Ulus Travma Acil Cerrahi Derg. 2019; 25(4): 383-388 | DOI: 10.5505/tjtes.2018.02403

Akut subdural hematom nedeni ile pediyatrik yaþ grubunda dekompresif kraniyektomi uygulanan hastalarýn geriye dönük analizi

M. Özgür Taþkapýlýoðlu¹, Ali Ýmran Özmarasalý¹, Gökhan Ocakoðlu^2
1Uludað Üniversitesi Týp Fakültesi, Beyin Cerrahisi Anabilim Dalý, Bursa-Türkiye
²Uludað Üniversitesi Týp Fakültesi, Biyoistatistik Anabilim Dalý, Bursa-Türkiye

AMAÇ: Dekompresif kraniyektominin (DK) pediyatrik subdural hematom hastalarýndaki sonuca etkisi tam olarak belirlenmemiþtir. Bu çalýþmada pediyatrik yaþ grubunda travmatik subdural hematom hastalarýnda DK rolünü araþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM: Pediyatrik akut subdural hematom hastalarýnda DK deneyimimiz sonuç analizleri ile açýklandý.
BULGULAR: On bir (7 tek taraflý ve 4 iki taraflý) DK uygulandý. Hastalarýn yaþlarý 8 ay ile 15 yaþ arasýnda idi. Ortalama Glasgow koma skoru (GKS) baþvuru anýnda 7.8 idi ve hastalarýn tümü ilk iki saat içinde duraplasti ile birlikte DK ameliyatýna alýndý. Tüm hastalar ameliyat sonrasý dönemde 10 gün yoðun bakým ünitesinde izlendi. Hastalarýn ortalama hastanede kalýþ süreleri 22 gün ve ortalama takip süreleri 3.7 yýl idi.
TARTIÞMA: Pediyatrik subdural hematom hastalarýnda erken DK hastaneye baþvuru anýndaki GKS’den baðýmsýz olarak yararlýdýr. Pediyatrik yaþ grubunda endikasyonlar, cerrahi teknik ve DK’nýn zamanlamasý için daha geniþ hasta sayýlý çalýþmalara ihtiyaç vardýr.

Anahtar Kelimeler: Akut subdural hematom, dekompresif kraniyektomi; kafa travmasý.

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Retrospective analysis of decompressive craniectomy performed in pediatric patients with subdural hematoma

M. Özgür Taþkapýlýoðlu¹, Ali Ýmran Özmarasalý¹, Gökhan Ocakoðlu^2
1Department of Neurosurgery, Uludað University Faculty of Medicine, Bursa-Turkey
²Department of Biostatistics, Uludað University Faculty of Medicine, Bursa-Turkey

BACKGROUND: The impact of decompressive craniectomy (DC) on the overall outcome of pediatric acute subdural hematoma patients has not been fully determined to date. In this paper, we aimed to investigate the role of decompressive craniectomy performed to treat traumatic subdural hematoma in patients from the pediatric age group.
METHODS: We described our experience with DC in pediatric acute subdural hematoma patients and analyzed the outcomes.
RESULTS: Eleven (7 unilateral and 4 bilateral) DCs were performed. The patients’ ages ranged from 8 months to 15 years. The mean GCS score at admission was 7.8. All patients underwent DC with duraplasty within 2 hours of injury. All the patients were admitted to the intensive care unit for 10 days postoperatively. The mean hospital stay was 22 days and the mean follow-up period was 3.7 years.
CONCLUSION: Early DC for pediatric subdural hematoma patients, independent of their initial GCS, was recommended. Larger studies are needed to define the indications, surgical techniques, and timing of DC in the pediatric population.

Keywords: Acute subdural hematoma, decompressive craniectomy; head injury.

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