PERBANDINGAN GANGGUAN FUNGSI LUHUR PASIEN CEDERA KEPALA ANTARA LESI CONTUSIO CEREBRI DAERAH FRONTAL DENGAN TEM PORAL M ENGGUNAKAN
M ETODE M INI M ENTAL STATE EXAM INATION (M M SE)
Dasa Sariadi, M . Zafrullah Arifin
Abstrak
Cont usio cerebri t erjadi 20% - 30% dari kasus cedera kepala dan paling berat t erjadi pada daerah front al dan t emporal. HaI ini disebabkan kedua daerah t ersebut paling rentan terhadap decelerasi dan accelerasi. Lesi yang mengenai Iobus frontal dan t em poral dapat menyebabkan gangguan fungsi luhur. Tujuan penelitian ini adalah menget ahui t ingkat keparahan gangguan fungsi luhur akibat cont usio cerebri di daerah front al dan t em poral.
Penelit ian prospekt if kohort t erhadap 38 pasien cedera kepala dengan lesi eont usio cerebri di daerah f ront al dan t em poral yang di raw at di bagian Bedah Saraf RS. Dr. Hasan Sadikin periode Okt ober 2009 - Februari 2010. Pemeriksaan menggunakan met ode M ini M ent al St at e Examinat ion(M M SE) dilakukan set elah t ingkat kesadaran pasien komposment is at au GCS:15.
Hasil penelit ian dengan uji M ann Whit ney t est menunjukkan t erdapat perbedaan komponen gangguan fungsi luhur meliput i oriet asi, regist rasi, perhat ian, meningkat dan bahasa ant ara lesi cont usio cerebri di daerah front al dengan t em poral dengan nilai p≤0,05. Skor M M SE dianalisa dengan chi square test.
Suat u lesi cont usio cerebri di daerah front al memiliki derajat gangguan fungsi luhur lebih berat di bandingkan t emporal. Komponen yang paling banyak t erganggu unt uk lesi di front al adalah at ensi, sedangkan t emporal adalah memori.
COM PRARISSON OF HIGHER CORTICAL FUNCTION IN PATIENT W ITH CEREBRAL CONTUSION FROM HEAD INJURY BETW EEN FRONTAL AND TEM PORAL LOBE
USING M INI M ENTAL STATE EXAM INATION (M M SE)
Dasa Sariadi, M . Zafrullah Arifin
Abstract
Cerebral Cont usion occurs 20 – 30% in head injury cases are usually more fat al in front al and t emporal area. This occurs because t hese areas are t he most vulnerable t o decelarat ion and accelerat ion mechanism. M ore fat al in head injury, t he higher chances of dist urbance in higher cort ical funct ions of t he brain. Lesion occuring in t he front al and t emporal lobe can cause higher cort ical funct ion dist urbance. By acknowledging higher cort ical funct ion dist urbance in t hese pat ient s, a bet t er informed consent about t he pat ient s diagnosis and prognosis can be present ed t o t he family and aft er care can be managed in neurorehabilit at ion cent re. The goal of t his research is finding higher brain dysfunct ional in pat ient wit h cerebral cont usion of t he front al and t emporal lobe by using M ini M ent al St at e Exam inat ion (M M SE).
The sample size, 38 pat ient s, is calculat ed using est imat ed proport ion formula and sampling is done using purposive sampling. Normalit y t est w it h Shapiro W ilk Test t o t est variable dat a dist ribut ion of t he higher cort ical funct ion. Whereas t o compare higher cort ical funct ions w it h cerebral cont usion in front al and t emporal area use M ann Whit ney Test . M M SE score is cat egorized and analyzed using Chi Square Test . Dat a analysis by using SPSS program for windows version 13.0 w it h degree of confidence 95% wit h p<0,05.
The result show a significant difference of t he component of higher cort ical funct ions including orient at ion, regist rat ion, at t ent ion, memory, language bet ween cerebral cont usion of t he front al and t emporal area in t hese pat ient s w it h p value <0,05. From RR value of pat ient s w it h front al lobe lesion have great er chances of dysfunct ion of t he higher cort ical funct ion compared t o pat ient s w it h t emporal lobe lesion.
M ini M ent al St at e Exam inat ion (M M SE) can be used t o sort higher cort ical brain dysfunct ion in head injury pat ient s especially in cerebral cont usion so t hat t he out come of each dist urbed component can be predict ed. This informat ion can be used for bet t er informed consent and furt her neurorehabilit at ion care.
