu Stroke
Sintomas / Sinal Stroke akontese ho
lalais,Stroke hatudo sinal hanesan:
1. Isin maten,isin sin,forsa la
iha/lakon forsa iha liman,oin
hahu tos sorin deit,ain,liu-liu
iha isin lolon sorin deit
2. Mudansa iha matan hare la
mos drepenti
3. Koalia ladun mos derepenti
4. Drepenti konfusaun/susar atu
kompreide declarasaun
simples ruma.
5. Drepenti lao la diak/susar atu
hamrik mesak ho postur isin
rasik
6. Ulun moras,drepenti ulun
moras makas la hanesan
baibain ulun moras
 Presisa konsulta kedas keta tauk & keta
demora !!!!

Se karik simtomas/sinal sira nee lakon lalais

deit,ne’e hatudo katak sinal kona stroke ki’ik,
(TIA) : sinal atu mosu stroke iha tempo oin
mai,iha biban ne’e kedas hetan kedas aimoruk
hodi prevene stroke
 • Moras Stroke hatene lalais,wainhira
mosu sinal/sintomas,doutor sei fo
aimoruk lalais hodi ajuda ita boot diak
fali.
• Pontu dalauluk hodi ita hatene katak
stroke nia spesifiko Stroke nee
ISKEMIK/HEMORAGIK,ho ida ne’e
importante tamba aimoruk nebe atu fo
Presisa ba lalais kedas doutor hodi kura stroke nebe kausa husi
intupido ran nebe bele hamate karik uja
ba stroke ne’ebe kausa husi ran sai iha
kakutak.
• Spesifiko Stroke :doutor examinasaun
:X-ray (resis)CT scan kakutak hodi
hatudo/hatene Stroke hemorragic stroke
Vs Iskemic Stroke
 Examinasaun sira seluk
(Sintomas,Sinal,Tinan,
Klinis: kondisaun pre&pasca
Stroke,Risko
Anamnesis/Interview
Examinasaun,orsamentu,Sll) Laboratorium
Examinasaun Fisiço
Fungsaun:
(Neurologis & Geral)
diagnosa,moras seluk,faktor
risko,komplikasaun,prognosa
&Tratamentu

Radiologis
Examinasaun Resis /Foto
Examinasaun Seluk Thorax (Infeksaun
EKG,Echocardiography,Carotin Deppler (USG Pulsaun,anomalia fuan),CT
Carotis),Transcranial Doppler (TCD) (Golden Standard) Scan kakutak la usa kontras
(Golden Standard)
CT Scan Ulun la usa kontras
,MRI Ulun
 Stroke hemorragic Vs Iskemic
stroke
Stroke Hemorragic Vs Stroke
Iskemic

Stroke Iskemic : akontese

tamba urat (pembuluh darah),
arteri nebe liga ran ba area
kakutak intupido ho ran maten
sira.

Stroke Hemorragic : akontese

tamba arteri iha kakutak
nakfera/kuak.
 Keta hakfodak (Panik)

Fo asistensia ajuda primeiro,bolu

ema ruma atu bolu Ambulansia

Bolu Ambulansia/lori lalais ba

hospital,Klinik nebe besik,bainhira
kona Stroke
Tratamentu Stroke iha 2
Geral:
1. Tratamentu
Geral,fungsaun
Vital;(pulmaun,fuan,rins
(ginjal),balanso elekrolit ho
be,nutrisaun,higiene.
Spesial:
1. Prevensaun & tratamentu ba
komplikasaun
2. Rehabilitasaun
3.prevensaun Stroke
Tratamentu Special
Stroke Iskemik: konsentrasaun ba atu hadia fali
dalan ran nian ba kakutak, Keta haluha ba kedas
Hospital wainhira sinal sira ne’e hahu mosu.
Doutor sei fo aimoruk atu hadia fali ran sira nebe
intupido
Aimoruk sei fo durante minutu 90 nia laran hahu
husi sintomas sira hahu mosu no aimoruk seluk
atu kontrola sinal stroke
Stroke Hemorragik: Difisil los atu kurtibu ho aimoruk,
presisa halo operasaun/ tratamentu seluk hodi hapara ran
nebe sai iha kakutak laran/hatun presaun iha
kakutak,bubu iha kakutak no problema sira seluk
 Tratamentu Stroke

 Kondisaun Stroke diak fali

Tratamentu nafatin lao hodi hare problema sira seluk no
prevene stroke iha tempo oin mai
 Sei hetan aimoruk balu hodi kontrola kondisaun nebe tama
ba risko bo’ot mosu stroke fali mak hanesan :
1. Tensaun aas
2. Kolesterol aas
3. Ran midar/mi midar
4. Iha kazu barak presisa halo operasaun hodi halakon fali
plak (mina kinur) husi urat (pembuluh darah) ne’ebe liga
ran ba kakutak
( arteri karotid)
 Operasaun sei hare ba kondisaun depois
mosu Stroke

Faktor importante
“DESIZAUN”
Kondisaun agora
(Kultura,fiar mate
bian,aikulit,matandok,kumu ho mina nu’u)

Tinan,Saude Geral molok moras


OPERASAUN STROKE ISKEMIK
 Karik iha Intupido signifikante iha urat (arteri
karotid) iha kakorok : Endarerektomi
(Operasaun ida ne’e dr.opera hodi halakon
tiha intupido plak (isin mina kinur sira) iha
area arteri karotid hodi hamenus atakasaun
stroke iha loron ikus mai
OPERASAUN STROKE
HEMORRAGIK
 Operasaun ida ne’e hodi hasai ran sira ne’ebe
iha area kakutak ne’ebe kausa husi urat iha
kakutak ne’ebe nakfera
 Operasaun (Kraniotomi) hodi hadia fali
aneurisma ne’ebe bele provoka fali stroke
hemorragik
 PLAK (ISIN MINA INTUPIDO IHA
RAN INTUPIDO RAN NIA DALAN IHA KAKUTAK
 Karik operasaun ida ne’e
halo depende ba fatin/lokasi
aneurisma,medida no
kondisaun saude geral
Operasaun Kraniotomi hodi
Sistema operasaun hamos/taka urat (pembuluh
ida ne’e hodi hapara darah abnormal) ne’ebe
ran ne’ebe sai iha moris (malformasi
kakutak laran arterivenosa) ne’ebe bele
halo kausa ran intupido iha
kakutak
Usa Klip logam Ki’ik hodi taka iha okos
 Faze Acut: Faze Kontinua:
2. Non- Neurologis:
1.Neurologis;mosu Tensaun aas,afeita ba 1. Neurologis
Stroke fali,kakutak pulmaun (Edema 2. Non- Neurologis
bubu,mosu ran sai iha Paru),afeita ba :Dekubitus (kotuk kanek)
kakutak,ulun sai bo’ot fuan,Infeksaun no selu- Infeksaun
seluk tan
Depresaun (Depresi)

Konsulta:
1. dr.moras laran Ema ne’ebe iha Kompetensia atu
(Rins,Tensaun Fatin Tratamentu : halo Tratamentu:
aas,Endokrin,Kardiologia) 1.Doutor Neorologia (ahli saraf)
2. dr.Sp.Serugia 1. Hospital :presisa baixa 2. Medico Geral (dokter
Neurologia Umum),Infermeiro/a,Terapis
2. Tratamentu fila kedas :
3.Rehabilitasi Medic momentu mosu sinal (Fisioterapi)
(fulan 3 hetan tratamentu primeiro faze acut 3.Laos matan dook!!!!
husi dr.Sp.Neuro
4. Specialista Nutrisaun
 Durasaun
Tratamentu

 Stroke Hemorragik : Presisasemana 3-4

(Depende ba kondisaun Geral Pasiente)

 Stroke Iskemik : Presisa semana 2 baixa (

se karik la iha komplikasaun ruma)
Kondisaun Moras Todan Stroke & Komplikasaun

Risko sai alejado / (Cacat) & depende ba

fisiço/kognitif depois tinan 1 : 20-30%