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Amaç: Travmatik pnömosefalus olgularında konservatif tedavi sonuçlarının hasta profili, etiyoloji, klinik ve radyolojik bulgular ve risk faktörleri ışığında değerlendirilmesi Yöntem: Bu çalışma, kafa travması sonucu pnömosefalus tespit edilerek medikal tedavi yapılan 73 hasta (medyan yaş 32(2–80) yıl, %78.1 erkek hasta) ile yürütüldü. Hastaların demografik özellikleri, travma tipleri, eşlik eden kanama ve fraktürler, risk faktörleri (otore ve/veya rinore, nöbet gelişimi ve menenjit gelişimi), üç farklı zamanda (0-24 saat, 1-3 gün ve 3-20. gün içinde) çekilen bilgisayarlı beyin tomografisi (BBT) bulguları (pnömosefalusun intrakranial yerleşimi, abzorbsiyon süresi) ve eş zamanlı GKS değerleri tespit edilerek, hastanede kalış süresi ve tedavi sonucu (normal taburculuk, nörolojik sekel ile taburculuk, eksitus) kaydedildi. Bulgular: Trafik kazası (%38.4) ve yüksekten düşme (%35.6) en sık nedenler olup, hastaların %8.4’ünde nöbet gelişimi, %29.4’ünde otore veya rinore ve 10(%13.7) hastada menenjit gelişimi gözlendi. Toplamda 58(%79.5) vakada tam iyileşme görülürken, 7(% 9.6) hasta nörolojik defisit ile taburcu edildi ve 8(%10.8) hasta eksitus oldu. Ortalama GKS değerinde pnömosefalus yerleşim yerine göre her üç ölçümde de (sırasıyla p<0.001, p<0.05 ve p<0.001) fark gözlendi. Menenjit gelişenlerde eş-zamanlı otore/rinore yaygın (%30-40), hastanede kalış süreleri (ort±SS 11.88±6.35 gün ve 7.01±3.50 gün, p<0.01) ve mortalite oranları (%20 ve %9.5, p<0.01) ise menenjit olmayan hastalara göre anlamlı şekilde daha yüksekti. Sonuç: Sonuç olarak, bulgularımız, travmatik pnömosefalusun uygun ve zamanında başlatılan konservatif tedavi ile yüksek oranda tam iyileşme ile sonuçlandığını göstermekte, ancak tedavinin klinik seyirle uyumlu şekilde yürütülmesinde tekrarlı BBT değerlendirmesi ve eş-zamanlı nörolojik değerlendirmenin rolüne işaret etmektedir.
Objective: To evaluate results of conservative treatment in traumatic pneumocephalus in terms of patient profile, etiology, clinical and radiological findings and risk factors Material and Method: A total of 73 patients (median age, 32(2-80) years, 78.1% were males) with traumatic pneumocephalus after head trauma and medical treatment were included. Data on patient demographics, trauma types, cocomitant hemorrhage and fractures, risk factors (otorrhea and/or rhinorrhea, seizure and meningitis development), three consecutive (0-24 h, 1-3 days, 3-20 days) brain computerized tomography (CT) findings (intracranial location of pnuemocephalus, absorption time) and concomitantly assessed GCS scores were determined. The length of hospital stay (LOS) and treatment outcome (discharge, discharge with neurological sequela and death) were recorded. Results: Traffic accident (38.3%) and falls (35.6%) were the most common reasons, while rates for seizure, otorrhea/rinorrhea and meningitis were 8.4%, 29.4% and 13.7% respectively. Total recovery was noted in 58(79.5%) patients, discharge with neurological sequela in 7(9.6%) and death in 8(10.8%) patients. GCS scores differed significantly with respect to location of pneumocephalus (p<0.001, p<0.05 and p<0.001, respectively). In patients with concomitant meningitis otorhhea/rhinorrhea was prevalent (30-40%), while LOS (mean±SD 11.88±6.35 vs. 7.01±3.50 days, p<0.01) and mortality rates (20 vs. 9.5%, p<0.01) were significantly higher than those without meningitis. Conclusion: In conclusion, our findings revealed the likelihood of full recovery with implementation of timely and approriate conservative treatment in traumatic pneumocephalus, while emphasizing the role of repeated CT imaging along with concomitant neurological assessment in provision of the appropirate treatment in accordance with the clinical course.
Objective: To evaluate outcome of conservative treatment in traumatic pneumocephalus in terms of patient profile, etiology, clinical and radiological findings and risk factors Material and Method: A total of 73 patients (median age, 32(2-80) years, 78.1% were males) with traumatic pneumocephalus after head trauma and medical treatment were included. Data on patient demographics, trauma types, cocomitant hemorrhage and fractures, risk factors (otorrhea and/or rhinorrhea, seizure and meningitis development), three consesutive (0-24 h, 1-3 day, 3-20 day) brain computerized tomography (CT) findings (intracranial location of pnuemocephalus, absorption time) and concomitantly assessed GCS scores were determined. Length of hospital stay (LOS) and treatment outcome (discharge, discharge with neurological sequela and death) were recorded. Results: Traffic accident (38.3%) and falls (35.6%) were the most common reasons, while rates for seizure, otorrhea/rinorrhea and meningitis were 8.4%, 29.4% and 13.7% , respectively. Total recovery was noted in 58(79.5%) patients, discharge with neurological sequela in 7(9.6%) and death in 8(10.8%) patients. GCS scores differed significantly with respect to location of pneumocephalus (p<0.001, p<0.05 and p<0.001, respectively). In patients with meningitis concomitant otorhhea/rhinorrhea was prevalant (30-40%), while LOS (mean±SD 11.88±6.35 vs. 7.01±3.50 days, p<0.01) and mortality rates (20 vs. 9.5%, p<0.01) were significantly higher than those without meningitis. Conclusion: In conclusion, our findings revealed the likelihood of full recovery with implementation of timely and approriate conservative treatment in traumatic pneumocephalus, while emphasize the role of repeated CT imaging along with concomitant neurological assessment in provision of the appropirate treatment in accordance with the clinical course.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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