Spontan intraserebral hemorajili hastalarda cerrahi ve medikal tedavilerin kıyaslanması

Amaç: İntraserebral hemoraji (ISH), kronik hipertansiyon, amiloid anjipati, antikoagülanlar ve malformasyonlar risk faktörleri sonucunda oluşan, inmelerin bir türüdür. Primer ve spontan ISH, hemorajik inmelerin büyük bir kısmını oluşturur. ISH tedavisi, medikal ve cerrahi yaklaşımları kapsar. Bu çalışmada, cerrahi ve medikal tedaviler Glasgow Coma Scale (GCS) kullanılarak kıyaslnamıştır. Hastalar ve Yöntem: Çalışmaya ISH’li 32 hasta katılmıştır. Tüm hastalarda tanı, kraniyal bilgisayarlı tomografi ve magnetik rezonans görüntüleme yöntemleri ile konulmuştur. Medikal tedavi 19 ve cerrahi tedavi 13 hastaya uygulanmıştır. İntrasebral hematomlu hastalarda, GCS skorları ilk kabulde ve tedavi sonrasında belirlenmiştir ve kıyaslanmıştır. Bulgular: Çalışmada, 4’ü medikal tedavi alan ve 4’ü opere edilen toplam 8 hasta hayatını kaybetmiştir. Katılımcılar, lezyonun lokasyonuna göre, pre- ve post-tedavi GCS skorlarına göre incelenmiştir. Elde edilen veriler, GCS skorlarının, medikal ve cerrahi uygulama gruplarında, işlem öncesi ve sonrası istatiksel olarak anlamlılık olduğunu göstermiştir. Medikal olarak tedavi edilen hastaların GCS skorları, opere edilenlerinkine göre daha yüksek bulunmuştur. Tedaviler sonrası GCS skorları iki grup arasında yakın bulunmuş ve istatiksel bir fark tespit edilmemiştir. Sonuç: Çalışma sonucunda elde edilen veriler, cerrahi tedavinin medikal tedaviye kıyasla daha iyi olmadığını göstermiştir.

Anahtar Kelimeler:

Spontan İntraserebral Hemoraji, Cerrahi Tedavi, Medikal Tedavi

Comparison of surgical and medical treatment in patients with spontaneous intracerebral hemorrhage

Aim: Intracerebral hemorrhage (ICH) is a subtype of stroke whose risk factors are chronic hypertension, amyloid angiopathy, anticoagulants, and malformations. Primary or spontaneous ICH constitutes a significant portion of hemorrhagic strokes. Management of ICH ranges from medical management to open surgery. In this study, surgical and medical treatments applied to the patients were compared with the Glasgow Coma Scale (GCS). Patients and Methods: A total of 32 patients with ICH were included in the study. Diagnosis was made by cranial computed tomography (CT) and magnetic resonance imaging (MRI) in all patients. Medical treatment was applied to 19 patients among the participants. Surgical treatment was applied to 13 patients. GCS points of patients presenting with intracerebral hematoma were recorded and compared at their first admission and after treatment. Results: In this study, a total of eight patients died, four of whom were followed up with medical treatment and four of those who underwent surgical treatment. Participants were examined in terms of pre- and post-treatment GCS scores according to the location of the lesion. As a result of the analysis of the data obtained, it was determined that there was a significant difference between the GCS values of the participants before and after the surgical and medical treatment. The mean GCS values of those who were treated medically were higher than those who were treated surgically. GCS values were very close to each other after treatment and no statistically significant difference was found between the groups. Conclusion: In the light of the findings obtained in the study, it was concluded that surgical treatment was not superior to medical treatment.

Keywords:

Spontaneous Intracerebral Hemorrhage, Surgical Treatment, Medical Treatment,

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