Halil ÇIKRIKLAR, Mehmet EKİCİ, Didem COŞAN, Arzu EKİCİ, Yasemin ÜSTÜNDAĞ, Mümin KARAALİ, Mahmut KAYNAK, Kamil UZ, Canan BAYDEMİR, Yusuf YÜRÜMEZ

SERUM GFAP DÜZEYİ, MİNOR KAFA TRAVMALI ÇOCUKLARDA BEYİN TOMOGRAFİSİNE ALTERNATİF OLABİLİR Mİ?

Amaç: Serum Glial fibriler asidik protein (GFAP) düzeyleri nöron hasarının önemli bir belirteci-dir. Bu çalışmada minor kafa travmalı (MKT) çocuklarda, serum GFAP’ın tanısal etkinliği ve beyinBT’sine alternatif bir tanı yöntemi olup olamayacağının araştırılması amaçlandı.Gereç ve Yöntemler: Orta ve yüksek riskli minor kafa travması olarak değerlendirilen, travmanın ilk altı saati içinde hastanemiz acil servisine başvuran 0- 6 yaş grubu 63 hasta ve 30 çocuk kontrol grubu çalışmaya alındı. Hastalara beyin BT çekildi. Travmanın 1. ve 3-5. saatlerinde serum GFAP düzeyleri ölçüldü.Bulgular: Hastaların %38.1’inde kusma, %28.6’sında kafa kemiklerinde kırık, %28.6’sında sefal he- matom, %3.2’sinde epidural hematom saptandı. Serum GFAP düzeyi travma grubunda ortalama2,250 ng/ml, kontrol grubunda ise ortalama 1,775 ng/ml idi. İki grup serum GFAP düzeyleri ara- sında anlamlı farklılık saptanmadı. Serum GFAP düzeyi, travmanın 1. saatinde ortalama 2,141 ng/ ml, 3-5.saatlerinde ise ortalama 3,011 ng/ml olarak saptandı. Birinci saat ile 3-5. saatler arasında alınan serum GFAP düzeyleri arasında istatiksel olarak anlamlı bir fark saptanmadı.Sonuç: MKT’li çocuklarda bazen gereksiz beyin BT çekilmektedir. Serum GFAP ölçümü, MKT olgu- larının yönetiminde umut verici gözükmektedir. Çalışmamızda serum GFAP değerleri ile travmatik beyin yaralanması arasında ilişki saptanamamıştır. Ancak daha fazla hasta sayılarıyla yapılan yeni çalışmalara ihtiyaç duyulmaktadır.Anahtar Kelimeler: Bilgisayarlı tomografi; Çocuklar; GFAP; Kırık; Minor kafa travmasıABSTRACTObjective: Serum Glial Fibrillary Acidic Protein (GFAP) level is an important marker of neuronaldamage. In this study, it was aimed to evaluate the diagnostic efficacy of serum GFAP and if it can be used as an alternative diagnostic method to brain CT at the minor head trauma (MHT) in children.Materials and Methods: Sixty three patients between the age of 0-6 years who were admitted to the emergency department within the first six hours of the trauma and the control group of 30 children were studied. Cranial CT was performed in patients. Serum GFAP levels were measured at the first and 3-5. hours of the trauma.Results: 38.1% of the patients’ had vomiting. 28.6% patients’ had skull fractures, 28.6% were determined cephal haematoma., 3.2% had an epidural hematoma. Average level of serum GFAP is2.250 ng / ml in the trauma group and 1,775 ng / ml in the control group ((p=0,167). The average of serum levels of GFAP wasn’t a significant difference between the patients who admitted in the first hour and within 3-5. hours (2,141 ng / ml, 3,011 ng / ml; respectively )Conclusion: Unnecessary brain CT is sometimes drawn at the minor head trauma in children. Measurement of GFAP appears to be promising for management of the patients with MHT. In our study, there was no relationship between the serum GFAP values and traumatic brain injury. However, the new studies with more number of patients are needed.Key words: Computed tomography; Children; Glial Fibrillary Acidic Protein; Fracture; Minor head trauma

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