Mustafa Kemal YILDIRIM, Fadimana KOYUNCU

GÖRME BULANIKLIĞI İLE GELEN VE FEOKROSİTOMA TANISI KONAN 12 YAŞINDAKİ KIZ ÇOCUĞUNDA ANESTEZİ YÖNETİMİ

Feokromasitoma sempatik sinir sisteminin kromaffin hücrelerinden gelişen nadir görülen bir tümördür. Hastamız görme bulanıklığı şikayeti ile acil servisimize başvurmuştur. Yapılan fizik muayenesinde, Kilosu 40 kg, Ateş: 36.4, Nabız 140 /dk ,Solunum sayısı 24 /dk, tansiyon arteryel 210/160 mmHg ölçülmüştür. Acil olarak Kranial MR görüntülemesi yapılmıştır. Görüntülemede patoloji izlenmemiştir. Yapılan fundoskopik göz muayenesinde ise bilateral optik disk ödemi ve optik disk etrafında hemoraji izlenmiştir. İleri tetkik amaçlı çocuk yoğun bakım ünitesine yatırılmıştır. Yapılan Renal doppler ultrasonografisinde; renal arter ölçümleri ve akımları normal, sol sürrenal lojda 30x26 mm boyutunda düzgün sınırlı hipovasküler böbrek parankimi ile izoekoik heterojen iç yapıda nodüler lezyon saptanmıştır. Kitlenin manyetik rezonans görüntüleme ve laboratuvar tetkikleriyle desteklenmesi ile feokromasitoma tanısı konmuştur. Görme bulanıklığı ile acil servise başvuran ve feokromasitoma tanısı konan 12 yaşındaki bu nadir pediatrik hastada preoperatif hazırlık, intraopraoperatif anestezi takip ve yönetimimizi tartıştık.

Anahtar Kelimeler:

Feokromasitoma, Anestezi, Pediatri

Comparison of Sensory Parameters and Balance in Patients with Hemiplegia

Objective: Hemiplegic patients experience loss of sensation and balance. In some patients, sensory and balance rehabilitation may vary depending on the treatment content they receive. It is a fact that the anatomical neuronal regions affected in such patients may cause different damages for each person with interneuronal relationships. In this study, we aimed to investigate the effects of proprioception and other sensory parameters and balance levels of hemiplegic patients who have completed treatment and are able to walk independently due to anatomically affected Fasciculus gracilis (FG) and Fasciculus cuneatus (FC). Methods: A total of 24 patients were included (12 female and 12 male) who were diagnosed and treated with hemiplegia in this study. Participants consisted of 12 dominant and 12 non-dominant hemiplegic patients. Extremity length-circumference measurements, evaluation of vibration, two-point discrimination, balance and proprioception (Technobody prokin 252) senses of participants were evaluated. Results: In the examination between balance and sensory parameters; a moderate positive correlation was found between proprioception-bipedal balance. In addition, a strong correlation was found between proprioception-left hemiplegia left leg balance (p˂0.05). Conclusion: In this study, we concluded that the effect rate of FC and FG will affect the sense of proprioception and that this sense is related to balance, which is one of the main parameters of mobilization, so that the general body balance and sensory integrity should be associated in the recovery process.

Keywords:

Hemiplegia Propripception, Balance, Sense,

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