Zizindikiro, Zizindikiro, ndi Chithandizo
Mawu akuti epidural hematoma amatanthauza kugawana magazi (hematoma) kunja kwa malo osungira (epidural). Ndi chitsanzo chimodzi cha vuto lalikulu la kutsekedwa , lomwe limaphatikizanso ma maatemas a subdural ndi kuchepa kwa masewera a sub-arachnoid.
Kuvulala kumutu kumutu , mofanana ndi kuvulala kwa ubongo , kumabwera kuchokera ku zowawa zosautsa kumalo omwe amachititsa kutupa kwa ubongo. Chomwe chimayambitsa kutupa-magazi, madzi, kutupa, ndi zina zotero-zimadalira kumene mkati mwa crane kuwonongeka kukupezeka.
Kranamu ndi malo otsekedwa, makamaka mbali. Ndilo gawo la chigaza chomwe chimaphatikiza ubongo. Theka la chigaza liri ndi mafupa a nkhope. Zonsezi, pali mafupa asanu ndi atatu (makapu, mazenera ophimba) omwe amalinganizidwa kuti apangire chidebe chowoneka ngati mpira.
The Meninges
Ngati ubongo umakhalapo mpaka pazigaza, zikhoza kuwonongeka nthawi zonse pamene mutayendayenda kapena kumumenya mutu wanu. Pofuna kupewa vutoli, komanso kuyendetsa magazi, mkati mwa keranium ili ndi mthunzi wochuluka, wolimba kwambiri wotchedwa dura mater (latin for mother hard). Ndilokutalika kwa katatu kanyamulidwe kakang'ono pakati pa ubwino wa ubongo ndi kuuma kosawonongeka kwa chigaza. Zigawo izi zimatchedwa meninges . Mankhwalawa samaphimba ubongo, komanso mzere wa msana.
Ngakhale phokosoli limaphatikizapo crani, palinso kachilombo kakang'ono kwambiri kamene kamaphimba ubongo.
Mbali iyi imatchedwanso mchimake (latin kwa mayi wamng'ono). Ndizochepa kwambiri kuti zimatsatira zotsatizana za ubongo kuphatikizapo nkhono ndi zinyama zazing'ono za ubongo.
Pakati pa nthendayi yolimba komanso yosakanikirana, palinso malo osungira otchedwa arachnoid chifukwa cha maonekedwe ake.
Chingwe cha arachnoid chimapereka chitsime pakati pa mtunda wokhazikika komanso chimbudzi. Mafunde ake amatha kusamba wathanzi wa cerebrospinal fluid (CSF) kutuluka mmenemo.
Mwazi wambiri umatuluka kumtunda wa kunja. Ndi pamene mitsempha yochokera kudziko kunja kwa ubongo imatha kubweretsa magazi kuti atsekeze chimene chiri choyenera kuti chiwalo chofunikira kwambiri thupi. Pansi pazomwe zimakhala zolimba, komwe malo ochezera a arachnoid komanso omwe amatha kukhalapo, magazi si ofunika chifukwa CSF imapereka zakudya zambiri.
Pathophysiology
Matenda a chiwindi amayamba kuchoka pamutu. Kaŵirikaŵiri zimatenga vuto lalikulu kwambiri kuti likhale ndi epidural hematoma, koma pali zinthu zomwe zingachititse kuti munthu akhale kosavuta kutulutsa magazi kunja kwazomera. Odwala omwe ali ndi matenda a magazi kapena omwe akutsatira magazi, amakhala ndi chiopsezo chachikulu cha matenda oopsa omwe amawopsa kwambiri kuposa anthu ena onse. Odwala okalamba ndi odwala omwe ali ndi mbiri ya kumwa mowa kwambiri amapezedwanso.
Pamene wodwalayo agwidwa mwamphamvu kuti athetse chiwiya cha magazi kunja kwa malo osungira mowa, kutuluka kwa magazi kumalowa mwamsanga mu malo omwe angakhalepo pakati pa chigaza ndi malo osungira, polekanitsa awiriwo.
Tsaga silipita kulikonse. Ndi kovuta komanso osakhululukidwa, osakayika kwambiri. Chokhazikikacho chimakhalanso cholimba, koma chili ndi zambiri ndipo chidzatayika. Momwe magazi amasonkhanitsira pakati pa phulusa ndi tsaga, chimangoyambacho chimayambira pakatikati pa crane, kukanikiza ubongo.
Zizindikiro ndi Zizindikiro
Zoopsa zonse za ubongo zimakhala bwino kwambiri, ndi zizindikiro zofanana kwambiri. Onsewa ali ndi kuphatikiza kwa zotsatirazi:
- kutaya chidziwitso
- chizungulire
- mutu
- kunyoza ndi kusanza
- chisokonezo
Izi zimapangitsa kukhala kovuta kufotokoza kusiyana kwa mitundu yosiyanasiyana ya zovulala za ubongo popanda kuchita CT scan ya crani.
Mwa kuyankhula kwina, simungadziwe ngati ndi epidural hematoma pamalo a kuvulala. Munthuyo amafunika kuwonedwa mu dipatimenti yowopsa.
Kuti pambali pake, pali zizindikiro zowopsya kwambiri zomwe ziyenera kukhala mbendera zazikulu zofiira pambuyo poti wodwala akugwedeza molimba. Izi zikuphatikizapo: ophunzira omwe ali osagwirizana (wina ndi wamkulu kuposa wina), kuthamanga kwa magazi kwambiri, pang'onopang'ono komanso koopsa kwambiri, kapena wodwala sangathe kudzuka.
Chizindikiro chimodzi chodziwika bwino cha epidural hematoma chimatchedwa "Talk and Die Syndrome". Zimatanthauzanso zomwe opaleshoni ya opaleshoni imatcha kukhumba kwachinyengo. Mwa kuyankhula kwina, wodwala akugwedezeka, akuwuka ndipo akuwoneka kuti ndi bwino, ndiye amatha kutaya chidziwitso kachiwiri. Kuphatikizana kumeneku kumatanthawuza kwambiri epidural hematoma yomwe ikukula mofulumira ndipo nthawi zambiri imakhala njira yosiyanitsira pakati pa kugunda ndi vuto lalikulu kwambiri la ubongo .
Thandizo Loyamba Loyamba
Thandizo loyamba pa epidural hematoma liri lokha kusamalira zovulaza zina zilizonse. Chofunika koposa, samalani ngati munthuyo ataya chidziwitso. Aliyense amene ataya nzeru amakwera kupita kuchipatala mu ambulansi. Itanani 911 kwa aliyense amene wagogoda chikumbumtima kuchoka pamutu. Palibe chifukwa chokhalira ndi munthu yemwe akuvulala ubongo, koma muyenera kufufuza kuti muwone nthawi iliyonse.
Kuchiza kwachipatala
Matenda akuluakulu oyambitsa matenda amafunika kuchitidwa opaleshoni kukhetsa magazi ndi kumasula ubongo. Nthawi ndi ubongo panopa, monga ngati matenda a stroke. Ochita opaleshoni adzachotsa mbali ya fuga ndi kukhetsa hematoma. Pambuyo pake, kukhetsa kungafunikire kukhazikitsidwa kwa tsiku limodzi kuti mulole kutuluka kwina kulikonse.
> Zotsatira:
> Kang, J., Hong, S., Hu, C., Pyen, J., Whang, K., & Cho, S. et al. (2015). Kusanthula Kachipatala ka Hematoma Yopatsa Opaleshoni Yochedwa. Korea Journal Of Neurotrauma , 11 (2), 112. do: 10.13004 / kjnt.2015.11.2.112
> Nguyen, H., Li, L., Patel, M., & Mueller, W. (2016). Kuyeza kwachulukidwe ndi computed tomography kwa odwala okhala ndi axial hematoma akhoza kulingalira mozama kuchuluka kwa ubongo. The Neuroradiology Journal , 29 (5), 372-376. lembani: 10.1177 / 1971400916658795
> Sribnick, E., Dhall, S., & Hanfelt, J. (2015). Kuchuluka kwa matenda okhudza opaleshoni opaleshoni yopweteketsa ubongo: Kuphunzira koyambirira. Opaleshoni ya Opaleshoni Yachilengedwe , 6 (1), 1. doi: 10.4103 / 2152-7806.148541