Beruflich Dokumente
Kultur Dokumente
Muhamad Yunus
Trauma
Komplit Inkomplit
1. Anterior cord syndrome
2. Central cord syndrome
3. Brown-Sequard syndrome
4. Posterior cord syndrome
Trauma Medula Spinalis
Umum :
• Posisi netral
• Pasien sadar / tidak sadar
• Flaccid areflexia
• Pernafasan diafragma
• Bisa fleksi elbow, ekstensi (-)
• Hipotensi + bradikardi, hipovolemik (-)
• Priapismus
Trauma Medula Spinalis
Pemeriksaan neurologis :
1. Motorik • Traktus kortikospinal
2. Sensorik • Traktus spinotalamikus
3. Refleks
• Posterior collum
4. Otonom
Picture
Diagnosis
•
klinis
A: complete
• B: incomplete: sensory but not motor
function is preserved below the
neurological level and includes the sacral
• Axial pain
segments S4-S5
• Radikulopati • C: incomplete: motor function is preserved
• Parese : para, below the neurological level, and more than
tetra half of key muscles below the neurological
level have a muscle grade less than 3
• Plegi : para, tetra
strength
• D: incomplete: motor function is preserved
below the neurological level, and at least
half of key muscles below the neurological
level have a muscle grade of 3 or more
strength
• E: normal
Trauma Medula Spinalis
Spinal shock :
Terjadi sesudah trauma spinal cord
Flaccid
Refleks Babinski (-)
Refleks hiperaktif (-)
• Radiologi
– Pemeriksaan X-ray
– CT-Scan
– MRI
• Foto X-Ray
Cervical Lateral
AML: anterior
Marginal Line
SLL: Spino
Laminar Line
Trauma Medula Spinalis
Efek terhadap organ lain :
• Paralisis interkostalis hipoventilasi
• Paralisis diafragma C3-C5
• Trauma abdomen “masking effect”
Trauma Medula Spinalis
Penatalaksanaan :
Umum :
• Tekanan sistolik diperhatikan
• Log-rolled pada matras
Khusus :
• Medikamentosa
• Konservatif
• Operatif
Trauma Medula Spinalis
Penatalaksanaan khusus :
Medikamentosa : Metilprednisolon < 8 jam
• 30 mg/kgBB, IV, 1 jam pertama
• 5,4 mg/kgBB drip dalam 23 jam
Trauma Medula Spinalis
Defisit Neurologis
(-) : Konservatif
(+)
Operatif :
– Dekompresi
– Stabilisasi anterior/posterior
Terima Kasih