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Yıl:2024; Cilt: 61; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2024;61(2):180-183
Kronik Subdural Hematomla İlişkili Yineleyici Psikotik Depresyon:Bir Olgu Sunumu
A Alp, M İ Yıldız, E Özçelik-Eroğlu,A İ Işıkay, Y Ayhan, A Ertuğrul
Hacettepe Üniversitesi Tıp Fakültesi, Ankara
Kronik subdural hematom (KSDH) seyri sırasında izole psikiyatrik belirtilerin olması oldukça nadirdir. Bu yazıda, tekrarlayan kafa travması sonrası nörolojik belirtilerin eşlik etmediği psikotik özellikli depresyon belirtilerin görüldüğü 77 yaşında bir kadın hasta sunulmuştur. Olgunun kraniyel manyetik rezonans görüntülemesinde sağ frontopariyetal bölgede 20 mm’lik ve sol frontal bölgede 7 mm’lik subdural hematom tespit edilmiştir. Olgunun belirtileri hematomun boşaltılmasından sonra hızlıca düzelmiş, ancak cerrahi işlem sonrası sağ taraflı pnömosefali gelişmiş ve belirtilerde ani nüks olmuştur. İzleminde pnömosefalinin kaybolması ile psikiyatrik belirtiler tekrar düzelmiştir. Kronik subdural hematoma bağlı olarak izole psikiyatrik belirtilerin görülebildiği ve hematomun boşaltılmasının pskiyatrik belirtilerin kontrol altına alınmasında önemli rolü olduğu göz önünde bulundurulmalıdır.
Recurrent Psychotic Depression Associated with Chronic SubduralHaematoma: A Case Report
Chronic subdural hematomas (CSDH) with isolated psychiatric presentation are rare. In this paper, we report a case of 77-year-old- female patient who had psychotic depression after repetitive head trauma without any neurological symptoms. The brain magnetic resonance imaging revealed an 20 mm subdural hematoma in the right frontoparietal region and a 7 mm subdural hematoma in the left frontal region. The psychiatric symptoms improved within the first week after evacuation but relapsed with the occurrence of right sided pneumocephalus. In the follow up, with the disappearance of the pneumocephalus, the psychiatric symptoms improved. It should be kept in mind that isolated psychiatric symptoms can be seen due to subdural hematoma and evacuation of the hematoma has an important role in improving the psychiatric symptoms.

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