1.

Cerebrospinalfluid(CSF)isproduced
a. bythechoroidplexus.
b. bytheependymalsurface.
c. bythebrainparenchyma.
d. bybulkflowfromthebrain.
e. alloftheabove

2.Theinternalcerebralveinreceiveseachofthefollowingveinsexceptthe
a. choroidalvein
b. epithalamicvein
c. greatcerebralveinofGalen
d. septalvein
e. thalamostriatevein

3.Whichofthefollowingistrueofpapilledema?
a. Absenceofvenouspulsationsisareliableindicatorofpapilledema
b. Mayprogresstototallossofvision
c. Thecongestedcapillariesderivefromthecentralretinalvein.
d. Unilateraledemaoftheopticdiskisneverseen.
e. Theopticmarginiswelldefined

4.Whichofthefollowingistrueoftuberculousmeningitis?
a. Headacheisusuallyabsent.
b. Ifuntreated,theclinicalcourseisselflimited.
c. Theinflammatoryexudateisconfinedtothesubarachnoidspace.
d. Theinflammatoryexudateisneverfoundatbasalmeninges
e. Theproteincontentofthecerebrospinalfluid(CSF)isalmostalwayselevated.

5.Whichofthefollowingantiseizuredrugshastheshortesthalflife?
a. carbamazepine
b. ethosuximide
c. diazepam
d. phenytoin
e. valproate
6.A45yearoldrighthandedmanwhohasbeenHIVpositiveforthepast3yearshasnoticed
somesortofvisualchangeoverthepast1to2months.Itisdifficultforhimtodescribe,butitis
somesortofdistortionofpartofhisrightvisualfield.Thereisa4cmrimenhancinglesioninthe
leftoccipitallobethatisrevealedbyMRI.Whichofthefollowingtumortypesiscommoninthe
brainofpatientswithAIDS,butotherwiseextremelyrare?
a. Lymphocyticleukemia
b. Metastaticlymphoma
c. Primarylymphoma
d. Kaposi'ssarcoma
e. Lymphosarcoma

HIV/AIDSrelated NonHodgkin lymphoma (NHL) is the second most common cancer

associatedwithHIV/AIDS,afterKaposi'ssarcoma.TherearemanydifferentsubtypesofNHL.

1
The most common subtypes of NHL in people with HIV/AIDS are primary central nervous
systemlymphoma(affectingthebrainandspinalfluid),foundin20%ofallNHLcasesinpeople
withHIV/AIDS,primaryeffusionlymphoma(causingfluidtoaccumulatearoundthelungsorin
the abdomen), or intermediate and highgrade lymphoma. More than 80% of lymphomas in
people with HIV/AIDS are highgrade Bcell lymphoma, while 10% to 15% of lymphomas
among people with cancer who do not have HIV/AIDS are of this type. It isestimated that
between4%and10%ofpeoplewithHIV/AIDSdevelopNHL.

7.Thetreatmentofchoicefortoxoplasmosisis
a. penicillin
b. praziquantel
c. pyrimethamineandsulfadiazine
d. rifampinandnafcillin
e. thiabendazole

8.Theexternalurethralsphincterisinnervatedby
a. parasympatheticpelvicnerves
b. somaticpudendalnerves
c. sympathetichypogastricnerves
d. AandB
e. BandC

9.Whichofthefollowingisleastsuggestiveofaparietallobelesion?
a. astereognosis
b. lossofpositionsense
c. lossoftemperaturesensation
d. lossoftwopointdiscrimination
e. atopognosia

Features of parietal lobe lesions are as follows:

Unilateral parietal lobe

Contralateral hemisensory loss

Astereognosis inability to determine 3-D shape by touch.

Agraphaesthesia inability to read numbers or letters drawn on hand, with

eyes shut.

Contralateral homonymous Lower quadrantanopia

Asymmetry of optokinetic Nystagmus (OKN)

Sensory Seizures

Extinction phenomenon (contralateral)

2
 Dominant hemisphere

Dysphasia/Aphasia

Dyscalculia

Dyslexia a general term for disorders that can involve difficulty in learning to
read or interpret words, letters, and other symbols.

Apraxia inability to perform complex movements in the presence of normal

motor, sensory and cerebellar function.

Agnosia (tactile agnosia) inability to recognize or discriminate.

Gerstmann syndrome Characterized by acalculia, agraphia, finger anomia

and difficulty in differentiation of right and left.

Non dominant hemisphere

Spatial disorientation

Constructional apraxia

Dressing apraxia

Anosognosia a condition in which a person suffering disability seems to be

unaware of the existence of his or her disability.

10.Whichofthefollowingfibertractsisnotapartofthelimbicsystem?
a. diagonalbandofBroca
b. fornix
c. mammillothalamictract
d. medialforebrainbundle
e. thalamicfasciculus

11.Abouthemodynamicsinbrain,except:
a. CPP=MAPICP
b. NormaladultCPPis>50mmHg
c. CPPwouldhavetoraiseupto50mmHginanormalbrainbeforeCBFwouldbe
impaired
d. EmergencymeasuresshouldbeinitiatedifICP>2025mmHg
e. NormalICPinadultsandolderchildrenis<1015mmHg;youngchildren03
07mmHg;interminfants1.506mmHgrespectively

12.Themostsignificantcontributiontothenasalseptumismadebythe
a. ethmoidandfrontalbones
b. ethmoidandsphenoidbones

3
 c. ethmoidandvomerbones
d. frontalandvomerbones
e. sphenoidandvomerbones

13.ThemostcommoncauseoflobarICHinelderlynormotensivepatientsis
a. Tumor
b. AVM
c. Trauma
d. Amyloidangiopathy
e. Aneurysm

14.ThemostcommonsiteofSpontaneousIntracerebralhemorrhageis
a. Lobar
b. Putamen
c. Cerebellum
d. Thalamus
e. Pons

15.A30yearsoldmaleisbroughttotheemergencydepartmentafteramotorvehiclecrash.His
GCSscoreis13.Hebeginstohaveseizureactivityintheemergencydepartmentandtheseizure
is continuing after several minutes. What is the pharmacologic treatment of choice for the
seizure?
a. Phenobarbital
b. Pancuronium
c. Phenytoin
d. Lorazepam
e. Paraldehyde

16.

a.EpiduralHematoma
b.Subduralhematoma
c.Intracerebralhematoma
d.Subarachnoidhemorrhage
e.Intraventricularhemorrhage

17.Apatientsuffersalargeintracranialhemorrhage.Onexamination,hehasrightfixeddilated
pupilandseemstobehemipareticontheleftside.Whichtypeofherniationdoesthispatient
have?
a. Uncalherniation
b. Subfalcineherniation
c. Tonsillarherniation
d. Centraltranstentorialherniation
e. Transcalvarialherniation

18.A71yearsoldmansuffersamassiveintracranialhemorrhageandnobrainstemreflexesare

4
presentonexamination.Thefollowingisnotconsistentwithadiagnosisofbraindeath:
a. Apnea test with no respiratory movements observed at a partial pressure of carbon
dioxidelevelof45mmHgwithacorebodytemperatureof31C
b. Absentbrainstemreflexes
c. CerebralangiographyshowingabsentfillingofcontrastintheCircleofWillis
d. NocerebralelectricalactivityonanEEGrecordedfor30minute
e. AbsentsignalsoftranscranialDoppler

19.A62yearoldpatientisfoundtohaveabrainmass.AnimageofhisMRIisshownbelow.
Whatarethecharacteristicsofthesurroundingcerebraledema?

a. ItiscausedbydisruptionoftheCSFflow
b. ItoccursfromNaKATPasepumpfailure
c. Itiscytotoxicedema
d. Itisvasogenicedema
e. Itiscausedbyobstructivehydrocephalus
AxialT2WMRI

20.Whichofthefollowingstatementsregardingprinciplesofmedicalethicsisincorrect?
a. Beneficenceistheprincipleofofferingtopatientsdiagnostictestingorinterventionsthat
wouldbeofbenefittothem
b. Nonmaleficenceistheprincipleofrefrainingfromprovidingpatientswithtreatmentsthat
willbeharmful
c. In medicine, practicing beneficence and nonmaleficence often entails weighing risks
againstbenefits,sincesomemedicalinterventions,whileperceivedasbeingbeneficial,
carrypotentialrisks
d. Justiceistheprincipleoffairandequitabledistributionofbenefitstoindividuals
e. Autonomyistheprincipleofprovidingpatientswithlimitedoptionssothattheyarenot
confusedbyallthepossibilities.

21.Whichofthefollowingisnotacauseofcerebraledema?
a. Prolongedcardiacarrest
b. Hypernatremia
c. Liverfailure
d. Leadintoxication
e. Rapidascentintohighaltitude

22.Whichofthefollowingfindingswillbeseeninacomatosepatientwithpinpointpupils?
a. Noresponsetopainonmotorexaminationandataxicbreathing
b. Apneusticbreathingpattern
c. Hyperventilationpatternwithdecorticateposture
d. CheyneStokesbreathing
e. Hyperventilation

23.A34yearoldmanpresentswithascendingparalysisoccurring2weeksafteradiarrheal
illness.Onexaminationhehasweaknessofallfourlimbs,moredistallythanproximallyanddeep
tendon reflexes are absent. Analysis of CSF shows 1 mcL WBCs (normal up to 5

5
lymphocytes/mcL)andaproteinlevelof114mg/dL(normalupto45mg/dL).Regardinghis
condition,whichofthefollowingisincorrect?
a. Corticosteroidarenotindicated
b. Vitalcapacityshouldbemeasuredfrequently
c. Hypercapnia on arterial blood gas is the most sensitive indicator of the need for
intubation
d. Bloodpressureandheartmonitoringisnecessaryinthesepatients
e. Intravenousimmunoglobulintherapyofplasmapheresiscanbeusedinthiscase

24.A16yearoldgirlisinvolvedinamotorcycleaccidentwhileridingwithherboyfriend.She
wasnotwearingahelmet.Onexamination,sheiscomatose,hasbruisingaroundhereyesand
behindherrightear,anddrainageofclearfluidfromthenoseandtherightear.Basedonthe
findings,whichofthefollowingismostlikelypresentinthiscase?
a. Epiduralhematoma
b. Skullbasefracture
c. Intraparenchymalhemorrhage
d. SAH
e. Subduralhematoma

25.A20yearoldmanhadamotorvehicleaccident.Hewaswearingahelmet.However,he
sufferedlungcontusion,leftsidedpneumothorax,multiplefractures,andspleniclaceration.He
remainedcomatose.Hisexaminationafewdaysafteradmissiondemonstratedmultiplepetechial
hemorrhagesthroughouttheskin,particularlyintheaxillaryregion.Thepatientdiedafewdays
later. On autopsy, the brain showed multiple diffuse petechial hemorrhages. Which of the
followingcausesexplaintheneuropathologyfindings?
a. Fatembolization
b. Diffuseaxonalinjury
c. Meningococcalmeningitis
d. Coupandcontrecoupinjury
e. SAH

26.Theposteriorcommunicatingarteryconnects
a. Thevertebralarterytothemiddlecerebralartery
b. Themiddlecerebralarterytotheanteriorcerebralartery
c. Posteriorcerebralarterytotheinternalcarotidartery
d. Vertebralarterytothemiddlecerebralartery
e. Rightanteriorcerebralarterytotheleftanteriorcerebralartery

27.Thevesselthatpassesthroughtheforamenspinosumismostlikelytocausewhichofthe
followingifitisdamaged?
a. Epiduralhematoma
b. Subduralhematoma
c. Subarachnoidhemorrhage
d. Intracerebralhemorrhage
e. Intraventricularhemorrhage

6
28. A 47yearold man comes to the physician 12 hours after the sudden onset of a severe
occipitalheadacheandstiffneck.Hehasnothadanyothersymptomsandhasnohistoryof
severeheadache.Hehashypertensionandgastroesophagealrefluxdisease.Currentmedications
include hydrochlorothiazide and ranitidine. He is oriented to person, place, and time. His
temperatureis36.7C(98.1F),pulseis100/min,andbloodpressureis160/90mmHg.Rangeof
motionoftheneckisdecreasedduetopain.Neurologicexaminationshowsnofocalfindings.
Whichofthefollowingisthemostlikelydiagnosis?
a. Clusterheadache
b. Meningitis
c. Migraine
d. Subarachnoidhemorrhage
e. Tensiontypeheadache

29.TheDepartmentofNeurosurgeryatRumahSakitH.AdamMalikMedan/MedicalFaculty
UniversitasSumateraUtarawasfoundedon:
a. November2006
b. November2007
c. November2008
d. November2009
e. November2010

30.Theserumosmolarityofapatientwithasodiumlevelof130meq/L,Kof4.0meq/L,glucose
of126mg/dL,andbloodureanitrogen(BUN)of28mg/dL,is
a. 276
b. 285
c. 296
d. 304
e. 310

QUESTIONS

1. DescribethehistoryofneurosurgeryinIndonesiaandmentionthefoundingfathers
PusatpertolonganbedahsarafpertamasekalidipeloporiolehProfCHLoensoekwarga
negarabelandakelaiharnasemarangdiprincessmargarethospitaltahun1948.Beliau
mengajakahlibedahsarafdaribelandauntukbekerjaselama6bulansecarabergantian
dengandukarela.Diantaranyaadalah:
Dr.Haenrat,Dr.Noordenboos,DRAcDeVet,Dr.Wiersma,ProfLoensoek,MPAMde
grooddandiakhirioelhdr.pedroalbert.Pelayananinidilakukansampaitahun1953.
Dr.indonesiayangpertamasekalisekolahbedahsarafdanbekerjadiklinikPrincess
margaret(padatahun1949diserahkankepemerintahIndonesiadandiberinamaKlinik
radensalehyangdikelolaPMIIndonesia)adalahProf.SKHandoyodanProfSoewadji
Prawirohardjo.Tahun1952 Dr.Basoeki skolahkebelandadankembalipadatahaun
1958membangunbedahsarafdisurabaya.Tahun1962dr.Iskarnomemulaipendidikan

7
 neurologidanbedahhinggakesemarangdanakhirtahun1971kembalidaripendidikan
bedahsarafdijermandanditempatkandiuniversitaspadjajaranuntukmengembangkan
bedahsarafdiBandung.Dr.Padmosantjojomemulaikarirsebagaiasistenbedahsaraf
diklinikradensalahpadatahun1962yangkemudiansekolahbedahsarahdiBelandadan
kembali ke Indonesia pada tahun 1969. Beliau mengembangkan klinik raden saleh
berikutnya.
Center Jakarta prof handoyo, prof soewadji, prof padmo Hilman Mahyuddin dan
Amanullah(jakarta),Dr.PSudiharto(UGMYogya),dr.LukasBudionoA,drTrihadji
(SemarangUndip)
CenterBandungprofIskarnodr.BenyAWdanProfKahdarSetyowididanM.Z
Arifin
CenterSurabayaProf.Basoekidr.SaidDarmadipura,UmarKasandanHafidBajamal
BedahSarafdiMedan:
Tahun1970stelehpensiunprofSoewadjipindahkemedandanmelayanibedahsarafdi
RSTembakauDelidanElisabethdankembalikejakartapadatahun1982.
September1983,profgofaryangbarumenyelesaikanpendidikanbedahsarafdiUNPAD
diminta Dekan Prof Bachtiar Fanany untuk menjadi staf di FK USU. Tahun 1984
dibukalahsubbagbedahsarahdideprtemenbedahfkusu.Tahun1985dibukapelayanan
bedahsarafdiRSDr.Pirngadidandiangkatprofgofarsebgaikepalaunit.
Tahun1986ProfIskandarJapardi(UNPAD)danProfAdrilArsyadHakim(UNAIR)ikut
bergabungdimedan.Tahun1991saatRS.AdamMalikselesaidansitunjukprofAdril
menjadikepalasmfbedahsaraf.
Tahun1995terjadiperalihanjabatan,profgofarsbgkepalasmfbedahsarafadammalik
danprofiskandarsebagaikepalaunitbedahsarafdr.pirngadi.
10tahunkemudian
2005ProfIJpindahkedivbedahsarafFKUSUAdammalikdansebagaipengantika
SMFpirngadiditunjukdr.Rezekisembiring.

Tahun2006dibuatproposalpendirianIPDSBedahsaraf.
Tahun2007ikutbergabungdr.Ridhadr.Susi,dr.Mahyudanilmenjadistaf
November2008keluarSKIzinIPDSBedahSaraf
SKstrukturdesember2008hinggasekarang

2. Describetheprimaryandsecondaryinsultsoftraumaticbraininjuryandhowtoprevent
thesecondarybraininjury
Primary : cedera yang timbul saat terjadi contact injury atau inertial injury berupa
intrakranialhematome,laserasi,Hemorrhage,axonalinjury,intrakranialinsult(edema,
pengingkatanTIK)dansistemikinsult(hipoksiadanhipotensi)
Secindary:adalahreaksipadatingkatselularyangterjadiakibatprimarybraindamage.
Reaksimerupakanresponmolekularneuroprotektifyangmengarahkeapoptosissel.
Untukmencegahsecondarybraindamage:
1. Bloodpressuredanoksigenasi:cegahhipotensi(SBP<90mmHg)dancegah
hipoksia(PaO2<60mmHgatauSaO2<90%)
2. MonitoringICPnormal
3. Hyperosmolartherapydosismanitol0,5g/kgBB,25%mannitol(250mg/ml)
4. Anastetic,Analgesic,Sedatif
5. Surgicalmanagement

8
3. Describetheopticpathway.Providewithappropriatediagram.Oke(terpentingoptic
nerve, optic chiasma, optic tract, optic radiation/geniculo calcarine tract, lateral
geniculatedbody,danseluruhdefectvisualfield
4. AnMRangiogramoftheCircleofWillisisshownhere.Identifythelabeledstructure

a. Leftvertebraa
b. RightVertebrala
c. Rightantcereberala
d. Basilaris
e. LSuperiorcereberala
f. Lposteriorcerebrala
g. RPCom
h. Gaktau
i. RInternalcarotid
j. LACA
k. LMCA
l. ACom
m. RMCA

CASEBASEDQUESTIONS

1.A40yearoldwomanpresentswithheadaches andblurredvisionongoingfor several

years.Recently,herheadachesweregettingworseandshewenttoseeaneurologist,who
orderedamagneticresonanceimaging(MRI)scan.Uponexamination,youfindthatshehas
a right temporal hemianopsia and decreased visual acuity of 20/50 in both eyes. The
remainderofherneurologicexamisnormal.

9
 a. InterprettheMRI.
b. Whatothersymptoms/signsdoyoususpectinthispatient,andwhatotherinvestigative
measureswouldyouliketoobtain?
c. Whatisyourdifferentialdiagnosis?

2.A60yearoldmanwasreferredwitha3yearhistoryofrightsidedfacialpain.Thepain,
which was described as stabbing, was in the cheek. It had been occasional but had now
increased in frequency such that he was experiencing several episodes a day. The pain was
triggeredbyanythingthattouchedthefaceandwhenheateorbrushedhisteeth.Theseveritywas
suchthathecouldnoteatortalknormally.
a. Whatisthediagnosis?
TrigeminalNeuralgia
b. Whatinvestigationsarerequired,andwhataretheotherpossiblediagnosestoconsider?
DD:Trigeminalterkaittumor,SklerotikNervusTrigeminal,PostTraumaticTrigeminal,
PostHerpeticTrigeminal.
PemeriksaanPenunjang:MRI,CTScan,
c. Whatarethemanagementoptions?
Medikamentosa:Carbamazepin,Fenitoin,Gabapentin
Operative:MSD

3.A35yearoldwomanwasanunrestraineddriverinacaraccident.Shestruckhershoulder
againstthesteeringwheel,whichcausedrightarmweaknessandnumbness.Sheisunableto
raisethearmorflexattheelbow.Painfulparesthesiasandnumbnessinthethumbandindex
fingerhavealsobeenpresentsincetheaccident.Imagingrevealednofracturesorrotatorcuff
tears.Despitephysicaltherapy,shehashadnoevidenceofrecoveryinthe3monthssincethe
accident.Onexamination,shehasatrophyofthedeltoid,supraspinatus,infraspinatus,andbiceps
muscles.Shecannotflex,abduct,orexternallyrotatethearmattheshoulderjoint.Shealso
cannotflexattheelboworsupinatetheforearm.Therestofherarmandhandmusclesarefull
strength.Shehasnumbnessalongtheradialforearmandhand,includingthethumbandindex
finger.ShehasapositiveTinelssignintherightsupraclavicularspacethatradiatestotheindex
finger.
a. Whatisyourdifferentialdiagnosisforthiswoman?
CervicalDiscSyndrome
DD : Sholuder Lesion, toracic Outlet Syndrome, Peripheral Nerve Lesion,
Cervicalspinetumor,acutebrachialneuritis
b. WhataresensoryterritoriesandmusclesinnervatedbyC5/C6(i.e.,theupper
trunk)?
Root:C6,MotorBiceps,ReflexBiceps,SensoryThumb

c. Whatdiagnostictestswouldyouorderforthispatient?
CSpineXRays
CT/MRI

10
 EMG,NerveConductionstudy
4.A58yearoldmanwasadmittedafterfallingdownaflightofconcretestepswhilstdrinking
alcohol.Onadmissiontotheemergencydepartmenthesmeltstronglyofalcoholandcomplained
ofheadacheandneckpain.Hewasagitatedandwasattemptingtoclimboffhistrolley.Hewas
disorientatedbutobeyingcommands(GCSE4,V4,M6),andhispupilswereequalandreactive.
The CT scan is shown below. The patient was treated conservatively. Seven days into his
admission,thepatienthasabloodtestpriortodischargeandhissodiumlevelis116mmol/L.He
isalertandorientated.

a. DescribetheCTScan
Gambaran hiperdense pada daerah frontal bilateral, dugaan
ICHakibatTBIdisertaioedemacerebri
b. Whataretherisksassociatedwithhyponatraemia?
Hiponatremia dapat disebabkan oleh SIADH, CSW
psychogenicpolydipsia,yangterjadisetelahTBI.Akibatdari
hiponatremia:
Ringan:tremor,keramotot,mualmuntah
Sedang : sakit kepala, Penurunan kesadaran, Mood Swing,
Halusinasi,edemacerebri
Berat:kejang,koma,Kematian
c. What is the likely diagnosis, and which investigations are
required?
ICHdenganCSWdanOedemaCerebri
Pemeriksaan lainnya : Elektrolit, osmolalitas darah, serum
urin,urinoutput,bodyweight,ADHserum

5.A39yearoldmanwasbroughttotheemergencydepartmentafterfallingoffaladderfroma
heightofapproximately5m.Hewasunsurehowhelandedbutdeniedlossofconsciousness.He
hadsevereneckpainatthesceneandtheambulancecrewplacedhimsupineonaboardwitha
hardcervicalcollarandblocks.Onexamination,hehasalacerationontheforehead.HisGCSis
15/15withnofocalneurologicaldeficits.Therestofthephysicalexaminationisnormal.
a. Howcanwedecideifthispatientshouldhaveimagingofthecervicalspine?
1. Adanyariwayattraumapadakepaladanleher
2. Adanyariwayatmultiple/highenergyinjury
3. Nyeripadaleher
4. Penurunankesadaran
5. Lemahanggotagerakplegiaatauparesisataudefisitneurologilainnya
6. Adanyadeformitas,edema,lukadanpatologislainnyapadaleher
b. The lateral cervical spine and openmouth odontoid views are shown below.
Describeanyabnormalities.Whatshouldbedonenext?\
Padafotolateral:C1garisfrakturdaricincinposterior,AtlantoDenseInterval
kurangdari3mm,
PadafotoOM:C1pergeseranlateraldarilateralmass(overhanging),terutama
padabagiankirimungkinmasihkurangdari7mm,
Atlantodentalspaceasimetris
KesimpulanJafersonFx
Tatalaksana:Mobilisasidenganhalovest

11
12
6. A 64yearold man presented to the emergency department after experiencing a severe
headachewhichbegansuddenlywhenhewaswatchingTV.Hefeltnauseousandhadvomited
severaltimes.Athospital,hisGCSwas14/15(E3,V5,M6),andhispupilswereequaland
reactive,withnofocalneurologicaldeficits.Hehadahistoryofhypertensionandhisblood
pressurewas181/122mmHg.
a. Whatisthedifferentialdiagnosis,andwhatinvestigationshouldbeperformed?
DD:SAH,Migrane,TTH,Stroke,Meningitis
Pemeriksaan Fisik : TD, Tingkat Kesadaran, Defisit Neurologis, Perangsangan
Meningismus(KakuKuduk,Brudzinski,Kernig),Funduskopi,
PemeriksaanPenunjang,CTtanpakontras,bilatidakdijumpaikelainanbisadilanjutkan
dengan LP. Bila dijumpai kelainan dengan kecurigaan etiologi adalah vaskular,
dilanjutkandenganangiograficerebral

b. TheCTisshownbelow.Whatisthediagnosis?Identifythearrowedfeaturesonthescan.
Diagnosis:SAH
1. Gambaranhiperdensepadafisurasylviandextradidugaperdarahan
2. Pembesaranventrikellateralfrontalhornbilateral
3. Pembesaranventrikellateraloccipitalhornbilateral.bagiankirilebihbesardari
padakanan
4. Dilatasiventrikel3
5. Hiperdensepadaruangventrikellateraloccipitalhorn,GambaranIVH
6. HipodensedianteriorFHventrikellateral,infarkcerebri,frontallobebilateral
7. Gambaranhiperdensediatastemporallobe,daerahfissurasylvianyangmeluas
hinggakefrontaldansisternabasal,RupturAneurysmaMCAdextra
8. GambaranHiperdense,perdarahansisternabasal
9. Gaktau
10. Gaktau
11. Dilatasiaquaductussylvii
12. Dilatasiventrikellateraltemporalhornbilateral
c. Whatarethecausesofsubarachnoidhaemorrhage?Whatisthelikelycauseinthis
patient?
PenyebabSpontanSAH:
Aneurysms(7580%)
Idipatik(1425%)
AVM
Infeksi
PadapasieninididugadisebabkanolehrupturaneurismadariMCAdextra

13
14