Amaç: Çalışmamızın amacı, COVID-19 ile ilişkili akut nörolojik bulguları olan hastaları tanımlamayı ve tanısında manyetik rezonans görüntüleme (MRG) etkinliğinin gösterilmesini amaçlamaktır. Gereç ve Yöntem: Haziran 2020 ve Aralık 2021 tarihleri arasında kliniğimizde Covid-19 tanısı almış, akciğerde pnömoni bulguları olan, akut nörolojik bulguları olan ve Beyin MRG olan 90 hasta çalışmaya alındı. Bulgular santral sinir sistemi (SSS) tutulumu bulgulari olmayan 46 hasta ve SSS bulgulari olan 44 hasta retrospektif olarak değerlendirildi. Bulgular: COVID-19 hastalarında en sık görülen nörolojik belirtiler; tedavi ile açıklanamayan şuur kayıbı (28/44, %63,6), focal nörolojik defisit (21/44, %47,7) and nöbet (9/44, %20,4). SSS tutulumu olan hastalarda yoğunbakımda yatış sürelerinde uzama, ventilator desteği gereksinimde artış ve mortalitede artış görüldü. Nörolojik semptomları olan 44 hastaya beyin MRG çekildi. MRG çekilen hastalarda 68,3 ortalama yaş (45–78). 32 hastanın (%72) MRG’nda akut bulgular saptandı. Beyin MR görüntülemesinde en sık konulan tanılar akut ve subakut infarktlardı. Sonuç: Merkezi sinir sistemi bulgularının mekanizması hala belirsizdir, COVID-19 hastalarında nörolojik semptomlar özellikle yoğun bakım ünitelerinde önemli bir sorundur. Bu nedenle SSS tutulumunun erken tespiti ve tedavisi çok önemlidir.
Procalcitonin (PCT) is a glicopeptide of 116 amino acid and precursor of calcitonin hormone. At the present day procalcitonin take attention because of being specific to bacterial infection and also is a new indicator for infection which do not affected from viral infection and Systemic Inflamatuar Response Syndrome. The objective of this study was to show the effect of neurosurgical procedures to procalcitonin levels and to distinguish neurosurgical procedure inflammatory reaction from postsurgical associated infection. We carried out our study in Çukurova University Neurosurgery department between May 2007- December 2007. Total number of 44 intracranial tumor existing patients carried out in the study. One day preoperative and four days postoperative values of procalcitonin, white blood cell, C-reactive protein (CRP) and fever were investigated. Results were analyzed in SPSS 15.0 program. In all infection developing patients of the study procalsitonin levels found over 0.1 ng/ml. According to our results patients with a higher of 0.1 ng/ml procalsitonin values in postoperative second and third need attention to followed carefully for postoperative infection. In our study crp exposed a similar kinetic activity in infection developing and infection free patients. We exposed high levels of crp (CRP>5 ng/ml) in both groups. This predicate that crp can not be used in the following of postoperative infection. We may suggest procalcitonin is superior to other existing infection parameters because of not effecting from surgical associated inflamatuar response and a quicker response to routine used other parameters. We suggest that procalcitonin will be a safe and serious parameter in following neurosurgical associated systemic complications by results of new studies which includes more patients and different surgical procedures.
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