Cerebral Infarction

As Neurosurgical Post Operative Complication : Serial Cases
ABSTRACT


Oleh: Ferry Wijanarko, dr, Sp BS

Many of the complications following surgery, previously critical, are now preventable or readily curable as a result of advances in anaesthesia, transfusion, fluid and electrolyte management, and control of infection. A cerebral infarction is the ischemic due to a disturbance in the blood vessels supplying blood to the brain. A cerebral infarction occurs when a blood vessel that supplies a part of the brain becomes blocked or leakage occurs outside the vessel walls. This loss of blood supply results in the death of that area of tissue. Cerebral infarctions vary in their severity with one third of the cases resulting in death.

Symptoms of cerebral infarction are determined by topographical localisation of cerebral lesion. If it is located in primary motor cortex- contralateral hemiparesis occurs, for brainstem localisation typical are brainstem syndromes: Wallenberg's syndrome, Weber's syndrome, Millard-Gubler syndrome, Benedikt syndrome or others. Infarctions will result in weakness and loss of sensation on the opposite side of the body. Physical examination of the head area will reveal abnormal pupil dilation, light reaction and lack of eye movement on opposite side. If the infarction occours on the left side brain, speech will be slurred. Reflexes may be aggravated as well.

We have tried to investigate patients who have cerebral infarction as neurosurgical post operative complication. There were 23 patients in Dr. Soetomo hospital from April 2009 to March 2010. The present study was undertaken to determine the nature, timing, and pattern of the complications relative to the patient's preoperative status, the magnitude of operative injury, and the stage of his post-operative response in which the complication occurred. As a result, it might be possible to identify predisposing factors, or at least predict those patients in whom such accidents are likely to occur as a part of their response, or failure to response, to accidental or surgical trauma.