Zamanında doğan bebeklerde kafa içi kanama; bir takip çalışması
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Date
2012-08-15
Authors
İpek, Mehmet Şah
Zenciroğlu, Ayşegül
Özkan, Mehpare
Çınar, Hasibe Gökçe
Aydın, Mustafa
Okumuş, Nurullah
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Giriş: Bu çalışmanın amacı, zamanında doğan bebeklerde kafa içi kanamalar ile ilişkili risk faktörleri, klinik belirtiler ve sonuçların belirlenmesidir. Gereç ve Yöntem: Dr. Sami Ulus Kadın Doğum ve Çocuk Hastanesi Yenidoğan Yoğun Bakım Ünitesinde 2005 ile 2010 tarihleri arasında kafa içi kanama tanısı alan zamanında doğmuş bebekler geriye dönük olarak değerlendirildi. Olgular ultrasonografi, bilgisayarlı tomografi veya manyetik rezonans görüntüleme ile tanı aldı. Ortalama 36 ay takip edilen bebekler nörolojik açıdan değerlendirmeye alındı. Bulgular: Kafa içi kanaması olan 14 bebek tanımlandı. Olguların yarısı yaşamın ilk haftası içerisinde tanı almıştı (7/14) ve en yaygın klinik bulgu nöbetti (8/14). Kanama sıklıkla ventrikül içi (9/14) ve subaraknoid (7/14) yerleşimli idi, ancak 8 bebekte iki veya daha fazla kanama alanı mevcuttu. Olguların büyük çoğunluğunda (11/14) kafa içi kanamaya neden olan veya katkıda bulunan bir risk faktörü mevcuttu. Sadece bir hastada cerrahi girişim gerekti. İki hasta yenidoğan döneminde, ağır engelli diğer bir hasta ise 10 aylıkken kaybedildi. Yaşayanlardan ikisi ağır, biri ise hafif nörogelişimsel gerilik gösterdi. Kalan 8 hastanın nörolojik gelişimleri normal seyretti. Sonuç: Zamanında doğan bebekte kafa içi kanama sıklıkla bir perinatal risk faktörü ile ilişkilidir. Şiddetli kanamalarda bile nörogelişimsel sonuç iyi olabileceğinden, uzun dönem sonucu öngörmek zordur.
Introduction: The aim of this study was to determine the risk factors related to, clinical presentation and outcome of intracranial hemorrhage among full-term newborn infants. Materials and Methods: Full-term newborn infants who were diagnosed with intracranial hemorrhage in the neonatal intensive care unit of Dr. Sami Ulus Maternity and Children’s Hospital, between 2005 and 2010, were reviewed retrospectively. Cases were diagnosed with ultrasonography, computed tomography, or magnetic resonance imaging. The infants followed an average of 36 months had been underwent neurologic evaluations. Results: Fourteen full-term infants with intracranial hemorrhage were identified. The half of cases presented within the first week of life (7/14), and the most common presenting sign was seizure (8/14). Bleeding were placed frequently intraventricular (9/14) and subarachnoid (7/14), while 8 patients had two or more hemorrhage areas. The majority of cases (11/14) had a causal or contributory risk factor for intracranial hemorrhage. Only one patient required neurosurgical intervention. Two patients died during the neonatal period, and another with severely handicapped at ten months of age. Of the survivors, two patients showed severe neurodevelopmental delay, while one patient showed mild. The remaining 8 patients had a favorable outcome. Conclusions: Intracranial hemorrhage in the term newborn is usually associated with perinatal risk factors. Because of neurodevelopmental outcome may surprisingly be normal, despite severe hemorrhage, the long-term outcome is difficult to predict.
Introduction: The aim of this study was to determine the risk factors related to, clinical presentation and outcome of intracranial hemorrhage among full-term newborn infants. Materials and Methods: Full-term newborn infants who were diagnosed with intracranial hemorrhage in the neonatal intensive care unit of Dr. Sami Ulus Maternity and Children’s Hospital, between 2005 and 2010, were reviewed retrospectively. Cases were diagnosed with ultrasonography, computed tomography, or magnetic resonance imaging. The infants followed an average of 36 months had been underwent neurologic evaluations. Results: Fourteen full-term infants with intracranial hemorrhage were identified. The half of cases presented within the first week of life (7/14), and the most common presenting sign was seizure (8/14). Bleeding were placed frequently intraventricular (9/14) and subarachnoid (7/14), while 8 patients had two or more hemorrhage areas. The majority of cases (11/14) had a causal or contributory risk factor for intracranial hemorrhage. Only one patient required neurosurgical intervention. Two patients died during the neonatal period, and another with severely handicapped at ten months of age. Of the survivors, two patients showed severe neurodevelopmental delay, while one patient showed mild. The remaining 8 patients had a favorable outcome. Conclusions: Intracranial hemorrhage in the term newborn is usually associated with perinatal risk factors. Because of neurodevelopmental outcome may surprisingly be normal, despite severe hemorrhage, the long-term outcome is difficult to predict.
Description
Keywords
Kafa içi kanama, Yenidoğan, Nörogelişimsel sonuç, Intracranial hemorrhage, Newborn, Neurodevelopmental outcome
Citation
İpek, M. Ş. vd. (2012). "Zamanında doğan bebeklerde kafa içi kanama; bir takip çalışması". Güncel Pediatri, 10(3), 85-91.