Stroke Hemorrhagic et Causa Ruptur Aneurysma Anterior Communicating Artery: Case Report
DOI:
10.29303/jbt.v25i4.10454Published:
2025-10-30Downloads
Abstract
Bleeding in the brain is life-threatening. Two types of bleeding are subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH). SAH is defined as bleeding that occurs in the subarachnoid space, which is the space between the arachnoid membrane and the pia mater. Meanwhile, IVH is bleeding that occurs within the brain's ventricular system, which is a cavity containing cerebrospinal fluid (CSF). The incidence of SAH is quite high, reaching 8.09 million cases out of all stroke cases. Meanwhile, IVH only accounts for 0.31% of total stroke cases. The purpose of this study is to document medical cases as a form of the latest clinical knowledge. The method used is qualitative with a case study design to analyze the management of hemorrhagic stroke patients at the RSUD Buleleng. The patient underwent a neurological physical examination in the form of a meningeal sign examination, which showed positive neck stiffness, Kernig's sign (-), and Brudzinski's sign I-IV (-). Eye examination revealed that both pupils were 3 mm in size, with light reflexes +/+. The patient did not exhibit any weakness or paralysis on one side of the body. Based on clinical symptoms and findings from radiological examinations and DSA, the patient was diagnosed with Hemorrhagic Stroke + Intraventricular Hemorrhage due to rupture of the anterior communicating artery aneurysm segment A1 with daughter SAC. The patient was administered Loading Normal Saline 0.9% 18 tpm, Oxygen 3 lpm, loading Mannitol 200 mL followed by 100 mL 6 times tapering off, Citicoline 2x250 mg intravenously, Omeprazole 2x40 mg intravenously, Painless 2x400 mg, and Dexamethasone injection 2x1 ampoule. as initial treatment.
Keywords:
Hemorrhage ICH Stroke SAHReferences
Anto, E. J., Siahaan, J. M., Rusli, K., & Eyanoer, P. C. (2024). Aplikasi Citicoline dalam Pengobatan Stroke Hemoragik. Cermin Dunia Kedokteran, 51(4), 231–234. https://doi.org/10.55175/cdk.v51i4.1057
Capirossi, C., Laiso, A., Renieri, L., Capasso, F., & Limbucci, N. (2023). Epidemiology, organization, diagnosis and treatment of acute ischemic stroke. European Journal of Radiology Open, 11, 100527. https://doi.org/10.1016/j.ejro.2023.100527
Greenberg, D. A., Aminoff, M. J., & Simon, R. P. (2020). Clinical neurology (11th ed.). McGraw-Hill Education. https://neurology.mhmedical.com/book.aspx?bookID=2975
Lebedeva, E. R., Ushenin, A. V., Gurary, N. M., Gilev, D. V., & Olesen, J. (2020). Sentinel headache as a warning symptom of ischemic stroke. Journal of Headache and Pain, 21(1), 1–10. https://doi.org/10.1186/s10194-020-01140-3
Muhammad, B., & Nabila, J. (2023). Perdarahan Intraserebral. Jurnal Ilmu Kesehatan dan Gizi, 1(4), 10–15. https://doi.org/10.55606/jikg.v1i4.1677
Pedoman Nasional Pelayanan Kedokteran (PNPK) Tata Laksana Stroke. (2019). PEDOMAN NASIONAL PELAYANAN KEDOKTERAN TATA LAKSANA STROKE.
Pai, A., Hegde, A., Nair, R., & Menon, G. (2020). Adult Primary Intraventricular Hemorrhage: Clinical Characteristics and Outcomes. Journal of neurosciences in rural practice, 11(4), 623–628. https://doi.org/10.1055/s-0040-1716770
Purnama D, Ismy S, Fahmi N. (2020). Edema Serebri: Penegakan Diagnosis dan Tatalaksana. Jurnal Sinaps, 3(1), 67–74. http://jurnalsinaps.com/index.php/sinaps/article/view/127
Ropper, A., Samuels, M., Klein, J., & Prasad, S. (2019). PRINCIPLES OF NEUROLOGY ELEVENTH EDITION. https://neurology.mhmedical.com/content.aspx?bookid=1477§ionid=85536145
Starr, R. (2023). Periventricular and Intraventricular Hemorrhage. https://www.ncbi.nlm.nih.gov/books/NBK538310/
Sanicola, H. W., Stewart, C. E., Luther, P., Yabut, K., Guthikonda, B., Jordan, J. D., & Alexander, J. S. (2023). Pathophysiology, Management, and Therapeutics in Subarachnoid Hemorrhage and Delayed Cerebral Ischemia: An Overview. Pathophysiology, 30(3), 420–442. https://doi.org/10.3390/pathophysiology30030032
Treggiari, M. M., & Rabinstein, A. A. (2023). Aneurysmal Subarachnoid Hemorrhage: A Look into Recent Guidelines. Neurocritical care, 39(3), 730–731. https://doi.org/10.1007/s12028-023-01806-1
Wiratama, B. K., Kamelia, L. P. L., Kesanda, I. M. P., Agustini, N. N. M., & Kapakisan, I. K. S. (2023). Nyeri Kepala Sentinel Pada Perdarahan Subarakhnoid. Ganesha Medicina Journal, 3(2), 114-120. https://doi.org/10.23887/gm.v3i2.69356
Ziu, E. (2023). Subarachnoid Hemorrhage. https://www.ncbi.nlm.nih.gov/books/NBK441958/
License
Copyright (c) 2025 Ni Komang Putri Meilani, Luh Putu Lina Kamelia, Made Bayu Permasutha, Ni Putu Leony Puspitayanti, Luh Made Anindita Adristi Soeka

This work is licensed under a Creative Commons Attribution 4.0 International License.

Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.























