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"Merokok merupakan faktar resiko Gangguan Pembuluh Darah Otak [GPDO] dan telah diketahui bahwa ada karelasi yang kuat antara merakak dengan Infark Iskemik. Akan tetapi, karelasi antara merakak dengan Perdarahan Intraserebral masih belum jelas. Tujuan: mempelajari hubungan antara pala kebiasaan merakak dan Perdarahan Intraserebral. Hetade: Telah dilakukan penelitian kasus kelala pada penderita GPDO pria dan wanita di bangsal perawatan saraf RS Umum Cipta Hangunkusuma selama tahun 1991. Setelah jenis GPDO ditega~kan dengan CT Scan, wawancara pala kebiasaan merakak dilakukan pada penderita-penderita itu sendiri atau pada salah satu keluarga yang terdekat. Data yang ada dianalisa dengan menggunakan Rasia Odd, Mantel Haenzsel dan tes x2. Hasil: Terdapat 60 penderita Perdarahan Intraserebral sebagai kasus dan 142 penderita Infark Iskemik sebagai kantral dalam penelitian. 92,4% dari 119 respanden yang mempunyai riwayat kebiasaan merakak, mengisap rakak lebih dari 11 tahun dan 797. dari respanden tersebut mengisap rakak kretek. Rasia Odd perakak berat dan perakak keseluruhan yang mengalami Perdarahan Intraserebral adalah 0,33 · [95% Interval Kepercayaan 0,15-0,77; P<0,05] dan 0,40 [957. Interval Kepercayaan 0,20-0,77; P<0,05], sedangkan untuk bekas perakak 0,59 [95% Interval Kepercayaan 0,25-1,43;P>0,05] dan perakak ringan 0,59 [95% Interval Kepercayaan 0,22-1,56;P>0,05]. Hasil-hasil tersebut praktis sama apabila kasus-kasus hipertensi dikeluarkan. Kesimpulan: Pada penderita GPDO, yang mempunyai derajat kebiasaan merokok berat, kemungkinan mengalami Infark Iskemik lebih besar daripada Perdarahan Intraserebral.

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Smoking is a risk factor for Cerebral Vascular Disorders [GPDO] and it is known that there is a strong correlation between smoking and Ischemic Infarction. However, the correlation between peacock and intracerebral hemorrhage is still unclear. Objective: to study the relationship between peacock nutmeg and intracerebral hemorrhage. Hetade: Research has been carried out on cases of cockroaches in male and female GPDO sufferers in the neurological care ward of Cipta Hangunkusuma General Hospital during 1991. After the type of GPDO was confirmed by CT Scan, interviews were conducted on the sufferers themselves or one of their closest relatives. The existing data was analyzed using Rasia Odd, Mantel Haenzsel and x2 tests. Results: There were 60 sufferers of Intracerebral Hemorrhage as cases and 142 sufferers of Ischemic Infarction as cantrals in the study. 92.4% of the 119 respondents who had a history of the habit of smoking rakak for more than 11 years and 797 of these respondents smoked kretek rakak. The odds ratio for severe and overall silver who experienced intracerebral hemorrhage was 0.33 · [95% Confidence Interval 0.15-0.77; P<0.05] and 0.40 [957. Confidence Interval 0.20-0.77; P<0.05], while for former silver it was 0.59 [95% Confidence Interval 0.25-1.43; P> 0.05] and light silver 0.59 [95% Confidence Interval 0.22-1.56; P> 0.05]. The results were practically the same if hypertension cases were excluded. Conclusion: In GPDO sufferers, who have a heavy smoking habit, the possibility of experiencing ischemic infarction is greater than intracerebral hemorrhage.

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"Merokok merupakan masalah kesehatan masyarakat di dunia, menurut World Health Organization (WHO 1988), kebiasaan merokok cenderung meningkat akhir-akhiir ini yaitu 50% pada laki-laki dan 8% pada wanita. Rokok adalah faktor risiko dari strok yang dapat dicegah (klasifikasi serebro vascular diasease III 1990), akan tetapi mekanisme rokok sebagai penyebab strok masih kontroversi. Barigarımenteria (1993) pada penelitianya menganggap rokok sebagai faktor risiko strok yang dapat menurunkan kadar protein S. Penelitian ini bertujuan untuk melihat pengaruh rokok terhadap penurunan kadar protein S pada strok iskemik fase akut. Penelitian dilakukan di Bagian Penyakit Saraf RSUPN-CM sejak bulan Mei 1996 sampai dengan Februari 1997 dengan disain kanıs kontrol pada 45 penderita strok iskemik akut perokok dan 45 penderita strok iskemik akut non perokok yang memenuhi kriteria inklusi. Semua penderita Paki-laki dengan rentang usia seluruh penderita 40 74 tahun. Pemeriksaan protein S dilakukan pada fase akut selambat-lambatnya hari keenam setelah serangan, menggunakan metode koagulometrik. Nilai standard protein 3 untuk orang Indonesia 76% 121,2%. Penilaian hasil aktifitas kadar protein S menurun bila nilai kurang dari 76%. Rerata usia pada kasus 57,2 ± 7,5, tahun dan rerata usia kontrol 56,9 ± 7,9 tidak terdapat perbedaan yang bermakna antara usia kasus dan kontrol (p=0,421). Rerata lama merokok 15,6 ± 8 talaan, 71% (32 orang) merokok lebih dari 10 tahun dan 28,8% (13 orang), merokok kurang dari 10 tahun, didapatkan perbedaan yang bermakna penurunan aktifitas protein S antara kasus dan kontrol (X 11,37, p- 0,0018; Ratio Odds 11,2). Rerata jumlah rokok yang dikonnanai perhari 15 ± 8 batang perhari, 35,5% (16 orang) merokok lebih dari 20 batang perhari, 64,4% (29 orang) merokok kurang dari 20 batang perhari (X²-4,45; p 0,0349, Ratio Odds-7,89). Semua penderita perokok kretek, 26,78% (12 orang) perokok kretek filter dan 73,3% (33 orang) perokok kretek non filter. Tidak didapatkan perbedaan bermakna perokok kretek filter dan non kretek filter (X=0,72; p = 0,403). Didapatkan penurunan aktifitas kadar protein S yang bermakna pada kasus dibanding dengan kontrol (Ratio Odds 14,3). Rata-rata aktifitas kadar protein S pada kasus 50,6% dan rata-rata pada kontrol 85,5%, terlihat perbedaan yang bermakna dengan uji t-test 7,5; p 0,0001. Tujub puluh lima persentil aktifitas kadar protein S menurun dibawah nilai standard normal pada kasus dan hanya lima belas persentil pada kontrol. Lama merokok dan jumlah rokok yang dikonsumsi setiap hari mempunyai pengaruh yang bermakna terhadap penurunan aktifitas kadar protein S (t-test-4,25; p- 0,0001; 95% CI 15,5-45,7) dan (t-test = 2,65; p=0,011; 95% CT 4,1-30,2.

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Smoking is a public health problem in the world, according to the World Health Organization (WHO 1988), smoking habits tend to increase recently, namely 50% in men and 8% in women. Cigarettes are a risk factor for preventable stroke (cerebro vascular disease classification III 1990), however the mechanism of smoking as a cause of stroke is still controversial. Barigarımenteria (1993) in his research considered smoking as a risk factor for stroke which can reduce protein S levels. This study aims to see the effect of smoking on reducing protein S levels in the acute phase of ischemic stroke. The research was conducted in the Neurological Diseases Department of RSUPN-CM from May 1996 to February 1997 with a control design on 45 acute ischemic stroke sufferers who were smokers and 45 sufferers of acute ischemic stroke who were non-smokers who met the inclusion criteria. All Paki sufferers were male with an age range of 40 to 74 years. Protein S examination is carried out in the acute phase no later than the sixth day after the attack, using the coagulometric method. The standard value of protein 3 for Indonesians is 76% 121.2%. Assessment of activity results means S protein levels decrease if the value is less than 76%. The mean age of cases was 57.2 ± 7.5 years and the mean age of controls was 56.9 ± 7.9. There was no significant difference between the ages of cases and controls (p=0.421). The average number of cigarettes consumed per day was 15 ± 8 cigarettes per day, 35.5% (16 people) smoked more than 20 cigarettes per day, 64.4% (29 people) smoked less than 20 cigarettes per day (X²-4.45; p 0.0349, Odds Ratio-7.89). All sufferers were kretek smokers, 26.78% (12 people) were filter kretek smokers and 73.3% (33 people) were non-filter kretek smokers. There was no significant difference between filtered kretek and non-filtered kretek smokers (X=0.72; p = 0.403). There was a significant decrease in the activity of protein S levels in cases compared to controls (Odds Ratio 14.3). The average activity level of protein S in cases was 50.6% and the average in controls was 85.5%, showing a significant difference using the t-test of 7.5; p 0.0001. Seventy-fifth percentile activity levels of protein S decreased below normal standard values ​​in cases and only fifteen percentiles in controls. Length of smoking and the number of cigarettes consumed each day had a significant influence on reducing the activity of protein S levels (t-test-4.25; p-0.0001; 95% CI 15.5-45.7) and (t-test = 2.65; p=0.011; 95% CT 4.1-30.2."

"Diagnosis strok sering ditegakkan berdasarkan pembuktian klinis dengan anamnesis dan pemeriksaan klinis neurologis saja. Akan tetapi gambaran klinis yang ditemukan tidaklah selalu sama, seringkali bervariasi sehingga diagnosa topis tidak selalu tepat. Diteliti hubungan antara gambaran klinis dengan topografi anatomi/ tipe infark pada CT-sken otak pad a penderita strok iskemik. Penelitian ini dilakukan secara prospektif, "cross sectional" dan bersifat deskriptif analitik. Populasi adalah penderita strok iskernik kejadian pertama berusia 40 tahun dan 65 tahun yang dirawat di ruang perawatan klas III RSUPN-CM Jakarta. Sejak bulan April sampai dengan Juli 1996, didapatkan 52 kasus strok iskemik kejadian pertama. Terdiri dari 34 laki-laki (65,3%) dan perempuan 18 (34,7%) dengan rasio laki : perempuan adalah 1,9 : 1 . Strok trombosis ditemukan terbanyak yaitu 93,9% sedangkan strok emboli 6,1 %. Dari 52 penderita yang diteliti, didapatkan basil CT-sken otak adalah 29 (59,2 %) berupa infark tentorial , 20 (40,8%) adalah infark lakunar, hanya satu kasus ditemukan berupa infark watershed dan dua lainnya dengan infark multipel. Pada pemeriksaan CT otak pertama, dua kasus tidak memperlihatkan adanya gambaran infark sehingga dilakukan pemeriksaan CT otak yang kedua yaitu antara hari ke 7 - 10 , didapatkan hasil berupa infark lakunar pada kedua kasus tersebut. Hemihipatesis ringan ditemukan pada 44,8% strok dengan tipe infark tentorial dan 70 % pada strok lakunar. Hemihipatesis berat hanya ditemukan pada strok dengan tipe infark tentorial. Hemihipestesi ditemukan 55,2% pada strok tipe tentorial dan 75 % pada strok tipe lakunar. Afasis hanya ditemukan pada strok tent

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The diagnosis of stroke is often made based on clinical evidence with anamnesis and neurological clinical examination alone. However, the clinical picture found is not always the same, it often varies so that the diagnosis of topis is not always correct. The relationship between clinical features and anatomical topography/type of infarction on brain CT scans in ischemic stroke sufferers was studied. This research was conducted prospectively, "cross sectional" and is descriptive analytic in nature. The population was first-time iskernic stroke sufferers aged 40 years and 65 years who were treated in class III treatment rooms at RSUPN-CM Jakarta. From April to July 1996, there were 52 cases of first-occurrence ischemic stroke. Consisting of 34 men (65.3%) and 18 women (34.7%) with a male: female ratio of 1.9: 1. The highest number of thrombotic strokes was found, namely 93.9%, while embolic strokes were 6.1%. Of the 52 patients studied, brain CT scan results showed that 29 (59.2%) were tentorial infarctions, 20 (40.8%) were lacunar infarctions, only one case was found to be a watershed infarction and the other two were multiple infarctions. In the first brain CT examination, two cases did not show any signs of infarction so a second brain CT examination was carried out, namely between days 7 - 10, the results were lacunar infarcts in both cases. Mild hemihypathesis was found in 44.8% of tentorial strokes and 70% of lacunar strokes. Severe hemihypathesis is only found in strokes with tentorial infarction type. Hemihypesthesia was found in 55.2% of tentorial type strokes and 75% of lacunar type strokes. Aphasis is only found in tentorial strokes."