Epidural hematoma

Epidural hematoma (EDH) iri kubuda ropa pakati pemukati mehenya uye chifukidziro chekunze chehuropi (chinonzi iyo dura).

EDH inowanzo kukonzerwa nekutsemuka kwedehenya panguva yehudiki kana kuyaruka. Iyo membrane inovhara huropi haina kunyatsosunganidzwa ne dehenya sezvazviri mune vanhu vakuru uye vana vadiki pane makore maviri. Naizvozvo, rudzi urwu rwekubuda ropa rwunowanzoitika kune vechidiki.

EDH inogonawo kuitika nekuda kwekutsemuka kweropa tsinga, kazhinji tsinga. Mudziyo weropa unobva wabuda ropa mukati mepakati peiyo nguva uye dehenya.

Midziyo yakakanganiswa inowanzo bvaruka nekutsemuka kwedehenya. Kutsemuka kunowanzo kuve chikonzero chekukuvara kwakanyanya mumusoro, senge izvo zvinokonzerwa nemudhudhudhu, bhasikoro, skateboard, chando kukwira, kana tsaona dzemotokari.

Kukurumidza kubuda ropa kunokonzera kuunganidzwa kweropa (hematoma) iro rinodzvanya pahuropi. Iko kumanikidza mukati memusoro (kusagadzikana kwekumanikidza, ICP) kunowedzera nekukurumidza. Iko kumanikidza kunogona kukonzera kukuvara kwehuropi kwakawanda.

Bata mutano wehutano kune chero kukuvara kwemusoro kunoguma nekurasikirwa kupfupi kwekuziva, kana kana paine zvimwe zviratidzo mushure mekukuvara kwemusoro (kunyangwe pasina kurasikirwa kwekuziva).

Izvo zvakajairika maitiro ezviratidzo zvinoratidza iyo EDH kurasikirwa kwekuziva, kunoteverwa nekungwarira, uye kurasikirwa kwekuziva zvakare. Asi iyi pateni INOGONA kuoneka muvanhu vese.

Zviratidzo zvakakosha zveEDH ndezvi:

• Kuvhiringidzika
• Dzungu
• Kukotsira kana danho rakachinjika rekusvinura
• Akawedzera mudzidzi mune rimwe ziso
• Musoro (wakakomba)
• Kukuvara kwemusoro kana kushungurudzika kunoteverwa nekurasikirwa nekuziva, nguva yekusvinura, uye nekukurumidza kudzikira kudzoka mukusaziva
• Kusvotwa kana kurutsa
• Kushaya simba mune chimwe chikamu chemuviri, kazhinji kune iro divi rakatarisana kubva kudivi nemudzidzi akawedzerwa
• Kugwinha kunogona kuitika semhedzisiro yemusoro kukanganisa

Zviratidzo zvinowanzoitika mukati memaminitsi kusvika maawa mushure mekukuvara kwemusoro uye zvinoratidza mamiriro ekukurumidzira.

Dzimwe nguva, kubuda ropa hakutange kwemaawa mushure mekukuvara kwemusoro. Zviratidzo zvekumanikidza pahuropi zvakare hazviitike ipapo.

Uropi uye hunyanzvi system (neurological) kuongororwa kunogona kuratidza kuti chimwe chikamu cheuropi hachishande zvakanaka (semuenzaniso, panogona kunge paine kushomeka kwemaoko kune rumwe rutivi).

Bvunzo dzinogona zvakare kuratidza zviratidzo zvekuwedzera ICP, senge:

• Kutemwa nemusoro
• Kusaziva
• Kuvhiringidzika
• Kusvotwa uye kurutsa

Kana paine yakawedzera ICP, kuvhiya kwechimbichimbi kungangodikanwa kudzikamisa kumanikidza uye kudzivirira kumwe kukuvara kwehuropi.

Musoro usingaenzanise musoro CT scan unosimbisa kuongororwa kweEDH, uye unonongedzera chaiko nzvimbo yehematoma uye chero yakabatana dehenya kuputsika. MRI inogona kubatsira kubatsira kuona madiki madiki hematoma kubva kune epasi.

Iyo EDH mamiriro ekukurumidzira. Zvirongwa zvekurapa zvinosanganisira:

• Kutora matanho ekuchengetedza hupenyu hwemunhu
• Kudzora zviratidzo
• Kuderedza kana kudzivirira kukuvara zvachose kuuropi

Hupenyu hutsigiro matanho anogona kudikanwa. Kuvhiyiwa kwechimbichimbi kunowanzo fanirwa kudzikisira kumanikidza mukati mehuropi. Izvi zvinogona kusanganisira kuchera gomba mu dehenya kubvisa kushushikana uye kubvumira ropa kubuda kunze kwehenya.

Makuru mahematoma kana akasimba eropa clots angangoda kubviswa kuburikidza nekuvhurwa kukuru muhadehenya (craniotomy).

Mishonga inoshandiswa kuwedzera pakuvhiya ichasiyana zvichienderana nerudzi uye kuomarara kwezviratidzo uye kukuvara kwehuropi kunoitika.

Mishonga yekudzivirira hutachiona inogona kushandiswa kudzora kana kudzivirira kubatwa. Mimwe mishonga inonzi hyperosmotic agents inogona kushandiswa kudzikisira kuzvimba kwehuropi.

Kune vanhu pane vanoonda ropa kana vane dambudziko rekubuda ropa, kurapwa kwekudzivirira kumwe kubuda kweropa kungangodiwa.

EDH ine njodzi huru yekufa pasina kupindira kwekukurumidza kwekuvhiya. Kunyangwe nekukurumidza kurapwa, njodzi yakakura yekufa nekuremara inoramba iripo.

Pane njodzi yekukuvara kwehuropi zvachose, kunyangwe EDH ikarapwa. Zviratidzo (sekubatwa) zvinogona kuenderera kwemwedzi yakati wandei, kunyangwe mushure mekurapwa. Nekufamba kwenguva dzinogona kushomeka kana kunyangarika. Kugwinha kunogona kutanga kusvika makore maviri mushure mekukuvara.

Muvanhu vakuru, kupora kwakawanda kunoitika mumwedzi mitanhatu yekutanga. Kazhinji pane kumwe kuvandudzwa pamusoro pemakore maviri.

Kana paine kukuvara kwehuropi, kupora kuzere hakugone. Zvimwe zvinetso zvinosanganisira zviratidzo zvechigarire, zvakadai se:

• Herniation yehuropi uye zvachose coma
• Chaizvoizvo kumanikidza hydrocephalus, iyo inogona kukonzeresa kushaya simba, kutemwa nemusoro, kusagadzikana, uye kunetsekana kufamba
• Kuoma mitezo kana kurasikirwa kwekunzwa (kwakatanga panguva yekukuvara)

Enda kuimba yekukurumidzira kana kufonera 911 kana iyo yemuno emergency emergency kana zviratidzo zveEDH zvikaitika.

Kukuvara kwepamuviri kunowanzoitika nekukuvara kwemusoro. Kana iwe uchifanira kufambisa munhu rubatsiro risati rasvika, edza kumuchengeta mutsipa wake wakadzikama.

Fonera mupiki kana izvi zviratidzo zvichiramba mushure mekurapwa:

• Kuyeuka ndangariro kana matambudziko ekutarisa
• Dzungu
• Kutemwa nemusoro
• Kufunganya
• Zvinetso zvekutaura
• Kurasika kwekufamba mune chimwe chikamu chemuviri

Enda kuimba yekukurumidzira kana kufonera 911 kana nhamba yemuno yechimbichimbi kana zviratidzo izvi zvikamuka mushure mekurapwa:

• Kunetseka kufema
• Kufenda
• Akawedzera vadzidzi vemeso kana vadzidzi havana kukura zvakaenzana
• Kuderera kwekuteerera
• Kurasikirwa kwekuziva

Iyo EDH inogona kunge isingadziviririke kana kukuvara kwemusoro kwaitika.

Kuti uderedze njodzi yekukuvara mumusoro, shandisa yakakodzera michina yekuchengetedza (senge ngowani dzakaoma, bhasikoro kana maheti emudhudhudhu, uye mabhandi echigaro

Tevedza chengetedzo pabasa uye mumitambo nekutandara. Semuenzaniso, usadonhera mumvura kana kudzika kwemvura kusingazivikanwe kana kana matombo angave aripo.

Hematoma yekuwedzera; Kuwanda kweropa; Epidural hemorrhage; EDH

National Institute yeNeurological Dambudziko uye Stroke webhusaiti. Inotambudza kukuvara kwehuropi: tariro kuburikidza nekutsvaga. www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Traumatic-Brain-Injury-Hope-Through. Yakagadziridzwa Kubvumbi 24, 2020. Yakasvika munaNovember 3, 2020.

Shahlaie K, Zwienenberg-Lee M, Muizelaar JP. Clinical pathophysiology yekushungurudzika kwepfungwa kukuvara. Mune: Winn HR, ed. Youmans uye Winn Neurological Kuvhiya. 7th ed. Philadelphia, PA: Elsevier; 2017: chits. 346.

Wermers JD, Hutchison LH. Kushungurudzika. Muna: Coley BD, rakanyorwa. Caffey Pediatric Kuongorora Kufananidza. 13 ed. Philadelphia, PA: Elsevier; 2019: chitsiko 39.