Fatma ŞİMŞEK, Nuray BİLGE, Mustafa CEYLAN

Erzurum ve çevre illerde psödotümör serebri tanısı ile takip edilen hastaların klinik ve demografik verileri

Amaç: Psödotümör serebri kafa içi basınç artışı ile karakterize olan ve doğurganlık çağındaki kadınlarda sık görülen bir hastalıktır. Çalışmamızda Türkiye’nin doğusunda yaşayan Erzurum ve çevre illerden gelen psödotümör serebri hastalarının klinik ve demografik özelliklerinin araştırılması amaçlanmıştır. Materyal ve Metot: Çalışmamızda Ocak 2015-Aralık 2018 tarihleri arasında Atatürk Üniversitesi Nöroloji kliniğinde psödotümör serebri tanısı ile takip edilen Erzurum ve çevre illerden gelen 27 hastanın kayıtları retrospektif olarak tarandı. Hastaların tanısı modifiye Dandy kriteleri ile konuldu.Bulgular: Hastaların 23’ ü (%85,18) kadın, 4’ü (%14,81) erkekti. Yaş ortalaması kadınlarda 38,75, erkeklerde 48,25 idi. 17 (%62,96) hastada baş ağrısı, 14 (%51,85) hastada bulanık görme, 4 (%14,81) hastada çift görme, 5 (%18,51) hastada bulantı-kusma, 3 (%11,11) hastada kulak çınlaması vardı. Göz dibi muayenesinde 3 (%11,11) hastada tek taraflı, 24 (%88,88) hastada bilateral papil ödem izlenmişti. BOS basınç ölçümü ortalaması 348,33 mmH2O idi. Manyetik rezonans venografide 5 (%18,51) hastada transvers sinüste tek taraflı hipoplazi izlenmişti. Manyetik rezonans görüntüleme incelemelerinde %62,96 (n=17) ile perioptik subaraknoid boşluğun genişlemesi en sık görülen bulguydu. Etiyolojik neden olarak 8 hastada obesite, 3 hastada ilaç kullanım öyküsü tesbit edilirken 16 hastada etiyoloji saptanamadı. Sonuç: Hastalarda en sık görülen semptom baş ağrısı ve en sık muayene bulgusu papil ödemdir. Nörogörüntülemede parankimal veya meningeal patoloji olmayıp tanıyı destekleyici bulgular izlenir. Hastalığın en önemli komplikasyonu görme kaybı olduğundan erken tanı vizüel fonksiyonları korumak için önemlidir.

Anahtar Kelimeler:

psödotümör serebri, manyetik rezonans görüntüleme, lomber ponksiyon

Clinical and demographic data of patients followed up with the diagnosis of pseudotumor cerebri in Erzurum and environmental provinces

Background: Pseudotumor cerebri is a common disease in reproductive-age women characterized by increased intracranial pressure. The aim of our study was to investigate the clinical and demographic characteristics of pseudotumor cerebri patients from Erzurum and nearby provinces living in eastern Turkey.Methods: In our study, the records of 27 patients from Erzurum and nearby provinces, followed-up with the diagnosis of pseudotumor cerebri at the Ataturk University, Neurology Outpatient Clinic between January 2015 and December 2018, were retrospectively reviewed. The diagnosis of the patients was made with modified Dandy criteria.Results: Of the patients, 23 (85.18%) were female and 4 (14.81%) were male. The mean age was 38.75 in females and 48.25 in males. Of the patients, 17 (62.96%) had headache, 14 (51.85%) had blurred vision, 4 (14.81%) had double vision, 5 (18.51%) had nausea and vomiting, 3 (11.11%) had tinnitus. Fundus examination revealed unilateral papilledema in 3 (11.11%) patients and bilateral papilledema in 24 (88.88%) patients. The mean CSF pressure measurement was 348.33 mmH2O. Magnetic resonance venography showed unilateral hypoplasia of the transverse sinus in 5 (18.51%) patients. Distention of the perioptic subarachnoid space was the most common finding on Magnetic resonance Imaging examinations with 62.96% (n=17). Obesity and history of drug use were found to be the etiological causes in 8 and 3 patients, respectively, while the etiology could not be determined in 16 patients. Conclusion: The most common symptom is headache and findings is papillary edema in patients. Neuroimaging does not show parenchymal or meningeal pathology, but findings that support the diagnosis are observed. Since the most important complication of the disease is loss of vision, early diagnosis is important to maintain visual functions.

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