Iimpawu zehematoma

I-hematoma ye-epidural (EDH) iphuma phakathi ngaphakathi kwekhayi kunye nesembozo esingaphandle kwengqondo (ebizwa ngokuba yidura).

I-EDH ihlala ibangelwa kukophuka kukakayi ngexesha lobuntwana okanye kwinqanaba lokufikisa. Inwebu egubungele ubuchopho ayihambelani ngokusondeleyo nekhakhayi njengoko injalo kubantu abadala nakubantwana abangaphantsi kweminyaka emi-2. Ke ngoko, olu hlobo lokopha luxhaphake kubantu abancinci.

I-EDH inokwenzeka kwakhona ngenxa yokuqhekeka kwenqanawa yegazi, ihlala iyimithambo. Umthambo wegazi emva koko wopha kwisithuba phakathi kwesiqhelo kunye nokakayi.

Iinqanawa ezichaphazelekayo zihlala zikrazulwa kukwaphuka kokakayi. Ukuqhekeka kuhlala kusisiphumo sokonzakala entloko, njengaleyo ibangelwe sisithuthuthu, ibhayisekile, i-skateboard, ukukhwela ikhephu, okanye iingozi zeemoto.

Ukopha ngokukhawuleza kubangela ingqokelela yegazi (hematoma) ecinezela kwingqondo. Uxinzelelo ngaphakathi kwentloko (uxinzelelo lwangaphakathi, ICP) lonyuka ngokukhawuleza. Olu xinzelelo lunokubangela ukonzakala kwengqondo okungakumbi.

Nxibelelana nomboneleli wezempilo ngayo nayiphi na into eyonzakeleyo entloko ekhokelela kwilahleko emfutshane yokuqonda, okanye ukuba ngaba zikhona ezinye iimpawu emva kokulimala entloko (nangaphandle kokulahleka kwengqondo).

Umzekelo oqhelekileyo weempawu ezibonisa i-EDH yilahleko yokuqonda, elandelwa kukuphaphama, emva koko uphinde ulahlekelwe sisazela. Kodwa le patheni ayinakuvela kubo bonke abantu.

Iimpawu ezibaluleke kakhulu ze-EDH zezi:

• Ukudideka
• Ukuba nesiyezi
• Ukozela okanye inqanaba lokutshintsha
• Ukwandiswa komfundi kwiliso elinye
• Intloko (enzima)
• Ukulimala kwentloko okanye ukwenzakala kulandela ukuphulukana nokuqonda, ixesha lokuphapha, emva koko ukonakala ngokukhawuleza kubuyela ezingqondweni.
• Isihlunu okanye ukugabha
• Ubuthathaka kwinxalenye yomzimba, uhlala ukwelinye icala elichaseneyo nomfundi owandisiweyo
• Ukuxhamla kunokwenzeka ngenxa yempembelelo yentloko

Iimpawu zihlala zenzeka kwimizuzu ukuya kwiiyure emva kokonzakala entloko kwaye zibonisa imeko kaxakeka.

Ngamanye amaxesha, ukopha akuqali kangangeeyure emva kokonzakala entloko. Iimpawu zoxinzelelo kwingqondo nazo azenzeki kwangoko.

Ingqondo kunye nenkqubo yeemvakalelo (ye-neurological) yovavanyo inokubonisa ukuba icandelo elithile lobuchopho alisebenzi kakuhle (umzekelo, kunokubakho ubuthathaka bengalo kwelinye icala).

Uviwo lunokubonisa iimpawu zokunyuka kwe-ICP, njenge:

• Intloko ebuhlungu
• Ubuthathaka
• Ukudideka
• Isicaphucaphu nokugabha

Ukuba kukho ukonyuka kwe-ICP, kunokufuneka kwenziwe utyando olungxamisekileyo ukunciphisa uxinzelelo kunye nokuthintela ukwenzakala kwengqondo ngakumbi.

Isentloko esingafaniyo nesentloko se-CT scan siya kuqinisekisa ukuxilongwa kwe-EDH, kwaye siyakuchaza ngqo indawo eyi-hematoma kunye nayo nayiphi na into enxulumene nokhakhayi. I-MRI inokuba luncedo ekuchongeni iihemmatomas ezincinci ezivela kwi-subdural.

I-EDH yimeko engxamisekileyo. Iinjongo zonyango zibandakanya:

• Ukuthatha amanyathelo okusindisa ubomi bomntu
• Ukulawula iimpawu
• Ukunciphisa okanye ukuthintela umonakalo ongapheliyo kwingqondo

Amanyathelo enkxaso yobomi anokufuneka. Utyando olukhawulezileyo luyimfuneko ukunciphisa uxinzelelo ngaphakathi kwengqondo. Oku kunokubandakanya ukubhola umngxunya omncinci kukhakhayi ukuze unciphise uxinzelelo kwaye uvumele igazi ukuba likhuphe ngaphandle kwekhakhayi.

Iihematomas ezinkulu okanye amahlwili egazi aqinileyo anokufuna ukususwa ngovulo olukhulu kwikakayi (craniotomy).

Amayeza asetyenzisiweyo ukongeza kutyando aya kwahluka ngohlobo kunye nobukhali beempawu kunye nokonakala kwengqondo okwenzekayo.

Amayeza okubulala iintsholongwane angasetyenziselwa ukulawula okanye ukuthintela ukuxhuzula. Amanye amayeza abizwa ngokuba zii-hyperosmotic agents anokusetyenziselwa ukunciphisa ukudumba kwengqondo.

Kubantu abaphantsi kwegazi okanye abanengxaki yokopha, unyango lokuthintela ukopha ngakumbi kunokufuneka.

I-EDH inomngcipheko omkhulu wokufa ngaphandle kongenelelo ngoncedo olukhawulezileyo. Nokuba unonophelo olukhawulezileyo lonyango, umngcipheko obonakalayo wokufa kunye nokukhubazeka uhlala.

Kukho umngcipheko wokulimala ngokusisigxina kwengqondo, nokuba i-EDH iyanyangwa. Iimpawu (ezinjengokubanjwa) zinokuqhubeka iinyanga ezininzi, kwanasemva konyango. Ekuhambeni kwexesha zinokwehla kancinci okanye zinyamalale. Ukuxhuzula kungaqala ukuya kwiminyaka emi-2 emva kokulimala.

Kubantu abadala, uninzi lokuchacha kwenzeka kwiinyanga ezintandathu zokuqala. Ngokwesiqhelo kukho ukuphucuka okungaphezulu kweminyaka emi-2.

Ukuba kukho umonakalo wengqondo, ukubuyiswa ngokupheleleyo akunakwenzeka. Ezinye iingxaki zibandakanya iimpawu ezisisigxina, ezinje:

• Herniation yengqondo kunye ne-coma engapheliyo
• Uxinzelelo oluqhelekileyo lwe-hydrocephalus, olunokubangela ubuthathaka, iintloko, ukungakwazi ukuzibamba kunye nobunzima bokuhamba
• Ukukhubazeka okanye ukulahleka kwemvakalelo (eyaqala ngexesha lokulimala)

Yiya kwigumbi likaxakeka okanye utsalele umnxeba ku-911 okanye inombolo yongxamiseko yendawo ukuba iimpawu ze-EDH zenzeka.

Ukulimala komqolo kuhlala kwenzeka ngokulimala entloko. Ukuba kufuneka umhambise phambi kokuba uncedo lufike, zama ukugcina intamo yakhe ithe cwaka.

Tsalela umnikezeli ukuba ezi mpawu ziyaqhubeka emva konyango:

• Ukuphulukana nenkumbulo okanye iingxaki kugxilwe
• Ukuba nesiyezi
• Intloko ebuhlungu
• Ixhala
• Iingxaki zentetho
• Ukuphulukana nentshukumo kwilungu lomzimba

Yiya kwigumbi likaxakeka okanye fowunela i-911 okanye inombolo yongxamiseko yendawo ukuba ezi mpawu zikhula emva konyango:

• Ingxaki yokuphefumla
• Ukuxhuzula
• Ukwandiswa kwamehlo okanye abafundi abalingani ngobukhulu
• Ukuphendula okunciphileyo
• Ukuphulukana nokuqonda

I-EDH ayinakuthintelwa yakuba yenzekile intloko.

Ukunciphisa umngcipheko wokwenzakala entloko, sebenzisa izixhobo zokhuselo ezifanelekileyo (ezinje ngeminqwazi eqinileyo, ibhayisekile okanye iminqwazi yokukhwela izithuthuthu, namabhanti ezihlalo).

Landela amanyathelo okhuseleko emsebenzini nakwezemidlalo nolonwabo. Umzekelo, sukuntywila emanzini ukuba ubunzulu bamanzi abaziwa okanye ukuba amatye anokubakho.

I-hematoma yangaphandle; Ukopha okungapheliyo; Ukuphuma kwegazi; EDH

IZiko leLizwe leengxaki zeNeological kunye newebhusayithi yeStroke. Ukulimala kwengqondo ebuhlungu: ithemba ngophando. www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Traumatic-Brain-Injury-Hope-Through. Ukuhlaziywa kwe-Epreli 24, 2020. Ifikeleleke ngoNovemba 3, 2020.

UShahlaie K, uZwienenberg-Lee M, Muizelaar JP. I-Clinical pathophysiology yokwenzakala kwengqondo ebuhlungu. Ku: Winn HR, ed. Ugqirha we-Youmans kunye no-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 346.

IWermers JD, Hutchison LH. Umonzakalo. Ku: Coley BD, ed. UCaffey's Pediatric Diagnostic Imaging. Umhla we-13. IPhiladelphia, PA: Elsevier; I-2019: isahluko 39.