SUBDURAL HÝGROMALI ÝKÝ ÇOCUK ÝSTÝSMARI OLGUSU

Bu yazýda, çocuk istismarý tanýsý ile yatýrýlýp tetkik edilen ve subdural higroma saptanan iki olgumuzu sunuyoruz. Ýlk olgumuz olan 2,5 yaþýndaki kýz hastanýn fizik muayenesinde vücudun deðiþik yerlerinde muhtelif yanýk izleri, yaygýn ekimotik alanlar, yer yer laserasyonlar saptandý. Tetkiklerinde ciddi anemisi, kemik grafilerinde multipl eski fraktürleri vardý. Bilgisayarlý beyin tomografisinde subdural higroma saptandý. Ýkinci olgumuz ise 5 yaþýnda erkek hasta olup halsizlik, inleme, baþaðrýsý þikayeti ile getirildi. Fizik muayenesinde kaþektik görünüm, vücudunda yaygýn ekimozlar, boyunda ip izi þeklinde peteþiler saptandý. Tetkiklerinde anemisi, kafa grafisinde biparyetal fraktürü vardý. Kranyal magnetik rezonans tetkikinde subdural higroma saptandý. Her iki hasta nöroþirurji kliniði tarafýndan öpere edildi. Günümüzde istismar edilen çocuklarýn sayýsý giderek artmaktadýr. Bu çocuklarda oluþabilecek klinik tablolarýn ciddiyeti ve tedavisindeki zorluklar nedeniyle, çocuk istismarýnýn erken teþhisi bu çocuklarýn tedavisinde, ailelerin psikolojik rehabilitasyonunda ve çocuklarýn korunmasýnda çok önemlidir.

TWO CASES OF ABUSED CHILDREN WITH SUBDURAL HIGROMA

In this report, we are discussing two different physical child abuse cases. Our first case was a 2.5 years old girl, who had widely-distributed scars of cigarette and other types of burns, widespread echymotic fields, and lacerations in her physical examination. Her radiological scans indicated multiple fractures which had been obtained at different times. Her CBC showed a profound microcytic anemia and the CT scan of her cranium showed subdural hygroma. The other patient was a boy at 5 years of age. His initial history showed complaints of malaise and headache. His physical examination revealed a cachectic body, thought to occur as severe malnutrition, widely-distributed ecimotic areas and around his neck were noted rope mark-like petechial fields. His CBC showed profound anemia, his cranial scans showed biparyetal fractures. Subdural hygroma was also noted in his cranial-MRI study. Both of the patients were later operated by the neurosurgeons in our hospital. Nowadays, child-abuse has been occupying more and more of a day's agenda. Due to difficulties in treatment and protection of these children and psychological rehabilitation of the families, early diagnosis and intervention is being recognized as being more and more important every day.