What is decortication rigidity?

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Dekortikasyon rijiditesi, beyinde özellikle kırmızı çekirdek seviyesinin üzerindeki kortikospinal traktusa zarar veren ciddi bir beyin hasarına bağlı olarak ortaya çıkan anormal bir postürdür. Bu durum, kollarda, bileklerde ve parmaklarda fleksiyon ile bacaklarda ve ayaklarda ekstansiyon şeklinde ortaya çıkar. Dekortikasyon rijiditesi, üst beyin merkezlerinin hasarı sonucu alt merkezlerin inhibisyon kontrolünden serbest kalmasıyla oluşur. Dekortikasyon rijiditesi genellikle serebral korteks veya bağlantılarının hasarına işaret eder ve inme, travmatik beyin hasarı, beyin tümörleri veya serebral hipoksi gibi durumların sonucu olabilir. Bu durum, Glasgow Koma Skalası puanı 6 veya daha düşük olan ciddi beyin disfonksiyonunu gösteren önemli bir nörolojik bulgudur. Dekerebrate rijiditesinden (her iki kol ve bacakta ekstansiyon) daha az şiddetli olmasına rağmen, dekortikasyon postürü vẫn önemli beyin hasarına işaret eder ve acil tıbbi müdahale gerektirir. Tedavi, beyin hasarının underlying nedenini ele almak ve daha fazla nörolojik hasarı önlemek için destekleyici bakım sağlamak üzerine odaklanır 1, 2. Dekortikasyon rijiditesinin yönetimi, hava yolu yönetimi ve mekanik ventilasyon dahil olmak üzere beyin hasarı yönetimine ilişkin güncel rehberlere uygun olmalıdır 3, 4. Hastaların yakın takibi ve gerekli olan durumlarda uzman merkezlere sevk edilmeleri önemlidir 5.

References

1
Research

Managing head injuries.

Emergency medical services, 2002

3
Research

Ventilatory targets following brain injury.

Current opinion in critical care, 2023

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