PERDARAHAN SUBARAKNOID

A. Definisi
Perdarahan subaraknoid adalah perdarahan yang terjadi secara mendadak di dalam
ruang subaraknoid, darah mengumpul di bawah lapisan araknoid dan berada di atas
lapisan pia mater.
B.
perdarahan yang terjadi didalam ruang
subarachnoid akibat trauma kapitis yang
sering disebabkan oleh kontusio serebri

Perdarahan subarachnoid (PSA) terjadi akibat pembuluh darah disekitar

permukaan otak pecah, sehingga terjadi ekstravasasi darah ke ruang
subarachnoid. Perdarahan subarachnoid umumnya disebabkan oleh rupturnya
aneurisma sakular atau perdarahan dari arteriovenous malformation (AVM).

Perdarahan di dalam rongga subarachnoid akibat robeknya pembuluh darah dan permukaan
otak, hampir selalu ada pad cedera kepala yang hebat.
Tanda dan gejala :
Nyeri kepala
Penurunan kesadaran
Hemiparese
Dilatasi pupil ipsilateral
Kaku kuduk

Gejala klinis :
Timbulnya nyeri kepala di daerah suboksipital secara
tiba-tiba
Pusing, mual, muntah
Kesadaran menurun hingga koma
Kaku kuduk (+)
Suhu tubuh meninggi
Refleks patologi (+)
Umumnya terjadi gejala diffus, sekali-sekali bisa
timbul kejang atau gejala fokal
LP berdarah.
Louis R. Caplan, MD 2005 Stroke American Academy of Neurology AAN Press page 11-14
Bleeding into the fluid around the brain is called subarachnoid hemorrhage,
because the blood collects and stays under the arachnoid membrane
that lies over the pia mater. Subarachnoid hemorrhages are usually
caused by rupture of an aneurysm, a weakened artery with a wall
that is ballooned outward. The artery breaks, spilling blood instantly into
the spinal fluid that circulates around the brain and spinal cord. The sudden

release of blood under high pressure increases the pressure inside

the skull and causes severe, sudden-onset headache, often with vomiting.
The sudden increase in pressure causes a lapse in brain function,
and the patient may stare, drop to his knees, or become confused and
unable to remember anything.
Most often, the symptoms in patients with subarachnoid hemorrhage
relate to a general decrease in brain function, because usually
there is no bleeding into one part of the brain. The decreased function is
caused by increased pressure within the skull. In contrast, in patients
with intracerebral hemorrhages, the hematoma is localized and causes
loss of function related to the area damaged by the local blood collection.
For example, if the bleeding occurs into the left cerebral hemisphere, the
patient often has weakness and loss of feeling in the right limbs and a
loss of normal speech, whereas a hemorrhage into the cerebellum will
cause dizziness and a loss of balance.