Ulus Travma Acil Cerrahi Derg. 1998; 4(1): 33-38

EARLY DIAGNOSIS, FOLLOW UP AND TREATMENT OF DELAYED TRAUMATIC INTRACEREBRAL HEMATOMAS

Murat Kutlay¹, Kenan Kýrýcý¹, M Nusret Demircan¹
Gata Haydarpaþa Eðitim Hastanesi Nöroþirurji Kliniði

Delayed traumatic intracerebral hematomas (DTICH) is a rare condition and ethiopatogenesis is still controversial. CT has been helpful to increase the diagnosed patients population. From January 1, 1990 to December 31, 1996, 840 patients, 10 patients developed DTICH were presented. There were 9 males (90%) and 1 females (10%). The ages of the patients ranged from 6 to 73 years (mean 43 years). The most common ethiological factor was traffic accident. Glasgow Coma Scale scores were 10 in all patients on admission. Of 10 patients 8 were treated conservatively. The mortality rate was 50% (n=5). The study indicated that the patients who sustained severe head trauma (GKS 10) the patients with intracerebral hematomas, contusion or extracerebral hematoma on the initial CT, older age (>50 age), one at greatest risk of developing DTICH. Additionally, the presence of a skull fracture and the findings of coagulopathy one the another risk factor. These patients should be followed up by the repetetive CT scans.

Keywords: DELAYED TRAUMATIC INTRACEREBRAL HEMATOMAS; COMPUTED TOMOGRAPHY; TREATMENT

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GECÝKMÝÞ TRAVMATÝK ÝNTRASEREBRAL HEMATOMLARIN ERKEN TANI, TAKÝP VE TEDAVÝSÝ

Murat Kutlay¹, Kenan Kýrýcý¹, M Nusret Demircan¹
Gata Haydarpaþa Eðitim Hastanesi Nöroþirurji Kliniði

Gecikmiþ travmatik intraserebral hematomlar (GTÝSH), nadir rastlanýlan ve etyopatolojisi hala tartýþmalý bir durumdur. Bilgisayarlý tomografi (BT) taný konan olgu sayýsýný arttýrmýþtýr. Kliniðimize, 1 Ocak 1990 ile 31 Aralýk 1996 tarihleri arasýnda 840 kafa travmalý olgu kabul edilmiþtir. Bu gruptan tedavi edilen 10 GTÝSH olgusu bu çalýþmada sunuldu. Olgularýn 9'u (%90) erkek, 1'i (%10) kadýndý. Yaþlarý 6 ile 73 arasýndaydý (ortalama yaþ 43). En sýk rastlanýlan etyolojik faktör, trafik kazasý idi. Olgularýn kabul sýrasýndaki Glasgow Koma Skorlarý (GKS) 10 du. 10 hastanýn 8'i konservatif olarak tedavi edildi. Mortalite oraný % 50 idi (n=5). Bu çalýþma, þiddetli kafa travmasý geçirenlerin (GKS 10), özellikle ileri yaþtaki olgularýn (>50 yaþ), ilk kranial BT'de küçük intraserebral hematomu, kontüzyonu veya ekstraserebral hematomu olanlarýn, kranyal fraktürü olanlarýn, hemostatik parametrelerinde bozukluðu olanlarýn GTÝSH açýsýndan yüksek risk taþýdýðýný göstermiþtir. Bu olgularýn takibinde kýsa aralýklarla BT takibi yapýlmalýdýr.

Anahtar Kelimeler: GECÝKMÝÞ TRAVMATÝK ÝNTRASEREBRAL HEMATOM; BÝLGÝSAYARLI TOMOGRAFÝ; TEDAVÝ

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