I-hematoma engaphantsi

I-hematoma engaphantsi kwendalo yingqokelela yegazi phakathi kokugqunywa kwengqondo (ixesha elide) kunye nomgangatho wobuchopho.

I-hematoma engaphantsi kwendalo ihlala isisiphumo sokonzakala entloko. Olu hlobo lwe-hematoma ye-subdural iphakathi kweyona ndawo ibulala kakhulu kuyo yonke into eyenzakeleyo entloko. Ukopha kugcwalisa indawo yengqondo ngokukhawuleza okukhulu, kucinezela izicwili zobuchopho. Oku kuhlala kukhokelela ekonzakaleni kwengqondo kwaye kunokukhokelela ekufeni.

I-hematomas engaphantsi kwendalo nayo inokwenzeka emva kokonzakala kwentloko encinci. Isixa sokopha sincinci kwaye senzeka ngokuthe chu. Olu hlobo lwe-hematoma engaphantsi kwesiqhelo luhlala lubonwa kubantu abadala. Oku kunokungaqapheleki kangangeentsuku ezininzi ukuya kwiiveki kwaye kubizwa ngokuba ziihematomas ezinganyangekiyo ezingaphantsi kwendalo.

Ngayo nayiphi na i-hematoma engaphantsi komhlaba, imithambo emincinci phakathi kobuso bengubo kunye nesembozo sayo sangaphandle (ixesha elihlala ixesha elide) yolula kwaye ikrazule, ivumela igazi ukuba liqokelele. Kubantu abadala abadala, imithambo ihlala isolulwa ngenxa yokuncipha kwengqondo (atrophy) kwaye yenzakala ngokulula.

Ezinye iihematomas ezingaphantsi kwendalo zenzeka ngaphandle kwesizathu (ngokuzenzekelayo).

Oku kulandelayo kwandisa umngcipheko we-hematoma engaphantsi komhlaba:

• Amayeza anciphisa igazi (njenge-warfarin okanye i-aspirin)
• Ukusetyenziswa kotywala ixesha elide
• Iimeko zonyango ezenza ukuba igazi lakho lijiye kakubi
• Ukuphindaphinda ukwenzakala entloko, njengokuwa
• Umncinci kakhulu okanye mdala kakhulu

Kwiintsana kunye nabantwana abancinci, i-hematoma engaphantsi kwendalo inokwenzeka emva kokuphathwa gadalala kwabantwana kwaye ixhaphake ngokubonakalayo kwimeko ebizwa ngokuba yi-shaken baby syndrome.

Kuxhomekeke kubukhulu be-hematoma kwaye apho icinezela kwingqondo, naziphi na kwezi mpawu zilandelayo zinokwenzeka:

• Intetho edidekileyo okanye engacacanga
• Iingxaki ngokulinganisela okanye ukuhamba
• Intloko ebuhlungu
• Ukungabikho kwamandla okanye ukudideka
• Ukuhlutha okanye ukulahleka kwengqondo
• Isicaphucaphu nokugabha
• Ukuba buthathaka okanye ukuba ndindisholo
• Iingxaki zombono
• Utshintsho kwindlela yokuziphatha okanye ngengqondo

Kwiintsana, iimpawu zingabandakanya:

• Amagqabantshintshi aqhawukayo (amabala athambileyo okakayi lomntwana)
• Ukwahlulahlula iisuture (iindawo apho ukukhula kwamathambo okakayi kujoyina)
• Iingxaki zokondla
• Ukuxhuzula
• Ukukhala okuphezulu, ukucaphuka
• Ubungakanani bentloko eyandisiweyo (umjikelo)
• Ukwanda kokulala okanye ukonwaba
• Ukuhlanza okungapheliyo

Fumana uncedo lwezonyango ngokukhawuleza emva kokulimala kwentloko. Sukulibazisa. Abantu abadala abadala kufuneka bafumane ukhathalelo lonyango ukuba babonisa iimpawu zeememori okanye ukwehla kwengqondo, nokuba ababonakali ngathi banokwenzakala.

Umboneleli ngononophelo lwempilo uya kuthi oda i-imaging test, efana ne-CT okanye i-MRI scan, ukuba ngaba zikhona ezi mpawu zidweliswe apha ngasentla.

I-hematoma engaphantsi kwendalo yimeko engxamisekileyo.

Utyando olungxamisekileyo lunokufuneka ukunciphisa uxinzelelo ngaphakathi kwengqondo. Oku kunokubandakanya ukubhola umngxunya omncinci kukhakhayi ukukhupha naliphi na igazi kunye nokunciphisa uxinzelelo kwingqondo. Iihematomas ezinkulu okanye amahlwili egazi aqinileyo anokufuna ukususwa ngenkqubo ebizwa ngokuba yi-craniotomy, eyenza ukuvulwa okukhulu kukhakhayi.

Amayeza anokusetyenziswa axhomekeke kuhlobo lwe-hematoma yangaphantsi, ukuba zibi kangakanani na iimpawu, kunye nokuba kungakanani na ukonakala kwengqondo. Amayeza anokubandakanya:

• I-diuretics (iipilisi zamanzi) kunye ne-corticosteroids ukunciphisa ukudumba
• Amayeza okuthintela ukuhlutha okanye ukukhusela ukuxhuzula

Imbonakalo ixhomekeke kuhlobo kunye nendawo yokwenzakala entloko, ubungakanani bokuqokelelwa kwegazi, kunye nokuba unyango luqalwa kungekudala kangakanani.

Iimpawu zehematomas ezincinci ezisezantsi zinamazinga aphezulu okufa kunye nokulimala kwengqondo. Iihematomas ezinganyangekiyo ezingaphantsi kwesakhiwo zineziphumo ezingcono kwiimeko ezininzi. Iimpawu zihlala zihamba emva kokuba kuqokelelwe igazi. Unyango lomzimba ngamanye amaxesha luyimfuneko ukunceda umntu abuyele kwinqanaba labo lokusebenza.

Ukuxhuzula kuhlala kwenzeka ngexesha lefomoma hematoma, okanye ukuya kwiinyanga okanye iminyaka emva konyango. Kodwa amayeza anokunceda ukulawula ukuxhuzula.

Iingxaki ezinokubangela zibandakanya:

• I-Brain herniation (uxinzelelo kwingqondo ebukhali ngokwaneleyo ukuba ibangele ikhoma kunye nokufa)
• Iimpawu ezingapheliyo njengokulahleka kwememori, ukuba nesiyezi, intloko ebuhlungu, unxunguphalo, kunye nobunzima bokugxila
• Ukuxhuzula
• Ixesha elifutshane okanye ubuthathaka obungapheliyo, ukuba ndindisholo, ubunzima bokuthetha

I-hematoma engaphantsi kwendalo ingxamisekileyo kwezonyango. Tsalela umnxeba ku-911 okanye inombolo yakho yongxamiseko, okanye uye kwigumbi likaxakeka emva kokonzakala entloko. Sukulibazisa.

Ukulimala komqolo kuhlala kwenzeka ngokulimala entloko, ke zama ukugcina intamo yomntu ithe nkqo ukuba kufuneka uyihambise phambi kokuba uncedo lufike.

Soloko usebenzisa izixhobo zokhuselo emsebenzini kwaye udlale ukunciphisa umngcipheko wenzakala entloko. Umzekelo, sebenzisa iminqwazi enzima, ibhayisekile okanye iminqwazi yokukhwela izithuthuthu namabhanti ezihlalo. Abantu abadala kufuneka bakuphaphele ngakumbi ukuphepha ukuwa.

Ukopha okungaphantsi; Ukulimala kwengqondo ebuhlungu - i-hematoma yangaphantsi; I-TBI - i-hematoma engaphantsi komhlaba; Ukulimala kwentloko - i-hematoma yangaphantsi

• Utyando lobuchopho-ukukhutshwa

• I-hematoma engaphantsi
• Ukunyuka koxinzelelo lwangaphakathi

UPapa L, Goldberg SA. Ukonzakala kwentloko. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: iikhonsepthi kunye nokuziqhelanisa neklinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2018: isahluko 34.

I-Stippler M. Craniocerebral trauma. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 62.