Selami SERHATLIOĞLU, Hadi UYSAL, Özgür KOCAÖZ, Fatih S. EROL, Polat DURUKAN, Erkin OĞUR

Minör Kafa Travmalı Hastalarda Serebral Hemodinamik Değişikliklerin Renkli Doppler Ultrasonografi ile İncelenmesi

Amaç: Ucuz, non invaziv ve kullanımı kolay bir yöntem olan Transkraniyal Doppler Ultrasonografi(TKDU), ana intrakraniyal arterlerdeki stenozun ve kollateral dolaşımın değerlendirilmesi, ekstrakraniyal oklüziv hastalığın intrakraniyal kan akımı üzerine etkisinin değerlendirilmesi, AVM taraması ve beyin ölümü tespiti için yaygın olarak kullanılmaktadır. Fonksiyonel testlerle serebral rezervin saptanması, menenjitte, migrende ve posttravmatik hemodinaminin değerlendirilmesi gibi konularda yeni çalışmalar yapılmaktadır. Biz de bu çalışmada minör kafa travmalı hastalarda posttravmatik serebral hemodinamik değişiklikleri değerlendirmeyi amaçladık. Gereç ve Yöntem: Temmuz 2003 ile Şubat 2004 tarihleri arasında minör kafa travmalı (MKT) 44 hasta (Grup 1) posttravmatik ilk 8 saat içerisinde değerlendirildi. Sağlıklı 24 bireyden kontrol grubu (Grup 2)oluşturuldu.Transtemporal bakı ile bilateral orta serebral arter (MCA),submandibular bakı ile internal karotid arter (İCA) akımları ölçüldü. Gruplar yaş, cinsiyet, MCA akım parametreleri, ekstrakranial İCA ortalama akımları, VMCA/VİCA oranları açısından birbiriyle karşılaştırıldı. Bulgular: Gruplar arasında yaş ve cinsiyet açısından istatistiksel anlamlı fark yoktu MKT'li olguların MCA akım hızları, rezistif (Rİ) ve pulsatilite indeksleri (Pİ) normal gruba göre anlamlı olarak yüksek bulundu. Buna karşılık İCA akımları ve VMCA/VİCA oranları açısından anlamlı fark saptanmadı (p>0.05). 6 vakada (%13.6) hiperemi ile uyumlu bulgular izlenirken hiçbir hastada vazospazm yoktu. Sonuç: MKT'li hastalarda MCA akım hızlarında, pulsatilite indeksleri(Pİ) ve rezistif indeks, (Rİ)'lerinde artış izlenmektedir. Bizim bulgularımız literatürde bildirilen minör kafa travmalarında vazospazmın beklenen bir bulgu olmadığı, buna karşılık hiperemi değerlerinin düşük oranda izlenebileceği kanaatini desteklemektedir.

Anahtar Kelimeler:

Kafa travması, doppler US, transkraniyal

Selami SERHATLIOĞLU1, Hadi UYSAL1, Özgür KOCAÖZ1, Fatih S. EROL2, Polat DURUKAN3, Erkin OĞUR1

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Kabul Tarihi:01.03.2005