Özhan UÇKUN, Denizhan DİVANLIOĞLU, Ergün DAĞLIOĞLU, Fatih ALAGÖZ, Ali DALGIÇ, Ahmet Deniz BELEN

Kronik Subdural Hematom Hastalarında Klinik Özellikler: Travma ve Antikoagülan/Antiagregan İlaç Kullanımı, Clinical Features in Chronic Subdural Hematoma Patients: Trauma and Anticoagulant / Antiagregan Drug Used

Amaç: Yaşlı popülasyonda sık görülen ve artan insidansa sahip olan kronik subdural hematom (KSDH) gelişiminin, antikoagülan ve / veya antiagregan tedavi ile travma ve rekürrens arasındaki ilişki araştırıldı.Gereç ve Yöntemler: Kliniğimizde, 2015 Ocak- Ocak 2018 tarihleri arasında KSDH tanısı ile cerrahi olarak tedavi edilen olguların dosyaları retrospektif olarak incelendi. Yaş, cinsiyet, kafa travması, antikoagülan ve / veya antiagregan ajan tedavisi ve eşlik eden hastalık, pıhtılaşma durumu, lateralizan nörolojik bulguları, cerrahi yöntem ve rekürrens araştırıldı.Bulgular: Çalışmaya 104 olgu (79 erkek, 25 kadın) katıldı. Hastaların yaş ortalaması 67,7 ± 15,6 (20-94 yaş) idi. 67’si (%64,4) 65 yaş üstündeydi. 29 (%27,9) hastada fokal nörolojik defisit mevcuttu. Travma öyküsü 71 olguda (%68,3) mevcuttu, hastaların 57’sinde (%54,8) kronik bir hastalık vardı. 81 olgu (%77,9) tek veya çift burr-hole kraniyostomi ile tedavi etti. Sonuç: Bu çalışmada KSDH’da travma sıklığının oldukça yüksek olduğu görülmüştür. Travma olan ve olmayan gruplarda antikoagülan/antiagregan ilaç kullanımı ve komorbid hastalık varlığı açısından fark gözlenmedi. Nüks oranın literatür ile benzer olduğu ve cerrahi sonuçlarının başarılı olduğu görülmüştür. Anahtar kelimeler: Burr-hole kraniyostomi, kronik subdural hematom, cerrahi, travma ABSTRACT OBECTIVE: Chronic subdural hematoma (CSDH) development is very common among elder population with an increased incidence under anticoagulant and/or antiaggregant therapy. The relationship of CSDH and recurrent CSDH development with or without head trauma under anticoagulant/antiaggregant medication was investigated. MATERIAL AND METHODS: The patients, diagnosed as CSDH in our clinic between January 2015 and January 2018 were investigated retrospectively. Age, sex, head trauma, anticoagulant and/or antiaggregant medications, comorbid diseases, coagulation parameters, neurological findings, surgical method and recurrence of CSDH were documented. RESULTS: 104 cases (79 males, 25 females) were included in the study. The mean age of the patients was 67.7 ± 15.6 (20-94 years). 67 (64.4%) were over 65 years old. 29 (27.9%) patients had focal neurological deficits. 71 cases (68.3%) were traumatic and 57 (54.8%) of the patients had a chronic disease. 81 cases (77.9%) were treated with single or double burr-hole craniostomy. CONCLUSIONS: In this study, trauma frequency was found to be quite high in CSDH. There was no difference between trauma and non-trauma groups for the presence of anticoagulant and/or antiaggregant medication and for the presence of comorbid disease. The recurrence rate was similar to the literature and surgical results were found to be successful. Keywords: Burr-hole craniostomy, chronic subdural hematoma, surgery, trauma

Anahtar Kelimeler:

Burr-hole kraniyostomi, kronik subdural hematom, cerrahi, Burr-hole craniostomy, chronic subdural hematoma, surgery

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