{"id":418,"date":"2026-05-20T17:00:44","date_gmt":"2026-05-20T14:00:44","guid":{"rendered":"https:\/\/tatd.org.tr\/sportibbi\/?p=418"},"modified":"2026-05-24T13:34:22","modified_gmt":"2026-05-24T10:34:22","slug":"saha-ici-kafa-travmasi-ve-konkuzyon","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/sportibbi\/genel\/saha-ici-kafa-travmasi-ve-konkuzyon\/","title":{"rendered":"Saha \u0130\u00e7i Kafa Travmas\u0131 ve Konk\u00fczyon"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">\u00d6zet<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Spor s\u0131ras\u0131nda geli\u015fen kafa travmalar\u0131 \u00e7o\u011fu zaman \u201chafif\u201d g\u00f6r\u00fcnse de, beyin sars\u0131nt\u0131s\u0131 ve ciddi intrakraniyal yaralanmalar a\u00e7\u0131s\u0131ndan dikkatle de\u011ferlendirilmelidir. Beyin sars\u0131nt\u0131s\u0131, bilgisayarl\u0131 tomografi ile kan\u0131tlanan yap\u0131sal bir hasardan \u00e7ok, travma sonras\u0131 geli\u015fen klinik belirti ve bulgularla tan\u0131nan fonksiyonel bir beyin hasar\u0131d\u0131r. Acil hekiminin temel g\u00f6revi; sahada k\u0131rm\u0131z\u0131 bayraklar\u0131 tan\u0131mak, sporcuyu gerekti\u011finde derhal oyundan \u00e7\u0131karmak, servikal omurga yaralanmas\u0131 ve intrakraniyal kanama gibi zaman duyarl\u0131 patolojileri d\u0131\u015flamak, uygun hastada bilgisayarl\u0131 tomografi karar\u0131n\u0131 vermek ve g\u00fcvenli taburculuk\/izlem plan\u0131n\u0131 olu\u015fturmakt\u0131r. \u015e\u00fcpheli beyin sars\u0131nt\u0131s\u0131nda ayn\u0131 g\u00fcn oyuna d\u00f6n\u00fc\u015fe izin verilmemeli; spora d\u00f6n\u00fc\u015f kademeli olarak ve t\u0131bbi g\u00f6zetim alt\u0131nda planlanmal\u0131d\u0131r.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Giri\u015f<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Sporla ili\u015fkili kafa travmalar\u0131, temas sporlar\u0131nda g\u00f6r\u00fclen yaralanmalar\u0131n g\u00f6rece k\u00fc\u00e7\u00fck bir b\u00f6l\u00fcm\u00fcn\u00fc olu\u015ftursa da, k\u0131sa ve uzun vadeli n\u00f6rolojik sonu\u00e7lar\u0131 nedeniyle acil t\u0131p prati\u011finde \u00f6zel \u00f6nem ta\u015f\u0131r. Futbol, rugby, Amerikan futbolu, buz hokeyi ve d\u00f6v\u00fc\u015f sporlar\u0131 gibi temas veya \u00e7arp\u0131\u015fma i\u00e7eren bran\u015flarda ba\u015fa do\u011frudan darbe, v\u00fccuda gelen darbenin ba\u015fa iletilmesi veya ani akselerasyon-deselerasyon mekanizmalar\u0131 sonucunda beyin sars\u0131nt\u0131s\u0131 geli\u015febilir. Bu yaralanmalar \u00e7o\u011fu zaman \u201chafif\u201d olarak tan\u0131mlansa da, klinik etkileri her zaman hafif olmayabilir<sup>1<\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sporla ili\u015fkili beyin sars\u0131nt\u0131s\u0131, hafif travmatik beyin hasar\u0131n\u0131n \u00f6zel bir formudur ve \u00e7o\u011fu hastada standart yap\u0131sal g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemlerinde patoloji saptanmaz. Bu nedenle tan\u0131 esas olarak klinik de\u011ferlendirmeye dayan\u0131r. Bilin\u00e7 kayb\u0131n\u0131n olmamas\u0131, kraniyal bilgisayarl\u0131 tomografinin normal olmas\u0131 veya semptomlar\u0131n travma an\u0131nda belirgin olmamas\u0131 beyin sars\u0131nt\u0131s\u0131n\u0131 d\u0131\u015flamaz<sup>1,2<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Temas sporlar\u0131nda yaln\u0131zca klinik olarak belirgin beyin sars\u0131nt\u0131lar\u0131 de\u011fil, belirgin semptom olu\u015fturmayan tekrarlayan kafa darbeleri de \u00f6nemlidir. \u00d6zellikle futbolda kafa topu, Amerikan futbolu ve rugbyde tekrarlayan \u00e7arp\u0131\u015fmalar, buz hokeyi ve d\u00f6v\u00fc\u015f sporlar\u0131nda ise s\u0131k ve y\u00fcksek enerjili kafa darbeleri uzun d\u00f6nem beyin sa\u011fl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan tart\u0131\u015f\u0131lan ba\u015fl\u0131ca risk alanlar\u0131d\u0131r. Bununla birlikte acil yakla\u015f\u0131m\u0131n oda\u011f\u0131, uzun d\u00f6nem tart\u0131\u015fmalardan \u00f6nce, akut ciddi yaralanmay\u0131 d\u0131\u015flamak ve sporcunun g\u00fcvenli y\u00f6netimini sa\u011flamakt\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu yaz\u0131da saha i\u00e7i kafa travmas\u0131 ve beyin sars\u0131nt\u0131s\u0131, acil t\u0131p bak\u0131\u015f a\u00e7\u0131s\u0131yla ele al\u0131nacak; sahada ilk de\u011ferlendirme, k\u0131rm\u0131z\u0131 bayraklar, acil serviste bilgisayarl\u0131 tomografi karar\u0131, taburculuk \u00f6nerileri ve spora g\u00fcvenli d\u00f6n\u00fc\u015f ilkeleri pratik bir \u00e7er\u00e7evede \u00f6zetlenecektir.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Saha \u0130\u00e7inde Kafa Travmas\u0131na Yakla\u015f\u0131m<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Spor s\u0131ras\u0131nda geli\u015fen kafa ve boyun yaralanmalar\u0131nda temel ama\u00e7, ya\u015fam\u0131 tehdit eden durumlar\u0131 h\u0131zla tan\u0131mak, sporcuyu g\u00fcvenli bir \u015fekilde stabilize etmek ve gerekti\u011finde gecikmeden acil servise naklini sa\u011flamakt\u0131r. Saha i\u00e7i de\u011ferlendirme yaln\u0131zca beyin sars\u0131nt\u0131s\u0131n\u0131 tan\u0131maya y\u00f6nelik olmamal\u0131; servikal omurga yaralanmas\u0131, intrakraniyal kanama, n\u00f6bet, bilin\u00e7 bozuklu\u011fu ve \u00e7oklu travma a\u00e7\u0131s\u0131ndan sistematik bir ilk de\u011ferlendirme i\u00e7ermelidir<sup>1,3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0130lk de\u011ferlendirme her zaman havayolu, solunum, dola\u015f\u0131m, n\u00f6rolojik durum ve maruziyet\/ek yaralanma de\u011ferlendirmesini i\u00e7eren xABCDE yakla\u015f\u0131m\u0131yla ba\u015flamal\u0131d\u0131r. Bilinci kapal\u0131, yan\u0131t vermeyen, yerde hareketsiz yatan veya hareket ettirildi\u011finde n\u00f6rolojik yak\u0131nmas\u0131 olan her sporcuda aksi kan\u0131tlanana kadar ciddi kafa travmas\u0131 ve servikal omurga yaralanmas\u0131 oldu\u011fu kabul edilmelidir. Bu hastalarda manuel in-line stabilizasyon sa\u011flanmal\u0131, gereksiz boyun hareketinden ka\u00e7\u0131n\u0131lmal\u0131 ve 112\/acil sa\u011fl\u0131k ekibi ile uygun immobilizasyon e\u015fli\u011finde hastaneye nakli planlanmal\u0131d\u0131r<sup>3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Saha i\u00e7inde en kritik kararlardan biri, sporcunun oyundan \u00e7\u0131kar\u0131lmas\u0131d\u0131r. Kafa travmas\u0131 sonras\u0131 beyin sars\u0131nt\u0131s\u0131 \u015f\u00fcphesi bulunan sporcu, bulgular\u0131 hafif g\u00f6r\u00fcnse veya k\u0131sa s\u00fcrede d\u00fczelmi\u015f olsa bile ayn\u0131 g\u00fcn oyuna d\u00f6nd\u00fcr\u00fclmemelidir. Bilin\u00e7 kayb\u0131, konf\u00fczyon, bo\u015f bakma, yava\u015f kalkma, dengesizlik, koordinasyon bozuklu\u011fu, amnezi, davran\u0131\u015f de\u011fi\u015fikli\u011fi, ba\u015f a\u011fr\u0131s\u0131 veya ba\u015f d\u00f6nmesi gibi bulgulardan herhangi birinin varl\u0131\u011f\u0131nda sporcu oyundan \u00e7\u0131kar\u0131lmal\u0131 ve saha kenar\u0131nda seri de\u011ferlendirmeye al\u0131nmal\u0131d\u0131r<sup>1,4<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Servikal omurga yaralanmas\u0131 a\u00e7\u0131s\u0131ndan \u00f6zellikle dikkatli olunmal\u0131d\u0131r. Boyun a\u011fr\u0131s\u0131 veya hassasiyeti, ekstremitelerde uyu\u015fma, kar\u0131ncalanma ya da g\u00fc\u00e7s\u00fczl\u00fck, hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131, belirgin deformite, bilin\u00e7 durumunda bozulma veya y\u00fcksek enerjili \u00e7arp\u0131\u015fma mekanizmas\u0131 varl\u0131\u011f\u0131nda servikal omurga yaralanm\u0131\u015f kabul edilmelidir. Bu durumda sporcu sahada oturtulmaya veya aya\u011fa kald\u0131r\u0131lmaya \u00e7al\u0131\u015f\u0131lmamal\u0131; boyun n\u00f6tral pozisyonda korunmal\u0131 ve acil sa\u011fl\u0131k ekibi gelene kadar stabilizasyon s\u00fcrd\u00fcr\u00fclmelidir<sup>3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Saha i\u00e7inde acil transfer gerektiren k\u0131rm\u0131z\u0131 bayraklar<\/strong>; bilin\u00e7 kayb\u0131 veya bilin\u00e7te k\u00f6t\u00fcle\u015fme, Glasgow Koma Skalas\u0131\u2019n\u0131n (GKS) 15\u2019in alt\u0131nda olmas\u0131, n\u00f6bet, tekrarlayan kusma, \u015fiddetlenen ba\u015f a\u011fr\u0131s\u0131, fokal n\u00f6rolojik defisit, dengesizlik veya ataksi, boyun a\u011fr\u0131s\u0131, parestezi\/g\u00fc\u00e7s\u00fczl\u00fck, kafatas\u0131 k\u0131r\u0131\u011f\u0131 \u015f\u00fcphesi, ciddi y\u00fcz-kafa travmas\u0131 ve belirgin davran\u0131\u015f de\u011fi\u015fikli\u011fidir. Bu bulgulardan biri varsa sporcu oyundan \u00e7\u0131kar\u0131lmal\u0131, ABCDE yakla\u015f\u0131m\u0131yla de\u011ferlendirilmeli ve acil servise transfer edilmelidir<sup>1,3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Saha kenar\u0131nda beyin sars\u0131nt\u0131s\u0131 de\u011ferlendirmesi; semptom sorgulamas\u0131, k\u0131sa bili\u015fsel de\u011ferlendirme, denge ve koordinasyon muayenesi, kraniyal sinir muayenesi ve servikal omurga de\u011ferlendirmesini i\u00e7ermelidir. Bu ama\u00e7la Concussion Recognition Tool-6 (CRT6) ve Sport Concussion Assessment Tool-6 (SCAT6) gibi standartla\u015ft\u0131r\u0131lm\u0131\u015f ara\u00e7lardan yararlan\u0131labilir. Ancak bu ara\u00e7lar klinik karar\u0131n yerine ge\u00e7mez; k\u0131rm\u0131z\u0131 bayrak bulgular\u0131 olan hastalarda zaman kaybetmeden acil servise nakil \u00f6nceliklidir<sup>4,5<\/sup>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Beyin Sars\u0131nt\u0131s\u0131 Nas\u0131l Tan\u0131n\u0131r?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Beyin sars\u0131nt\u0131s\u0131, ba\u015fa, boyna veya g\u00f6vdeye gelen darbenin olu\u015fturdu\u011fu impulsif kuvvetin beyne iletilmesi sonucunda geli\u015fen, \u00e7o\u011funlukla ge\u00e7ici n\u00f6rolojik i\u015flev bozuklu\u011fu ile seyreden bir hafif travmatik beyin hasar\u0131d\u0131r. Sporla ili\u015fkili beyin sars\u0131nt\u0131s\u0131nda yap\u0131sal g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemleri \u00e7o\u011fu zaman normaldir; bu nedenle tan\u0131 bilgisayarl\u0131 tomografi (BT) veya manyetik rezonans g\u00f6r\u00fcnt\u00fcleme (MRG) ile de\u011fil, travma mekanizmas\u0131 ve klinik bulgular\u0131n birlikte de\u011ferlendirilmesiyle konur<sup>1,2<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tan\u0131da tek bir semptom, muayene bulgusu veya test yeterli de\u011fildir. Kafa, boyun ya da g\u00f6vdeye darbe sonras\u0131 ortaya \u00e7\u0131kan yeni n\u00f6rolojik, bili\u015fsel, duygusal veya denge ile ili\u015fkili yak\u0131nmalar ba\u015fka bir klinik durumla a\u00e7\u0131klanam\u0131yorsa, beyin sars\u0131nt\u0131s\u0131 lehine de\u011ferlendirilmelidir. Bu nedenle de\u011ferlendirme; ayr\u0131nt\u0131l\u0131 semptom sorgulamas\u0131, k\u0131sa n\u00f6rolojik muayene, bili\u015fsel durumun g\u00f6zden ge\u00e7irilmesi, denge-koordinasyon de\u011ferlendirmesi ve servikal omurga muayenesini i\u00e7eren b\u00fct\u00fcnc\u00fcl bir yakla\u015f\u0131mla yap\u0131lmal\u0131d\u0131r<sup>1,5<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bilin\u00e7 kayb\u0131, beyin sars\u0131nt\u0131s\u0131n\u0131n dikkat \u00e7ekici bulgular\u0131ndan biri olsa da tan\u0131 i\u00e7in zorunlu de\u011fildir. Olgular\u0131n \u00f6nemli bir b\u00f6l\u00fcm\u00fcnde bilin\u00e7 kayb\u0131 olmadan ba\u015f a\u011fr\u0131s\u0131, ba\u015f d\u00f6nmesi, bulant\u0131, dengesizlik, bulan\u0131k veya \u00e7ift g\u00f6rme, \u0131\u015f\u0131k-ses hassasiyeti, konf\u00fczyon, amnezi, yava\u015f cevap verme ya da \u201csisli hissetme\u201d gibi yak\u0131nmalar g\u00f6r\u00fclebilir. Bu nedenle saha i\u00e7i de\u011ferlendirmede yaln\u0131zca bilin\u00e7 kayb\u0131na odaklanmak, klinik olarak \u00f6nemli sars\u0131nt\u0131lar\u0131n g\u00f6zden ka\u00e7mas\u0131na neden olabilir<sup>1,2<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Beyin sars\u0131nt\u0131s\u0131nda semptomlar genel olarak somatik, bili\u015fsel, duygusal ve uyku ile ili\u015fkili belirtiler \u015feklinde grupland\u0131r\u0131labilir. Somatik belirtiler aras\u0131nda ba\u015f a\u011fr\u0131s\u0131, ba\u015f d\u00f6nmesi, bulant\u0131, kusma, g\u00f6rme bulan\u0131kl\u0131\u011f\u0131, \u0131\u015f\u0131k veya ses hassasiyeti ve denge bozuklu\u011fu yer al\u0131r. Bili\u015fsel belirtiler; konf\u00fczyon, dezoryantasyon, olay \u00f6ncesini veya sonras\u0131n\u0131 hat\u0131rlayamama, dikkat g\u00fc\u00e7l\u00fc\u011f\u00fc ve sorulara gecikmi\u015f yan\u0131t verme \u015feklinde ortaya \u00e7\u0131kabilir. Duygusal dalgalanma, irritabilite, kayg\u0131, kendini iyi hissetmeme, uykuya e\u011filim, \u00e7abuk yorulma ve uykuya dalmada g\u00fc\u00e7l\u00fck de klinik tabloya e\u015flik edebilir<sup>1,2<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Saha i\u00e7inde g\u00f6zlenen baz\u0131 davran\u0131\u015fsal ve motor bulgular da tan\u0131 a\u00e7\u0131s\u0131ndan \u00f6nemlidir. Sporcunun yerde hareketsiz kalmas\u0131, dengesiz veya ataksik y\u00fcr\u00fcmesi, bo\u015f bakmas\u0131, basit sorulara yanl\u0131\u015f yan\u0131t vermesi, pozisyonuna d\u00f6nmekte zorlanmas\u0131, koordinasyonunun bozulmas\u0131 veya davran\u0131\u015f\u0131n\u0131n ola\u011fandan farkl\u0131 olmas\u0131 beyin sars\u0131nt\u0131s\u0131 a\u00e7\u0131s\u0131ndan uyar\u0131c\u0131 kabul edilmelidir. Semptomlar\u0131n travma an\u0131nda ba\u015flamayabilece\u011fi, dakikalar veya saatler i\u00e7inde belirginle\u015febilece\u011fi unutulmamal\u0131d\u0131r<sup>1,4<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sonu\u00e7 olarak, beyin sars\u0131nt\u0131s\u0131n\u0131 tan\u0131mada temel yakla\u015f\u0131m, bilin\u00e7 kayb\u0131n\u0131 beklemek de\u011fil; darbe sonras\u0131 geli\u015fen yeni semptomlar\u0131, davran\u0131\u015f de\u011fi\u015fikliklerini, bili\u015fsel yava\u015flamay\u0131, amneziyi, denge bozuklu\u011funu ve g\u00f6rsel yak\u0131nmalar\u0131 birlikte de\u011ferlendirmektir. Kafa travmas\u0131 sonras\u0131 bu bulgulardan biri bile mevcutsa sporcu \u201c\u015f\u00fcphe varsa saha d\u0131\u015f\u0131\u201d ilkesiyle y\u00f6netilmeli ve ayn\u0131 g\u00fcn oyuna d\u00f6nd\u00fcr\u00fclmemelidir<sup>1<\/sup>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Acil Serviste De\u011ferlendirme ve Bilgisayarl\u0131 Tomografi Karar\u0131<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Acil serviste spor ili\u015fkili kafa travmas\u0131 ile ba\u015fvuran hastan\u0131n de\u011ferlendirilmesinde temel ama\u00e7, klinik olarak \u00f6nemli intrakraniyal yaralanmalar\u0131 erken tan\u0131mak ve ayn\u0131 zamanda gereksiz BT kullan\u0131m\u0131n\u0131 azaltmakt\u0131r. Bu nedenle yakla\u015f\u0131m yaln\u0131zca \u201cBT \u00e7ekelim mi?\u201d sorusuna indirgenmemeli; travman\u0131n mekanizmas\u0131, semptomlar\u0131n seyri, n\u00f6rolojik muayene bulgular\u0131, e\u015flik eden servikal omurga yaralanmas\u0131 riski ve hastan\u0131n bireysel kanama riski birlikte de\u011ferlendirilmelidir<sup>3,6<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0130lk de\u011ferlendirme genel travma yakla\u015f\u0131m\u0131yla ba\u015flamal\u0131d\u0131r. Havayolu, solunum ve dola\u015f\u0131m g\u00fcvence alt\u0131na al\u0131nd\u0131ktan sonra bilin\u00e7 durumu, pupil yan\u0131tlar\u0131, ekstremite motor-duyu muayenesi, konu\u015fma, koordinasyon ve y\u00fcr\u00fcme de\u011ferlendirilmelidir. GKS kafa travmas\u0131n\u0131n \u015fiddetini s\u0131n\u0131flamada temel ara\u00e7lardan biridir. GKS 13\u201315 aras\u0131 olgular hafif travmatik beyin hasar\u0131 grubunda de\u011ferlendirilse de, GKS\u2019nin 15\u2019in alt\u0131nda olmas\u0131, bilin\u00e7 durumunda k\u00f6t\u00fcle\u015fme veya n\u00f6rolojik muayenede yeni patoloji saptanmas\u0131 daha dikkatli izlem ve g\u00f6r\u00fcnt\u00fcleme gerektirir<sup>3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">N\u00f6rolojik muayenede fokal defisit, pupiller asimetri, posttravmatik n\u00f6bet, bilin\u00e7 d\u00fczeyinde azalma, giderek artan uyku hali veya davran\u0131\u015f de\u011fi\u015fikli\u011fi varl\u0131\u011f\u0131 ciddi intrakraniyal yaralanma a\u00e7\u0131s\u0131ndan uyar\u0131c\u0131d\u0131r. Benzer \u015fekilde a\u00e7\u0131k veya \u00e7\u00f6kme kafatas\u0131 k\u0131r\u0131\u011f\u0131 \u015f\u00fcphesi, bazal kafatas\u0131 k\u0131r\u0131\u011f\u0131 bulgular\u0131, ciddi y\u00fcz-kafa travmas\u0131 veya y\u00fcksek enerjili yaralanma mekanizmas\u0131 BT endikasyonunu g\u00fc\u00e7lendirir. Bu hastalarda \u00f6ncelik, beyin sars\u0131nt\u0131s\u0131n\u0131 kan\u0131tlamak de\u011fil, kanama, kont\u00fczyon, \u00f6dem veya k\u0131r\u0131k gibi zaman duyarl\u0131 patolojileri d\u0131\u015flamakt\u0131r<sup>3,6<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Travma mekanizmas\u0131 karar s\u00fcrecinde \u00f6nemlidir. Y\u00fcksek enerjili \u00e7arp\u0131\u015fmalar, y\u00fcksekten d\u00fc\u015fme, h\u0131zl\u0131 akselerasyon-deselerasyon mekanizmalar\u0131 veya ba\u015f-boyun b\u00f6lgesine do\u011frudan ve \u015fiddetli darbe ciddi yaralanma riskini art\u0131r\u0131r. Spor sahas\u0131nda bu durum kafa kafaya \u00e7arp\u0131\u015fma, yere kontrols\u00fcz d\u00fc\u015fme, y\u00fcksek h\u0131zda temas, sert zeminle temas veya e\u015flik eden boyun yaralanmas\u0131 \u015f\u00fcphesi \u015feklinde kar\u015f\u0131m\u0131za \u00e7\u0131kabilir. Mekanizma tek ba\u015f\u0131na karar verici olmasa da, semptomlar ve muayene bulgular\u0131 ile birlikte de\u011ferlendirilmelidir<sup>3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Kusma, amnezi, \u015fiddetli veya giderek k\u00f6t\u00fcle\u015fen ba\u015f a\u011fr\u0131s\u0131, kal\u0131c\u0131 ba\u015f d\u00f6nmesi, dengesizlik ve belirgin konf\u00fczyon gibi bulgular da BT karar\u0131nda dikkate al\u0131nmal\u0131d\u0131r. Antikoag\u00fclan veya antiagregan ila\u00e7 kullan\u0131m\u0131, koag\u00fclopati, ileri ya\u015f, \u00f6nceki n\u00f6rolojik hastal\u0131klar ve alkol\/madde etkisi alt\u0131nda olma gibi durumlar de\u011ferlendirmeyi g\u00fc\u00e7le\u015ftirebilir. Bu hasta grubunda semptomlar hafif g\u00f6r\u00fcnse bile intrakraniyal kanama riski daha y\u00fcksek olabilir veya klinik muayenenin g\u00fcvenilirli\u011fi azalabilir; bu nedenle BT e\u015fi\u011fi daha d\u00fc\u015f\u00fck tutulmal\u0131d\u0131r<sup>3,6<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">BT\u2019nin beyin sars\u0131nt\u0131s\u0131 tan\u0131s\u0131n\u0131 koymak i\u00e7in kullan\u0131lan bir test olmad\u0131\u011f\u0131 \u00f6zellikle vurgulanmal\u0131d\u0131r. Beyin sars\u0131nt\u0131s\u0131 \u00e7o\u011fu zaman fonksiyonel bir bozuklukla seyreder ve standart BT\u2019de yap\u0131sal patoloji saptanmaz. Normal BT sonucu, hastada beyin sars\u0131nt\u0131s\u0131 olmad\u0131\u011f\u0131 anlam\u0131na gelmez. BT\u2019nin acil servisteki temel rol\u00fc epidural hematom, subdural hematom, intraparenkimal kanama, kont\u00fczyon, beyin \u00f6demi veya kafatas\u0131 k\u0131r\u0131\u011f\u0131 gibi klinik olarak \u00f6nemli yaralanmalar\u0131 d\u0131\u015flamakt\u0131r<sup>2,6<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Gereksiz BT kullan\u0131m\u0131n\u0131 azaltmak ve y\u00fcksek riskli hastalar\u0131 daha tutarl\u0131 belirlemek i\u00e7in klinik karar kurallar\u0131ndan yararlan\u0131labilir. Eri\u015fkin hafif kafa travmas\u0131nda Canadian CT Head Rule ve New Orleans Criteria, pediatrik hastalarda ise PECARN bu ama\u00e7la en s\u0131k kullan\u0131lan ara\u00e7lardand\u0131r. Bununla birlikte bu karar kurallar\u0131 klinik de\u011ferlendirmenin yerine ge\u00e7mez; \u00f6zellikle antikoag\u00fclan kullanan, n\u00f6rolojik muayenesi g\u00fcvenilir olmayan veya semptomlar\u0131 ilerleyen hastalarda tek ba\u015f\u0131na yeterli kabul edilmemelidir<sup>3,6<\/sup>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Taburculuk, \u0130zlem ve Spora D\u00f6n\u00fc\u015f<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Sahada beyin sars\u0131nt\u0131s\u0131 \u015f\u00fcphesi veya tan\u0131s\u0131 bulunan sporcu derhal oyundan \u00e7\u0131kar\u0131lmal\u0131 ve ayn\u0131 g\u00fcn spora d\u00f6n\u00fc\u015f\u00fcne izin verilmemelidir. Acil serviste ciddi intrakraniyal yaralanma d\u0131\u015fland\u0131ktan sonra taburculuk karar\u0131, yaln\u0131zca g\u00f6r\u00fcnt\u00fcleme sonucuna g\u00f6re de\u011fil; klinik stabilite, g\u00fcvenilir g\u00f6zlemci varl\u0131\u011f\u0131, hastan\u0131n anlayabilece\u011fi yaz\u0131l\u0131 uyar\u0131lar\u0131n verilmesi ve tekrar ba\u015fvuru ko\u015fullar\u0131n\u0131n net anlat\u0131lmas\u0131yla birlikte verilmelidir<sup>1,3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Taburculuk s\u0131ras\u0131nda hastaya ve yak\u0131nlar\u0131na yaz\u0131l\u0131 bilgilendirme yap\u0131lmal\u0131d\u0131r. \u0130lk 24 saat boyunca eri\u015fkin bir g\u00f6zetici bulunmas\u0131, bilin\u00e7 de\u011fi\u015fikli\u011fi, \u015fiddetlenen ba\u015f a\u011fr\u0131s\u0131, tekrarlayan kusma, n\u00f6bet, uyand\u0131r\u0131lamama, fokal g\u00fc\u00e7s\u00fczl\u00fck, konu\u015fma bozuklu\u011fu veya davran\u0131\u015f de\u011fi\u015fikli\u011fi geli\u015firse acil servise ba\u015fvurulmas\u0131 gerekti\u011fi a\u00e7\u0131k\u00e7a belirtilmelidir. Alkol kullan\u0131m\u0131, sedatif ila\u00e7lar, riskli fiziksel aktivite ve ara\u00e7 kullan\u0131m\u0131 konusunda dikkatli olunmal\u0131d\u0131r<sup>2,3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u0130lk 24\u201348 saatte mutlak yatak istirahat\u0131 yerine g\u00f6receli fiziksel ve bili\u015fsel istirahat \u00f6nerilir. Bu d\u00f6nemde g\u00fcnl\u00fck aktiviteler semptomlar\u0131 art\u0131rmayacak d\u00fczeyde tutulmal\u0131; ekran kullan\u0131m\u0131, yo\u011fun zihinsel \u00e7al\u0131\u015fma ve a\u011f\u0131r egzersiz semptomlara g\u00f6re s\u0131n\u0131rland\u0131r\u0131lmal\u0131d\u0131r. Semptomlar\u0131 provoke etmeyen hafif g\u00fcnl\u00fck aktivitelere ve kontroll\u00fc aerobik egzersize erken d\u00f6nemde kademeli ge\u00e7i\u015f, g\u00fcncel yakla\u015f\u0131mlarda desteklenmektedir<sup>1,7<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Spora d\u00f6n\u00fc\u015f bireyselle\u015ftirilmi\u015f ve kademeli bir protokolle yap\u0131lmal\u0131d\u0131r. Genel yakla\u015f\u0131m; d\u00fczenli g\u00fcnl\u00fck aktivitelere d\u00f6n\u00fc\u015f, hafif aerobik egzersiz, orta yo\u011funluklu aktivite, temas i\u00e7ermeyen spora \u00f6zg\u00fc egzersiz, kontroll\u00fc tam temasl\u0131 antrenman ve yar\u0131\u015fmaya d\u00f6n\u00fc\u015f basamaklar\u0131ndan olu\u015fur. Her basamak genellikle en az 24 saat s\u00fcrmeli, semptomlar tekrarlarsa bir \u00f6nceki basama\u011fa d\u00f6n\u00fclmeli ve tam spora d\u00f6n\u00fc\u015f i\u00e7in sa\u011fl\u0131k profesyonelinin onay\u0131 al\u0131nmal\u0131d\u0131r<sup>7<\/sup>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Sonu\u00e7: Acilci \u0130\u00e7in 5 Mesaj<\/h2>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li>Spor sahas\u0131nda kafa travmas\u0131 ge\u00e7iren sporcuda ilk hedef beyin sars\u0131nt\u0131s\u0131n\u0131 adland\u0131rmak de\u011fil, ya\u015fam\u0131 tehdit eden kafa-boyun yaralanmas\u0131n\u0131 d\u0131\u015flamakt\u0131r.<\/li>\n\n\n\n<li>Bilin\u00e7 kayb\u0131 olmamas\u0131, beyin sars\u0131nt\u0131s\u0131n\u0131 d\u0131\u015flamaz. Ba\u015f a\u011fr\u0131s\u0131, ba\u015f d\u00f6nmesi, konf\u00fczyon, amnezi, dengesizlik veya davran\u0131\u015f de\u011fi\u015fikli\u011fi varl\u0131\u011f\u0131nda sars\u0131nt\u0131dan \u015f\u00fcphelenilmelidir.<\/li>\n\n\n\n<li>\u015e\u00fcpheli beyin sars\u0131nt\u0131s\u0131nda sporcu ayn\u0131 g\u00fcn oyuna d\u00f6nd\u00fcr\u00fclmemelidir.<\/li>\n\n\n\n<li>BT, beyin sars\u0131nt\u0131s\u0131n\u0131 g\u00f6stermek i\u00e7in de\u011fil; intrakraniyal kanama, kont\u00fczyon ve kafatas\u0131 k\u0131r\u0131\u011f\u0131 gibi ciddi yaralanmalar\u0131 d\u0131\u015flamak i\u00e7in kullan\u0131l\u0131r.<\/li>\n\n\n\n<li>G\u00fcvenli taburculuk; yaz\u0131l\u0131 uyar\u0131 bulgular\u0131, g\u00fcvenilir g\u00f6zlemci, tekrar ba\u015fvuru kriterleri ve kademeli spora d\u00f6n\u00fc\u015f plan\u0131 olmadan tamamlanm\u0131\u015f say\u0131lmaz.<\/li>\n<\/ol>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<h2 class=\"wp-block-heading\">Kaynaklar<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">1.&nbsp;Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022.&nbsp;<em>Br J Sports Med<\/em>. 2023;57(11):695-711. doi:10.1136\/bjsports-2023-106898&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">2. CDC. Mild TBI Management Guideline. Traumatic Brain Injury &amp; Concussion. July 29, 2025. Accessed May 16, 2026. https:\/\/www.cdc.gov\/traumatic-brain-injury\/hcp\/data-research\/index.html&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">3. National Institute for Health and Care Excellence. Head Injury: Assessment and Early Management. NICE Guideline NG232. 2023.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">4. Echemendia RJ, Ahmed OH, Bailey CM, et al. The Concussion Recognition Tool 6 (CRT6).&nbsp;<em>Br J Sports Med<\/em>. 2023;57(11):692-694. doi:10.1136\/bjsports-2023-107021&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">5. Echemendia RJ, Brett BL, Broglio S, et al. Sport concussion assessment tool<sup>TM<\/sup>&nbsp;&#8211; 6 (SCAT6).&nbsp;<em>Br J Sports Med<\/em>. 2023;57(11):622-631. doi:10.1136\/bjsports-2023-107036&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">6. American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Mild Traumatic Brain Injury, Valente JH, Anderson JD, et al. Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Mild Traumatic Brain Injury: Approved by ACEP Board of Directors, February 1, 2023 Clinical Policy Endorsed by the Emergency Nurses Association (April 5, 2023).\u00a0<em>Ann Emerg Med<\/em>. 2023;81(5):e63-e105. doi:10.1016\/j.annemergmed.2023.01.014\u00a07.CDC. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">7. Returning to Sports. HEADS UP. September 15, 2025. Accessed May 16, 2026. https:\/\/www.cdc.gov\/heads-up\/guidelines\/returning-to-sports.html\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00d6zet Spor s\u0131ras\u0131nda geli\u015fen kafa travmalar\u0131 \u00e7o\u011fu zaman \u201chafif\u201d g\u00f6r\u00fcnse de, beyin sars\u0131nt\u0131s\u0131 ve ciddi intrakraniyal yaralanmalar a\u00e7\u0131s\u0131ndan dikkatle de\u011ferlendirilmelidir. Beyin sars\u0131nt\u0131s\u0131, bilgisayarl\u0131 tomografi ile kan\u0131tlanan yap\u0131sal bir hasardan \u00e7ok,&hellip;<\/p>\n","protected":false},"author":4044,"featured_media":419,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[1,10014,10015],"tags":[10023,10017,10021,10019],"class_list":["post-418","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","category-akademik-blog-yazisi","category-sosyal-blog-yazisi","tag-konkuzyon","tag-spor","tag-spor-acilleri","tag-travma"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts\/418","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/users\/4044"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/comments?post=418"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts\/418\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/media\/419"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/media?parent=418"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/categories?post=418"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/tags?post=418"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}