INTRACRANIAL BLEEDING DUE TO TRAUMA

Traumatic intracranial hemorrhages (TÝK) can be classified as acute epidural hematomas (AEH), acute subdural hematomas (ASH), subacute subdural hematomas (SSH), chronic subdural hematomas (KSH), traumatic intracerebral hematomas (TÝH) and traumatic subarachnoid hemorrhages (TSAK), and they are one of the common causes of death before fourth decade. During last four years, from 5410 cases, admitted to Þiþli Etfal Hospital Emergency Service due to a trauma history, 250 cases had TÝK and they are discussed retrospectively in this study. Falls and traffic accidents were the frequent causes of the trauma. Usually, the cases were in their first four or seventh decade. Near to half of the cases who had traffic accident had alcohol use, and bicycle accidents were one of the most common causes at the first decade. Hundred and twenty-seven cases were treated surgically, and 123 conservatively. Acute epidural hematomas were the most common type of the hemorrhages. The mortality rate was 13.6%, and the most mortal hemorrhages were ASH. In this study, the different types of TÝK are discussed with their etiology and physiopathology, treatment principles and mortality rates.

TRAVMATÝK ÝNTRAKRANYAL KANAMALAR

Akut epidural hematom (AEH), akut subdural hematom (ASH), subakut subdural hematom (SSH), kronik subdural hematom (KSH), travmatik intraserebral hematom (TÝK) ve travmatik subaraknoid kanama (TSAK) olarak sýnýflayabileceðimiz travmatik intrakranyal kanamalar (TÝK) dördüncü dekat altý en önemli ölüm nedenlerinden birisidir. Son dört yýl içinde Þiþli Etfal Hastanesi Beyin Cerrahisi acil polikliniðimize baþ vuran 5410 kafa travmasý olgusundan TÝK tespit edilen 250 olgu retrospektif olarak deðerlendirildi. En sýk iki neden düþmeler ve trafik kazalarý idi. Olgularýn yaþý ilk dört dekatta ve yedinci dekatta pik yapmakta idi. Trafik kazalarýnýn yarýya yakýnýnda alkol kullanýmý, ilk dekatta görülen travmalarda bisiklet kazalarýnýn sýklýðý dikkati çekti. Yüzyirmiyedi olgu cerrahi, 123 olgu ise konservatif olarak tedavi edildi. En sýk görülen kanama tipi ASH idi. Mortalite oraný % 13.6 olup, en mortal kanama ASH olarak tespit edildi. Bu çalýþmada, TÝK'lerin tipleri, etyolojik ve fizyopatolojik özellikleri, tedavi prensipleri ve mortalite oranlarý göz önünde bulundurularak tartýþýldý.