Spondylolisthesis

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Laporan Kasus Neurologi

Spondilolisthesis Pembimbing: dr. Sesmi Betris c c c c c c c c

dleh: Kharisma Prasetya A.

070100083

Benny Harmoko

070100097

Marintan A. Sitio

070100165

Vitri Alya

070100143

Ivan C. Pasaribu

070100367

KEPANITRAAN KLINIK SENIdR DEPARTEMEN SMF NEURdLd I FAKULTAS KEDdKTERAN USU/ RSUP HAM MEDAN 2011

c c

KATA PEN ANTAR c cc c c c c cccccc cc

c c cc c cc c c c c

c c c c c c c c

c c c c c c c c ! c " c #$ c c# c c c c c

c c c c c c c c c

c c c c c c c c c c c c c c c c c c c c % c &c c c c c c c &c c c cc c c c c c c c c cccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccc &c'(c$ c')**c c c cccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccc c

ac c

DAFTAR ISI c KATA PEN ANTAR .................................................................................................. ii DAFTAR ISI ............................................................................................................... iii BAB 1 PENDAHULUAN ..............................................................................................1

**c+ c, cc*c *'ccc*c BAB 2 LAPdRAN KASUS ...........................................................................................2 BAB 3 TINJAUAN PUSTAKA ................................................................................... 32

-*c c-'c -'c c-'c --c c--c -(c. c" c--c -/cc-(c -0c c c-0c -1c c-0c -2c" c-2c -3c c-2c BAB 4 DISKUSI KASUS ............................................................................................ 39 BAB 5 PERMASALAHAN ......................................................................................... 41 BAB 6 KESIMPULAN ................................................................................................ 42 BAB 7 SARAN ............................................................................................................ 43 DAFTAR PUSTAKA .................................................................................................. 44

aac c

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c

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c

ccc

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c

c

c

8c@c c

c c

c

c

8c*0)=2)c7c

c c

c

c

c

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c

c

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c

c

c

8c-0&/c?@c

c

c ××c c

Nervus Kranialis c

c

c

c

c

8c c

&cc

c

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

c

8c c cc:<;c

Cc

c

c

c

c

8c cc c:<;c

Cc c

c

c

c

8cc c c

Ccc

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c

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c

c

c

8c$ c c

Hc c

c

c

c

8c c:<;c

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c

c

c

8c c c c

c Status Neurologis c

8c@c c

c"c

8c c c:;&cc:;& c:;c

6c c

8c:;c

6 c! c

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8cc<=
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c

8c/////=/////c 8c/////=/////c

Diagnosa c! c 8c+, c c c

8c c

c5 c 8c+ c c" c

8c+, c c c
c

c

ccccccc

Penatalaksanaan c C!c6 c')=c c c" c*cc: =;c c c6c*c=*'c c c c'c>c/)cc ×Ñc c

c ,c@ >c-c>c*c c @ c'c>c'/c c HASIL LABdRATdRIUM I D 15 November 2011 Jenis Pemeriksaan

Satuan

Darah Lengkap

c

Hasil

Nilai Normal c

Hemoglobin

Ic

8.90

**1*//c

Eritrosit

*)0=-c

3.73

('cJc(21c

Leukosit

*)-=-c

2')c

(/cJc**)c

Hematrokrit

Ic

27.70

-2cJc((c

Trombosit

*)0=-c

(''c

*/)cJc(/)c

MCV

+c

1(-)c

2/cJc3/c

MCH

c

23.90

'2cJc-'c

MCHC

Ic

32.10

--cJc-/c

Diftel

c

c

Neutrofil

Ic

/-/)c

-1cJc2)c

Limfosit

Ic

-(3)c

')cJc()c

Monosit

Ic

-0)c

'cJc2c

Eosinofil

Ic

'')c

*cJc0c

Basofil

Ic

)*))c

)cJc*c

Faal Hemostasis PT

c

c

c

c

Kontrol

c

*'3)c

Pasien

c

*-'c

INR

c

*)0c

aPTT

c

TT

Kontrol

c

'33c

Pasien

c

'3-c

c

c

c

×c c

Kontrol

c

*')c

Pasien

c

*-)c

c

c

c

S dT

#=+c

**c

Kc-'c

S PT

#=+c

(c

Kc-*c

c

c

c

=+c

*13/)c

Kc'))c

injal

c

c

c

Ureum

=+c

(2-)c

Kc/)c

Kreatinin

=+c

1.32

)/)cJc)3)c

c

c

c

Natrium (Na)

A=+c

*-0c

*-/cJc*//c

Kalium (K)

A=+c

(*c

-0cJc//c

Chloride (Cl)

A=+c

*)-c

30cJc*)0c

Faal Hati

Metabolisme Karbohidrat lukosa Darah

Elektrolit Serum

c

Jawaban Konsultasi Kardiologi atas Pembacaan EK

15 November 2011:

".8c 6&cL6c c 02c >=&c>c &c . c c &c 6c c )&*0M&cc c :;&c +C7c:;&cCc:;c c " 8cc c

×½c c

Follow Up Follow Up 16 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*3)=1)c7c

c

8c1(c>=c

! c c

8c')c>=c

c

8c-0&/c@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

8c cc c:<;c

Cc c

c

c

8cc c c

Ccc

c

c

8c :<;c

H&Hc

c

c

8c$ c c

Hc c

c

c

8c c:<;c

Hc

c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

" c

,=c

8cc<=
<=
" 6=5 6c

8cc<=
<=
6 c c

"c

" c

7=c

8cccc=c

=c

, c

8ccccccc

c

" c c

8c8c/////=/////c 8c/////=/////c

×c c

c

8c/////=/////c 8c/////=/////c

+ A c c:;c c cc c

c

58c+, c c c cc/)cc c ,c@ >c-c>c*c c @ c'c>c'/c 6=c5 c*>*'&/c

HASIL LABdRATdRIUM 16 November 2011 Jenis Pemeriksaan

Satuan

Metabolisme Karbohidrat

c

Hasil

Nilai Normal c

lukosa darah

=+c

*/-c

1)*')c

lukosa 2jPP

=+c

*01c

K'))c

c

c

c

c

c

c

Kolesterol Total

=+c

*3/c

K'))c

Trigliserida

=+c

*()c

()'))c

Kolesterol HDL

=+c

51

N0/c

Kolesterol LDL

=+c

*-2

K*/)c

Lemak

c

×xc c

Jawaban Konsultasi Radiologi atas Pembacaan Foto Thoraks 16 November 2011:

9c &c @6c /(I&c c c &c c &c c c c c $ &c c $ c c &c c c cc c &c c c " 8c" &c c c8c c c Jawaban Konsultasi Radiologi atas Pembacaan Foto Lumbosakral AP/L 16 November 2011: c " c c $ c &&c c c

c &c c c c $ c +/=*c c c +/c c *c c c c c c c+/c9 c c $ c c c cc cc c cc " 8c c ccc &c c c+/=*cc

×Àc c

Follow Up 17 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*2)=1)c7c

c

8c0*c>=c

! c c

8c*3c>=c

c

8c-1&0c?@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

8c cc c:<;c

Cc c

c

c

8cc c c

Ccc

c

c

8c :<;c

H&Hc

c

c

8c$ c c

Hc c

c

c

8c c:<;c

Hc

c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

" c

,=c

8cc<=
<=
" 6=5 6c

8cc<=
<=
6 c c

"c

" c

7=c

8cccc=c

=c

, c

8ccccccc

c

" c c c

8c8c/////=/////c 8c/////=/////c 8c/////=/////c 8c/////=/////c

+ A c c:;c ×îc c

c cc c

c

58c+, c c c cc/)cc c ,c@ >c-c>c*c c @ c'c>c/)c c 5 c*>*'&/c

×Jc c

Follow Up 18 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*/)=1)c7c

c

8c1'c>=c

! c c

8c')c>=c

c

8c-0&c@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

8c cc c:<;c

Cc c

c

c

8cc c c

Ccc

c

c

8c :<;c

H&Hc

c

c

8c$ c c

Hc c

c

c

8c c:<;c

Hc

c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

" c

,=c

8cc<=
<=
" 6=5 6c

8cc<=
<=
6 c c

"c

" c

7=c

8cccc=c

=c

, c

8ccccccc

c

" c c c

8c8c/////=/////c 8c/////=/////c 8c/////=/////c 8c/////=/////c

+ A c c:;c Ñ c c

c cc c

c

58c+, c c c cc/)cc c @ c'c>c/)c c 5 c*>*'&/c c ,c@ >c-c>c*c c

c" c

Ñ×c c

Follow Up 19 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*0)=2)c7c

c

8c0(c>=c

! c c

8c*0c>=c

c

8c-1c@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

8c cc c:<;c

Cc c

c

c

8cc c c

Ccc

c

c

8c :<;c

H&Hc

c

c

8c$ c c

Hc c

c

c

8c c:<;c

Hc

c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

" c

,=c

8cc<=
<=
" 6=5 6c

8cc<=
<=
6 c c

"c

" c

7=c

8cccc=c

=c

, c

8ccccccc

c

" c c c

8c8c/////=/////c 8c/////=/////c 8c/////=/////c 8c/////=/////c

+ A c c:;c ÑÑc c

c cc c

c

c

58c+, c c c cc/)cc c 5 c*>c'/cc c @ c'c>c/)c c Cc,c@ >c-c>c*c c >cc: =;

Ñc c

Follow Up 20 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*3)=1)c7c

c

8c00c>=c

! c c

8c*3c>=c

c

8c-0&3c@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

8c cc c:<;c

Cc c

c

c

8cc c c

Ccc

c

c

8c :<;c

H&Hc

c

c

8c$ c c

Hc c

c

c

8c c:<;c

Hc

c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

" c

,=c

8cc<=
<=
" 6=5 6c

8cc<=
<=
6 c c

"c

" c

7=c

8cccc=c

=c

, c

8ccccccc

c

" c c c

8c8c/////=/////c 8c/////=/////c 8c/////=/////c 8c/////=/////c

+ A c c:;c Ñ½c c

c cc c

c

58c+, c c c cc/)cc c 5 c*c>c'/cc c @ c'c>c/)c c Cc,c@ >c->* c >cc: =;

Ñc c

Follow Up 21 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*3)=3)c7c

c

8c0(c>=c

! c c

8c*1c>=c

c

8c-/&/c@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

8c cc c:<;c

Cc c

c

c

8cc c c

Ccc

c

c

8c :<;c

H&Hc

c

c

8c$ c c

Hc c

c

c

8c c:<;c

Hc

c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

" c

,=c

8cc<=
<=
" 6=5 6c

8cc<=
<=
6 c c

"c

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7=c

8cccc=c

=c

, c

8ccccccc

c

" c c c

8c8c/////=/////c 8c/////=/////c 8c/////=/////c 8c/////=/////c

+ A c c:;c Ñxc c

c cc c

c

c

58c+, c c c cc/)cc c 5 c*>'/cc c @ c-c>c/)c c Cc,c@ >c->* c !

ÑÀc c

Follow Up 22 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*0)=*))c7c

c

8c10c>=c

! c c

8c')c>=c

c

8c-0&)c@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

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&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

8c cc c:<;c

Cc c

c

c

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c

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c

c

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Hc c

c

c

8c c:<;c

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c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

" c

,=c

8cc<=
<=
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8cc<=
<=
6 c c

"c

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=c

, c

8ccccccc

c

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8c8c/////=/////c 8c/////=/////c 8c/////=/////c 8c/////=/////c

+ A c c:;c Ñîc c

c cc c

c

c

58c+, c c c cc*/)cc c c c'c>c/)cc c 5 c*c>c'/cc c ,c@ >c-c>c*c c @ c-c>c/)c c !

ÑJc c

Follow Up 23 November 2011 8c ccc %8c Status Presens c

8c@c

c c

8c*3)=3)c7c

c

8c2)c>=c

! c c

8c')c>=c

c

8c-0&0c@c

c Nervus Kranialis c

c

c

c

8c c

&cc

c

c

8c6@c<=<&c c cGc-c

&C&Cc

c

c

8c c cc:<;c

Cc

c

c

c

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Cc c

c

c

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Ccc

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c

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c

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Hc c

c

c

8c c:<;c

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c8c c c c

STATUS NEURdLd IS c c"c 6c c 6 c! c

8c@c c 8c c c:;&cc:;& c:;c 8c:;c "c

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,=c

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<=
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=c

, c

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c

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8c8c/////=/////c 8c/////=/////c 8c/////=/////c 8c/////=/////c

+ A c c:;c c c

c cc c

c

c

58c+, c c c cc*/)cc c c c'c>c/)cc c 5 c*c>c'/cc c @ c-c>c/)cc c ,c@ >c-c>c*c

×c c

BAB 3 TINJAUAN PUSTAKA c 3.1 Definisi c

"c V

VV V c c c c c c c c c

V c c c O c c :$ ;M&c c VV Vc c c O Mc c c c c c c c :c c ;c c$ c c c$ cc*&(&/&3c c 3.2 Etiopatofisiologi c

c c c c c c c c

: c c c c c c ;c c &c c c c &ccc c c:;&c c c c &cc c c c c c cc cc c c c c c c c c c c c c &c

&c &c c c c c c c c c*&3c c

5c c c c c c c c c

cD 8c *c c c c c c c c c + c ccc' c

'c c c + c c c c c -c 8c c &c c c &c c c c

'c -c c c c c c &c &c c c &c &c &c c c c c c c c 'c (c c c c

c c c c c c c c

cc c c 'c /c

cc Ñc

c

c c

9 c c &c c c c c &c

c c c 9 c c c c c c c c c c : c c c c c c c c c c c ;c c c c c9 cc c c c c c c c :c c 9 c

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c c c c c c c c c ;&c c : c c c c c c c c c c c c c c ;&c c c &cc c 'c c c

c c c c c c c c c

c c c c c c c c c c c /c c c c c c c c c c 'c c 3.3 Epidemiologi c

c c c c c /Ic c c c

c c c c c c c c c c c c c c c c $ c +(+/c c/&2Ic cc3&*Icc c c c*&'&2c c 3.4

ejala klinis

c c c &c c c c c

c c c c c c &c c c c c c c c c c c c c c c c &c c c $c . c c c c c &c c c c c c c c c c c c c c c &c &c c c c c c c c c c :c *;-c . cc cc c c 8c *c ccc

c c

7 cc c c c c c c c c c c (c 'c , c c c c &c c &c &c c cc c c c c" c c c cc c c c ccc c c ( c -c " c cc c c c c c cc ( c c c c c c c c c c c c c &c &c c &c c c c c c c c c c c c +(/c c c c c +-(c. c c c c c c c c c cc c c=cc c c5 c c+/c c c c c c c c c c c c c c c c cc c c(c c c c c c c c6c c c c c c c c c c c c c ! c c c c c c c $c &c c c c c &c c c c c 7 cc c cc c c c&c c &c c

c (c

3.5 Diagnosis c c &c c c c c c c c c c c c c c c c c c c c c c c c c c c c &cc cc c c c c c c c c c c H c c c c c c c $ c c c c c c c$ cc c cc c c c c c $ c c c$ cc &c8c

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c c c

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c c

c . c-c c c. cCc 9 c c c &c &c c c &c c cc c

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c

c

c

c

c

c

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c c c c c c c c c c cc V cc c c @c @c c c c c 9 c @c c c c c c c cc xc c

c c @ c c:@;cc @c c c c *c &c c c &c c c cc c c c c@ccc c c c c cc c c cc c c cc:6;c 6c c

c c c c c c c 6ccc cc c c c c c c c c c c .c .c

c

c

c

c

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c

1c

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c c c c c c c 9c c c c 8c c &c $c c c c'/I&c ccc &c c-c c = c c > c !c c c c c $ c &c $c &c $c &c &c cc c c c c c c c c c, c c c c : cc;c c ()Ic c c c 2Ic c c c!cc c c c c 80c *c c c 'c c c:c c c ;c -c c c c

3.8 Komplikasi

c c c c c c c c Î c c c &c c c c c c c c c c c c c &c c c c c c :K*I;&c c c c :'I*)I;&c c c c c c c :*I/I;c

c :/I'/I;&c c c c c c &c

c c c c c c c c c :N/)I;c c c c c c c c c c c c c ccc cc c c6 c c c c c c c c0c c c c c c 2cc c 3.9 Prognosis c c c cc c cc c c c c c c c c c c c c $ c c c c $ c c c c c c c c 6 c c c c $ c c c c c &c c c $ c c c c c -)Ic c , c c $ c c &c c c c c c c c c c c Î VV c c V c cc c c c 2c îc c

BAB 4 DISKUSI KASUS c

%6c

"5#c

c

c

c

c

c

c c c c /(c c

c c c c c c c c 'c c c &c cc c c c c c c c c c c c $ c +(+/c c cc+/c c /&2Ic c c 3&*Ic c c c cc c ! c c c c &c &c

c

c

c c /(c &c c c c

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c

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c c c c c c

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&c c &c

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cc c c c c c c c c : c

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c

c

c c c c &c c c

c c c c c cc c c ccc c c c ;&c c c c c c c c c ccc c c c c c

c

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c

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c

c

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c c c c c c c c c c c c c c c H c

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6c

c

c

c

c c c c

c $ c 7 c c c c 8c c c c &c

8ccccccccC!c6 c')=c

c > &c c &c

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c

c

c

7 c

c c c c

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c c cc

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c c

c

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c c c c c

cc c8c 5c$c8ccccc 5c c8ccc 5cc8ccccc

c $ c c c c c $ c c c c cc c c c

½ c c

BAB 5 PERMASALAHAN c

*c 5 ccc ccc Pc c &c c c c c c c c c &c c &c c c &c c c c c c c 5 =+c c c +/c c*c c c c 'c 5 c cc ccc Pc

c c c c c c &c c c c $ c # c c c c c c c

c c c c ccc c c -c ,c cc cPc

cc c8c 5c$cc

8cccc

5c cc

8cc

5ccc

8cccc

½×c c

BAB 6 KESIMPULAN

, c &c c cc &c cc c /(c c c c c c c c c c

c c &c c c

c c c c c c

c5 =+c c c c c c+/c c*c c c c c c c c c c : ;c c c c c c c c c c &c c &c c c &c c c # c c c c c c c c c c c ccc c

½Ñc c

BAB 7c SARANc c cc

c cc c c c 8c *c c c c ccc &c c c cc c c $c 'c c c &c c c c c c c c c -c c c c

½c c

DAFTAR PUSTAKA

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VV Vc 8c6# c cc

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cQ c c''c$ c')**Rc 1c c9 &cD

c@c VV Vc ccc c8cc 8== = = 'cQ c cc ''c$ c')**Rc 2c 9 &c'))'&c c c##c c+ c! c " &c,c, &c#$ c c# cc 3c c c. &c'))3c cc c8c 8== = = c c c

½½c c

Spondylolisthesis

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