Professional Documents
Culture Documents
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3 https://www.youtube.com/watch?v=dEgaaJWRf7g
Source: Duus’ Topical Diagnosis in Neurology, ed 5th
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Source: Duus’ Topical Diagnosis in Neurology, ed 5th
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Source: Duus’ Topical Diagnosis in Neurology, ed 5th
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Source: Duus’ Topical Diagnosis in Neurology, ed 5th
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Source: Duus’ Topical Diagnosis in Neurology, ed 5th
Part 2
Mati
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Henti Napas (tidak ada gerakan napas spontan)
Henti sirkulasi (jantung)
MATI KLINIS
Aktivitas otak terhenti
Tidak irreversible
(Wijdicks,2001; Buckley, et al.,1995)
Kerusakan berat irreversible pada pasien yang pasien yang tetap tidak sadar dan
MATI SOSIAL /
responsive, tetapi memiliki EEG aktif dan beberapa reflek yang utuh
VEGETATIVE STATE
(Arnold, et al.,1999)
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Part 2
Mati Batang Otak (MBO)
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1959
Mollaret and goulon
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1968
Harvard medical school
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1976
The Conference of Medical Royal
Colleges
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1995
American Academy of Neurology
(AAN)
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2015
American Academy of Neurology
(AAN)
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Part 3
Patofisiologi MBO
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ETIOLOGI:
MOST COMMON:
• Direct traumatic injury to the head (e.g. road accident)
• subarachnoid hemorrhage
• ischemic stroke
OTHERS:
• intracerebral hemorrhage
• hypoxic-ischemic
• Encephalopathy
• Etc.
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Severe
Damage Oedema Increase ICP
neuronal tissue
Brain-stem
death
Dhanwate, AD. 2014. Brainstem death: A comprehensive review in
Indian perspective. Indian Journal of Critical Care Medicine. Indian
Society of Critical Care Medicine
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Part 5
Kriteria MBO
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American Academy of Neurology
(AAN)
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Pernyataan IDI No. 336/PB/A.4/88
Seseorang dinyatakan mati bila
a) Fungsi spontan pernafasan dan jantung telah
berhenti secara pasti
Atau
b) Telah terbukti terjadi MBO (mati batang otak)
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Part 4
Pemeriksaan MBO
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Tes Klinis MBO
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COMA
Coma is best defined as an eyes-closed
unresponsive state
Huff JS, Dulebohn SC. 2018. Coma. Treasure Island (FL): StatPearls
Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430722/
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a state in which the patient does not open his or her
eyes even on very vigorous stimulation and displays
no evidence of psychologically interpretable contact
with the outside world, even after the discontinuation
of analgesic and/or sedating drugs that might impair
consciousness
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Refleks Batang otak
Dhanwate, AD. 2014. Brainstem death: A comprehensive review in Indian perspective.
Indian Journal of Critical Care Medicine. Indian Society of Critical Care Medicine
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PUPIL
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CALORIC TEST
- Fungsi Pupil
- Pergerakan Mata
Nervus IV, V, VI
Nervus IX, X
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Tes Apneu
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Persistent Vegetative State
a state in which the patient’s eyes are intermittently
open (wakefulness), but there is nonetheless no
evidence for an ability to make contact, or for
awareness
(Persistent Vegetative State/Unsresponsive Wakefulness Syndrome)
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Bender et al. 2015. Persistent Vegetative State and Minimally
Conscious State A systematic review and meta-analysis of diagnostic
procedures. Dtsch Arztebl 41
Int Journal. 112(4): 235-242
Locked-In Syndrome
a condition in which a patient is aware but cannot
move or communicate verbally due to complete
paralysis of nearly all voluntary muscles in the body
except for vertical eye movements and blinking. The
individual is conscious and sufficiently intact
cognitively to be able to communicate with eye
movements.
(Pseudocoma)
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Lesion in Ventral Pontine
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SOURCE
✣ Wijdicks et al. 2015. Determining Brain Death. Neurocritical Care. American Academy of
Neurology
✣ Dhanwate, AD. 2014. Brainstem death: A comprehensive review in Indian perspective. Indian
Journal of Critical Care Medicine. Indian Society of Critical Care Medicine
✣ Baehr M, Frotscher M. 2012. Duus’ Topical Diagnosis in Neurology: Anatomy, Physiology,
Signs, Symptoms. 5th ed. Thieme. Germany
✣ Wijdicks, Eelco FM. 2001. The Diagnosis of Brain Death. N Engl J Med. 344 (16)
✣ Buckley. 1995. Guidelines On Certification Of Brain Death, The Hong Kong Society Of
Critical Care Medicine, journal of the Royal College of Physicians of London, 29:381-2
✣ Sagishima K, Kinoshita Y. 2017. Pupil diameter for confirmation of brain death in adult organ
donors in Japan. Acute Medicine & Surgery. (4). 9-12. Japan
✣ Cameron EJ et al. 2017. Confirmation of brainstem death. Pract Neurol. (16). 129-135. London.
✣ Bender et al. 2015. Persistent Vegetative State and Minimally Conscious State A systematic
review and meta-analysis of diagnostic procedures. Dtsch Arztebl Int Journal. 112(4): 235-242
✣ Duff JR. 2007. Motor speech disorders substrates, differential diagnosis, and management.
Elsevier. p 295
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