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  • Sutis Nasia, dr, SpS

  • PENDAHULUAN

    Tumor primer (70-80%):

    Otak dan selaput otak

    Insidensi 6: 100.000

    Tumor sekunder (20-30%):

    metastase paru, tiroid, payudara, prostat, cervix, dll

  • Lokasi Tumor

    Supratentorial

    Infratentorial

    Dewasa 80% supratentorial : 20% Infratentorial

    Anak 40% supratentorial : 60% Infratentorial

  • KLASIFIKASI TUMOR :

    Klasifikasi Samuels (1986) berdasarkan atas lokasi tumor,

    1. Tumor supratentorial

    a. Hemisfer otak :

    Glioma : - glioblastoma multiforme

    - astrositoma

    - oligodendroglioma

    Meningioma

    Tumor metastasis

    b. Tumor struktur median :

    Adenoma hipofisis

    Tumor glandula pinealis

    Kraniofaringioma

  • 2. Tumor infratentorial

    Dewasa :

    a. Schwannoma akustikus (neurilemmoma, neurinoma akustik)

    b. Tumor metastasis

    c. Meningioma

    d. Hemangioblastoma (Von Hippel Lindau)

    Anak-anak :

    a. Astrositoma serebelaris

    b. Medulloblastoma

    c. Ependimoma

    d. Glioma batang otak

  • 3. Tumor medulla spinalis

    a. Ekstradural : Metastasis, Dermoid

    b. Intradural :

    Ekstramedular :

    Meningioma

    Neurofibroma (30 %)

    Angioma

    Intramedular : Ependimoma (60 % tumor MS)

  • Most common brain tumors in adults Meningiomas

    Glioblastomas

    Pituitary adenomas

    Metastatic tumors

  • Most common brain tumors in children Astrocytomas

    Medullobastomas

  • ETIOLOGI ::

    1. Bawaan (meningioma, astrositoma dan neurofibroma)

    2. Bangunan embrional yang tersisa (kraniofaringioma, teratoma

    intrakranial, kordoma,.

    3. Radiasi dengan dosis terapeutik dapat merangsang sel-sel

    mesenkhimal. Beberapa laporan bahwa radiasi berperan

    timbulnya meningioma.

    4. Virus (virus Epstein Barr) disangka berperan dalam

    genesisnya Burkitts lymphoma juga karsinoma anaplastiknasofaring.

    5. Zat-zat karsinogenik methylcholanthrone dan nitro-ethyl-urea dapat menyebabkan tumor otak primer.

  • CAUSES

    Only unequivocal risk factor for glial and meningeal neoplasms is ionizing radiation.

    Alledged to increase the risk of brain tumors

    Use of cellular telephones

    Exposure to high-tension wires

    Use of hair dyes

    Head trauma

    Dietary exposure to n-nitrosurea compounds

  • DIAGNOSIS

    Based on classic symptoms (headache) and findings on neurologic exam that are substantiated by specific diagnostic imaging.

  • TREATMENT Surgery is part of the initial management of virtually

    all brain tumors.

    Establishes diagnosis

    Relieves symptoms

    Radiation therapy is useful in the management of malignant brain tumors.

  • Meningioma

  • CT-scan Meningioma

  • Edema cerebri

    Meningioma

  • operasi

    radiosurgery

  • METASTASIS KE OTAK

  • SISTEM LIQUOR CEREBRI SPINAL LCS diproduksi 500 cc / hari

    Plexus choroidalis di ventrikel lateralis-III-IV

    Hidrosefalus

    Peningkatan cairan sekresi

    Hambatan absorbsi

  • TerapiAtasi Etiologi : SAH, Meningitis, Tumor, dll

    Drainage :

    -eksternal : infeksi/septik

    -Ventriculo-peritoneal shunt: steril

  • VP-shunt

  • TRAUMA CAPITIS

  • SUBDURAL HEMATOMA

  • EPIDURAL HEMATOMA

    BICONCAF