Altan GÜNEŞ, Damla HANALİOĞLU, Dilek CEBECİ

Akut Atipik İnme Şikayetleriyle Başvuran Çocuklarda Nörogörüntüleme Bulguları

Amaç: Acil serviste akut atipik inme şikayetleri ile başvuran hastalarda, bu klinik tabloya neden olan hastalıklarıaraştırmak, klinik bulgular ile anormal nörogörüntüleme bulguları arasındaki ilişkiyi değerlendirmektir.Gereç ve Yöntemler: Çalışmamız hastane etik kurul onayı alınarak yapıldı. Ocak 2016 ile Ocak 2018 tarihleri arasında,akut atipik inme şikayetleri nedeniyle beyin bilgisayarlı tomografisi (BT) ve/veya manyetik rezonans (MR) görüntülemesiyapılmış ardışık 117 hastanın (66 kız, 51 erkek, ortalama yaş 10.9±4.8 yıl), klinik ve nörogörüntüleme bulguları geriyedönük olarak tarandı. Kategorik ve sayısal değişkenler Ki-kare, Fisher, t-testi ile analiz edilerek lojistik regresyon analiziyapıldı.Bulgular: Hastalarda en sık saptanan şikayetler baş ağrısı (%25.6), kusma (%19.6) ve bilinç bulanıklığı (%17.9)’di.Hastaların %20.5’inde klinik ile ilişkili vaskülopati, konjenital afibrinojenemi gibi komorbiditeler saptanırken, %39.3’ününnörolojik muayenesi ve %35’inin nörogörüntülemesi anormaldi. On iki hastada klinik ve nörogörüntüleme bulularına göreacil tedavi gerektiren patolojiler (akut arteriyal iskemik inme [1 hasta], sinovenöz tromboz [1 hasta], intrakraniyal kitle [3hasta], menenjit [3 hasta], ensefalit [4 hasta]) saptandı. Eşlik eden komorbiditelerin varlığı, bilinç bulanıklığı ve nörolojikmuayenenin anormal olması ile nörogörüntülemede anormal bulgu saptanması arasında istatistiksel olarak anlamlı ilişkibulundu (p=0.045). Lojistik regresyon analizinde anormal nörogörüntüleme bulgularını öngörmede, bilinç bulanıklığı venörolojik muayenenin anormal olması anlamlıydı (p=0.006). MR görüntüleme (%45.2) ile saptanabilen anormal bulgularBT’ye göre (%17.1) anlamlı olarak fazlaydı (p

Neuroimaging Findings in Children with Acute Atypical Stroke Symptoms

Objective: To investigate the abnormalities detected in patients with acute atypical stroke symptoms in the emergency department and to determine the relationship between clinical and abnormal neuroimaging findings. Material and Methods: The study was approved by the local ethics committee. We retrospectively reviewed the medical and imaging records of 117 consecutive patients (male/female=51/66; mean age±standard deviation=10.9±4.8 years) who had brain computed tomography (CT) and/or magnetic resonance imaging (MRI) between January 2016 and January 2018. Categorical and numerical variables were analyzed by Chi-square, Fisher’s exact, t-tests and logistic regression analysis was performed. Results: The most common complaints were headache (25.6%), vomiting (19.6%), and confusion (17.9%). 20.5% of the patients had clinical-related comorbidities such as vasculopathy, congenital afibrinogenemia, 39.3% had abnormal neurological examination findings, and 35% had abnormal neuroimaging findings. In 12 patients, a disorder requiring urgent treatment was detected based on their clinical features, laboratory and neuroimaging findings. (acute arterial ischemic stroke [n=1], dural sinus thrombosis [n=1], neoplasia [n=3], meningitis [n=3], and encephalitis [n=4]). There were statistically significant correlations between the presence of comorbdities, confusion, abnormal neurological examination and neuroimaging findings (p=0.045). In predicting abnormal neuroimaging findings in logistic regression analysis, confusion and abnormal neurological examination findings were found to be significant (p=0.006). Abnormal findings detected by MRI (45.2%) were significantly higher than CT (17.1%) (p

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