Hubungan lokasi lesi otak dengan timbulnya nyeri neuropatik pada pasien stroke: A literature review
DOI: https://doi.org/10.33024/hjk.v20i4.2899
Brain Lesion Location Neuropathic Pain Stroke Patients
Abstract
Background: Stroke is a cerebrovascular disorder characterized by reduced or interrupted blood flow to the brain, resulting in tissue damage and impaired neurological function. One common complication in post-stroke patients is neuropathic pain, specifically Central Post-Stroke Pain (CPSP), which occurs due to damage to the central sensory pathways. The location of the brain lesion plays a crucial role in the development of neuropathic pain, as damage to areas such as the thalamus, brainstem, putamen, insula, and somatosensory cortex can affect the transmission and modulation of pain signals in the central nervous system.
Purpose: To analyze the relationship between brain lesion location and the development of neuropathic pain in stroke patients.
Method: This study used a systematic literature review approach to examine the relationship between brain lesion location and the development of neuropathic pain in stroke patients. Nine journals were collected for review by the researchers and synthesized into a comprehensive dataset for reporting.
Results: The literature review showed that brain lesion location was significantly associated with the development of post-stroke neuropathic pain. Lesions in the thalamus, particularly in the ventroposterolateral nucleus (VPL), as well as involvement of the putamen, insula, brainstem, and somatosensory cortex, have been shown to play a significant role in the pathogenesis of CPSP. A synthesis of all reviewed journals revealed that the thalamus is the most frequently reported lesion site associated with CPSP, particularly with involvement of the ventroposterolateral nucleus (VPL). Furthermore, damage to white matter pathways, such as the fronto-striatal and fronto-insular, contributes to sensory connectivity dysfunction and increased hypersensitivity to stimuli. Factors such as lesion laterality (right-sided predominance) and stroke type (ischemic) also influence the risk of CPSP.
Conclusion: Mapping lesion locations through neuroimaging examinations such as MRI and fMRI is crucial for diagnosis and treatment planning. A deeper understanding of the relationship between brain anatomy and post-stroke neuropathic pain can aid clinicians in early detection, prevention, and effective management of chronic pain, thereby improving the overall quality of life of stroke patients.
Keywords: Brain Lesion Location; Neuropathic Pain; Stroke Patients.
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