İntrakraniyal Hemorajiler: Tanısal Yaklaşım
Özet
İntrakraniyal hemorajiler (İKH), beyin dokusu içinde veya beyin zarları arasında kan birikmesi durumudur ve travma, hipertansiyon, vasküler malformasyonlar, koagülopatiler ve tedavi komplikasyonları gibi çeşitli nedenlerle ortaya çıkabilir. İKH, yüksek mortalite ve morbidite oranlarına sahip olup, acil müdahale gerektiren bir tıbbi durumdur. Epidemiyolojik veriler, İKH'nin özellikle hipertansiyonu olan ve antikoagülan tedavi gören hastalarda yaygın olduğunu göstermektedir. Hemofili ve lösemi gibi belirli hasta gruplarında ise bu oran daha da yüksektir.
Tanı süreci genellikle bilgisayarlı tomografi ve manyetik rezonans görüntüleme gibi nörogörüntüleme yöntemleriyle gerçekleştirilir. Erken tanı ve müdahale, hematom genişlemesini ve ikincil beyin hasarını önlemek açısından kritik öneme sahiptir. Tedavi, kanamanın kontrolü, intrakraniyal basıncın azaltılması ve semptomatik komplikasyonların yönetimi üzerine odaklanır. Cerrahi müdahale, özellikle büyük hematomlar için hayatidir.
Referanslar
J. Heit, M. Iv, M. Wintermark. Imaging of Intracranial Hemorrhage. J Stroke. 12 Aralık 2016;19:11-27.
Velander AJ, DeAngelis LM, Navi BB. Intracranial Hemorrhage in Patients with Cancer. Curr Atheroscler Rep. Ağustos 2012;14(4):373-81.
Zwagemaker AF, Gouw SC, Jansen JS, vd. Incidence and mortality rates of intracranial hemorrhage in hemophilia: a systematic review and meta-analysis. Blood. 30 Aralık 2021;138(26):2853-73.
R. Raychev, R. Jahan, D. Liebeskind, vd. Determinants of Intracranial Hemorrhage Occurrence and Outcome after Neurothrombectomy Therapy: Insights from the Solitaire FR With Intention For Thrombectomy Randomized Trial. Am J Neuroradiol. 01 Aralık 2015;36:2303-7.
Y. Hao, Zhizhong Zhang, Hao Zhang, vd. Risk of Intracranial Hemorrhage after Endovascular Treatment for Acute Ischemic Stroke: Systematic Review and Meta-Analysis. Interv Neurol. 19 Ocak 2017;6:57-64.
L. Brass, J. LİKHtman, Yun Wang, vd. Intracranial hemorrhage associated with thrombolytic therapy for elderly patients with acute myocardial infarction: results from the Cooperative Cardiovascular Project. Stroke. 01 Ağustos 2000;31 8:1802-11.
Naidech AM. Intracranial Hemorrhage. Am J Respir Crit Care Med. Kasım 2011;184(9):998-1006.
Park E, Park SY, Dobkin C, vd. Development of a novel cysteine sulfinic Acid decarboxylase knockout mouse: dietary taurine reduces neonatal mortality. J Amino Acids. 2014;2014:346809.
A. Tan, Patricia Svrckova, F. Cowan, vd. Intracranial hemorrhage in neonates: A review of etiologies, patterns and predicted clinical outcomes. Eur J Paediatr Neurol EJPN Off J Eur Paediatr Neurol Soc. 01 Temmuz 2018;22 4:690-717.
B. Devi, P. Singh. New insights in intracerebral hemorrhage. Indian J Med Res. 01 Mart 2017;146:434-5.
Li X, Zhang L, Wolfe CDA, vd. Incidence and Long-Term Survival of Spontaneous Intracerebral Hemorrhage Over Time: A Systematic Review and Meta-Analysis. Front Neurol [Internet]. 10 Mart 2022 [a.yer 21 Ağustos 2024];13. Erişim adresi: https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.819737/full
Fletcher-Sandersjöö A, Thelin EP, Bartek J, vd. Incidence, Outcome, and Predictors of Intracranial Hemorrhage in Adult Patients on Extracorporeal Membrane Oxygenation: A Systematic and Narrative Review. Front Neurol. 06 Temmuz 2018;9:548.
Joachim Ögren, Anna-Lotta Irewall, L. Bergström, vd. Intracranial Hemorrhage After Ischemic Stroke: Incidence, Time Trends, and Predictors in a Swedish Nationwide Cohort of 196 765 Patients. Circ Cardiovasc Qual Outcomes. 01 Temmuz 2015;8:413.
Robert D. Brown, D. Wiebers, J. Torner, vd. Frequency of intracranial hemorrhage as a presenting symptom and subtype analysis: a population-based study of intracranial vascular malformations in Olmsted Country, Minnesota. J Neurosurg. 01 Temmuz 1996;85 1:29-32.
Intusoma U, Nakorn CN, Chotsampancharoen T. Intracranial Hemorrhage in Childhood Acute Leukemia: Incidence, Characteristics, and Contributing Factors. Pediatr Neurol. Ekim 2019;99:23-30.
B. Psaila, A. Petrovič, L. Page, vd. Intracranial hemorrhage (İKH) in children with immune thrombocytopenia (ITP): study of 40 cases. Blood. 26 Kasım 2009;114 23:4777-83.
P. Kranz, M. Malinzak, T. Amrhein. Approach to Imaging in Patients with Spontaneous Intracranial Hemorrhage. Neuroimaging Clin N Am. 01 Ağustos 2018;28 3:353-74.
Tahereh Soleimani, B. Mosher, Laura Ochoa-Frongia, vd. Delayed Intracranial Hemorrhage After Blunt Head Injury With Direct Oral Anticoagulants. J Surg Res. 03 Eylül 2020;257:394-8.
J. Elliott, Martin R. Smith. The Acute Management of Intracerebral Hemorrhage: A Clinical Review. Anesth Analg. 01 Mayıs 2010;110:1419.
S. Alavi, M. Jalalvand, V. Assadollahi, vd. Intracranial Hemorrhage: A Devastating Outcome of Congenital Bleeding Disorders—Prevalence, Diagnosis, and Management, with a Special Focus on Congenital Factor XIII Deficiency. Semin Thromb Hemost. 12 Eylül 2017;44:267-75.
Yamada C, Hagiwara S, Ohbuchi H, vd. Risk of Intracranial Hemorrhage and Short-Term Outcome in Patients with Minor Head Injury. World Neurosurg. Eylül 2020;141:e851-7.
S. Galliazzo, M. Bianchi, A. Virano, vd. Intracranial bleeding risk after minor traumatic brain injury in patients on antithrombotic drugs. Thromb Res. 01 Şubat 2019;174:113-20.
Wenwen Li, Qiying Sun, Xian Duan, vd. [Etiologies and risk factors for young people with intracerebral hemorrhage]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 28 Kasım 2018;43 11:1246-50.
Alberto Cantalapiedra, O. Gutierrez, J. Tortosa, vd. Oral anticoagulant treatment: Risk factors involved in 500 intracranial hemorrhages. J Thromb Thrombolysis. 01 Ekim 2006;22:113-20.
William A Florez, E. García-Ballestas, Harsh Deora, vd. Intracranial hypertension in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Neurosurg Rev. 01 Şubat 2020;44:203-11.
P. Tiili, J. Putaala, J. Mehtälä, vd. Poor Quality of Warfarin Treatment Increases the Risk of All Types of Intracranial Hemorrhage in Atrial Fibrillation. Circ J Off J Jpn Circ Soc. 25 Şubat 2019;83 3:540-7.
Al-Saadi T, Al-Kindi Y, Allawati M, vd. Intracranial Hemorrhage following Spinal Surgery: A Systematic Review of a Rare Complication. Surg J. 03 Mart 2022;8(1):e98-107.
Bassi P, Bandera R, Loiero M, vd. Warning signs in subarachnoid hemorrhage: a cooperative study. Acta Neurol Scand. Ekim 1991;84(4):277-81.
Paris D, Rousset D, Bonneville F, vd. Cerebral Venous Thrombosis and Subdural Collection in a Comatose Patient: Do Not Forget Intracranial Hypotension. A Case Report. Headache. Kasım 2020;60(10):2583-8.
S. Ko, H. A. Choi, Kiwon Lee. Clinical Syndromes and Management of Intracerebral Hemorrhage. Curr Atheroscler Rep. 27 Nisan 2012;14:307-13.
R. von Kummer, J. Broderick, B. Campbell, vd. The Heidelberg Bleeding Classification: Classification of Bleeding Events After Ischemic Stroke and Reperfusion Therapy. Stroke. 01 Ekim 2015;46 10:2981-6.
F. Rincon, S. Mayer. Clinical review: Critical care management of spontaneous intracerebral hemorrhage. Crit Care. 10 Aralık 2008;12:237-237.
Mei-Chen Ou-Yang, Chung-Bin Huang, Hsin-Chun Huang, vd. Clinical manifestations of symptomatic intracranial hemorrhage in term neonates: 18 years of experience in a medical center. Pediatr Neonatol. 01 Ağustos 2010;51 4:208-13.
Carabias CS, Gomez PA, Panero I, vd. Chitinase-3-Like Protein 1, Serum Amyloid A1, C-Reactive Protein, and Procalcitonin Are Promising Biomarkers for Intracranial Severity Assessment of Traumatic Brain Injury: Relationship with Glasgow Coma Scale and Computed Tomography Volumetry. World Neurosurg. 01 Şubat 2020;134:e120-43.
Davis RL, Mullen N, Makela M, vd. Cranial Computed Tomography Scans in Children After Minimal Head Injury With Loss of Consciousness. Ann Emerg Med. 01 Ekim 1994;24(4):640-5.
Vilke GM, Chan TC, Guss DA. Use of a complete neurological examination to screen for significant intracranial abnormalities in minor head injury. Am J Emerg Med. 01 Mart 2000;18(2):159-63.
Czap AL, Sheth SA. Overview of Imaging Modalities in Stroke. Neurology. 16 Kasım 2021;97(20, Supplement_2):S42-51.
Kundisch A, Hönning A, Mutze S, vd. Deep learning algorithm in detecting intracranial hemorrhages on emergency computed tomographies. PLOS ONE. 29 Kasım 2021;16(11):e0260560.
Westerlaan HE, van Dijk J m. c., Jansen-van der Weide MC, vd. Intracranial Aneurysms in Patients with Subarachnoid Hemorrhage: CT Angiography as a Primary Examination Tool for Diagnosis—Systematic Review and Meta-Analysis. Radiology. Ocak 2011;258(1):134-45.
Bodanapally UK, Archer-Arroyo KL, Dreizin D, vd. Dual-Energy Computed Tomography Imaging of Head: Virtual High-Energy Monochromatic (190 keV) Images Are More Reliable Than Standard 120 kV Images for Detecting Traumatic Intracranial Hemorrhages. J Neurotrauma. 15 Nisan 2019;36(8):1375-81.
Ker J, Singh SP, Bai Y, vd. Image Thresholding Improves 3-Dimensional Convolutional Neural Network Diagnosis of Different Acute Brain Hemorrhages on Computed Tomography Scans. Sensors. Ocak 2019;19(9):2167.
Yuh EL, Gean AD, Manley GT, vd. Computer-Aided Assessment of Head Computed Tomography (CT) Studies in Patients with Suspected Traumatic Brain Injury. J Neurotrauma. Ekim 2008;25(10):1163-72.
Aygun N, Masaryk TJ. Diagnostic imaging for intracerebral hemorrhage. Neurosurg Clin N Am. 01 Temmuz 2002;13(3):313-34.
Szwargulski P, Wilmes M, Javidi E, vd. Monitoring Intracranial Cerebral Hemorrhage Using Multicontrast Real-Time Magnetic Particle Imaging. ACS Nano. 27 Ekim 2020;14(10):13913-23.
Chen W, Zhu W, Kovanlikaya Iı, vd. Intracranial Calcifications and Hemorrhages: Characterization with Quantitative Susceptibility Mapping. Radiology. Şubat 2014;270(2):496-505.
Chalela JA, Gomes J. Magnetic resonance imaging in the evaluation of intracranial hemorrhage. Expert Rev Neurother. 01 Mart 2004;4(2):267-73.
Almoghazy SM. Radiopaedia. [a.yer 29 Ekim 2024]. Hyperacute intracranial hemorrhage | Radiology Case | Radiopaedia.org. Erişim adresi: https://radiopaedia.org/cases/hyperacute-intracranial-haemorrhage
Josephson CB, White PM, Krishan A, vd. Computed tomography angiography or magnetic resonance angiography for detection of intracranial vascular malformations in patients with intracerebral haemorrhage - Josephson, CB - 2014 | Cochrane Library. [a.yer 13 Ağustos 2024]; Erişim adresi: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009372.pub2/full
Abrigo JM, Ko K long, Chen Q, vd. Artificial intelligence for detection of intracranial haemorrhage on head computed tomography scans: diagnostic accuracy in Hong Kong. Hong Kong Med J. 21 Nisan 2023;29(2):112-20.
Yeo M, Tahayori B, Kok HK, vd. Review of deep learning algorithms for the automatic detection of intracranial hemorrhages on computed tomography head imaging. J NeuroInterventional Surg. 01 Nisan 2021;13(4):369-78.
Fan Y, Zhang X, Guan H. Value of combined examination of cerebrospinal fluid heme oxygenase-1 and peripheral blood neutrophil lymphocyte ratio in evaluating neonatal intracranial hemorrhage. Cent Plains Med J. 2020;(47):33-5.
Nagy K, Skagervik I, Tumani H, vd. Cerebrospinal fluid analyses for the diagnosis of subarachnoid haemorrhage and experience from a Swedish study. What method is preferable when diagnosing a subarachnoid haemorrhage? Clin Chem Lab Med CCLM. 01 Kasım 2013;51(11):2073-86.
Shahan B, Choi EY, Nieves G. Cerebrospinal Fluid Analysis. Am Fam Physician. 01 Nisan 2021;103(7):422-8.
Deisenhammer F, Bartos A, Egg R, vd. Guidelines on routine cerebrospinal fluid analysis. Report from an EFNS task force. Eur J Neurol. 2006;13(9):913-22.
Freeman WD, Aguilar MI. Intracranial Hemorrhage: Diagnosis and Management. Neurol Clin. 01 Şubat 2012;30(1):211-40.
Machinsky PA, Plotnikova NA, Uliankin VE, vd. [Some features of the postmortal diagnosis of hemorrhagic strokes as a type of cerebrovascular disease]. Sud Med Ekspert. 2021;64(1):51-6.
