Iimpawu, iimpawu kunye noTyango
Ixesha elithi epidural hematoma libhekisela ekuhlahleni igazi (i-hematoma) ngaphandle kwexesha lokuhlala (epidural). Omnye umzekelo weentlungu ezivaliweyo zentloko , ezibandakanya i-hematomas kunye ne-sub-arachnoid.
Ukulimala kwentloko evaliweyo , okufana nokulimala kongqondo , kuvela entlekweni ephazamisayo ukuya kwi-noggin eyenza ukukhukhuma kwengqondo. Yintoni eyenza ukuba ukuvuvukala-igazi, umbane, ukuvuvukala, njl.-Kuxhomekeke kwimeko apho ngaphakathi kwekriban umonakalo ufunyanwa.
I-krano iyindawo evaliweyo, inxalenye enkulu. Yingxenye yecayi efaka ingqondo. Esinye isiqingatha sekhayi senziwe ngamathambo ebuso. Konke, kukho amathambo anesibhozo ezisibhozo (ububanzi, amacwecwe aqhotyoshelweyo) adibaniswa ukwenza ibhakethi engamanzi ebhokisini yakho.
The Meninges
Ukuba ubuchopho buhlala ngokukhawuleza kwinqaba, luya kubonakaliswa rhoqo xa uhamba okanye utyumbile intloko yakho. Ukuze ugweme loo ngxaki, kwaye uququzelele ukuhamba kwegazi, ngaphakathi kwekribri ihlanganiswe ne-membrane enesibindi, ebizwa ngokuba yi- dura mater (latin for mother mother). Ingumda ongaphandle kwintambo ephindwe kathathu phakathi kwentsipho yengqondo kunye nobunzima obungashenxiseki bekrele. Ezi ziqendu zibizwa ngokuba ngama- meninges . Ama-meninges ayigubungeli kuphela ubuchopho, kodwa kunye nomgca wesipelini.
Nangona i-long-mater row line i-crane, kukho i-membrane enomzimba ogqithiseleyo ombethe iishubhu zengqondo.
Le membrane ibizwa ngokuba yi- mater (latin kumama omncinci). Kancinci kangangokuthi ilandela intambo yengqondo, kuquka neoks kunye nemigqomo yeengxowa zeengqondo zobuchopho.
Phakathi kwesigxina esinomsoco kunye nesincinci, kuluhlu oluthile olubizwa ngokuba yi- arachnoid ngenxa yokubonakala kwayo kwewebhu.
Uluhlu lwama-arachnoid lunikeza umgca phakathi kwexesha elide kunye ne-mater. Ubume bawo obunxantathu buvumela ukuba ibhotile enomsoco we-cerebrospinal fluid (CSF) iphumelele kuyo.
Ukuhamba kwegazi amaninzi kumanqaku kubonakala kwinqanaba elikude lomlingani ohlalayo. Yilapho imirhobho evela kwihlabathi ngaphandle kweengqondo ikwazi ukuletha igazi ekukhutsheni kwezinto ezibhekiselele kwiziko elibaluleke kakhulu lomzimba. Ngaphantsi kwe-mater ehlalayo, apho iindawo ze-arachnoid kunye nezobubanzi zihlala khona, ukuhamba kwegazi akubalulekanga ngoba i-CSF inikezela ezininzi izondlo.
Pathophysiology
Iimathambo ze-epidural zivela ekuthinzeni intloko. Ngokuqhelekileyo kuthatha isiphumo esihle kakhulu sokwenza i-hematoma ye-epidural, kodwa kukho iimeko ezingenza kube lula ukuba umntu akhuphe ukuphuma kwegazi ngaphandle kwexesha elide. Izigulane ezinokuphazamiseka kwegazi okanye abo bathatha igazi abaxhamli begazi, umzekelo, banomngcipheko omkhulu we-hematomas epidural kunabantu bonke. Izigulane eziguga kunye nezigulane ezineembali zokusetyenziswa kakubi kotywala nazo ziyakuthi zenzeke.
Xa isigulane sitshitshiswa kanzima ukuze siphume umkhumbi wegazi ngaphandle kwexesha elide, ukuphuma kwamanzi kuya kufakwa ngokukhawuleza kwisithuba esiphakathi kwendoda kunye nexesha elide, ukwahlula ezimbini.
Ikhayi ayikho ndawo. Kunzima kwaye akuxoleli, akunakwenzeka ukuba uhambe kakhulu. Umlingani osisigxina naye unzima kakhulu, kodwa unika kakhulu kwaye uya kulahleka lo mgangatho othile. Njengoko igazi liqokelela phakathi kwexesha elide kunye nekhanga, umlenze ohlala phambili uhamba waya kwiziko lekratshi, ebeka ingcinezelo kwingqondo.
Izimpawu kunye neMpawu
Konke ukulimala kwengqondo kuphazamisa kakhulu ngendlela efanayo, kunye nempawu kunye neempawu ezifanayo. Bonke banokudibanisa oku kulandelayo:
- ukulahleka kwengqondo
- ukungcola
- intloko
- isicupunu kunye nokuhlanza
- kudideka
Oku kwenza kube nzima ukuchazela umahluko phakathi kweentlobo ezahlukeneyo zokulimala kwengqondo ngaphandle kokwenza i-CT scan ye-krikri.
Ngamanye amagama, awukwazi ukuxelela ukuba i-hematoma epidural kwindawo yokulimala. Umntu kufuneka abonakale kwisebe elingxamisekileyo.
Ngaphandle, kukho iimpawu kunye neempawu eziphazamisayo ezifunekayo zibe ziflegi ezinkulu ezibomvu emva kokuba isigulane sithinte kanzima kwi-noggin. Ezi zibandakanya: abafundi abangalinganiyo (enye inkulu kunomnye), uxinzelelo oluphezulu lwegazi, i-pulse epholileyo kunye neyomeleleyo, okanye isiguli asikwazi ukuvuka.
Esinye isibonakaliso esicacileyo se-hematoma ye-epidural ebizwa ngokuthi "Talk and Die Syndrome". Libhekisela kwiingcamango zobuchopho zibiza umnqweno. Ngamanye amagama, isigulane sitshitshiswa, siphakamise kwaye sibonakale silungile, kwaye siphinde siphumelele ukuqonda. Olu nxu lumisa kakhulu i-hematoma epidural ekhula ngokukhawuleza kwaye kaninzi iyindlela yokuhlukanisa phakathi kwengxube kunye nokulimala kakhudlwana kwengqondo .
Uncedo lokuqala loNcedo
Uncedo lokuqala kwi-hematoma ye-epidural iyancipha ukunyamekela nayiphi na inzakalo. Okubaluleke kakhulu, qaphela ukuba umntu ulahlekelwa ingqalelo. Nabani na olahlekelwa ingqondo uya kukhwela esibhedlele kwi-ambulensi. Shayela u-911 nabani na okhonkqiswayo ngaphandle kokuvuthwa entloko. Akukho sizathu sokugcina umntu onokulimala ngengqondo, kodwa kufuneka ukhangele ukuze ubone ukuba ungazivusa ngezikhathi ezithile.
Unyango lwe zi bhedlele
Ii-hematomas eziphambili ze-epidural zidinga ukuhlinzwa ukuze zikhuphe igazi kwaye zikhulule uxinzelelo kwingqondo. Ixesha linengqondo kule meko, nje nge-stroke. Abagqirha baya kususa isahluko segazi kunye ne-hematoma. Emva koko, umdaka ungadinga ukufakelwa usuku okanye okanye ukuvumela ukuphuma kwamanzi okongeziweyo.
> Imithombo:
> Kang, J., Hong, S., Hu, C., Pyen, J., Whang, K., & Cho, S. et al. (2015). Uhlalutyo lwezonyango lweDemedical Surgical Epidural Hematoma. I-Korean Journal Ye-Neurotrauma , 11 (2), 112. i-doi: 10.13004 / kjnt.2015.11.2.112
> Nguyen, H., Li, L., Patel, M., & Mueller, W. (2016). Amanqanaba okunyaniseka kunye ne-tomography ekhompyutheni kwizigulane ezine-hematoma eyongezelelekileyo inokulinganisela ubuninzi beqondo lobuchopho. I-Neuroradiology Journal , 29 (5), 372-376. i-doi: 10.1177 / 1971400916658795
> USribnick, E., uDhall, S., noHanfelt, J. (2015). Isilinganisi sekliniki ukunxibelelana ngokukhawuleza ngokukhawuleza kokulimala kwengqondo: Ukufunda kwangaphambili. I-Neurology International , 6 (1), 1. i-doi: 10.4103 / 2152-7806.148541