İNTRAKRANİAL APSELERDE CERRAHİ TEDAVİ SONUÇLARI

Giriş: İntrakranyal apselerde cerrahi tedavi sonuçlarımızı sunmaktır. Gereç ve Yöntem: 2005-2016 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Beyin ve Sinir Cerrahisi kliniğinde intrakranial abse tanısı ile tedavi edilen 11 olgu retrospektif olarak incelendi. Bu çalışmada, intrakranial apseli hastaların şikâyetleri, apsenin meydana geliş şekli, apsenin yerleşimi ve bulguların dağılımı incelendi. Hastalara uygulanan cerrahi yaklaşım şekilleri ve sonuçları karşılaştırıldı. Cerrahi teknik olarak Stereotaksik Burrhole'den aspirasyon veya kraniektomi ile drenaj ve kapsül eksizyonu uygulandı. Bulgular: Onbir hasta çalışmaya alındı. Hastaların yaşları 11-63 yaş arasındaydı. Ortalama yaş 33±3 idi. Hastaların şikayetleri, görülme sıklığına göre, 7 hastada (%63.6) bilinç bulanıklılığı, 4 hastada (%27.2) bulantı-kusma, daha az oranda baş ağrısı, kuvvetsizlik, ateş ve baş dönmesi şikayetleri vardı. Hastaların abse lokalizasyonları genellikle temporal semptomların başlaması sonrası kliniğimize başvuru süreleri, ortalama 23.6±5 gün'dü. Cerrahi olarak 11 hastanın 7'sine (%63.6) Burr-holle ile abse drenajı, 2 hastaya kraniektomi ile abse drenajı ve 2 hastaya kapsül eksizyonu (%18.1) operasyonu yapıldı. Operasyon öncesi ve sonrası radyolojik olarak Kranial Bilgisayarlı Tomografi (BT) çekildi. Klinik takipte laboratuar analizi olarak CBC, Sedimantasyon, hsCRP düzeylerine bakıldı. Operasyon sırasında abse materyalinden kültür gönderildi. Hastaların GOS (Glaskow outcome scala) puanlaması 8 hastada 5 (%72.7), bir hastada 4 (%9.09), bir hastada 2 (%9.09) ve bir hastada 1 (%9.09) puan olarak hesaplandı. Sonuç: İntrakranial abselerin cerrahisinde uygulanan cerrahi yaklaşımlardan abse aspirasyonu ile kapsül eksizyonu arasında GOS oranı açısından belirgin bir fark görülmedi. Ek olarak cerrahi sonrası takiplerde apse boyutun 2 cm'in altında ise Kranial BT takibine ihtiyaç olmadığı, medikal tedavi ve CRP düzeyi takibinin tek başına yeterli olduğu görüldü.

Results of Surgical Treatment of Intracranial Abscess

Introduction: We aim to present our results of surgical treatment of intracranial abscess. Material and Methods: In our study, between the years 20052016 at Kirikkale University Faculty of Medicine, Neurosurgery department was performed. Intracranial abscess treated with the diagnosis of 11 patients were evaluated retrospectively. Intracranial abscess, their complaints, occurrence form of abscesses, abscesses and examined the distribution of the settlement findings. Surgical forms applied to patients and compared. Stereotactic aspiration or Burr-hole craniectomy from the surgical drainage technique were excised and capsules. Results: 11 patients were enrolled in the study. The ages of the patients ranged from 11-63 years old. The average age was 33±3. Patients' complaints, according to the incidence; 7 patients (63.6%) consciousness turbidity,4 patients (27.2%), nausea and vomiting, to a lesser extent, headache, weakness, fever and dizziness complaints. Abscess localization of the patients were generally located in the temporal lobe. After the onset of symptoms of patients to our clinic application period, the average 23.6±5 days. Surgery in 11 patients and 7 patients with (63.6%) abscesses with Burr-hole to 2 craniectomy patients with abscesses and 2 patients with capsular excision (18.1%) operations were performed. Preoperative and postoperative radiographic Cranial Computed Tomography (CT) was performed. As laboratory analysis in the clinical follow-up CBC, Sedim, hsCRP levels were measured. Culture sent the abscess material during the operation. Patients GOS (Glasgow outcome scale) score of 8 patients in 5 (72.7%), one patient in 4 (9.09%) to a patient in 2 (% 9.09) and a patient 1 (% 9.09) were calculated as points. Conclusion: Intracranial abscess of the surgical approach in the surgical excision of the capsule with the aspiration of the abscess was not observed a significant difference in the rate of GOS. In addition, post-surgical follow-up less than 2 cm in size of the abscess, Cranial CT is not needed to follow, and CRP levels were seen in follow-up medical treatment alone is enough.

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