Fetüsü sezaryenle doğurtulan maternal ölüme neden olan serebral infarkt olgusu
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2004
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info:eu-repo/semantics/openAccess
Özet
21 yaşında, G.2, P.O, A. 1, Y.O ve 35 haftalık gebe olarak şiddetli baş ağrısı ve anlamsız konuşma yakınması ve intrakranial kitle ön tanısı ile Beyin Cerrahi kliniğine yatırılan Bilgisayarlı Beyin Tomografisi (BBT)'nde sol parietalde 3x2cm.lik akut infarkt alanının, ertesi gün yapılan Magnetik Rezonans Görüntüleme (MRG)'sinde ise sol parietotemporooksipital lopta infarkt sabitlendiğinden medikal tedavi için Nöroloji kliniğine taburcu edildiği ve obstetrik muayene ve ultrasongrafısinde 35 haftalık ınakad prezentasyonlu canlı gebeliği saptanan olgunun, izlemi sırasında pulmoner arrest olması üzerine mekanik ventilasyon için Yoğun bakım ünitesine yatırıldı. Obstetrik rekonsültasyon sonrası sezaryen yapılarak makadi prezentasyonlu 1640 gram ağırlıklı I -5.dakika Apgar skoru 7-9 olan canlı erkek çocuk duğurtuldu. Postoperatuvar 2. gün kardiyak arrest gelişen olgu resusitasyon girişimlerine rağmen exitus önlenemedi. MRI, serebral infarkt tanısında ilk tercih edilen görüntüleme yöntemi olmalı ayrıca anjiyografı yardımıyla trombolitik tedavi seçeneğinin de bundan sonraki akut serebral infarktlı olguların medikal tedavisinde yer alması düşünülmektedir.
A 21 years old woman gravidity.2, parity.O, Abortion. 1 presented with severe headache and hospitolised because of intracranial mass in the Brain Surgery Clinic. Since the 3x2cm mass in the left parietal lobe found by Computerised Brain Tomograpy (CBT) was revealed as acute infarct in the left parieto-temporo-parietal lobe with Magnetic Resonanse Imaging (MRI), the patient was delivered to the Neurology Clinic for medical treatment. Obstetric ultrasonograhy revealed 35 weeks gestation with cardiac arrest and breech presentation. Because pulmonary arrest occured during the treatment, mechanical ventilation was needed and the patient was transferred to the Extensive Care Unit of The Anestesiology and Reanimation Department. Cesariannea section was performed and 1640 gram male baby in breech presentation was delivered with Apgar scores 7 at the first minute and 9 at the fifth minute. Since cardiac arrest occured or the postoperative second day, the patient could not be rescued despite resusitation. MRI should be the first line imaging method for diagnosis of cerebral infarct. Besides, with the aid of cerebral angiography, thrombolytic therapy is thought to take place as an alternative in the medical treatment of acute cerebral infarct cases.
A 21 years old woman gravidity.2, parity.O, Abortion. 1 presented with severe headache and hospitolised because of intracranial mass in the Brain Surgery Clinic. Since the 3x2cm mass in the left parietal lobe found by Computerised Brain Tomograpy (CBT) was revealed as acute infarct in the left parieto-temporo-parietal lobe with Magnetic Resonanse Imaging (MRI), the patient was delivered to the Neurology Clinic for medical treatment. Obstetric ultrasonograhy revealed 35 weeks gestation with cardiac arrest and breech presentation. Because pulmonary arrest occured during the treatment, mechanical ventilation was needed and the patient was transferred to the Extensive Care Unit of The Anestesiology and Reanimation Department. Cesariannea section was performed and 1640 gram male baby in breech presentation was delivered with Apgar scores 7 at the first minute and 9 at the fifth minute. Since cardiac arrest occured or the postoperative second day, the patient could not be rescued despite resusitation. MRI should be the first line imaging method for diagnosis of cerebral infarct. Besides, with the aid of cerebral angiography, thrombolytic therapy is thought to take place as an alternative in the medical treatment of acute cerebral infarct cases.
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