Izimpawu, Izimpawu, Nokunakekelwa
Igama elithi epidural hematoma libhekisela ekuhlanganiseni igazi (hematoma) ngaphandle kwenkathi yokugcina (epidural). Yisibonelo esisodwa sokuhlukunyezwa kwekhanda elivaliwe , elihlanganisa nama-hematomas angaphansi kwe-subdural kanye nokulimala kwamaphesenti angaphansi kwe-arachnoid.
Ukulimala kwekhanda , kuvinjelwe ukulimala kwengqondo ebuhlungu , kuvela ekuhlukumezeni okungahambi kahle kuya ku-noggin okuholela ekuvupheni kobuchopho. Okubangela ukuthi ukuvuvukala-igazi, uketshezi, ukuvuvukala, njll-kuxhomeke ekutheni kutholakala kuphi ngaphakathi kwe-cranium umonakalo.
I-cranium yindawo evaliwe, yingxenye enkulu. Yingxenye ye-skull efaka ubuchopho. Esinye isigamu se-skull sakhiwa amathambo ebuso. Konke, kunamathumba ayisishiyagalombili ama-cranial (okubanzi, amapulethi aqoshiwe) ahlanganiswa ukwenza ibhakede elingenalutho lebhokisi lobuchopho bakho.
I-Meninges
Uma ubuchopho buhlala ngokumelene ne-skull, buzolimala njalo uma uhamba noma ugoqa ikhanda lakho. Ukugwema leyo nkinga, nokusiza ukugeleza kwegazi, ngaphakathi kwe-cranium kuhlanganiswe nekhanda elimnyama, elinzima elibizwa ngokuthi i- dura mater (latin for mother mother). Ingxenyeni engaphandle kwe-cushion yobukhulu obuphakathi kathathu phakathi kobubele bobuchopho kanye nobunzima obungasuswe be-skull. Lezi zigaba zibizwa ngokuthi yi- meninges . Ama-meninges awahlanganisi ubuchopho kuphela, kodwa futhi umgogodla.
Ngenkathi i-long mater igxilile i-cranium, kune-membrane encane kakhulu ehlanganisa izicubu zobuchopho.
Le membrane ibizwa ngokuthi i- too mater (latin for umama omncane). Kuyinto encane kangangokuthi ilandela impikiswano yobuchopho kufaka phakathi ama-nooks nama-jrannies emiphakathini yobuchopho.
Phakathi kwenkimbinkimbi enamandla yokuqina nokuqina okunamathelayo, kukhona uhla lwe-spongy olubizwa ngokuthi i- arachnoid ngenxa yokubukeka kwe-web.
Isendlalelo se-arachnoid sinikeza umkhombandlela emkhatsini we-mater asekugcineni kanye ne-mater too. Isakhiwo sawo esibuhlungu sivumela ukugeza okunomsoco we-cerebrospinal fluid (CSF) ukugeleza kuyo.
Iningi lokugeleza kwegazi emalenzeni livela engxenyeni engaphandle yomuntu ohlala isikhathi eside. Yilapho izidakamizwa ezivela emhlabeni ongaphandle kobuchopho ziyakwazi ukuletha igazi ekugxilweni kwezinto okusobala ukuthi isitho esibaluleke kakhulu emzimbeni. Ngaphansi komsila wokugcina, lapho izingqimba ze-arachnoid nezama-mater zihlala khona, ukugeleza kwegazi akubalulekile ngoba i-CSF inikeza kakhulu izakhi.
I-Pathophysiology
Ama-hematomas e-Epidural avela ekutheni afike ekhanda. Ngokuvamile kuthatha inqwaba ephawulekayo yokwakha i-hematoma ye-epidural, kodwa kunezimo ezingenza kube lula kumuntu ukuba athuthukise ukuphuma kwegazi ngaphandle kwesikhashana. Iziguli ezinezinkinga zokuphuma kwegazi noma labo abathwala igazi, isibonelo, basengozini enkulu ye-epidural hematomas kunabanye abantu. Iziguli ezigugile kanye neziguli ezinomlando wokuphuza utshwala obunzima nazo ziyingozi kakhulu.
Uma isiguli sishaya kanzima ngokwanele ukuze siphume umkhumbi wegazi ngaphandle komuntu ohlala isikhathi eside, ukuphuma kwegazi kuzongena ngokushesha esikhaleni esingaba khona phakathi kwe-skull ne-dura mater, ehlukanisa lezi zibili.
I-skull ayikho ndawo. Kulukhuni futhi akuthetheleli, kungenakwenzeka ukuhambisa okuningi. I-mater yokugcina iphinde ibe yinhle, kodwa iningi linikeza futhi lizolahlekelwa lokhu okumele kube khona. Njengoba igazi liqoqa phakathi kwe-mater kanye ne-skull, i-mater ehlala isikhathi eside isondela enkabeni ye-cranium, ibeka ingcindezi ebuchosheni.
Izimpawu Nezibonakaliso
Zonke ukulimala kobuchopho ezibuhlungu zikhona kakhulu ngendlela efanayo, ngezimpawu nezimpawu ezifanayo kakhulu. Zonke zinokuhlanganiswa okulandelayo:
- ukulahlekelwa kokwazi
- isiyezi
- ikhanda
- isicanucanu nokuhlanza
- ukudideka
Lokhu kwenza kube nzima ukutshela umehluko phakathi kwezinhlobo ezahlukene zokulimala komqondo ongathinteki ngaphandle kokwenza i-CT scan ye-cranium.
Ngamanye amazwi, awukwazi ukutshela ukuthi i-hematoma ye-epidural endaweni yesehlakalo sokulimala. Lo muntu udinga ukubonakala emnyangweni ophuthumayo.
Ngaphandle kwalokho, kunezinye izimpawu nezimpawu eziphazamisayo okufanele zibe yizigqila ezinkulu ezibomvu ngemuva kokuba isiguli sithinte kanzima ku-noggin. Lokhu kufaka phakathi: abafundi abangalingani (eyodwa inkulu kunomunye), umfutho wegazi ophakeme kakhulu, impuphu ephuthumayo nangokwengeziwe, noma isiguli asikwazi ukuvuka.
Esinye isibonakaliso esivelele kakhulu se-epidural hematoma sibizwa ngegama elithi "Talk and Die Syndrome." Libhekisela kulokho odokotela abahlinzayo bobuchopho babiza ukukhishwa isikhathi eside. Ngamanye amazwi, isiguli sitholwa ngaphandle, siphakamise futhi sibonakale silungile, bese siphinde silahlekelwe. Le nhlanganisela iphakamisa kakhulu i-hematoma ye-epidural ekhula ngokushesha kakhulu futhi ngokuvamile iyindlela yokuhlukanisa phakathi kokuncintisana nokulimala okungathí sina kobuchopho .
Usizo lokuqala lokuqala
Usizo lokuqala lwe-hematoma ye-epidural inomkhawulo wokunakekela noma yikuphi ukulimala. Okubaluleke kakhulu, qaphela uma lo muntu elahlekelwa ukuqonda. Noma ubani olahlekelwa yinkinga uthola ukugibela esibhedlela i-ambulensi. Shayela u-911 kunoma ubani oshayiswayo ngaphandle kokushaywa ikhanda ekhanda. Asikho isizathu sokugcina umuntu ongalimala ebuchosheni aphapheme, kodwa kufanele uhlole ukuthi uzobavusa ngezikhathi ezithile.
Ukwelapha Isibhedlela
I-hematomas eyingozi kakhulu ye-epidural idinga ukuhlinzekwa ukukhipha igazi futhi ikhulule ingcindezi ebuchosheni. Isikhathi ubuchopho kulokhu, njengokufana nesifo sohlangothi. Odokotela abahlinzayo bazosusa ingxenye ye-skull bese bekhipha i-hematoma. Ngemuva kwalokho, ukudonsa kungadingeka ukuthi kufakwe usuku noma ngaphezulu ukuvumela noma yikuphi ukwelapha okwengeziwe.
> Imithombo:
> Kang, J., Hong, S., Hu, C., Pyen, J., Whang, K., & Cho, S. et al. (2015). Ukuhlaziywa Kwemitholampilo YeHematoma Yokuphefumula Yokuphelelwa Isikhathi Esincane. I-Korean Journal Of Neurotrauma , 11 (2), 112. ini: 10.13004 / kjnt.2015.11.2.112
> Nguyen, H., Li, L., Patel, M., & Mueller, W. (2016). Izilinganiso zesilinganiso nge-tomography ye-computed kwiziguli ezine-hematoma eyengeziwe-ye-hematoma zingalinganisa isilinganiso sezinga lokucindezeleka kobuchopho. I-Neuroradiology Journal , 29 (5), 372-376. i-doi: 10.1177 / 1971400916658795
> USribnick, E., uDhall, S., & Hanfelt, J. (2015). Isilinganiso somtholampilo ukuxhumana ngokuphuthumayo okuhlinzekwa ukulimala kwengqondo ebuhlungu: Isifundo sokuqala. I-Neurology International , i- 6 (1), i-doi: 10.4103 / 2152-7806.148541