Does a History of Surgically Repaired Intracranial Aneurysm Interfere with Electroconvulsive Therapy?

Electroconvulsive therapy (ECT) is a comparably safe treatment option frequently administered for treatment-refractory mental disorders. It has no absolute contraindication; however, careful attention should be given when ECT is applied to patients with comorbid conditions. Intracranial aneurysms are among the comorbidities that increase certain risks associated with ECT. Increase in cerebral blood flow during ECT may be associated with increased risk of rupture of an aneurysm and bleeding from vascular malformation. In the literature, there is a limited number of case reports on ECT administration in patients with surgically repaired cerebral aneurysm. In this case report, application of ECT in a 53-year-old female patient diagnosed with treatment-refractory major depressive disorder and with a history of surgical repair for intracranial aneurysm is presented. In addition, special considerations and precautions about ECT application for patients with repaired intracranial aneurysms are reviewed.

Geçirilmiş intrakranial anevrizma operasyonu elektrokonvülzif tedavi için bir engel mi?

Elektrokonvülzif tedavi (EKT) tedaviye dirençli ruhsal bozukluklarda uygulanan, görece güvenli bir tedavi yöntemidir. Kesin kontrendikasyonu bulunmasa da tıbbi ek tanıları olan hastalarda EKT uygulanırken dikkatli davranılması gerekmektedir. İntrakranial anevrizma, EKT uygulanırken risk oluşturabileceği düşünülen tıbbi tanılardandır. EKT sırasında serebral kan akımı ve kafa içi basınç artarak anevrizma rüptürü ve vasküler malformasyon kanaması riskini arttırabilir. Tıbbi yazında çeşitli yöntemlerle onarılmış intrakranial anevrizması olan hastalara EKT uygulanmasıyla ilgili sınırlı sayıda olgu sunumu mevcuttur. Bu yazıda 53 yaşında, anevrizma operasyonu öyküsü olan, majör depresif bozukluk tanısı ile takip edilen, ilaç tedavisinden yarar görmemiş kadın hastada yapılan EKT uygulaması sunulmuş ve bu vaka üzerinden intrakranial anevrizması olan hastalarda EKT uygulaması sırasında dikkat edilecek hususlar tartışılmıştır.

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