Subaraknoid Kanama ve Komplikasyonlarının Tedavisi

Year 2011, , 52 - 55, 01.01.2011

Mevci Özdemir Melih Bozkurt Gökmen Kahiloğlu Hasan Çaglar Uğur Editörden Nihat Egemen

https://doi.org/10.1501/Tipfak_0000000785

Abstract

Keywords

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Subaraknoid Kanama ve Komplikasyonlarının Tedavisi

Abstract

Subaraknoid kanama kanın subaraknoid mesafeye dağıldığı patolojik bir durumdur ve orta-ileri yaş grubunda önemli bir morbidite ve mortalite nedenidir. Subaraknoid kanamalı bir hastanın tedavi- sinde primer hedef anevrizma kesesinin tamamının, rezidü bırakmadan güvenli bir şekilde oklüde edilmesidir. Ancak yalnızca anevrizma kesesini oklüde etmek yeterli olmayıp subaraknoid kanama- ya bağlı meydana gelen komplikasyonlarda dikkatlice tedavi edilmelidir. Bu komplikasyonların baş- lıcaları; tekrar kanama, vazospazm, parankimal hematom, intraventriküler hemoraji, hidrosefali ve intrakranial basınç artışıdır. Anevrizma tedavisinde hastaların monitörize edilerek yakın bir şekilde takip edilmesi ve bu komplikasyonların gelişmesi halinde erken tanı konularak müdahale edilmesi postop morbidite ve mortalite oranlarını büyük oranda azaltacak ve başarı oranını arttıracaktır

Keywords

Anevrizma, Parankimal Hematom, Subaraknoid Kanama

References

• Ozdemir M, KahilogullarıG, Comert A, Caglar YS, Elhan A, Sılav G, Ugur HC. Processus clinoideus anterior ve posterior arası köprüleşme ve foramen caroticoclinoidale: anatomik çalışma. Ankara Universitesi Tıp Fakultesi Mecmuası 2006; 59: 175-8.
• Yasargil M, Fox J. The microsurgical approach to intracranial aneurysms. Surg Neurol; 1975;3: 7-14.
• Yasargil M. Microneurosurgery, Vol. II. Stuttgart: Georg Thieme Verlag; 1984; 165-221.
• Rinkel GJ, Djibuti M, Algra A: Prevalance and risk of rupture of intracranial aneurysms: A systematic review. Stroke 1998; 29:251-256.
• Mc Fadzen RM, Doyle D, Rampling R, Teasdale E, Teasdale G: Pituitary apoplexy and its effects on vision. Neurosurg 1991; 29: 669-75.
• McDonald RL, Weir B: Perioperatine Management of Subarachnoid Hemorrhage. Youmans Fifth edition, Vol II, Philadelphia, Elsevier 1996; 1813-38.
• Binet EF, Angtuaca EJC. Radiology of intracranial aneurysm. In Wilkins RH, New York. 1985; 1341-54.
• Jayaraman MV, Mayo-Smith WW, Tung GA, et al. Detection of intracranial aneurysms: multi-detector row CT angiography compared with DSA. Radiology 2004; 230: 510-8.
• Karamessini MT, Kagadis GC, Petsas T, et al. CT angiography with three-dimensional techniques for the early diagnosis of intracranial aneurysms. Comparison with intraarterial DSA and the surgical findings. Eur J Radiol 2004; 49: 212-23.
• Turkvatan A, Kelahmet E, Olcer T. İnternal karotid arter pseudoanevrizmasında radyolojik bulgular. Ankara Universitesi Tıp Fakultesi Mecmuası 2003; 56 (3): 193-6.
• Wintermark M, Uske A, Chalaron M, et al. Multislice computerized tomography angiography in the evaluation of intracranial aneurysms: a comparison with intraarterial digital subtraction angiography. J Neurosurg 2003; 98: 828-36.
• Uysal E, Yanbuloglu B, Erturk M, Kilinc BM, Basak M. Spiral CT angiography in diagnosis of cerebral aneurysms of cases with acute subarachnoid hemorrhage. Diagn Interv Radiol 2005; 11: 77-82.
• Hernesniemi J, Dashti R, Lehecka M, Niemelä M, Rinne J, Lehto H, Ronkainen A, Koivisto T, Jääskeläinen JE. Microneurosurgical management of anterior communicating artery aneurysms. Surgical Neurology 2008; 70: 8–29.
• Kassel NF, Torner JC, Jane JA, et al: The international cooperative study on the timing of aneurysm surgery: II. Surgical results. J Neurosurg 1990; 73: 37-47.
• Friedman AH: Timing of aneurysm surgery. In Wilkins RH, Rengachary SS (eds): Neurosurgery, 2nd ed. New York, McGraw-Hill, 1996, pp 2255-60.
• Vinuela F, Duckwiler G, Mawad M: Guglielmi detachable coil embolization of acute intracranial aneurysm: Perioperative anatomical and clinical outcome in 403 patients. J Neurosurg 1997; 86: 475-82.
• Egemen N, Birler K, Avman N, Turker RK. Experimental cerebral vasospasm: Resolution by Iloprost. Acta Neurochir 1988; 95:131-5.
• Egemen N, Birler K, Avman N, Turker RK. The effect of iloprost on experimental cerebral arterial spasm in rabbit. Turkish Neurosurgery Suppl 1989; 1: 113-5.
• Egemen N, Turker RK, Sanlidilek U, Zorlutuna A, Bilgic S, Baskaya M, Unlu A, Caglar S. The effect of intrathecal sodium nitroprusside on severe chronic vasospasm. Neurological Research 1993; 15: 308- 15.
• Egemen N, Turker RK, Sanlidilek U, Zorlutuna A, Bilgic S, Baskaya M, Unlu A, Caglar S. The effect of Iloprost on Chronic Cerebral Vasospasm. Gen. Pharmac. 1993; 24 (2): 403-9.
• Egemen N, Baskaya MK, Turker RK, Unlu A, Caglar S, Guven C, Akbay C, Attar A. Protection by Iloprost (Stable Analogue of Prostacyclin) of endothelial damage due to chronic vasospasm in dogs: An electron microscope study. Neurological Research 1995; 17: 301-6.
• Pasqualin A, Bazzan A, Cavanazzi P, et al: Intracranial hematomas following aneurysmal rupture: Experience with 309 cases. Surg Neurol 1986; 25: 6-17.
• Findlay JM, Grace MG, Weir BK: Treatment of intraventricular hemorrhage with tissue plasminogen activator. Neurosurgery 1993; 32: 941-7.
• Selcuki D, Selcuki M: Aneurysmal Subarachnoidal Hemorrhage. Turkiye Klinikleri J Int Med Sci 2005; (1) 5: 43-8.
• Hasan D, Tanghe HL: Distribution of cisternal blood in patients with acute hydrocephalus after subarachnoid hemorrhage. Ann Neurol 1992; 31: 374-8.
• Selcuki D, Selcuki M: Aneurysmal subarachnoidal hemorrhage: post hemorrhagic complications. Turkiye Klinikleri J Int Med Sci 2006; (2) 22: 79-84.
• Solenski NJ, Haley ECJ, Kassel NF, et al: Medical complications of aneurysmal subarachnoid hemorrhage: A report of the multicenter, cooperative aneurysm study. Participants of the multicenter cooperative aneurysm study. Crit Care Med 1995; 23:1007-17