Stroke is a clinical syndrome with characteristic including either focal or global cerebral function lost for more than 24 hours. Stroke is one of the most common cause of death and disability in the world. Every year, 5,7 million people died from stroke and it is the second highest disease mortality rate. The first one being heart disease. Stroke can happen because of vascular blockage or brain hemorrhage. The mortality rate of hemorrhagic stroke reaches 20,3% within the firs 3 days. Overall, hemorrhagic stroke patient needs a total of 17 days of hospital care.
Clinical outcome of hemorrhagic stroke patient is determined by two processes happening in the brain, namely primary injury caused by a mechanical shift by the hematoma, and secondary injury caused by cells metabolic disturbance after being exposed to red blood cells and its degraded products. When intracranial pressure comes back to normal and hematoma is not visible anymore in the CT Scan, some patients shows no improvement in their clinical appearance or even worsen. This condition happens because of the secondary injury.
From those background, a staff from Neurosurgery Department FMUI-RSCM, dr, Hanif Gordang Tobing, SpBS, did a research to find outcome predictor in patient with secondary injury after evacuation of intracerebral hemorrhage craniotomy.
The research was done by analyzing samples of brain fluid around the hematoma. The indicator analyzed are tumor necrosis factor alpha (TNF-a), superoxide dismutase (SOD), iron ion, total iron binding capacity (TIBC) and lactate.
The result of this study shows that post-operative volume of hematoma and TNF-a in the brain fluid can predict brain injury caused by cell metabolism disruption. The prediction can be done through a scoring system. Therefore, the course of hemorrhagic stroke can be studied and clinical outcome can be estimated accurately. The result can complete the existing hemorrhagic stroke management recommendation.
The result was presented by dr. Hanis Gordang Tobing, SpBS at his doctoral hearing on Thursday, June 27th 2019 in IMERI Auditorium. The dissertation was titled “Hemoatoma volume and Secondary Brain Injury Marker as a Predictor of Spontaneous Post-Operative Intracerebral Hemorrhage”. The head examiner was Prof. Dr. dr. Suhendro, SpPD-KPTI, and other examiners include Dr. dr. Wismaji Sadewo, SpBS(K); Prof. Dr. dr. Rianto Setiabudy, SpFK; Prof. Dr. dr. Sptawati Bardosono, MSc; and Kolonel (Kes). Dr. dr. Wawan Mulayan, SpBS, SpKP.
At the end of the hearing Prof. Dr. dr. Ari Fahrial Syam, SpPD-KGEH, MMB inaugurated dr. Hanif Gordang Tobing, SpBS as a Doctor in Medical Science of FMUI. On their closing remarks promotor, dr. RM. Padmosantjojo, SpBS, and co-promotors, Prof. dr. Teguh AS. Ranakusuma, SpS(K) and Dr. dr. Ina Susianti Timan, SpPK(K) hoped this study can give a huge contribution to secondary brain injury treatment.
(Public Relations FKUI)