Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients

Demiral, Yucel; Karcioglu, Ozgur; TOPAÇOĞLU, Hakan; KIYAN, Selahattin; ÖZSARAÇ, Murat; ULUER, Hatice; Ayrık, Cüneyt; GÜMRÜKÇÜ, Serhat; ŞENER, Serkan

Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients

Murat ÖZSARAÇ, (Ege Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Özgür KARCIOĞLU, (Acıbadem Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İstanbul, Türkiye)

Hakan TOPAÇOĞLU, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Cüneyt AYRIK, (Acıbadem Bursa Hastanesi, Acil Tıp Kliniği, Bursa, Türkiye)

Selahattin KIYAN, (Ege Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Serkan ŞENER, (Acıbadem Bursa Hastanesi, Acil Tıp Kliniği, Bursa, Türkiye)

Serhat GÜMRÜKÇÜ, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, İzmir, Türkiye)

Yücel DEMİRAL, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Hatice ULUER (Ege Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, İzmir, Türkiye)

Türkiye Acil Tıp Dergisi

8 0

Yıl: 2009 Cilt: 9 Sayı: 4 Sayfa Aralığı: 153 - 158 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients

Öz:

Amaç: Bu çalışmada, travmatik beyin yaralanması (TBY) ve kafa kemiği kırığı (KKK) tespit edilen pediyatrik hastalarda klinik semptom ve bulguların hassas belirleyiciler olup olmadığı değerlendirildi. Gereç ve Yöntem: Retrospektif kesitsel çalışmamızın evrenini, pediyatrik acil servise 7 yıllık dönem içinde, kafa travması ile başvuran 17 yaş altındaki çocuklar oluşturdu. Bu hastalar içerisinden TBY veya KKK tespit edilenler çalışmamıza dahil edildi. Bulgular: Çalışma süresince 1167 hasta acil servise kafa travması nedeniyle başvurdu. Bu hastaların 984’ü tomografilerinde radyolojik anormallik bulunmaması veya yeterli tıbbi kayda ulaşılamaması nedeniyle çalışmadan dışlandı. Geri kalan 183 hasta çalışma grubunu oluşturdu. Kırk (%21.9) hastada KKK olmaksızın TBY, 61 (%33.3) hastada hem TBY hemde KKK tespit edilirken, 82 (%44.8) hastada izole KKK olduğu belirlendi. TBY olan hastalar içerisinde, 45 (%44.6) hastanın bilinç düzeyinin normal, GKS’nın 15 olduğu ve herhangi bir fokal nörolojik defisitin olmadığı tespit edildi. En sık yaralanma mekanizmasının, 1.5 metre üzerindeki yükseklikten düşmeler olduğu izlendi. TBY’nin bilinç kaybı (p=0.044) dışında hiçbir klinik parametre ile (kusma, travma sonrası nöbet, uykuya meyil, irritabilite skalp hematomu) arasında istatistiksel anlamlı ilişki olmadığı görüldü. KKK olan hastalarda ise skalp hematomu (p=0.015) ve bilinç kaybı (p=0.052) bulgularının görülmesi istatistiksel olarak anlamlıydı. Sonuç: Elde edilen bulgular, TBY’de nöbet, kusma, letarji, skalp hematomu, irritabilite ve bilinç kaybının hassas belirleyiciler olmadığını destekler niteliktedir. Bilinç kaybı, sadece <2 yaş altı grupta, TBY için risk belirleyici olarak görünmektedir. Skalp hematomu, KKK için potansiyel risk faktörüdür.

Anahtar Kelime:

Konular: Cerrahi

Pediyatrik kafa travmalı hastalarda, travmatik beyin yaralanması ve kafa kemiği kırıkları için klinik belirleyiciler

Öz:

Background: To determine whether clinical signs and symptoms of brain injury are sensitive indicators of traumatic brain injury (TBI) and skull fracture (SF) in pediatric patients admitted with head trauma. Methods: A retrospective cross-sectional analysis of all patients younger than 17 years of age admitted to the university-based pediatric Emergency Department (ED) with the complaint of head trauma during a 7-year period was conducted. All children who were admitted into pediatric emergency department had a TBI and/or SF were included in the study. Results: 1167 patients with the chief complaint of head trauma were admitted to pediatric emergency department during the study period. Of these, 984 subjects were excluded because they had no acute radiographic abnormalities noted or had inadequate records of symptoms. The remaining 183 subjects constituted the study sample. Isolated TBI without SF was found in 40 (21.9%) patients, whereas isolated SF was found in 82 (44.8%) patients, and both TBI and SF were found in 61 (33.3%) patients. Forty five (44.6%) of the patients who had TBI were conscious, with GCS of 15 and had no focal neurological abnormalities. The most common mechanism of head injury was >5- feet fall. Findings that were not significantly associated with TBI were vomiting, post-traumatic seizure, lethargy, irritability, and scalp hematoma without loss of consciousness (LOC) (p=0.044). There was a significantly higher incidence of scalp hematoma (p=0.015) and LOC (p=0.052) in children with SF. Conclusion: Our results support that seizure, vomiting, lethargy, scalp hematoma, irritability and LOC are insensitive clinical predictors of TBI. LOC appear to be a risk predictor of TBI for patients of only those younger than 2 years old. Scalp hematoma is a potential risk factor for SF.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÖZSARAÇ M, Karcioglu O, TOPAÇOĞLU H, Ayrık C, KIYAN S, ŞENER S, GÜMRÜKÇÜ S, Demiral Y, ULUER H (2009). Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. , 153 - 158.
Chicago	ÖZSARAÇ Murat,Karcioglu Ozgur,TOPAÇOĞLU Hakan,Ayrık Cüneyt,KIYAN Selahattin,ŞENER Serkan,GÜMRÜKÇÜ Serhat,Demiral Yucel,ULUER Hatice Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. (2009): 153 - 158.
MLA	ÖZSARAÇ Murat,Karcioglu Ozgur,TOPAÇOĞLU Hakan,Ayrık Cüneyt,KIYAN Selahattin,ŞENER Serkan,GÜMRÜKÇÜ Serhat,Demiral Yucel,ULUER Hatice Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. , 2009, ss.153 - 158.
AMA	ÖZSARAÇ M,Karcioglu O,TOPAÇOĞLU H,Ayrık C,KIYAN S,ŞENER S,GÜMRÜKÇÜ S,Demiral Y,ULUER H Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. . 2009; 153 - 158.
Vancouver	ÖZSARAÇ M,Karcioglu O,TOPAÇOĞLU H,Ayrık C,KIYAN S,ŞENER S,GÜMRÜKÇÜ S,Demiral Y,ULUER H Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. . 2009; 153 - 158.
IEEE	ÖZSARAÇ M,Karcioglu O,TOPAÇOĞLU H,Ayrık C,KIYAN S,ŞENER S,GÜMRÜKÇÜ S,Demiral Y,ULUER H "Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients." , ss.153 - 158, 2009.
ISNAD	ÖZSARAÇ, Murat vd. "Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients". (2009), 153-158.

APA	ÖZSARAÇ M, Karcioglu O, TOPAÇOĞLU H, Ayrık C, KIYAN S, ŞENER S, GÜMRÜKÇÜ S, Demiral Y, ULUER H (2009). Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. Türkiye Acil Tıp Dergisi, 9(4), 153 - 158.
Chicago	ÖZSARAÇ Murat,Karcioglu Ozgur,TOPAÇOĞLU Hakan,Ayrık Cüneyt,KIYAN Selahattin,ŞENER Serkan,GÜMRÜKÇÜ Serhat,Demiral Yucel,ULUER Hatice Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. Türkiye Acil Tıp Dergisi 9, no.4 (2009): 153 - 158.
MLA	ÖZSARAÇ Murat,Karcioglu Ozgur,TOPAÇOĞLU Hakan,Ayrık Cüneyt,KIYAN Selahattin,ŞENER Serkan,GÜMRÜKÇÜ Serhat,Demiral Yucel,ULUER Hatice Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. Türkiye Acil Tıp Dergisi, vol.9, no.4, 2009, ss.153 - 158.
AMA	ÖZSARAÇ M,Karcioglu O,TOPAÇOĞLU H,Ayrık C,KIYAN S,ŞENER S,GÜMRÜKÇÜ S,Demiral Y,ULUER H Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. Türkiye Acil Tıp Dergisi. 2009; 9(4): 153 - 158.
Vancouver	ÖZSARAÇ M,Karcioglu O,TOPAÇOĞLU H,Ayrık C,KIYAN S,ŞENER S,GÜMRÜKÇÜ S,Demiral Y,ULUER H Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients. Türkiye Acil Tıp Dergisi. 2009; 9(4): 153 - 158.
IEEE	ÖZSARAÇ M,Karcioglu O,TOPAÇOĞLU H,Ayrık C,KIYAN S,ŞENER S,GÜMRÜKÇÜ S,Demiral Y,ULUER H "Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients." Türkiye Acil Tıp Dergisi, 9, ss.153 - 158, 2009.
ISNAD	ÖZSARAÇ, Murat vd. "Clinical indicators of traumatic brain injury and skull fracture in pediatric head trauma patients". Türkiye Acil Tıp Dergisi 9/4 (2009), 153-158.