{"id":31801,"date":"2022-08-27T02:51:04","date_gmt":"2022-08-27T02:51:04","guid":{"rendered":"https:\/\/haberulus.net\/?p=31801"},"modified":"2022-08-27T02:51:04","modified_gmt":"2022-08-27T02:51:04","slug":"migren-ameliyatla-tedavi-edilir-mi","status":"publish","type":"post","link":"https:\/\/haberulus.net\/?p=31801","title":{"rendered":"Migren ameliyatla tedavi edilir mi"},"content":{"rendered":"

\u015eiddetli ba\u015f a\u011fr\u0131lar\u0131na yol a\u00e7\u0131p, ya\u015fam kalitesini d\u00fc\u015f\u00fcren bir hastal\u0131k olan migrenin ameliyatla tedavi edilip edilmedi\u011fi \u00e7ok merak ediliyor. \u0130\u015fte Prof. Dr. Derya Ulud\u00fcz\u2019\u00fcn bu konudaki a\u00e7\u0131klamalar\u0131:<\/b><\/p>\n

Migren<\/strong>; aile, i\u015f ve sosyal ili\u015fkiler dahil olmak \u00fczere g\u00fcnl\u00fck ya\u015fam\u0131 olumsuz etkileyen \u00e7ok \u015fiddetli bir a\u011fr\u0131d\u0131r. Hastalar ya\u015famlar\u0131 boyunca hayatlar\u0131n\u0131n hep k\u0131s\u0131tlanarak ge\u00e7ti\u011fini s\u0131k\u00e7a dile getirir. \u0130stediklerini yiyemez, g\u00fcne\u015fte kalamaz, u\u00e7a\u011fa binemez, sinirlenemez ve uykusuz kalamazlar. \u00c7\u00fcnk\u00fc a\u011fr\u0131lar\u0131 tetiklenir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc’n\u00fcn (DS\u00d6) migreni birincil ba\u015f a\u011fr\u0131s\u0131 bozuklu\u011fu aras\u0131nda g\u00f6sterdi\u011fini belirten N\u00f6roloji Uzman\u0131 Prof. Dr. Derya Ulud\u00fcz’e bu hastal\u0131kla ilgili bilinmesi gerekenleri \u00f6zellikle de ameliyatla tedavi edilip edilmedi\u011fini sordum. \u0130\u015fte a\u00e7\u0131klamalar\u0131\u2026<\/p>\n

\"\"<\/p>\n

Prof. Dr. Derya Ulud\u00fcz’e<\/p>\n<\/div>\n

En \u00e7ok kimleri etkiliyor?<\/b><\/p>\n

En s\u0131k ergenlik d\u00f6neminde ba\u015flayan migren, yine DS\u00d6’n\u00fcn verilerine g\u00f6re 35 ve 45 ya\u015f aras\u0131ndaki grubu etkiliyor. 50 ya\u015f alt\u0131 \u00fcretkenlik \u00e7a\u011f\u0131nda 369 kronik hastal\u0131k aras\u0131nda en fazla engellilik yapan hastal\u0131k. Hormonal etkileri sebebiyle kad\u0131nlarda daha s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fc art\u0131k bilinen bir ger\u00e7ek. Beynin derinliklerinde, sinirler ve kan damarlar\u0131 \u00e7evresinde a\u011fr\u0131 \u00fcreten inflamasyon maddelerin sal\u0131n\u0131m\u0131na yol a\u00e7an mekanizman\u0131n aktivasyonundan kaynaklanan bu sinsi misafirin ziyareti birka\u00e7 saat s\u00fcrebildi\u011fi gibi 2-3 g\u00fcn\u00fc de bulabiliyor. Bir de a\u011fr\u0131lara e\u015flik eden mide bulant\u0131s\u0131, \u0131\u015f\u0131\u011fa bakamama, sese a\u015f\u0131r\u0131 hassasiyet var ki, konuyu iyiden iyiye sevimsizle\u015ftirmeye yetiyor da art\u0131yor. \u00dcst\u00fcne \u00fcstl\u00fck bu a\u011fr\u0131lar\u0131n bir de ay\u0131n yar\u0131s\u0131nda oldu\u011funu d\u00fc\u015f\u00fcn\u00fcn! Hayat i\u015fte o zaman iyice \u00e7ekilmez oluyor. Bu migren tipine kronik migren
diyoruz. 10 migrenlinin birinde kronik migren var.<\/p>\n

\"\"<\/p>\n

Te\u015fhis ve tedavide ge\u00e7 kal\u0131n\u0131yor<\/b><\/p>\n

Migrenlilerde bu kadar \u015fiddetli ve s\u0131k ataklara ra\u011fmen T\u00fcrkiye genelinde tedaviye ula\u015fma konusunda fark\u0131ndal\u0131k sadece y\u00fczde 14. Bu kadar d\u00fc\u015f\u00fck fark\u0131ndal\u0131k oran\u0131 maalesef migren hastas\u0131n\u0131n te\u015fhis ve tedavisini geciktiriyor ve migren bir ba\u015f a\u011fr\u0131s\u0131ndan \u00e7ok daha \u00f6te sonu\u00e7lar yaratabiliyor. \u0130\u015fte tam da bu ama\u00e7la kurulan hastalar\u0131m\u0131z\u0131n da \u00fcyeleri aras\u0131nda oldu\u011fu Global Migren ve A\u011fr\u0131 Derne\u011fimizde (GMPS) 2019 y\u0131l\u0131ndan beri yo\u011fun \u00e7al\u0131\u015fmalar s\u00fcrd\u00fcr\u00fcyoruz.<\/p>\n

Hacamat ve cerrahi fayda sa\u011flar m\u0131?<\/b><\/p>\n

Migrende a\u011fr\u0131 ata\u011f\u0131n\u0131 tedavi edecek ve\u00a0 a\u011fr\u0131n\u0131n gelmesini \u00f6nleyecek ila\u00e7lar\u0131m\u0131z ve tedavi y\u00f6ntemlerimiz var. Hacamat, s\u00fcl\u00fck tedavisi, yoga gibi y\u00f6ntemlerin migrenin \u00f6nlenmesinde tedavi k\u0131lavuzlar\u0131nda yeri yoktur. Daha k\u00f6t\u00fcs\u00fc ise son y\u0131llarda 10 hastadan 1’inin migren cerrahisine ba\u015fvurmas\u0131d\u0131r. Migren ameliyat\u0131 konusunda yap\u0131lm\u0131\u015f plasebo ve migrenin klasik tedavileri ile kar\u015f\u0131la\u015ft\u0131rmal\u0131, etkinlik bildiren yeterli \u00e7al\u0131\u015fma bulunmamaktad\u0131r. Var olan \u00e7al\u0131\u015fmalar\u0131n da bilimsel kalitesi sorgulan\u0131r durumdad\u0131r.\u00a0 Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131’n\u0131n kararlar\u0131na referans te\u015fkil eden ABD G\u0131da ve \u0130la\u00e7 Dairesi (FDA) ve Avrupa \u0130la\u00e7 Ajans\u0131 (EMA) \u015fu an i\u00e7in\u00a0 migrenin tedavisinde cerrahi giri\u015fimlere yer vermemektedir. Ayr\u0131ca T\u00fcrk N\u00f6roloji Derne\u011fi, Amerikan N\u00f6roloji Akademisi (AAN)\u00a0 ve Avrupa N\u00f6roloji Akademisi (EAN)\u00a0 taraf\u0131ndan yay\u0131nlanan migren tedavi k\u0131lavuzlar\u0131nda b\u00f6yle bir tedavi se\u00e7ene\u011fi yer almamaktad\u0131r. Bu ameliyat\u0131 olan hastalar\u0131n bir\u00e7o\u011funda yan etkiler ortaya \u00e7\u0131kmaktad\u0131r. Maalesef internette \u00e7ok fazla bilgi kirlili\u011fi mevcut. En do\u011fru yakla\u015f\u0131m bu konuda Ba\u015fa\u011fr\u0131s\u0131 Derne\u011fi’nin web sitesine bakmak olacakt\u0131r.<\/p>\n

\"\"<\/p>\n

Hastalar nelere dikkat etmeli<\/b><\/p>\n

\u25a0 Kesinlikle a\u00e7 kalmay\u0131n.<\/p>\n

\u25a0 \u00d6\u011f\u00fcnlerinizi asla atlamay\u0131n.<\/p>\n

\u25a0 Karbonhidrattan uzak durun, protein miktar\u0131n\u0131 art\u0131r\u0131n.<\/p>\n

\u25a0 Bol su t\u00fcketin.<\/p>\n

\u25a0 Uykunuzun 7 saatin alt\u0131nda ve 9 saatin \u00fczerinde olmamas\u0131na dikkat edin.<\/p>\n

\u25a0 A\u00e7\u0131k havada egzersiz yap\u0131n.<\/p>\n

\u25a0 D vitamini de\u011ferlerinize dikkat edin.<\/p>\n

\u25a0 Kans\u0131zl\u0131k, guatr gibi hastal\u0131klar\u0131n kontrol\u00fcn\u00fc yapt\u0131r\u0131n.<\/p>\n

\u25a0 Sigaradan uzak durun.<\/p>\n

\u25a0 G\u00fcnde 300 miligramdan fazla kafein t\u00fcketmeyin.<\/p>\n

\u25a0 Stresten uzak durun.<\/p>\n

\"\"<\/p>\n

Migren a\u015f\u0131s\u0131 ne kadar etkili?<\/b><\/p>\n

Migren 4 ile 72 saat s\u00fcren \u015fiddetli bir a\u011fr\u0131d\u0131r, hareketle k\u00f6t\u00fcle\u015fir, tek tarafl\u0131d\u0131r. Ba\u015f a\u011fr\u0131s\u0131na bulant\u0131, kusma veya \u0131\u015f\u0131\u011fa ve sese hassasiyet e\u015flik edebilir. A\u011fr\u0131lar nedeniyle i\u015fimiz, sosyal ili\u015fkilerimiz, aile hayat\u0131m\u0131z olumsuz etkilenir. Ancak bu kadar \u015fiddetli a\u011fr\u0131ya ra\u011fmen \u00e7o\u011funlukla hekimlerin yazd\u0131\u011f\u0131 migren ila\u00e7lar\u0131n\u0131 i\u00e7mek istemeyiz. \u00c7\u00fcnk\u00fc hepsinin farkl\u0131 yan etkileri vard\u0131r ve hi\u00e7biri migren i\u00e7in spesifik ila\u00e7lar de\u011filler. Ya depresyon ya sara n\u00f6betinde kullan\u0131lan ila\u00e7lar ya da kalp ila\u00e7lar\u0131n\u0131 migren i\u00e7in kullanmak istemeyiz. \u00c7o\u011fu hastan\u0131n da birer a\u011fr\u0131 kesici deposu gibi migren \u00e7antalar\u0131 vard\u0131r. \u0130\u015fte tam da bu noktada 2019 y\u0131l\u0131nda devreye migrene spesifik tedavi se\u00e7ene\u011fi girdi. Biz asl\u0131nda bu tedaviye migren a\u015f\u0131s\u0131 diyoruz ama tam \u00f6yle de\u011fil. Ayl\u0131k aral\u0131klarla uygulan\u0131yor, en az 6-12 ay kullan\u0131l\u0131yor. Bu migrende inflamasyondan sorumlu olan ana madde CGRP’ye kar\u015f\u0131 geli\u015ftirilmi\u015f bir tedavi. A\u015f\u0131y\u0131 kullanmaya ba\u015flaman\u0131za ra\u011fmen ciddi bir uykusuzluk problemiyle kar\u015f\u0131 kar\u015f\u0131ya iseniz ya da ins\u00fclin direnci ya\u015fay\u0131p beslenme d\u00fczeninize dikkat etmiyorsan\u0131z bu durumlarda migren a\u015f\u0131s\u0131n\u0131n da tedavide ge\u00e7ici etkili ya da nafile kalaca\u011f\u0131n\u0131 bilmeniz gerekir. Migren a\u015f\u0131s\u0131, ayda d\u00f6rtten fazla migren a\u011fr\u0131s\u0131 ya\u015fayan her hastaya ayda bir kez uygulanabilir. \u00d6nceli\u011fimiz s\u0131k ataklar\u0131 olan kronik hastalard\u0131r. Hastalar\u0131m\u0131za 6 ayl\u0131k d\u00fczenli a\u015f\u0131 kullan\u0131m\u0131 sonras\u0131nda a\u011fr\u0131lar\u0131n\u0131n s\u0131kl\u0131\u011f\u0131n\u0131 g\u00f6zlemleyerek a\u015f\u0131n\u0131n devam\u0131na ya da tedavinin kesilmesine karar veriyoruz. A\u015f\u0131n\u0131n ba\u015far\u0131s\u0131n\u0131 belirlemede en \u00f6nemli kriterimiz; a\u011fr\u0131 ata\u011f\u0131n\u0131n y\u00fczde 50’den fazla azalmas\u0131d\u0131r. \u00d6rne\u011fin; ayda 10 g\u00fcn migren a\u011fr\u0131s\u0131 \u00e7eken bir hastam\u0131z\u0131n a\u011fr\u0131lar\u0131n\u0131n ayda en az 5 g\u00fcn azalmas\u0131 biz hekimler i\u00e7in ba\u015far\u0131n\u0131n birinci ko\u015fuludur.<\/p>\n","protected":false},"excerpt":{"rendered":"

\u015eiddetli ba\u015f a\u011fr\u0131lar\u0131na yol a\u00e7\u0131p, ya\u015fam kalitesini d\u00fc\u015f\u00fcren bir hastal\u0131k olan migrenin ameliyatla tedavi edilip edilmedi\u011fi \u00e7ok merak ediliyor …<\/p>\n","protected":false},"author":1,"featured_media":31802,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[4109,180,188,6669,376],"class_list":["post-31801","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik","tag-agri","tag-asi","tag-bas","tag-migren","tag-tedavi"],"_links":{"self":[{"href":"https:\/\/haberulus.net\/index.php?rest_route=\/wp\/v2\/posts\/31801","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/haberulus.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/haberulus.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/haberulus.net\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/haberulus.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31801"}],"version-history":[{"count":1,"href":"https:\/\/haberulus.net\/index.php?rest_route=\/wp\/v2\/posts\/31801\/revisions"}],"predecessor-version":[{"id":31803,"href":"https:\/\/haberulus.net\/index.php?rest_route=\/wp\/v2\/posts\/31801\/revisions\/31803"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/haberulus.net\/index.php?rest_route=\/wp\/v2\/media\/31802"}],"wp:attachment":[{"href":"https:\/\/haberulus.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31801"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/haberulus.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31801"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/haberulus.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31801"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}