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Yıl:2010; Cilt: 13; Sayı: 4>> Özet
TAM METİN
Klinik Psikiyatri Dergisi; 2010;13(4):209-214
Geçici Global Amnezi ve Demansiyel Bulgular ile Başlayan Glioblastome Multiforme Olgusu
ET Parlayan, M Bakar
Osmangazi Tıp Merkezi, Bursa
Demans ve depresyon yaşlı popülasyonda en sık karşılaşılan nöropsikiyatrik sendromlardandır. Geçici global amnezi de en sık 56-75 yaşları arasında görülmektedir. Yaşlılık döneminde ortaya çıkan depresyonlarda bilişsel bozukluklar daha fazla görülmektedir. Yaşlılıkta çeşitli nedenlere bağlı olarak ortaya çıkan demanslara da depresif belirtilerin eşlik ettiği bilinmektedir. Beynin bazı bölgelerinde, özellikle corpus callosum, fronto-bazal bölge ve temporal lobda yerleşen tümörlerin ise ilk bulgusu, yanlışlıkla demans veya depresyon olarak değerlendirilebilen mental değişikler olabilir. Geçici global amnezi de beyin tümörlerinin ilk semptomu olabilir. Altmışaltı yaşında erkek hasta; başvurusundan iki hafta önce geçici bilinç kaybı nedeniyle yolunu kaybeden ve sonrasında unutkanlık problemleri başlayan hastanın, yapılan nöropsikiyatrik testlerinde demansiyel bulgular saptandı. Geçmiş döneme ait öyküsünden hastada iki yıldır depresyon semptomlarının mevcut olduğu anlaşıldı.Geçici global amnezi ardından devam eden atipik demansiyel özellikler gösteren olgunun, yapılan Kranial Manyetik Rezonans görüntülemesinde; multi-fokal tümoral lezyonlar saptandı. Tümör rezeksiyonu operasyonu sonrasında patoloji sonucu glioblastome multiforme idi. Ani başlangıçlı ve hızlı ilerleyen mental değişiklikler ve atipik demansiyel bulgular saptanan hastalarda, klinik bulguların dikkatli olarak değerlendirilmesi ve nörogörüntüleme yapılmasının doğru tanı açısından önemini vurgulamak istedik.
Glioblastome Multiforme Case Starting with Global Amnesia and Demential Findings
Dementia and depression are the most common neu-ropsychiatric syndromes seen in elder peoople. Transient global amnesia is most commonly seen in ages between 56 and 75. Depressions in older ages also show more cognitive deficiency. It is known that the depressif symptoms also accompany dementias which appear due to various resons in the old ages. The first sign of tumors located in some parts of the brain, especially in the corpus callosum, frontal- basal region and temporal lobe may be mental variations which may be mistakenly assessed as dementia or depression. Transient global amnesia may also be the first sign of brain tumors. 66 [year]s old male patient demential findings were determined by neuropsychiatric tests on patient who lost his way due to transient loss of consciousness two weeks ago as he beat his head and who had forgetfullness problems. The patient's story uncovered that he has been suffering from depression symptoms for the last two [year]s. In his cranial MR, multifocal tumoral lesions were determined on patiens demonstrating atypical demential features following transient global amnesia. As a result of the operation after tumor resection, pathology was glioblastome multiforme. We wanted to show that clinical findings should be carefully evaluated on patients having mental changes with sudden onset and atypical demantial findings and wanted to emphasize the importance of neuroimaging.

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