Araştırma Makalesi
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PONS HEMATOMLARINDA BAŞVURU ANINDAKİ BİLİNÇ DÜZEYİ VE KLİNİK DURUMUN PROGNOZ ÜZERİNE ETKİSİ

Yıl 2017, Cilt: 50 Sayı: 1, 36 - 40, 01.09.2017

Öz

ABSTRACT



 



OBJECTİVE: The aim of the study determining the
risk factors in pons hematomas, and to examine the level of consciousness at
the time of admission, and the effect of clinical status on prognosis.



 



MATERIAL AND METHOD:  The study was prospectively carried out with
twenty-two cases diagnosed as primary pontine hematoma by computed tomography
(CT) in a Neurology Clinic of
Istanbul Research and Education Hospital,  
between  1991-1994.



 



RESULTS: 14 of our patients were male (63.7%),
8 were female (36.3%) and mean age of 59.1 (31-82), respectively. The 43.4% of the cases which were
conscious were alived.  3 of 5 patients
with somnolence (22.8%) , and all 7 
patients with coma (31.8%) had all died.  The  all of 9 
patients with thermoregulation impairment (49.9% of the cases ) died.



 



CONCLUSION:  Poor prognostic factors in pons  hematomas have been identified as  state of consciousness and thermoregulation
disorder. The planning of studies in the future to correct thermoregulation may
contribute to improving the prognosis.



 



Keywords:  pons, prognosis, consciousness, hematoma



 



AMAÇ:Bu çalışmada; pons hematomlarında
risk faktörlerinin belirlenmesi, başvuru anındaki  bilinç düzeyi­nin ve klinik durumun prognoz
üzerine etkisini incelemeyi amaçladık.



 



GEREÇ VE YÖNTEMLER: 1991 - 1994 yılları arasında üçüncü
basamak İstanbul Eğitim ve Araştırma Hastanesi Nöroloji Kliniğinde Bilgisayarlı
Tomografi (BT)  ile primer pontin hematom
tanı­sı konan 22 olgu prospektif olarak incelendi.



BULGULAR:
Olgularımızın 14’ü erkek (% 63.7), 8’i kadın (% 36.3) ve yaş ortalaması 59,1
(31-82) idi. Bilinci açık olan 10 olgumuzun (% 43.4) hepsi yaşadı. Somnolansta
olan 5 olgunun (% 22.8) 3’ü, komada olan 7 olgunun (%31,8) hepsi eksitus oldu.
Termoregülasyon bozukluğu (hiperpireksi) olan  9 olgumuzun (% 49.9) hepsi yaşamını yitirmiştir.



SONUÇ: Pons hematomlarında kötü prognostik
faktörler bilinç düzeyi ve termoregülasyon bozukluğu olarak belirlenmiştir.
Termoregülasyonun düzeltilmesine yönelik çalışmaların planlanması  prognozun iyileştirilmesine katkıda bulunabilir
düşüncesindeyiz.



Anahtar Kelimeler: Pons, Prognoz, Bilinç, Hematom



 

Kaynakça

  • 1-Kushner MJ, Bressman SB; The clinical manifestations of pontine hemorrhage. Neurology 1985, 35:637-643.
  • 2-Russell B, Rengachary SS, Mcbregor D; Primer pontine hematoma presenting as a cerebellopontine angle mass. Neurosurgery 1986, 19:129-133.
  • 3-Lavi E, Rothman S, Reches A; Primary pontine hemorrhage with complete recover,. Arch Neurol 1981, 38:320.
  • 4-Dere F; Nöroanatomi ve Fonksiyonel Nöroloji. Okullar Kitapevi 1990, 161-188.
  • 5-Steegman AT; Primary pontine hemorrhages. J Nerv ment Dis. 1951, 114:35-65.
  • 6-Çaplan İR, Goodwin JA; lateral tegmental brainstem hemorrhages. Neurology 1982, 32:252-260.
  • 7-OkuderaT, Uemura K, Nakajima K; Primary pontine hemorrhage: cor¬relations of pathologic features with postmortem microangiographic and vertebral angiography studies. Mt Sinai J Med 1978, 45:305.
  • 8-Kase C, Maulsby G, Mohr J; Partial pontine hematomas. Neurology 1980, 30:652-655.
  • 9-Nakajima K; Ciinicopathological study of pontine hemorrhage. Stroke 1983, 14:485-493.
  • 10-Chung CS, Park CH; Primary pontine hemorrhage: A new classificati¬on. Neurology 1992, 42:830-834.
  • 11-Fisher CM; Pathological observations in hypertensive cerebral hemorrhage. J Neuropathol Ex Neurol 1971, 30:536-50
  • 12-Tuhrim S, Yang WC, Rubinowitz H, Weinberger J; Primary pontine hemorrhage and the dysarthria-clumsy hand syndrome. Neurology. 1987, 44:483.
  • 13-Masiyama S, Niizuma H, Suzuki J; Pontine hemorrhage: A clinical analysis of 26 cases. J Neurol Neurosurg Psychiatry 1985, 48:658-662.
  • 14-Plum F, Posner JB, The diagnosis of stupor and coma. Philadelphia. FA Davis Company 1972.
  • 15-Carlos S, Kase MD, Gilbert O, Muslby MD and J.P Mohr, M.D.; Parti¬al pontine hematomas. Neurology 1980, 30:652-655.
  • 16-Khurana RK; Autonomic dysfunction in pontomedullary stroke. Ann Neurol 1982; 12:86.
  • 17-Scheibel AB; On detailed connections of the medullary and pontine reticuler formation. Anat Rec 1951, 109:345-6.
  • 18-Bora t, Turan F; Beyin sapı hematomları. Nöroloji Kongresi 1989, 50-55.
  • 19-Kanaya H, Yamada T, Oana K, Okudero T; Clinicopathological study on pontine hemorrhage. Brain and Nerve 1968, 20:49-55.
Yıl 2017, Cilt: 50 Sayı: 1, 36 - 40, 01.09.2017

Öz

Kaynakça

  • 1-Kushner MJ, Bressman SB; The clinical manifestations of pontine hemorrhage. Neurology 1985, 35:637-643.
  • 2-Russell B, Rengachary SS, Mcbregor D; Primer pontine hematoma presenting as a cerebellopontine angle mass. Neurosurgery 1986, 19:129-133.
  • 3-Lavi E, Rothman S, Reches A; Primary pontine hemorrhage with complete recover,. Arch Neurol 1981, 38:320.
  • 4-Dere F; Nöroanatomi ve Fonksiyonel Nöroloji. Okullar Kitapevi 1990, 161-188.
  • 5-Steegman AT; Primary pontine hemorrhages. J Nerv ment Dis. 1951, 114:35-65.
  • 6-Çaplan İR, Goodwin JA; lateral tegmental brainstem hemorrhages. Neurology 1982, 32:252-260.
  • 7-OkuderaT, Uemura K, Nakajima K; Primary pontine hemorrhage: cor¬relations of pathologic features with postmortem microangiographic and vertebral angiography studies. Mt Sinai J Med 1978, 45:305.
  • 8-Kase C, Maulsby G, Mohr J; Partial pontine hematomas. Neurology 1980, 30:652-655.
  • 9-Nakajima K; Ciinicopathological study of pontine hemorrhage. Stroke 1983, 14:485-493.
  • 10-Chung CS, Park CH; Primary pontine hemorrhage: A new classificati¬on. Neurology 1992, 42:830-834.
  • 11-Fisher CM; Pathological observations in hypertensive cerebral hemorrhage. J Neuropathol Ex Neurol 1971, 30:536-50
  • 12-Tuhrim S, Yang WC, Rubinowitz H, Weinberger J; Primary pontine hemorrhage and the dysarthria-clumsy hand syndrome. Neurology. 1987, 44:483.
  • 13-Masiyama S, Niizuma H, Suzuki J; Pontine hemorrhage: A clinical analysis of 26 cases. J Neurol Neurosurg Psychiatry 1985, 48:658-662.
  • 14-Plum F, Posner JB, The diagnosis of stupor and coma. Philadelphia. FA Davis Company 1972.
  • 15-Carlos S, Kase MD, Gilbert O, Muslby MD and J.P Mohr, M.D.; Parti¬al pontine hematomas. Neurology 1980, 30:652-655.
  • 16-Khurana RK; Autonomic dysfunction in pontomedullary stroke. Ann Neurol 1982; 12:86.
  • 17-Scheibel AB; On detailed connections of the medullary and pontine reticuler formation. Anat Rec 1951, 109:345-6.
  • 18-Bora t, Turan F; Beyin sapı hematomları. Nöroloji Kongresi 1989, 50-55.
  • 19-Kanaya H, Yamada T, Oana K, Okudero T; Clinicopathological study on pontine hemorrhage. Brain and Nerve 1968, 20:49-55.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Cüneyt Uzunlar

Yayımlanma Tarihi 1 Eylül 2017
Gönderilme Tarihi 21 Nisan 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 50 Sayı: 1

Kaynak Göster

AMA Uzunlar C. PONS HEMATOMLARINDA BAŞVURU ANINDAKİ BİLİNÇ DÜZEYİ VE KLİNİK DURUMUN PROGNOZ ÜZERİNE ETKİSİ. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Eylül 2017;50(1):36-40.