GERMİNAL MATRİKS KAYNAKLI İNTRAVENTRİKÜLER HEMORAJİLERDE TEDAVİ YÖNETİMİ

Amaç: Bu çalışmada Ocak 2016-Mart 2020 tarihleri arasında Beyin ve Sinir Cerrahisi Kliniği’nde ameliyat edilen germinal matriks kaynaklı intraventriküler hemorajili 6 hastada uygulanan nöroşirürjikal cerrahi yöntemleri ve sonuçlarının restrospektif olarak incelenmesi amaçlanmıştır.Yöntem: İlgili kurumda Ocak 2016-Mart 2020 tarihleri arasında germinal matriks kaynaklı intraventriküler hemorajili prematüre altı hastaya operasyon öncesi tanı amaçlı transfontanel ultrasonografi, beyin manyetik rezonans görüntüleme, beyin tomografi tetkikleri yapıldı. Hastalara cerrahi işlem olarak eksternal ventriküler drenaj sistemi, endoskopik üçüncü ventrikülostomi, endoskopik septostomi, ventrikülo-peritoneal şant, transaraknoid ponksiyon uygulandı. Hastalar post operatif 1,3,6. aylarda kontrol beyin tomografi ve manyetik rezonans görüntüleme ile takip edildiler.Bulgular: 26 ve 32 gebelik haftaları arasında doğan altı hastada prematüre ve düşük doğum ağırlığındaydı. Bunlardan üçü erkek , üçü kızdı. Kızlardan sadece biri ikiz eşiydi. Doğum şekli sezaryen olan prematüre hastaların doğum ağırlıkları 900gr ile 1825gr arasında değişmekteydi.Sonuç: Prematüre düşük doğum ağırlıklı bebeklerde gelişen intraventriküler hemorajilere bağlı oluşan hidrosefalilerde bebek doğum ağırlığı 2000 gr üzerine çıkana kadar eksternal ventriküler drenaj sistemi ile takip edilmesi, zorunlu haller dışında endoskopik üçüncü ventrikülostomi tercih edilmeden uygun zamanlama içerisinde yapılan planlama ile ventriküloperitoneal şant uygulanmasının prognoz açısından daha iyi olacağı düşünülmektedir.

THE MANAGEMENT OF TREATMENT IN GERMINAL MATRIX ORIGINATING FROM INTRAVENTRICULAR HEMORRHAGE

Aim: In this study, it was aimed to investigate retrospectively the neurosurgical surgery methods and their results in 6 patients with intraventricular hemorrhage originating from germinal matrix who were operated in the Brain and Nerve Surgery Clinic between January 2016 and March 2020.Methods: Between January 2016 and March 2020, six premature patients with intraventricular hemorrhage originating from the germinal matrix were subjected to transfontanel ultrasonography, brain magnetic resonance imaging, and cerebral tomography for pre-operative diagnosis purposes. External ventricular drainage system, endoscopic third ventriculostomy, endoscopic septostomy, ventriculo-peritoneal shunt, transarachnoid puncture were performed as surgical procedures to the patients. The patients were followed up with control brain tomography and magnetic resonance imaging at postoperative 1,3 and 6. months. Results: Six patients born between 26 and 32 weeks of gestation were premature and low birth weight. Three of them were boys and three were girls. Only one of the girls was a twin. The birth weight of premature patients whose birth type was cesarean section varied between 900gr and 1825gr.Conclusion: Hydrocephalus due to intraventricular hemorrhages in premature low birth weight babies, it is thought to be better in terms of prognosis following by external ventricular drainage system, ventriculoperitoneal shunt application with planning made in an appropriate timing without preferring endoscopic third ventriculostomy except in mandatory cases until the baby's birth weight exceeds 2000 g.

Keywords:

Hemorrhage, Hydrocephalus Premature,

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