Ulus Travma Acil Cerrahi Derg. 2019; 25(6): 622-627 | DOI: 10.14744/tjtes.2019.42675

Kafa travmalý olgularda tüm vücut tarama tomografisinin gerekliliðinin deðerlendirilmesi

Ýffet Yasaran¹, Ali Karakuþ¹, Güven Kuvandýk¹, Ahmet Sebe², Zeynep Kekec^2
1Mustafa Kemal Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Hatay
²Çukurova Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Adana

AMAÇ: Bu çalýþmada, kafa travmalý olgularýn tüm vücut bilgisayarlý tomografi (TVBT) ile deðerlendirilip, hastalarda eþlik edebilecek diðer vücut yaralanmalarýnýn tespiti için TVBT’nin ne kadar gerekli olduðu ortaya konmaya çalýþýldý.
GEREÇ VE YÖNTEM: Çalýþmamýza 2012–2016 tarihleri arasýnda hastanemiz acil servisine kafa travmasý sonrasýnda baþvurmuþ, beyin tomografisinde (BT) lezyon saptanmýþ, ek muayene bulgusu olmayan ve TVBT çekilmiþ 198 hasta alýndý. Geriye dönük olarak yapýlan çalýþmada hastalarýn yaþ, cinsiyet, beyin BT’deki lezyonun tipi, Glaskow Koma Skalasý (GKS) deðerleri ve TVBT bulgularý incelendi.
BULGULAR: Hastalarýn %85.4’ü erkek olup, yaþ ortalamasý 25.7 yýldý. En sýk saptanan kraniyal BT bulgusu kýrýk, takiben parankimal kanamaydý. Hastalarýn %67’sinin GKS’si 8’in altýndaydý. Hastalarýn 78’inde (%39.4) ek travma saptandý. En sýk saptanan ek lezyon toraksta kontüzyondu. BT’de belirlenen servikal yaralanmasý olan hastalarýn yaþ ortancalarý anlamlý olarak yüksekti (p<0.05). Kraniyal kýrýk ve yabancý cisim sýklýðý ile toraks yaralanmasý arasýnda anlamlýlýk tespit edildi (p<0.05). Beyin BT’de kontüzyon saptanan hastalarda servikal yaralanma sýklýðý anlamlý olarak yüksekti (p<0.05). TVBT’de ek lezyon varlýðý ile kýrýk sýklýðý anlamlý olarak yüksekti (p<0.05). Diðer kraniyal lezyonlar ve ek yaralanma bölgesi arasýnda iliþki saptanmadý (p>0.05).
TARTIÞMA: Literatürde TVBT’lerin deðerlendirildiði çalýþma sayýsý çoktur. Ancak, çalýþmamýz kafa travmasý olan ve vücudunda ek lezyon olmayýp TVBT’deki bulgularýn deðerlendirildiði ilk çalýþmadýr. Klinik deðerlendirilmesi tam yapýlamayan hastalarda TVBT çekimi önerilmelidir. TVBT baþta toraks içi lezyonlar olmak üzere, birçok patolojinin tanýsýnda önemli bir taný aracýdýr.

Anahtar Kelimeler: Acil servis, kraniyal travma; tüm vücut bilgisayarlý tomografi.

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Evaluation of the necessity of whole-body scan tomography in cases with head trauma

Ýffet Yasaran¹, Ali Karakuþ¹, Güven Kuvandýk¹, Ahmet Sebe², Zeynep Kekec^2
1Department of Emergency Medicine, Mustafa Kemal University Faculty of Medicine, Hatay-Turkey
²Department of Emergency Medicine, Çukurova University Faculty of Medicine, Adana-Turkey

BACKGROUND: In our study, we have tried to find out how necessary whole-body computed tomography (WBCT) is to detect other body injuries that may accompany the patients, evaluating head trauma cases with WBCT.
METHODS: In our study, we included 198 patients, who were referred to our hospital’s emergency service after head trauma, had brain lesions detected in brain tomography (BT), had no additional examination findings and who underwent WBCT. In this retrospective study, patients’ age, gender, type of lesion in brain CT, Glasgow Coma Scale (GCS) values and WBCT findings were examined.
RESULTS: In this study, 85.4% of the patients were male and the average age was 25.7 years. The most common cranial CT findings were fracture, followed by parenchymal bleeding. 67% of the patients’ GCS were below 8. Additional trauma was detected in 78 of the patients (39.4%). The most common additional lesion was the thoracic contusion. The mean age of the patients with cervical injuries determined in CT was significantly high (p<0.05). Statistical significance was determined between cranial fracture, foreign body incidence and thoracic injuries (p<0.05). The incidence of cervical injuries was significantly higher in patients with brain contusion detected in CT (p<0.05). Fracture frequency and presence of additional lesions in WBCT were significantly high (p<0.05). There was no correlation between other cranial lesions and additional injury areas (p>0.05).
CONCLUSION: The number of studies evaluating WBCT is high in the literature. However, our study is important concerning that to our knowledge this study is the first study to evaluate the WBCT findings in the head trauma cases without the additional lesions on their bodies. WBCT scan should be recommended in patients whose clinical evaluation could not be completed. WBCT is an important diagnostic tool for the diagnosis of many pathologies, especially for intrathoracic lesions.

Keywords: Cranial trauma, emergency department; whole-body CT.

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