Travma ve Hipoksik Beyin Hasarı: Nöroradyolojik Yaklaşım ve Görüntüleme Bulguları
Özet
Çocukluk çağı kranial travmalarında tanı, takip ve tedavi yönetiminde bilgisayarlı tomografi (BT) akut dönemin altın standardı iken, manyetik rezonans görüntüleme (MRG) parankimal ve nonhemorajik hasarları göstermede üstündür. Epidural hematomlar genellikle kemik kırıklarının eşlik ettiği bikonveks yapılar olarak izlenirken, subdural hematomlar hilal şeklinde uzanım gösterir ve cerrahi karar için hematom kalınlığı ile orta hat şifti kritik rol oynar. Kafa içi basınç artışına bağlı olarak subfalsian, unkal veya tonsiller herniasyonlar gelişebilir; bu süreç diffüz aksonal hasar, kortikal kontüzyon, subaraknoid kanama ve sekonder iskemik enfarktlar gibi ağır komplikasyonlarla seyredebilir.
In pediatric cranial trauma, computed tomography (CT) serves as the gold standard for acute evaluation, while magnetic resonance imaging (MRI) is superior in demonstrating non-hemorrhagic parenchymal damage. Epidural hematomas typically appear as biconvex collections frequently associated with skull fractures, whereas subdural hematomas present as crescent-shaped collections, with hematom thickness and midline shift being critical criteria for surgical intervention. Increased intracranial pressure can lead to subfalcine, uncal, or tonsillar herniations, which may be accompanied by severe complications such as diffuse axonal injury, cortical contusion, subarachnoid hemorrhage, and secondary ischemic infarcts.
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