Cüneyt UZUNLAR

PONS HEMATOMLARINDA BAŞVURU ANINDAKİ BİLİNÇ DÜZEYİ VE KLİNİK DURUMUN PROGNOZ ÜZERİNE ETKİSİ

ABSTRACT OBJECTİVE: The aim of the study determining the risk factors in pons hematomas, and to examine the level of consciousness at the time of admission, and the effect of clinical status on prognosis. MATERIAL AND METHOD: The study was prospectively carried out with twenty-two cases diagnosed as primary pontine hematoma by computed tomography (CT) in a Neurology Clinic of Istanbul Research and Education Hospital, between 1991-1994. RESULTS: 14 of our patients were male (63.7%), 8 were female (36.3%) and mean age of 59.1 (31-82), respectively. The 43.4% of the cases which were conscious were alived. 3 of 5 patients with somnolence (22.8%) , and all 7 patients with coma (31.8%) had all died. The all of 9 patients with thermoregulation impairment (49.9% of the cases ) died. CONCLUSION: Poor prognostic factors in pons hematomas have been identified as state of consciousness and thermoregulation disorder. The planning of studies in the future to correct thermoregulation may contribute to improving the prognosis. Keywords: pons, prognosis, consciousness, hematoma AMAÇ:Bu çalışmada; pons hematomlarında risk faktörlerinin belirlenmesi, başvuru anındaki bilinç düzeyinin ve klinik durumun prognoz üzerine etkisini incelemeyi amaçladık. GEREÇ VE YÖNTEMLER: 1991 - 1994 yılları arasında üçüncü basamak İstanbul Eğitim ve Araştırma Hastanesi Nöroloji Kliniğinde Bilgisayarlı Tomografi (BT) ile primer pontin hematom tanısı konan 22 olgu prospektif olarak incelendi. BULGULAR: Olgularımızın 14’ü erkek (% 63.7), 8’i kadın (% 36.3) ve yaş ortalaması 59,1 (31-82) idi. Bilinci açık olan 10 olgumuzun (% 43.4) hepsi yaşadı. Somnolansta olan 5 olgunun (% 22.8) 3’ü, komada olan 7 olgunun (%31,8) hepsi eksitus oldu. Termoregülasyon bozukluğu (hiperpireksi) olan 9 olgumuzun (% 49.9) hepsi yaşamını yitirmiştir. SONUÇ: Pons hematomlarında kötü prognostik faktörler bilinç düzeyi ve termoregülasyon bozukluğu olarak belirlenmiştir. Termoregülasyonun düzeltilmesine yönelik çalışmaların planlanması prognozun iyileştirilmesine katkıda bulunabilir düşüncesindeyiz. Anahtar Kelimeler: Pons, Prognoz, Bilinç, Hematom

Anahtar Kelimeler:

pons, prognosis, consciousness

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