İbrahim KARAKAYA, Özlem ERDEN AKİ, Koray BAŞAR, Suzan ÖZER

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.

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

Electroconvulsive therapy (ECT) is a comparably safe treatment option frequently administered fortreatment-refractory mental disorders. It has no absolute contraindication; however, careful attentionshould be given when ECT is applied to patients with comorbid conditions. Intracranial aneurysms areamong the comorbidities that increase certain risks associated with ECT. Increase in cerebral blood flowduring ECT may be associated with increased risk of rupture of an aneurysm and bleeding from vascularmalformation. In the literature, there is a limited number of case reports on ECT administration in patientswith surgically repaired cerebral aneurysm. In this case report, application of ECT in a 53-year-old femalepatient 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 ECTapplication for patients with repaired intracranial aneurysms are reviewed.

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