{"id":16513,"date":"2025-09-18T17:35:12","date_gmt":"2025-09-18T15:35:12","guid":{"rendered":"https:\/\/ivrt.de\/?p=16513"},"modified":"2026-05-14T16:24:34","modified_gmt":"2026-05-14T14:24:34","slug":"akut-vestibueler-sendrom-inme-seyrinde-nistagmus-goezlemi-neden-hints-anahtar-olmaya-devam-ediyor","status":"publish","type":"post","link":"https:\/\/ivrt.de\/tr\/studien-evidenz\/akutes-vestibulaeres-syndrom-nystagmusbeobachtung-im-schlaganfallverlauf-warum-hints-der-schluessel-bleibt\/","title":{"rendered":"Akut Vestib\u00fcler Sendrom: \u0130nme Seyrinde Nistagmus G\u00f6zlemi \u2013 HINTS Neden Anahtar Olmaya Devam Ediyor"},"content":{"rendered":"<p><strong>Uzman personel i\u00e7in:<\/strong><\/p>\n\n\n\n<p>Akut vestib\u00fcler sendromlu (AVS) hastalarda, \u015fu ayr\u0131m\u0131n yap\u0131lmas\u0131 \u00f6nem ta\u015f\u0131r: <a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/vestibueler-nevrit\/\" data-type=\"post\" data-id=\"7427\">Vestib\u00fcler N\u00f6rinit<\/a> ve bir <a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/labilent-enfarktuesue\/\" data-type=\"post\" data-id=\"6001\">\u0130nme<\/a> (posterior circulation stroke; PCS) acil servisteki en \u00f6nemli g\u00f6revler aras\u0131ndad\u0131r. HINTS testi (Head Impulse, Nystagmus, Test of Skew), bu ba\u011flamda erken evre MR'dan daha duyarl\u0131 bulunmu\u015ftur.<\/p>\n\n\n\n<p>\ud83d\udd17 Akdal G, Nham B, Kwok B, et al. Akut posterior sirk\u00fclasyon inmesinde vestib\u00fcler olay takibi: acil servisten inme \u00fcnitesine ve \u00f6tesine.&nbsp;<em>J Neurol<\/em>. 2025;272(8):510. Yay\u0131m tarihi: 15 Tem 2025. doi:10.1007\/s00415-025-13163-4<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40664905\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>PubMed'deki Orijinal \u00c7al\u0131\u015fma<\/strong><\/a><\/p>\n\n\n\n<p><strong>\u00c7al\u0131\u015fma tasar\u0131m\u0131:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Akut PCS ve AVS semptomlar\u0131 (ba\u015f d\u00f6nmesi, denge bozukluklar\u0131) olan 80 hasta<\/li>\n\n\n\n<li>Kay\u0131t s\u0131ras\u0131nda ve sonras\u0131ndaki 9 g\u00fcne kadar Videonistagmografi (VNG), toplam 238 kay\u0131t<\/li>\n\n\n\n<li>Nystagmus'un ba\u015fvuru an\u0131nda var olup olmad\u0131\u011f\u0131n\u0131n veya s\u00fcre\u00e7 i\u00e7inde geli\u015fip geli\u015fmedi\u011finin g\u00f6zlemlenmesi<\/li>\n<\/ul>\n\n\n\n<p><strong>Temel Bulgular<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hasta grubunun 47\/80'inde (47\/80 hastada) ba\u015fvuru an\u0131nda (do\u011frudan yat\u0131\u015fta) nistagmus (merkezi veya periferik g\u00f6r\u00fcn\u00fcml\u00fc) mevcuttu.<\/li>\n\n\n\n<li>33\/80'inde ba\u015flang\u0131\u00e7ta nistagmus g\u00f6r\u00fclmedi; bunlardan 12'sinde s\u00fcre\u00e7 i\u00e7inde nistagmus geli\u015fti<\/li>\n\n\n\n<li>21\/80'i tamamen nystagmussuz kald\u0131<\/li>\n\n\n\n<li>Nistagmus tipi, \u201eperiferik\u201c ve \u201emerkezi\u201c aras\u0131nda ge\u00e7i\u015f olmaks\u0131z\u0131n stabil kald\u0131\u201c<\/li>\n<\/ul>\n\n\n\n<p><strong><strong>Klinik \u00f6nem<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u0130lk muayenede nistagmusun bulunmamas\u0131 bir inme olas\u0131l\u0131\u011f\u0131n\u0131 d\u0131\u015far\u0131ndan b\u0131rakmaz<\/li>\n\n\n\n<li>Nistagmus sonradan da geli\u015febilir.<\/li>\n\n\n\n<li>Doktorlar hastalar\u0131 yatarak izlemek, kontrol muayenesi yapmak ve gerekti\u011finde MR kullanmak zorundad\u0131r<\/li>\n\n\n\n<li>\u201eKan\u0131t\u0131n olmamas\u0131, yoklu\u011fun kan\u0131t\u0131 de\u011fildir.\u201c<\/li>\n<\/ul>\n\n\n\n<p><strong>Pratik \u0130\u00e7in Sonu\u00e7<\/strong><\/p>\n\n\n\n<p>Ara\u015ft\u0131rma \u015funu do\u011fruluyor: HINTS, hekimin elinde akut tan\u0131da vazge\u00e7ilmez olmaya devam ediyor. Eksik nistagmus yanl\u0131\u015f yorumlanmamal\u0131d\u0131r \u2013 tekrarlanan muayeneler gereklidir.<\/p>\n\n\n\n<p>Terapistler bu s\u00fcre\u00e7te \u00f6nemli bir rol oynamaktad\u0131r: Vestib\u00fcler bozuklu\u011fun \u015fiddetini ve t\u00fcr\u00fcn\u00fc kapsaml\u0131 bir \u015fekilde inceleyebilir ve periferik veya santral k\u00f6kenli olmas\u0131na bak\u0131lmaks\u0131z\u0131n hastalar\u0131 hedef odakl\u0131 bir \u015fekilde rehabilite edebilirler.<br><br><strong>\ud83d\udc49 Kapsaml\u0131 bir ileri e\u011fitime ilgi duyuyorsunuz: <a href=\"https:\/\/ivrt.de\/tr\/hasta-egitimi\/vestibueler-rehabilitasyon-tedavisi-ve-denge-egitimi\/\" data-type=\"post\" data-id=\"8932\">vestib\u00fcler rehabilitasyon tedavisi<\/a> ve akut evreden sonra vestib\u00fcler bozukluklar\u0131n nas\u0131l ay\u0131rt edilebilece\u011fi ve rehabilite edilebilece\u011fi?<\/strong><\/p>\n\n\n\n<p>G\u00fcncel e\u011fitim tekliflerini \u015furada bulabilirsiniz: <strong><a href=\"https:\/\/ivrt.de\/tr\/saglik-personeli-icin\/hizmet-ici-egitim-arama\/\" data-type=\"link\" data-id=\"https:\/\/ivrt.de\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\">IVRT E\u011fitim Arama<\/a>.<\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>Hastalar i\u00e7in \u2013 basit\u00e7e a\u00e7\u0131kland\u0131<\/strong><\/p>\n\n\n\n<p><strong><strong>Acil Serviste Ba\u015f D\u00f6nmesi: Eksik Bir Nystagmus Neden Her Zaman Tehlikenin Ge\u00e7ti\u011fi Anlam\u0131na Gelmez<\/strong><\/strong><\/p>\n\n\n\n<p>Ani \u015fiddetli ba\u015f d\u00f6nmesi, <a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/vestibueler-nevrit\/\" data-type=\"post\" data-id=\"7427\">\u0130\u00e7 kulak iltihab\u0131<\/a> veya bir <a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/labilent-enfarktuesue\/\" data-type=\"post\" data-id=\"6001\">\u0130nme <\/a>kaynaklanmak. Acil serviste \u00f6zel bir test olan HINTS testi, genellikle erken evre bir MR'dan daha do\u011frudur.<br><br>\ud83d\udcc4 Akdal G, Nham B, Kwok B ve ark. Akut posterior sirk\u00fclasyon inmesinde vestib\u00fcler olay takibi: acil servisten inme \u00fcnitesine ve \u00f6tesine.\u00a0<em>J Neurol<\/em>. 2025;272(8):510. Yay\u0131m tarihi: 15 Tem 2025. doi:10.1007\/s00415-025-13163-4<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40664905\/\" data-type=\"link\" data-id=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40421807\/\" target=\"_blank\" rel=\"noreferrer noopener\">Orijinal \u00e7al\u0131\u015fmaya<\/a><\/p>\n\n\n\n<p><strong><strong>Bu ne anlama geliyor?<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ba\u015f d\u00f6nmesinin ilk, \u015fiddetli evresindeki te\u015fhisi yaln\u0131zca doktorlar koyabilir.<\/li>\n\n\n\n<li>G\u00f6z se\u011firmesi hem i\u00e7 kulak iltihab\u0131nda hem de inmede ortaya \u00e7\u0131kabilir<\/li>\n\n\n\n<li>Ba\u015flang\u0131\u00e7ta hi\u00e7 g\u00f6z se\u011firmesi g\u00f6r\u00fclmese bile, bu yine de bir fel\u00e7 olabilir<\/li>\n\n\n\n<li>Bu nedenle tekrarlanan t\u0131bbi muayeneler ve genellikle birka\u00e7 g\u00fcn sonra bir MR da gereklidir.<\/li>\n<\/ul>\n\n\n\n<p><strong>Ve terapistlerin rol\u00fc nedir?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u0130lk m\u00fcdahalenin ard\u0131ndan \u00f6zel e\u011fitim alm\u0131\u015f vestib\u00fcler terapistler ileri tetkiki devral\u0131r<\/li>\n\n\n\n<li>Denge sisteminin ne \u00f6l\u00e7\u00fcde etkilendi\u011fini \u00f6l\u00e7\u00fcyorsunuz<\/li>\n\n\n\n<li>Hedefli y\u00f6netiyorsunuz <a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/vestibueler-rehabilitasyon-tedavisi-ve-denge-egitimi\/\" data-type=\"post\" data-id=\"8932\">Rehabilitasyon egzersiz programlar\u0131 <\/a>\u2013 sebebin ister i\u00e7 kulakta ister beyinde olmas\u0131 fark etmez<\/li>\n<\/ul>\n\n\n\n<p><strong>Sonu\u00e7<\/strong><\/p>\n\n\n\n<p><strong>Bu sizin i\u00e7in ne anlama geliyor?<\/strong><\/p>\n\n\n\n<p>Ani ve \u015fiddetli ba\u015f d\u00f6nmesinde ilk de\u011ferlendirme ve tan\u0131, doktorlar taraf\u0131ndan yap\u0131lmal\u0131d\u0131r. Daha sonra uzman terapistler, dengenizi e\u011fitmenize ve kendi hareketlerinize olan g\u00fcveninizi yeniden kazanman\u0131za yard\u0131mc\u0131 olabilir.<\/p>\n\n\n\n<p>\ud83c\udfaf <strong>\u00d6zel olarak e\u011fitilmi\u015f IVRT\u00ae ba\u015f d\u00f6nmesi ve vestib\u00fcler terapistlerimiz<\/strong>, die Sie individuell unerst\u00fctzen k\u00f6nnen, finden Sie \u00fcber unsere <strong><a href=\"https:\/\/ivrt.de\/tr\/etkilenenler-icin\/terapist-arama\/\" data-type=\"page\" data-id=\"101\" target=\"_blank\" rel=\"noreferrer noopener\">IVRT Terapist Arama<\/a><\/strong><\/p>\n\n\n\n<p><a id=\"_msocom_1\"><\/a><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>F\u00fcr Fachpersonal: Bei Patient:innen mit akutem vestibul\u00e4rem Syndrom (AVS) z\u00e4hlt die Unterscheidung zwischen Neuritis Vestibularis und einem Schlaganfall (posterior circulation stroke; PCS) zu den wichtigsten Aufgaben in der Notaufnahme. Der HINTS-Test (Head Impulse, Nystagmus, Test of Skew) hat sich dabei als sensibler als ein fr\u00fches MRT erwiesen. \ud83d\udd17 Akdal G, Nham B, Kwok B, et [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":18089,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"_jf_save_progress":"","iawp_total_views":356,"footnotes":""},"categories":[215],"tags":[],"class_list":["post-16513","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-studien-evidenz"],"_links":{"self":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts\/16513","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/comments?post=16513"}],"version-history":[{"count":1,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts\/16513\/revisions"}],"predecessor-version":[{"id":17494,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts\/16513\/revisions\/17494"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/media\/18089"}],"wp:attachment":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/media?parent=16513"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/categories?post=16513"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/tags?post=16513"}],"curies":[{"name":"Naber","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}