Ulus Travma Acil Cerrahi Derg. 2009; 15(1): 91-94

Kesici ve delici spinal yaralanma: Ýki olgu sunumu

Nebi Yýlmaz, Nejmi Kýymaz, Çiðdem Mumcu
Yüzüncü Yýl Üniversitesi Týp Fakültesi, Beyin ve Sinir Cerrahi Ana Bilim Dalý, Van

Delici ve kesici aletle olan penetran spinal kord yaralanmalarý seyrek görülür. Bu yaralanmalarda spinal kordun nöral elamanlarýnýn doðrudan hasarý, kord infarktý ve nadiren de intardural veya epidural hematoma olabilir. Bu yazýda, býçakla spinal kord ve L4 kök yaralanmasý olan iki olgu sunuldu. Birinci olgu 22 yaþýndaki erkek hasta, sýrt bölgesinin ortasýndan býçakla yaralanma þikayeti ile acil polikliniðimize baþvurdu. Nörolojik muayenesinde paraplejik olan hastanýn spinal MRG incelemesi ile T7-T8 seviyesinde total spinal kord lezyonu saptandý. Yara primer dikilmesine edilmesine raðmen, takibinde beyin omirilik sývýsý sýzýntýsýnýn olmasý nedeniyle ameliyata alýndý. Ameliyatta T7-T8 total laminektomi yapýlarak yýrtýlmýþ olan duramater primer olarak dikildi. Ýkinci hasta, belinde býçakla yaralanma sonrasý acil polikliniðimize baþvurdu. Hastanýn L3 seviyesindeki yara yerinde sap kýsmý kýrýlmýþ býçak 2-3 cm’lik derinlikte görüldü. Hasta acil olarak ameliyata alýnarak kýrýlan ve metalik kýsmý içeride kalmýþ olan býçak çýkartýdý.

Anahtar Kelimeler: Delici ve kesici spinal yaralanma; býçak yaralanmasý; spinal kord.

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Penetrating spinal injury: reports of two cases

Nebi Yýlmaz, Nejmi Kýymaz, Çiðdem Mumcu
Department of Neurosurgery, Yuzuncu Yil University Faculty of Medicine, Van

Penetrating spinal cord injuries caused by stab wounds are rare. Such injuries may result from a direct lesion of the neural elements of the spinal cord, cord infarcts or, more rarely, intradural or epidural hematoma. In the present study, two cases with spinal cord and L4 root injuries caused by a knife are presented. The first case, a 22-year-old male, referred to our emergency outpatient clinic with a stab wound injury at the mid-section of his back. Neurological examination of this patient showed paraplegia, and spinal MRI displayed a total spinal cord lesion at the T7-T8 level. The wound was primarily sutured; however, during follow-up, CSF (cerebrospinal fluid) leakage continued and the patient was operated. The ruptured dura mater was primarily sutured in a surgical intervention that involved T7-T8 total laminectomy. The second patient referred to our emergency outpatient clinic with a torso injury caused by a sharp knife. The knife was embedded 2-3 cm deep at the wound site at the L3 level and the handle was broken. The patient was immediately operated and the broken and embedded metallic part of the knife was extracted.

Keywords: Penetrating spinal cord injury; stab wound; spinal cord.

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