Enye inokukhokelela nakwezinye, kodwa ayifani
Ukulimala kweNtloko kunye nokulimala kwengqondo yomonakalo yimiqathango emibini ibonisa iingxaki ezinzulu ngengqondo yesigulane kunye nokukwazi kwakhe ukubuyisela nokuphila ubomi obuqhelekileyo ngaphezu kwexesha elide. Ukulimala kwengqondo ngokugqithiseleyo kukubhekiselele kwingxaki yengqondo ekhokelela kwintlobo yokulahleka ngonaphakade (ukulahleka kwexesha elide lomsebenzi).
Kwiminyaka eyadlulileyo, ukulimala kwentloko evaliweyo kwakusisigama esivame ukusetyenziswa ukuchaza imoto (ukunyakaza kwemisipha) kunye nokuqonda (ukukwazi ukuva, ukubona, ukuthintela, ukunambitha, okanye ukuvumba) iintlobo zokulimala.
Ukuqonda indlela ukulimala kwentloko kwahluke ngayo ukulimala kongqondo kubandakanya ukuqonda okusemgangathweni kwintsimbi kunye neengqondo. Igoyi yimeko egcina kwaye ikhusela ingqondo.
Ikhanga neBongo: Akunjalo
Ikhayi yinkqubo efanelekileyo kakhulu ukukhusela ubuchopho bethu kumonakalo. Yenziwe ngamathambo athile ahlanganisene kunye (oko kuthetha ukuba baye bakhula ndawonye, kungekhona ukuba umntu wawafaka ndawonye). Ikhanga (eyaziwa nangokuthi i- kribri ) inomkhono phezu kwengqondo eyenziwe ngamathambo amane, aphilileyo, aphilileyo abizwa ngokuba yi-frontal, kwesokudla nangesobunxele, kunye namathambo e-occipital. Isiseko sekhayi senziwe ngamathambo amaninzi, kuquka i-ethmoid, i-temporal, inxalenye yecala, kunye nenye ye-occipital. Ingqondo ihlala phezu kwesiseko skull kunye nekhanda lekhayi ikhula phezu kwengqondo ukuyikhusela kwingozi. Konke, ingqondo igxininiswe ngokupheleleyo kwithambo xa zonke i-anatomy zikhoyo kwaye zingenakonakaliswa.
Iintlobo zoKhuselo
Ukwakhiwa ukusuka ngaphandle, ngaphakathi kwekhayi kuhlanganiswe nomlenze onzima obizwa ngokuba ngumama wokugcina (translation literal latin: umama onzima). Ngaphantsi kweqabane lexesha elide liyi- mater (umama omncinci) kunye naphakathi kwexesha elide kunye nebala elifanayo kunye nocingo lwe-arachnoid, uluhlu lwesiponysi olubizwa ngokuba lufana ne-spiderweb xa lubonwa phantsi kwe-microscope.
Iimbumba ezintathu ziyaziwa ngokuba yi-meninges kwaye zinika ukhuseleko kunye nezondlo kwiingqondo. I-Cerebrospinal fluid igeleza ngqongquthela lwe-arachnoid, ihlamba ingqondo kwishukela kunye nezondlo. Umkhuhlane uvumela ingqondo ukuba ihambe kwaye isilayidi ngaphandle kokulimala ukusuka kumabhobho amancinci kunye nokuhamba. Igazi ligeleza ngokusebenzisa ama-mening kunye nengqondo. Kwiimeko ezininzi, ukuphuma kwegazi kubangelwa ukulimala kwentloko.
Ukulimala kweNtloko
Yonke loo bone ayikuxolelanga kakhulu xa kuziwa ukuvuvukala okanye ukuphaphaza ngaphakathi kwekhayi. Ithefu linomfanekiso walo kwaye alivumeli nayiphi na ingcinezelo yokukhululeka xa kwenzeka ukuphuma. Njengoko igazi liqokelela ngaphakathi kwekhanga, ukunyuswa kwengcinezelo kubangela ingqondo, eyonakalisa iicyunu zengqondo.
Ngaphandle kwegazi, ezinye iimfudu ziyakwazi ukuqokelela ngaphakathi kwekrele kwaye zidale umonakalo wezicubu zengqondo. Ingqondo ewonakalisiweyo ingakhula kwezinye izifo kunye noxinzelelo olubangelwayo lunokubangela uxinzelelo olongezelelweyo kwiisisu zengqondo. Esi siprofeto esizizalisayo; Ukuvuvukala kubangela ukulimala, okubangela ukuvuvukala.
Ngethuba nje ikheki lihambile, naluphi na uhlobo lokuphaphaza okanye ukuvuvukala ngaphakathi kwekhayi elifakwe kulo lukhokelela kule nkxininiso eyongeziweyo. Ekubeni ingqayi ingacacile, sibiza ukuba ukulimala kwentloko.
Ngamanye amazwi, i-gawu ayivumeli uxinzelelo ukuba lukhutshwe njengegazi okanye umbane uqokelela ngoba "kuvaliwe" kunokuba "kuvulwe" (ukuphuka kwithengi ukuvumela igazi okanye umbane ukuba uphume kwi-kkull kwaye unciphise uxinzelelo).
Kwiqhekeza elivulekile, ukutyhoboza okanye iindawo eziqhelekileyo ze-skull ezingekhoyo zikhokelela kumanzi olahlekileyo okanye igazi kwingqondo. Kufana nje nomonakalo kumsebenzi wengqondo, kodwa ukulimala kwentloko evaliweyo kuchazwe ngokwenene ngongcinezelo ophezulu.
Iintlobo zeeNyango zeNtloko eziValiweyo
Uxinzelelo ngaphakathi kwekhayi luvela kwizimbangela ezininzi, kodwa iintlobo eziqhelekileyo ziphuma ekuphumeni kwegazi ngaphakathi kwegazi (ekuthiwa yi-hemorrhage).
Iimpawu ze -hematomas ezisezantsi kunye nezidalwa zemizimba ziyimimiselo yokuphaphaza ngaphakathi kwe-gace (hematoma), mhlawumbi ngaphezulu okanye ngaphantsi kwexesha elide.
Ukuhlamba ngaphezu kwexesha elide (i-epidural) liphuma ekunikezeni igazi ngegazi, elinamandla kunamandla kunye nokuphuma kwegazi kunokugqithisa. Ukuhlamba okuvela ngaphantsi kwexesha elide (i-subdural) i-venous, ehamba ngokukhawuleza kwaye ithatha ixesha elide ukuba liqoke ngaphakathi kwekhayi.
Ngaphandle kwamathambo e-subdural and epidural hemomas, kunokuphinda kube nokuphuma kwegazi kunzulu kunomgca we-arachnoid kunye ( ukuphahlazeka kwamathambo ). Inxulumene nantlungu okanye iimeko ezithile zezokwelapha ezifana ne-cerebral aneurysm okanye i-arteriovenous malformation (AVM), zombini leyo inokukhokelela kwisifo esibuhlungu .
Skull Fractures
Ikhanga lilukhuni, kodwa alinakonakala. Iyakwazi ukuphazamiseka okanye ukuphulwa, njengawo nawaphi na amathambo. Ukuqhekeka okanye ukuphuka kwamathambo enkkull kungakhokelela ekuphumeni kwamanzi okanye ukuvuza kwe- cerebrospinal fluid (CSF) ehlamba ubuchopho kwaye iqhube kwiqonga le-arachnoid ye-meninges.
Iingxabano ze-Skull zihlobo olubi kakhulu lokulimala kwentloko. Izona zimbi kakhulu zinokwenza ukuba intloko ibonakale iphosakele ukuba i-kagadi iye yaphuka kabi kangangokuthi ikhupha ithambo. Uninzi lweengxabano zengqayi zibuqili, zibonise ngokwazo iimpawu ezifana negazi okanye i-CSF ephuma ezindlebeni okanye ekhaleni.
Ukuphuka kwamathambo okwenza isiseko sekrele (amathambo apho ubuchopho buhlala khona xa ikhanda lisesimweni esifanelekileyo) kunzima kakhulu ukuchonga. Kule meko, ukuphuma kwi-fracture kungabangela ukuvuthwa kwegazi xa iqokelela igazi emva kweendlebe (uphawu lweMfazwe) okanye ngeenxa zonke (i-periorbital ecchymosis).
Ukunyuka kwe-Intracranial Pressure
Zonke ezi zikhokelela ekunyanzelekeni okongeziweyo ngaphakathi kwegazi ( ingcinezelo ye-intracranial ). I-CSF, kunye negazi eligeleza ngeengxube ezithandelweyo, kufuneka ukuba negalelo elincinci kakhulu, ukuba likhona, kwingqondo ngokwayo. Ukwanda kwe-ICP ekugqibeleni kubangela umonakalo kwengqondo. Nguloo monakalo obaluleke kakhulu.
Ingqondo ayinayo indawo yokuqhuba ngaphakathi kwekhayi kwaye ivumelane nokunyuka kwe-ICP. Kwiimeko ezigqithiseleyo, uxinzelelo ngaphakathi kwintloko lugqithisa ingqondo ekuvulekeni okukhulu kwisiseko skull, ebizwa ngokuba yi-foramen magnum (eguqulelwe ngentsingiselo: enkulu imbobo ). Kule ngxuma ukuba intambo yomgudu ifakwe kwingqondo. Kungaba yinto evulekileyo yokuvula, kodwa sisathetha kuphela ezimbini okanye ezintathu zamentimitha, ngokucacileyo akukho ndawo eyaneleyo yokuba ingqondo yonke iphume.
Njengoko ubuchopho bubaleka nge-foramen magnum, kunqongophe kwaye umonakalo ubangelwa uxinzelelo oluzeleyo kwingqondo yengqondo. Kukho konke, akulungile.
Ukulimala kweBrain Injury
Kuze kube yile ngongoma, yonke ingxoxo ibe yenzakaliswe kwintyikolongo okanye iziqulatho zezicubu ezungeze ingqondo, ukunyanga kwengcinezelo ngaphakathi kwenkqubo yevayiweyo, mhlawumbi ngokuphuma kwamanzi okanye ukuhamba kwamanzi. Naluphina uhlobo loxinzelelo-ngokuthe ngqo okanye ngokungathanga ngqo-kumbandela wengqondo kungabangela ukulimala kuwo.
Ingozi yokulimala kwengqondo: umonakalo kwimizimba yengqondo. Iguqula umsebenzi wengqondo, ngamanye amaxesha ngokusisigxina. Sinokubona umsebenzi oguqulwe ngempawu ezifana nabafundi abangalinganiyo, ubuthakathaka obuthathaka, ukudideka , ukuthetha nzima, ukulahlekelwa kwengqondo , njl. Xa sithetha ngengozi yengqondo, sibiza le miqondiso.
Ngaphandle kweziphulo ezenza izibonakaliso zokulimala kwengqondo, ukulimala kongqondo (TBI) isigulane sinokukhalaza iimpawu. Isigulane se-TBI sinokuzivala kwintloko, isisongomso, ukubona inkathazo, okanye ukukhalaza ezindlebeni (i-tinnitus).
Njengokuba kukho iintlobo ezahlukeneyo zokulimala kwentloko kunye nokulimala kwentloko, kukho iintlobo ezahlukeneyo okanye amanqanaba e-TBI. Ukulimala ngokuqondile kwingqondo (umtsalane wengozi, umzekelo) kunokubangela ukulahleka okungakumbi kunento ethile ephosakeleyo. Enyanisweni, ukulimala kwentloko kubangela ukulimala kwengqondo ngokukhawuleza kangangokuthi kuba lula ukukhumbula ukungaphumeleli okanye isiguli singakwazi ukungaqondi kakuhle ukubaluleka kweempawu.
Coup-Contrecoup
I-Coup-contrecoup (i- coo-contra-coo ebizwa ngokuthi yi- coo-contra-coo ) yinto yokulimala kwingqondo evela ekuvutheni kwentloko. Isigulane sinokuyeka ngokukhawuleza-ukuwa okanye yengozi yemoto-okanye iyakuthatyathwa yinto. Kuwuphi na umzekelo, ingqondo ayitshintshisi isivinini kwisantya esifanayo njengengqayi, ibangela ukuba idibanise ngaphakathi ngaphakathi kwekhredari (ukukhankanya) uze uyibuyisele emva kwaye uyixabise kwicala elincinane le-cranium (contrecoup).
Uhlobo oluqhelekileyo lwe-coup-contrecoup luyingqungquthela . Iingxubusho ngamanye amaxesha zibizwa ngokuba yi- TBI enomoya kwaye zingenakho ukukhokelela kuyo nayiphi na imali ebonakalayo.
Ukugxotha ngaphantsi kwengqondo ngaphakathi kwekrireji kunokukhokelela kuyo yonke into yokuphuma kwegazi engathethekiyo esiyithethayo ngasentla, kodwa nayo ingabangela umonakalo othe ngqo kwingqondo, esiyibona njengento engxamisekileyo. Ukulimala kwe-Coup-contrecoup kuqhelekileyo kwiibhokisi, amajoni, kunye nabadlali bebhola: Nantoni na ekhokelela ekunqongeni nzima kwi-noggin.
Ukubuyiswa kwe-TBI
Ingqondo yinto ephawulekayo. Kwacingelwa iminyaka kangangokuba nayiphi na umonakalo kwengqondo isisigxina, kodwa siyazi kakuhle ngoku. Ingqungquthela, umzekelo, yayingacingi ukuba yinto engumonakalo wengqondo. Oogqirha ngoku bayaqonda ukuba iingxubusho zonakalisa izicubu zengqondo kunye neengqungquthela eziphindaphindiweyo zingaba nemiphumo engunaphakade.
Ngakolunye uhlangothi, umonakalo omkhulu wengqondo obangelwa kukulimala kwentloko-njenge-hematoma-epidural-inokuphulukisa kwaye ngokuqhelekileyo, ngokuhamba kwexesha, kulunge. Isigulane singenakubuyela kumsebenzi wokuqala we-TB, kodwa ubuchopho buyakwazi ukuziphilisa ngendlela ecacileyo. Njengoko imisipha kufuneka inselele ngonyango oluthile ukuze lomelele, ingqondo kufuneka inselele ngonyango lwengqondo ukulungisa ezo nxu lumano.
> Imithombo:
> Kucera, K., Yau, R., Bhalisa-Mihalik, J., Marshall, S., Thomas, L., & Wolf, S. et al. (2017). Ubunzima obubuhlungu kunye nentambo yomgada Ukufa phakathi kwabaPhakamileyo beSikolo kunye neKholeji yeBhola bebhola Abadlali base-United States, 2005-2014. MMWR. Ukuxhatshazwa kunye nokufa kweveki yeveki , 65 (52), 1465-1469. i-doi: 10.15585 / mmwr.mm6552a2
> Soberg, H., Roe, C., Brunborg, C., von Steinbüchel, N., & Andelic, N. (2017). I-Norwegian version ye-QOLIBRI - isifundo seempawu zeetriki ezixhomekeke kwiinyanga ezili-12 ezilandelelweyo zabantu abanokulimala kwengqondo ebuhlungu. Impilo kunye neMigangatho yeZiphumo zoBomi , 15 (1). i-doi: 10.1186 / s12955-017-0589-9