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Brain arteriovenous malformations (AVM) present complex treatment decisions, particularly for low-grade AVM where surgical resection is often considered the standard. This case report emphasizes the importance of patient preferences and cultural considerations in selecting endovascular embolization over traditional surgical approaches for Spetzler-Martin Grade I AVM management, highlighting the evolving practice of patient-centered care in neurointervention. A 30-year-old male presented with recurrent seizures, characterized by a sudden onset of headache followed by speech arrest, without any preceding medical history of neurological deficits. Initial physical examination revealed no focal neurological deficits. Non-contrast computed tomography, magnetic resonance imaging, and magnetic resonance angiography suggested an AVM involving the cortical-subcortical regions of the left frontal lobe, measuring approximately 1.7 × 2.6 × 1.5 cm, fed by the left middle cerebral artery M3 segment, and draining into the superior sagittal sinus. Spetzler-Martin Grade I classification was confirmed via digital subtraction angiography. Given the patient's strong preference against invasive procedures, driven by personal and cultural beliefs, endovascular embolization was selected as the treatment strategy. Post-embolization, the patient showed marked symptomatic improvement with no evidence of residual AVM on follow-up imaging, and no postprocedure complications were reported. This case highlights the importance of considering patient preferences in AVM treatment planning, illustrating that endovascular embolization can be an effective and less invasive alternative to surgery in selected patients, reinforcing the need for personalized, patient-centered approaches in neurointerventional care.

Obstructive sleep apnea (OSA) is a common sleep disordered breathing in stroke patients. This case report aimed to show the presence of OSA in stroke can contribute to the increasing chance of mortality and morbidity. We presented a case of first-time stroke in a 64-year-old female with a history of pre-stroke OSA. She underwent intravenous thrombolysis as main therapy within the time limit under 4.5 hours since the stroke onset. She had prolonged hospital stay due to complications from OSA, even though she only had a small ischemic core (9 mL) in follow-up radiological imaging and was discharged with a greater National Institutes of Health Stroke Scale (NIHSS) score than admission (5 to 10). OSA can be one of warning signs for poor prognosis in stroke patients. Understanding the presence of OSA not only can be beneficial toward choosing the next steps of therapy, but also important for the rehabilitation and recovery period of stroke patients.

Abstract Background Clopidogrel has been the primary choice of antiplatelet in ischemic stroke that inhibits adenosine diphosphate (ADP)-induced platelet aggregation. P-glycoprotein (P-gp) multidrug resistance-1 (MDR1) is a transmembrane efflux transporter in intestinal cells that plays a significant role in clopidogrel absorption, therefore may affect platelet aggregation. P-gp is encoded by the ABCB1 gene. This study aims to evaluate the effect of ABCB1 polymorphism on clopidogrel response variability in ischemic stroke patients and its genotype frequency. Methods A cross-sectional study was conducted in ischemic stroke patients who received clopidogrel between 2020 and 2023 in RSUI/RSCM. All subjects were assessed for ABCB1 polymorphisms C3435T and C1236T. Platelet aggregation were measured using VerifyNow PRU. Clopidogrel response variability was classified into unresponsive (> 208 PRU), responsive (95–208 PRU), and bleeding risk (

Background. Over the last three decades, stroke management has witnessed substantial progress, from the introduction of recombinant tissue plasminogen activator (rtPA) in 1995 to the approval of thrombectomy in 2016. Intravenous tissue plasminogen activator (tPA) within 4.5 hours of symptom onset is the standard for eligible acute ischemic stroke patients, dissolving clots and restoring blood flow. Endovascular thrombectomy (EVT) surpasses intravenous thrombolysis for large vessel occlusion cases, typically within 6 to 24 hours based on CT-perfusion criteria. CT perfusion (CTP) provides crucial quantitative data on cerebral blood flow, aiding in ischemia detection, tissue assessment, treatment guidance, and outcome prediction. This case report marks a pivotal moment in Indonesian stroke management, introducing the inaugural use of CTP for diagnostic purposes. By scrutinizing blood flow dynamics and cerebral conditions, CTP augments conventional diagnostics, offering enhanced prognostic value. Case presentation. The case of a 58-year-old male with notable comorbidities exemplifies this successful integration. He presented with sudden left-sided weakness and dysarthria, without accompanying symptoms. Neurological evaluation revealed a Glasgow Coma Scale score of E3M6V5, 7th cranial nerve paresis, and a positive Babinski reflex on the left side. With a National Institute of Health Stroke Scale (NIHSS) score of 10, a head CT scan rules out cerebral hemorrhage, prompting precise thrombolysis at 0.7 mg/kg. Within one hour post-thrombolysis, the NIHSS score improved to 6, ultimately culminating in an NIHSS score of 2 upon discharge. Conclusion. This case underscores the efficacy of acute ischemic stroke management, fortified by the strategic integration of CTP, heralding a new era in Indonesian stroke care.

A 28-year-old man was brought to the emergency room (ER) with a history of decrease of consciousness 30 minutes before admission. In the previous 1 hour, the patient felt bitten or stabbed in the left temple area. Physical examination showed signs of N VII paresis, upper extremity motoric 3/2 (right/left) and lower extremity 3/2 (right/left), positive left extremity hypesthesia. Noncontrast MRI brain examination showed increased DWI signal intensity, suggesting diffusion restriction in bilateral centrum semiovale, bilateral posterior crus internal capsule, and bilateral corpus callosum leading to suspicion of acute-hyperacute ischemia. The therapy given while in the emergency room was IVFD asering, IV dexamethasone 5 mg, IV diphenhydramine 10 mg, oral paracetamol 500 mg, oral aspirin 80 mg, oral clopidogrel 75 mg, and oral atorvastatin 40 mg. We report a case of stroke due to an anaphylactic reaction in an effort to add to the point of view if the same case occurs.

Objectives This study aimed to evaluate the predictive value of admission D-dimer levels for in-hospital mortality in patients with COVID-19 and acute ischaemic stroke.Design Cohort (prospective).Setting Tertiary referral hospital in the capital city of Indonesia conducted from June to December 2021.Participants 60 patients with acute ischaemic stroke and COVID-19 were included. Patients were classified into D-dimer groups (low and high) according to a 2 110 ng/mL cut-off value, determined via receiver operating characteristic analysis.Primary and secondary outcome measures The primary outcome was in-hospital mortality, with admission D-dimer levels as the major predictor. Secondary outcomes included associations between other demographic and clinical variables and the admission D-dimer value. Kaplan-Meier method was used to carry out survival analysis, with univariable and multivariable Cox regression performed to assess the association of D-dimer levels and other confounding variables (including demographic, clinical and laboratory parameters) with in-hospital mortality.Results The findings demonstrated an association between elevated admission D-dimer levels (≥2 110 ng/mL) and an increased likelihood of death during hospitalisation. The adjusted HR was 14.054 (95% CI 1.710 to 115.519; p=0.014), demonstrating an increase in mortality risk after accounting for confounders such as age and diabetes history. Other significant predictors of mortality included a history of diabetes and increased white blood cell count.Conclusions Admission D-dimer levels may be a useful predictive indicator for the likelihood of death during hospitalisation in individuals with COVID-19 and acute ischaemic stroke.

Coronavirus 2 or SARS-CoV-2 is predominantly manifests as a respiratory infection; however, it has been linked to a spectrum of neurological disorders such as vertigo, cephalalgia, cognitive impairment, myalgia, and anosmia. Emerging reports indicate several neurological illnesses that coincide with COVID-19, such as encephalitis and, notably, stroke. In this report, We present an instance of a patient infected with COVID-19 with Guillain-Barré Syndrome in this case report. Guillain-Barre Syndrome (GBS) is an inflammatory polyradiculoneuropathy linked to various viral infections. We present the case of a 76-year-old female patient hospitalized with acute progressive symmetric ascending quadriparesis. Seven days before hospitalization, the patient experienced fever and cough with RT-PCR testing confirmed a positive COVID-19 infection. Cerebrospinal fluid analysis revealed dissociation of cytoalbumin. Coronavirus stimulates inflammatory cells and produces various cytokines, leading to immune-mediated processes. GBS represents an immune-mediated disorder, with its pathogenesis intricately influenced by the pivotal role of molecular mimicry in its onset. Plasmapheresis was performed, resulting in an improved clinical outcome for the patient.

Abstract Introduction Clopidogrel is recommended as an alternative to Acetyl Salicylic Acid (ASA), the first-line drug for secondary stroke prevention. Clopidogrel resistance in Indonesia is reportedly 15.8%. The Stent Thrombosis in Belgium (STIB) is a scoring system proposed to assess clopidogrel resistance which has not been tested for the reliability in Indonesian population. Objectives The objective of the study is to test the reliability of the STIB scoring and modified-STIB scoring system in Indonesian population. Methods This study was conducted cross-sectionally in Dr. Cipto Mangunkusumo Hospital and Universitas Indonesia Hospital from January 2020 to December 2021. Laboratory examinations of human CYP450 concentration in blood plasma from 112 subjects were carried out using the ELISA method. The clopidogrel resistance test was carried out using the VerifyNow method. Results Out of 112 ischemic stroke patients in this study, 14.3% of them did not respond to clopidogrel. Cross-tabulation between the STIB score and clopidogrel resistance showed significant results (p

Background: Indonesia as a developing nation faces a plethora of challenges in applying endovascular therapy (EVT), mostly due to the lack of physicians specialized in neuro-intervention, high operational cost, and time limitation. The efficacy of EVT in improving functional outcomes of stroke in developing countries has not been previously studied. Methods: This retrospective cohort study was conducted at Dr. Cipto Mangunkusumo Hospital (Jakarta, Indonesia) from January 2017 to December 2021. Large vessel occlusion (LVO) diagnosis was established based on a combination of clinical and imaging characteristics. We assessed patients’ functional independence on day-90 based on modified Rankin Scale (mRS) between the endovascular treatment group and the conservative group (those receiving intravascular thrombolysis or medical treatment only). Functional independence was defined as mRS ≤2. Results: Among 111 stroke patients with LVO, we included 32 patients in the EVT group and 50 patients in the conservative group for this study. Patients with younger age (p = 0.004), lower hypertension rate (p

Abstract Background Cortical deafness is an unusual occurrence caused by injury to the central auditory pathway but not to the hearing organ. This paper reports the first case of cortical deafness as a sequel of recurrent stroke in a patient with prosthetic heart valves and atrial fibrillation in Asia. Case presentation A 40-year-old man with a history of atrial fibrillation and valvular heart disease comes with weakness on the right side of the body and slurred speech. Examination showed hemiplegia with increased d-dimer and activated partial thromboplastin time. (APTT). Brain MRI showed multiple subacute infarctions in the temporal lobe. Diffusion Tensor Imaging (DTI) tractography showed no visible auditory tract. Pure tone audiogram and brainstem auditory evoked potential test was normal, but speech reception threshold test was very poor. The patient has been diagnosed with recurrent ischemic stroke with sequel cortical deafness and received anticoagulant therapy and speech therapy. The patient reported minimal subjective impairment 1 month later with no further neurological deterioration. Conclusions A multidisciplinary clinical approach is needed in patients with cortical deafness, especially distinguishing it from other central hearing losses.

Abstract Background This study was aimed to analyze the performance of door-to-CT scan (DTC) time of code stroke at the central referral hospital in Indonesia. Data from 310 patients were obtained in this cross-sectional study. Inclusion criteria were: notified with code stroke within the period between November 2016 and April 2019. Bivariate and multivariate analyses were carried out to find which factors affecting DTC time. Results A tendency of decreasing DTC time was reported from November 2016 until April 2019. The median DTC time at study endpoint was 19.5 (1–210) minutes. Chi-square analysis showed that CT scan location was the factor associated with DTC (OR: 12.6, 95% CI 6.8–23.35, p

Abstract Background COVID-19 increases the risk of acute ischemic stroke. The objective of this study is to identify the risk factors, comorbidities, and outcomes in COVID-19 patients with acute ischemic stroke at University of Indonesia Hospital. Results The clinical condition of COVID-19 patients with ischemic stroke is more severe for patients older than 55 years (p

Entrepreneurship in the agricultural sector produces creative, innovative, and independent farmers who can improve farm performance. Therefore, this research aimed to determine the impact of individual characteristics and entrepreneurship on rice farming performance. The method employed in this research was a descriptive method to provide a qualitative description of individual characteristics and entrepreneurship in the performance of rice farming. The research was executed in one of the rice-producing centers in Kubu Raya Regency, West Kalimantan. The simple random sampling method was used in selecting farmers with 150 respondents selected as the sample size. Furthermore, the research variables involved were individual characteristics, farmer’s entrepreneurship, and rice farming performance. Data were collected using questionnaires, interviews, and observations, and analysis was performed using Structural Equation Modeling (SEM) with SMART-PLS software. The results showed that individual characteristics and entrepreneurship had a significant and positive effect on rice farming performance. Consequently, it can be concluded to improve rice farming performance, farmers suggested strengthening their characteristics, particularly those related to farming motivation, and enhancing their entrepreneurial characteristics through their task and outcome-oriented behavior.

Subarachnoid hemorrhage (SAH) due to Arteriovenous Malformation (AVM) is a rare emergency case, which is often misdiagnosed as migraine. Here we present a case of SAH due to AVM that mimics migraine. A 41-year-old man came with headaches that radiated to the neck, worsened in the last week, accompanied by nausea, vomiting, photophobia, and a history of intermittent headaches for the previous 2 years. Physical examination was within normal limits, initial laboratory tests showed leukocytosis, and CT scan was not typical. The patient was diagnosed with migraine. Apparently, the lumbar puncture showed very high red blood cells, suspected as SAH. CT angiography revealed an extra-axial AVM. The patient was later diagnosed as SAH due to AVM. We recommend applying 4 key points, namely headache progressivity, neck pain, neck stiffness, and leukocytosis, to differentiate SAH due to AVM from migraine, especially in areas with limited facilities.

Despite patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) and receiving clopidogrel therapy, some patients still experience major adverse cardiovascular events (MACEs). Clopidogrel resistance, which may be regulated by genetic and epigenetic factors, may play a role in MACEs. This study aimed to determine the association between genetic (CYP2C19 and P2Y12 polymorphisms) and epigenetic (DNA methylation of CYP2C19 and P2Y12 and miRNA-26a expression) factors and their effects on MACEs among post-PCI patients. Post-PCI patients who received a standard dosage of clopidogrel at Harapan Kita Hospital between September 2018 and June 2020 were included in this study. MACEs were observed in patients within 1 year after PCI. Platelet aggregation was assessed using light transmission aggregometry (LTA). DNA methylation of CYP2C19 and P2Y12 was assessed using the bisulfite conversion method. CYP2C19 and P2Y12 polymorphisms and miRNA-26a expression were evaluated using quantitative real-time polymerase chain reaction (qRT-PCR). Among a total of 201 subjects, 49.8% were clopidogrel-resistant, and 14.9% experienced MACEs within 1 year after PCI (death was 7.5%). Hypomethylation of CYP2C19 (p = 0.037) and miRNA-26a upregulation (p = 0.020) were associated with clopidogrel resistance. CYP2C19*2/*3 polymorphisms (p = 0.047) were associated with MACEs in 1 year. This study demonstrated that hypomethylation of CYP2C19 and miRNA-26a upregulation increased the risk of clopidogrel resistance in post-PCI patients, but there was no correlation between clopidogrel resistance and MACEs. However, CYP2C19*2/*3 polymorphisms were the factors that predicted MACEs within 1 year.

The emergence of SARS-CoV-2 has caused worldwide pandemic of COVID-19. Infection is difficult to diagnose early as some patients remain asymptomatic and may carry this virus to other people. Currently, qRT-PCR is the widely accepted mode for detection. However, the need for sophisticated instrument and trained personnel may hinder its application, especially in remote and facility-lacking areas. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) may serve as a potential approach for detection of SARS-CoV-2 as the resources needed in its application is far less complex than those of qRT-PCR. Herein, we evaluated RT-LAMP based analytical method (COVIDNow), relative to qRT-PCR, in detecting SARS-CoV-2 by using 63 clinical respiratory samples. Based on our finding, COVIDNow exhibited sensitivity and specificity values of 87.5% and 80.6%, respectively. Taken together, RT-LAMP based detection of SARS-CoV-2 by utilizing COVIDNow might serves as a valuable diagnostic tool in the management of global COVID-19 pandemic condition.

Background. Stroke is one of the top causes of death and disability in several nations. Patients with psoriasis are susceptible to multiple comorbidities, including stroke. In addition to acute ischemic stroke, psoriasis and chronic inflammation require comprehensive treatment. Here, we present a comprehensive management case of a patient with an acute ischemic stroke and psoriasis. Case Presentation. A 42-year-old man came to the emergency department complaining of sudden left-sided weakness that started two and a half hours before being admitted to the hospital. The patient was treated with cyclosporine from 2013 to 2019 for a history of psoriasis. The patient was then treated for secondary stroke prevention using aspirin, vitamin B6, vitamin B12, folic acid, simvastatin, cyclosporine, and topical treatment. After two days of treatment, the patient’s condition improved clinically, and he was discharged without further neurological deficits. As a home medication, the patient’s cyclosporine was switched to the initial dose of methotrexate (7.5 mg/week) and titrated weekly to a response dose of 10 mg in the 10th week. After three months of follow-up, the patient’s condition remained stable, devoid of similar symptoms or sequelae. Conclusions. Cyclosporine should only be used for a maximum of 1 year for stroke management with psoriasis and be substituted for other systemic agents such as methotrexate. In addition, anticoagulants, antihypertensive, antihyperlipidemic, vitamin B6, vitamin 12, and folic acid regimens are highly recommended for comprehensive therapy of cardiovascular comorbidities.

Indonesia is facing increasing stroke prevalence in the past 5 years. Ischemic stroke imposes economic and productivity burden if it is not addressed properly. Endovascular treatment studies are conducted in developed countries where facilities and cost do not count in therapy consideration if it is indicated. Developing countries like Indonesia should work hard to provide the best hyperacute stroke care with protocol deviation and limitation. This is the first review on endovascular treatment practice in a top single-center hospital in Indonesia. Further improvement is needed to catch up with state-of-the-art hyperacute ischemic stroke treatment.

In 2020, a new type of coronavirus (SARS-CoV-2) whose disease is called Coronavirus disease 2019 (COVID-19) has been reported. This virus was first discovered in Wuhan, China and has infected 90,308 people per March 2, 2020. As of the end of October 2020, more than 40 million people have been infected, with the death toll reaching 1,150,000 worldwide. Apart from respiratory tract infections, patients infected with this virus may exhibit other symptoms, such as diarrhea, abdominal pain, nausea, or vomiting. This means that the virus can be found in feces and anus, hence the anal swab can be used as a diagnostic tool for COVID-19 infection. The results of the specimen test show that the sensitivity of the nasopharyngeal swab positive detection rate is the highest and remains the gold standard for diagnosis. This sensitivity can also be influenced by the course of the disease that can infect the gastrointestinal tract so that anal PCR is performed for the diagnosis to detect the COVID-19 virus in patients.

Facing the rising cases of with higher fatalities COVID-19, some countries decided to give the third dose of vaccine as a booster. As of 9 January 2022, 90.31% of health workers in Indonesia have received the third dose vaccine. This study aims to provide an evaluation of adverse events following immunization (AEFI) in a single center in Indonesia to form a basis for ensuring safety for booster administration nationally. A retrospective, cross-sectional study was conducted using an online survey. Demographic data, AEFI complaints, and factors influencing AEFIs were evaluated. In this study, there were a total of 311 subjects were gathered. The most common AEFI symptoms found at onset

Background: COVID-19 infection is caused by a novel coronavirus. One of the most used strategies that can be used to control the spread of COVID-19 is the 3T (test, trace, and treatment) strategy. This study aimed to evaluate the 3T strategy to control COVID-19 infection in a COVID-19 Referral Hospital in Depok, West Java, Indonesia. Methods: this is a cross-sectional study conducted at the University of Indonesia Hospital. The study was conducted in June 2020 with 742 participants (staff members) using secondary data from polymerase chain reaction (PCR) test results. We presented data in the descriptive form and performed bivariate analysis using the chi-square/Fischer test for categorical data. Results: the PCR test results were positive in 83 (11.1%) participants, with a case-per-tracing ratio of 1:24 and 1:2 in the first and third phases of tracing, respectively. The COVID-19 case graph for the participants decreased along with the implementation of the 3T strategy. The positivity rate in the first phase of tracing was 20% and decreased to 5% in the third phase of tracing. Staff with confirmed positive test results were advised to isolate themselves (hospital or self-isolation). Hospital isolation was found to be associated with the duration of PCR test conversion (p

The purpose of this research is to develop strategies that can be applied in the development of local food diversification in West Kalimantan. The data used are primary data and secondary data. Variables examined included internal factors (strengths and weaknesses) and external factors (opportunities and threats) in the development of local food diversification in West Kalimantan. Data analysis were conducted in qualitative descriptive to describe the pattern of food consumption in West Kalimantan and continued with a SWOT analysis to carry out the development strategy of the local food diversification in West Kalimantan. The analysis result showed that the strategy for the development of local food diversification in West Kalimantan is SO strategy (Strengths - Opportunities) those are: 1) the increase in synergy between the government and the micro, small and medium enterprises for the development of local food products, 2) the utilization of communications and market information system in improving the marketing of local food products on micro, small and medium enterprises, and 3) the utilization of unutilized agricultural land to improve the quality and quantity of local food products.

ABSTRACT Kubu Raya Regency retains potential fisheries sector, yet its development is constrained by subsistence and traditional characteristic pertaining to fishermen, poor facilities and infrastructure, as well as limited information related to the fisheries sector. The purpose of the study is to determine strategies of sustainable coastal fisheries management in Kubu Raya Regency. It is conducted through survey and in-depth interviews with knowledgeable respondents to collect information related to SWOT variable and alternative strategies. Data consist of primary and secondary data. Primary data include strengths, weaknesses, opportunities and threats in the management of coastal fisheries in Kubu Raya Regency, whilst the later incorporates the utilization of fishing facilities and infrastructure in addition to fisheries production data. The study was conducted from April to August 2017. A combination of SWOT and AHP analysis was applied to select important strategies in sustainable fisheries management in Kubu Raya Regency. The result shows that priorities should be given to the improvement of infrastructure (0,404), the increasing of technology adoption (0,367) and the development of human and institutional resources (0,228). Keywords: Management strategies, fisheries, coastal areas ABSTRAK Kabupaten Kubu Raya berpotensi dalam pengembangan sektor perikanan, namun terkendala dengan karakteristik nelayan yang bersifat subsisten dan tradisional, minimnya sarana dan prasarana perikanan, serta kurangnya informasi bidang perikanan. Tujuan penelitian ini adalah untuk menyusun strategi pengelolaan perikanan tangkap berkelanjutan di wilayah pesisir Kabupaten Kubu Raya. Metode penelitian yang digunakan adalah metode survei dan wawancara mendalam dengan menggunakan key informan untuk mendapatkan variabel SWOT dan alternatif strategi. Data penelitian yang dikumpulkan yaitu data primer dan data sekunder. Data primer meliputi variabel kekuatan, kelemahan, peluang dan ancaman dalam pengelolaan perikanan tangkap di Kabupaten Kubu Raya. Data sekunder meliputi data penggunaan sarana dan prasarana penangkapan ikan dan data produksi perikanan di Kabupaten Kubu Raya. Penelitian dilakukan bulan April hingga Agustus 2017. Analisis data menggunakan kombinasi analisis SWOT (Strengths, Weaknesses, Opportuinities, Threats) dan AHP (Analytical Hierarchy Process) untuk menentukan prioritas strategi pengelolaan perikanan tangkap berkelanjutan di Kabupaten Kubu Raya. Hasil penelitian menunjukkan urutan prioritas strategi pengelolaan perikanan tangkap berkelanjutan yaitu peningkatan sarana dan prasarana (bobot 0,404), peningkatan adopsi teknologi (bobot 0,367) serta pengembangan sumber daya manusia dan kelembagaan (bobot 0,228). Kata kunci: strategi pengelolaan, perikanan, wilayah pesisir

Background and Purpose: Stroke is the number one cause of morbidity and mortality in Indonesia. Lacunar infarction is one of cerebral small vessel disease spectrum. This study aimed to present stroke epidemiology in Indonesia and risk factors associated with cerebral small vessel disease. Methods: A multicenter prospective cross-sectional study of 18 hospitals in Indonesia was conducted using Stroke Case Report Form from 2012 to 2014. Stroke was diagnosed based on clinical findings confirmed with non-contrast computed tomography of the brain. Subjects were classified into two large groups: ischemic (lacunar and non-lacunar) and hemorrhagic (intracranial and subarachnoid hemorrhage). Other risk factors were assessed on admission. Results: We enrolled 5411 patients, of whom 3627 (67.03%) had ischemic stroke and 1784 (32.97%) had hemorrhagic stroke. Male patients were prevalent in both large groups, although found less in subarachnoid hemorrhage group. Among patients with hemorrhagic stroke, 1603 (89.54%) of them had intracerebral hemorrhage and 181 (10.46%) had subarachnoid hemorrhage. From 3627 ischemic stroke patients, 1635 (45.07%) of them had lacunar infarction. We found that age above 55 years old, male gender, hypertension, dyslipidemia, and diabetes were important risk factors associated with lacunar stroke (p

Background and Purpose. Stroke is a leading cause of death and disability, with ischemic stroke as the highest prevalent cases in Indonesia. Ischemic stroke can be classified further into five subtypes according to TOAST classification. Numerous studies have revealed that stroke risk factor has variable correlation with different stroke subtype. Currently, there is no data regarding this phenomenon in Indonesia. The aim of study is to identify characteristic of ischemic stroke subtypes and the risk factors in TOAST classification. Methods. A retrospective, cross-sectional study of patients diagnosed with ischemic stroke at Cipto Mangunkusumo Hospital from January till December 2016. Demographic data, ischemic stroke subtypes, risk factors, and other relevant data were documented. Bivariate and multivariate analysis was done using SPSS 23. Results. 235 recorded data patients were included. Large artery atherosclerosis (LAA) was the most prevalent stroke subtypes at 59,6%, followed with small vessel disease (SVD) at 26,7%, undetermined etiology at 9,8%, cardioembolism (CE) at 2,1%, and other determined etiology at 0,9%. Hypertension was the most common vascular risk factor. However, it was only significant in SVD (p=0,023) and undetermined etiology subtypes (p