Subdural hematoma

A subdural hematoma muunganidzwa weropa pakati pekuvhara kwehuropi (dura) uye nepamusoro pehuropi.

Iyo subdural hematoma inowanzo kuve mugumisiro wekukuvara kwakanyanya kwemusoro. Iyi mhando ye subdural hematoma iri pakati pekufa kwekukuvara kwemusoro kwese. Kubuda ropa kunozadza nzvimbo yehuropi nekukasira, kumanikidza hura hwehuropi. Izvi zvinowanzo guma nekukuvara kwehuropi uye zvinogona kutungamira kurufu.

Subdural hematomas inogona zvakare kuitika mushure mekukuvara kwemusoro mudiki. Kuwanda kwekubuda ropa kudiki uye kunoitika zvishoma nezvishoma. Iyi mhando ye subdural hematoma inowanzoonekwa kune vakuru vakuru. Izvi zvinogona kuenda zvisingazivikanwe kwemazuva mazhinji kusvika kumavhiki uye zvinodaidzwa zvinonzi chronic subdural hematomas.

Iine chero subdural hematoma, tutsinga tudiki pakati pechiso chehuropi uye nekunze kwekufukidza (iyo dura) inotambanuka uye kubvaruka, ichibvumira ropa kuti riunganidze. Muvakuru vakura, tsinga dzinowanzove dzakatambanudzwa nekuda kwehuropi shrinkage (atrophy) uye zvinokuvara zviri nyore.

Dzimwe subdural hematomas dzinoitika pasina chikonzero (zvoga).

Izvi zvinotevera zvinowedzera njodzi yeiyo subdural hematoma:

• Mishonga inotetepa ropa (senge warfarin kana aspirin)
• Yenguva refu-doro kushandisa
• Mamiriro ekurapa anoita kuti ropa rako rigadzike zvakanaka
• Kudzokorora kukuvara kwemusoro, senge kubva kudonha
• Mudiki kwazvo kana kuchembera zvakanyanya

Mune vacheche uye vana vadiki, iyo subdural hematoma inogona kuitika mushure mekushungurudzwa kwevana uye inowanzoonekwa mune inonzi inonzi shaken baby syndrome.

Zvichienderana nesaizi yehematoma uye painomanikidza pauropi, chero cheanotevera zviratidzo anogona kuitika:

• Kuvhiringidzika kana kutaura kusanzwisisika
• Matambudziko nekuenzanisa kana kufamba
• Kutemwa nemusoro
• Kushaya simba kana kuvhiringidzika
• Kufenda kana kurasikirwa kwekuziva
• Kusvotwa uye kurutsa
• Kushaya simba kana chiveve
• Matambudziko ekuona
• Maitiro ekuchinja kana psychosis

Muvacheche, zviratidzo zvinogona kusanganisira:

• Kubhururuka fontanelles (iwo akapfava mavara ehenya remwana)
• Akaparadzaniswa suture (iyo nzvimbo panokura dehenya mapfupa anobatana)
• Matambudziko ekudyisa
• Kufenda
• Kuchema kwepamusoro-soro, kusagadzikana
• Yakawedzera musoro saizi (denderedzwa)
• Kuwedzera kurara kana kuneta
• Kuramba uchirutsa

Wana rubatsiro rwechiremba ipapo mushure mekukuvara kwemusoro. Usanonoka. Vakwegura vakuru vanofanirwa kupihwa kurapwa kana vachiratidza zviratidzo zvematambudziko ekurangarira kana kudzikira kwepfungwa, kunyangwe kana vachiratidzika kunge vasina kukuvara.

Iye wekuchengetedza hutano angango kuraira bvunzo yekufungidzira yehuropi, senge CT kana MRI scan, kana paine chero ezviratidzo zvakanyorwa pamusoro.

Iyo subdural hematoma ndeye emergency mamiriro.

Kuvhiyiwa kwechimbichimbi kunogona kudikanwa kudzikisa kumanikidza mukati meuropi. Izvi zvinogona kusanganisira kuchera gomba mu dehenya kubvisa chero ropa uye kubvisa kumanikidza uropi. Makuru mahematoma kana akasimba eropa clots angangoda kubviswa kuburikidza nenzira inonzi craniotomy, iyo inogadzira kuvhurika kukuru mudehenya.

Mishonga inogona kushandiswa inoenderana nerudzi rwe subdural hematoma, kuti yakanyanya sei zviratidzo, uye kuwanda kwehuropi kwakaitika. Mishonga inogona kusanganisira:

• Diuretics (mapiritsi emvura) uye corticosteroids yekudzora kuzvimba
• Mishonga yekudzivirira kudzora kana kudzivirira kubata

Maonero anoenderana nerudzi uye nzvimbo yekukuvara kwemusoro, saizi yekuunganidzwa kweropa, uye nekukurumidza kurapwa kwatanga.

Acute subdural hematomas ane akakwira mwero yekufa uye kukuvara kwehuropi. Chronic subdural hematomas ine mhedzisiro iri nani muzviitiko zvakawanda. Zviratidzo zvinowanzoenda mushure mekuunganidzwa kweropa. Kurapa kwepanyama dzimwe nguva kunodiwa kubatsira munhu kuti adzokere padanho ravo rekuita.

Kufenda kunowanzoitika panguva iyo hematoma mafomu, kana kusvika kumwedzi kana makore mushure mekurapwa. Asi mishonga inogona kubatsira kudzora pfari.

Matambudziko anogona kuguma anosanganisira:

• Brain herniation (kumanikidza uropi zvakakomba zvakakwana kukonzeresa kufa uye kufa)
• Zviratidzo zvinoramba zvakaita sekurangarira, dzungu, kurwadziwa nemusoro, kushushikana, uye kunetseka kuisa pfungwa
• Kufenda
• Ipfupi-yenguva kana kusingaperi kushaya simba, chiveve, kunetsekana kutaura

A subdural hematoma chirwere chekukurumidzira. Fonera 911 kana yako yemuno nenjodzi nhamba, kana enda kuchimbichimbi kamuri mushure mekukuvara kwemusoro. Usanonoka.

Kukuvara kwepamuviri kunowanzoitika nekukuvara mumusoro, saka edza kuchengeta mutsipa wemunhu wakadzikama kana uchifanira kuuendesa rubatsiro risati rasvika.

Nguva dzose shandisa midziyo yekuchengetedza pabasa uye tamba kudzikisa njodzi yako yekukuvara musoro. Semuenzaniso, shandisa ngowani dzakaoma, bhasikoro kana ngowani dzemudhudhudhu, uye mabhandi echigaro. Vakwegura vanofanirwa kungwarira kuti vasadonhe.

Subdural hemorrhage; Kunetseka kwehuropi kukuvara - subdural hematoma; TBI - subdural hematoma; Kukuvara kwemusoro - subdural hematoma

• Kuvhiya kwehuropi - kubuda

• Subdural hematoma
• Kuwedzera kwekumanikidza kushushikana

Papa L, Goldberg SA. Kushungurudzika kwemusoro. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 34.

Stippler M. Craniocerebral kushungurudzika. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits. 62.