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  • Küçük Resim Yok
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    The assessment of outcome after traumatic intracerebral hematomas: A clinical study of 34 cases
    (1998) Döşoğlu, Murat Servan; Orakdöğen, Metin; Ateş, Özkan; Somay, Hakan; Özdoğan, Cumhur; Tevrüz, Mahir
    Objective: Traumatic intracerebral hematomas (TICH's) occur with the multivectorial strength of the neural tissue in patients with a severe head injury. Prognosis is poor due to the generally accompanying intracranial and extracranial lesions. The treatment of these lesions are still controversial. Methods: This study was performed at Haydarpasa Numune Hospital, Department of Neurosurgery and consisted of 34 head injured patients who had intraparenchymal lesions greater than 2 cm in size. The effects of age, trauma mechanism, timing of admission after injury, Glasgow Coma Scale (GCS) score of the patients and multiplicity, midline shift, cisternal obliteration, localization and size of the lesions, and the choice of the treatment on the outcome are investigated and compared with nonparametric Kruskal-Wallis test. Results: The present study demonstrated that age, trauma mechanism, GCS, multiple lesions, midline shift, cisternal obliteration and localization had no effect on the final outcome of patients, but a significant correlation was found between the conservative treatment and hematomas less than 30 cc and early hospitalization in the minor head injured patients. Conclusion: Based on the results, it is argued that the medical treatment should be recommended for the lesions less than 30 cc.
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    Effect of axial loading on bone mineral density in patients with traumatic spinal cord injury
    (Turkish Assoc Trauma Emergency Surgery, 2007) Can, Aytaç; Döşoğlu, Murat Servan; Karacan, İlhan; Karamehmetoğlu, Şafak
    BACKGROUND Osteoporosis occurs in paralyzed extremities secondary to immobilization following spinal cord injury (SCI). Bone mineral density (BMD) is rapidly lost after SCI Loss of BMD may reach fracture threshold although it slows with time. This study was planned to investigate the option of impediment of osteoporosis by early axial loading in immobilized patients. METHODS Fifteen patients with complete paraplegia having spinal cord lesion between T4-L1 and 15 normal volunteers were included into the study. Time, mechanism and type of injury, BMD, serum calcium, phosphorus and alkaline phosphatase levels were undertaken as variables. BMD was measured by dual energy X-ray absorbtiometry (DEXA) in the femoral neck, trochanteric region and T1 and L3 spine. RESULTS The BMD values were lower in the femoral neck and trochanteric region, but there were no significant differences at T1 and L3 spine in paraplegics. CONCLUSION BMD decreases in the femoral neck and trochanteric region, secondary to immobilization. Absence of significant differences of BMD values at T1 and L3 spine in the study and control groups might be due to early rehabilitation. Sitting exercises early after stabilization might impede of the loss of BMD by axial loading to the spine. Thus, complications such as osteoporosis and pathological fractures can be prevented.
  • Küçük Resim Yok
    Öğe
    Travmatik omurilik felci olan olgularda aksiyel yüklenmenin kemik mineral yoğunluğu üzerine etkisi
    (2007) Can, Aytaç; Döşoğlu, Murat Servan; Karacan, Ilhan; Karamehmetoğlu, Şafak
    AMAÇ: Omurilik yaralanmalı olgularda paralitik bölgelerde hareketsizlik nedeniyle osteoporoz meydana gelir. Yaralanma sonrası kemik mineral yoğunluğunda (KMY) hızlı bir kayıp gözlenir. KMY kaybı kırılma eşiğine ulaşabilir. Bu çalışma, hareket kabiliyetini yitirmiş olgularda erken aksiyel yüklenme ile osteopororozun engellenebileceği düşüncesini araştırmak amacı ile planlandı. GEREÇ-YÖNTEM: Travma düzeyleri T4-L1 arasında değişen 15 komplet paraplejik olgu ile kontrol grubu olarak 15 normal olgu incelendi. Olgularda KMY dışında, yaralanma zamanı, şekli, mekanizması ile serum kalsiyum, fosfor ve alkali fosfataz değişken olarak alındı. KMY ölçümü; femur boynu, trokanter, T1 ve L3 omurlarından “Dual Energy X-ray Absorptiometry” (DEXA) cihazı kullanılarak yapıldı. BULGULAR: Kemik mineral yoğunluğunun paraplejik olgularda femur boynu ve trokanterde azaldığı, buna karşılık T1 ve L3 omurlarında anlamlı bir değişiklik olmadığı görüldü. SONUÇ: Femur boynu ve trokanterde hareketsizliğe bağlı olarak KMY azalmaktadır. Çalışma ve kontrol grupları arasında, T1 ve L3 omurlarında KMY’da anlamlı bir değişiklik olmaması olguların erken rehabilitasyonundan kaynaklanabilir. Stabilizasyon sonrası başlanan oturma egzersizleri omurlarda aksiyel yüklenme ile KMY’nun azalmasını engelleyebilir; böylece osteoporoz ve patolojik kırık komplikasyonu önlenebilir.