KATA PENGANTAR

Dengan mengucapkan puji syukur atas kehadirat Allah SWT yang mana atas
rahmat dan karuniaNya sehingga penulis dapat menyelesaikan referat ini dengan baik.
Adapun judul case ini yaitu Cedera Kepala Berat yang diajukan untuk memenuhi
salah satu syarat dalam mengikuti kepaniteraan klinik senior di Bagian Neurologi
Rumah Sakit Umum Daerah Solok.
Penulis menyadari bahwa masih banyak terdapat kesalahan. Penulis
mngucapkan terima kasih atas

bimbingan dan bantuan dari dr. Reno Sari

Chaniago,Sp.S, M.Biomed dan berbagai pihak sehingga penulis dapat menyelesaikan

case ini sebagaimana mestinya.
Demikianlah case ini yang tidak trlepas dari kekurangan, sehingga penulis
mengharapkan kritik dan saran yang membangun untuk menyempurnakan referat ini.
Mudah-mudahan referat ini dapat bermanfaat bagi penulis dan bagi pembaca.

Solok, 16 November 2015

Penulis

DAFTAR ISI
KATA PENGANTAR..............................................................................................i
DAFTAR ISI...........................................................................................................ii
DAFTAR GAMBAR.............................................................................................iv
DAFTAR TABEL...................................................................................................v
BAB 1. PENDAHULUAN.....................................................................................1
1.1.............................................................................................. Latar Belakang
1.2...........................................................................................................Tujuan
1.3..........................................................................................................Manfaat
BAB 2. TINJAUAN PUSTAKA............................................................................3
2.1. Definisi.........................................................................................................3
2.2. Anatomi Kepala............................................................................................3
2.2.1. Kulit Kepala.........................................................................................3
2.2.2. Tengkorak Otak....................................................................................3
2.2.3. Selaput Otak.........................................................................................4
2.2.4. Otak......................................................................................................5
2.3. Penyebab Cedera Kepala..............................................................................7
2.4. Epidemiologi................................................................................................7
2.5. Klasifikasi Cedera Kepala............................................................................8
2.5.1. Klasifikasi berdasarkan beratnya.........................................................9
2.5.1.1. Cedera Kepala Ringan ...............................................................10
2.5.1.2. Cedera Kepala Sedang...............................................................10
2.5.1.3. Cedera Kepala Berat..................................................................10
2.5.2. Berdasarkan Morfologi.......................................................................11
2.5.2.1. Fraktur Tengkorak......................................................................11
2.5.2.2. Lesi Intrakranial.........................................................................12
2.5.2.2.1. Lesi Fokal........................................................................13
2.5.2.2.2. Lesi Difus........................................................................16
2.6. Patofisiologi...............................................................................................17
2.6.1. Proses primer......................................................................................17

2.6.2. Proses Skunder...................................................................................20

2.6.3. Munculnya Gejala dan tanda..............................................................22
2.7. Diagnosa.....................................................................................................23
2.7.1. Gejala dan tanda.................................................................................23
2.7.2. Anamnesa...........................................................................................23
2.7.3. Pemeriksaan Fisik..............................................................................24
2.7.4. Pemeriksaan Penunjang.....................................................................24
2.7.5. Penentuan derajat cedera kepala........................................................24
2.8. Penatalaksanaan.........................................................................................25
2.8.1. Survei Primer.....................................................................................26
2.8.2. Survei Skunder...................................................................................26
2.9. Prognosa.....................................................................................................28
BAB 3. Tinjauan Kasus.......................................................................................29
BAB 4. Pembahasan Kasus.................................................................................43
BAB 5. Penutup....................................................................................................44
DAFTAR PUSTAKA............................................................................................45

DAFTAR GAMBAR

Gambar 1. Tengkorak Otak.....................................................................................4

Gambar 2. Meningen................................................................................................5
Gambar 3, 4. Anatomi Otak..................................................................................6-7
Gambar 5. Lesi-lesi intracranial.............................................................................12
Gambar 6. Hematom Epidural dan subdural..........................................................13
Gambar 7. Hematom Epidural...............................................................................14
Gambar 8. Hematom Subdural...............................................................................15
Gambar 9. Cedera kepala primer...........................................................................18
Gambar 10,11. Coup dan countercoup..............................................................18-19
Gambar 12. Derajat Kerusakan Cedera Kepala.....................................................20
Gambar 13. Patofisiologi munculnya gejala dan tanda..........................................22
Gambar 14. Geajala dan tanda.................................................................................... 23

Gambar 15. Foto Ro Thorak..................................................................................37

Gambar 16. Foto Ro Kepala...................................................................................38
Gambar 17. Foto Ro Kepala...................................................................................39

DAFTAR TABEL
4

Tabel 1. GCS............................................................................................................9
Tabel 2. Derajat Cedera Kepala..............................................................................24