Ahmet ÇOLAK, Dilaver DEMİREL, Kadir DÜNDAR, Murat KUTLAY, Nusret DEMİRCAN, Osman N. AKIN

Deneysel akut subdural hematom ile geliştirilen iskemik nöronal hasara hiperbarik oksijen ve dekstran uygulaması

Serebral iskemilerin tedavisinde hiberbarik oksijen uygulamasının olumlu etkileri bilinmektedir. Hiperbarik oksijen etkisini plazmada çözünmüş oksijen miktarını artırmak yolu ve serebral vazokonstriksiyon etkisi ile serebral kan akımını azaltmak şeklinde gösterir. Düşük molekül ağırlıklı dekstran ise eritrosit aglütinasyonunu etkileyerek ve kan viskozitesini düşürerek basit dilüsyon etkisi ile kan akımını artırır. Bu iki alternatifin kombine edilerek akut subdural hematomdaki iskemik nöronal beyin hasarındaki etkisini gözlemek amacıyla bu çalışma yapıldı. Sıçanlarda akut dönemde, hiperbarik oksijenin yalnız ve düşük molekül ağırlıklı dekstran infüzyonu ile kombine edilmesinin sonuçları histopatolojik olarak değerlendirildi. Kombine tedavi uygulanan deneklerde oluşturulan iskemik hasar bölgesi ile normal serebral doku arasında iyileşme gösteren geçiş alanının bulunduğu, sadece hiperbarik oksijen uygulananlarda ise iskemik nöronal hasar alanının kesin sınırlarla çevrelendiği görüldü. ikili tedavi uygulaması ile alınan sonuçlar histolojik olarak olumludur. Ancak, sonuçların klinik "çalışmalar ile teyit edilmesine ihtiyaç vardır.

Treatment of ischemic neuronal damage after experimental acute subdural hematoma with hyperbaric oxygen and dextran

The benefits of hyperbaric oxygen in the treatment of cerebral ischemia are well known. Hyperbaric oxygen increases the amount of oxygen dissolved in the plasma and decreases the cerebral blood flow by way of cerebral vasoconstriction. Low molecular weight dextrans increase the blood flow by affecting the erythrocyte agglutination and blood viscosity. An experimental study was performed to see the combined therapeutic effects of these two alternatives on the ischemic neuronal damage after acute subdural hematoma. The results of hyperbaric oxygen treatment only and combined with low molecular weight dextran infusion in the acute stage on the rats were evaluated with histopathological studies. There was a transitional probable healing zone between normal cerebral area and the ischemic damage area in the combined treatment group. In the group treated with only hyperbaric oxygen, the areas of normal and ischemic areas were separated with a clear line. Although the combined treatment group is more effective histopathologically the results need to be confirmed with clinical studies.

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