I-hematoma engaphansi

I-submatural hematoma iqoqo legazi phakathi kokumbozwa kobuchopho (ubude) nobuso bengqondo.

I-hematoma engaphansi komhlaba imvamisa ingumphumela wokulimala kanzima ekhanda. Lolu hlobo lwe-subdural hematoma luphakathi kokulimala kakhulu ekhanda. Ukopha kugcwalisa indawo yobuchopho ngokushesha okukhulu, kucindezela izicubu zobuchopho. Lokhu kuvame ukuholela ekulimaleni kwengqondo futhi kungaholela ekufeni.

Ama-hematomas angaphansi angenzeka futhi ngemuva kokulimala okuncane ekhanda. Inani lokopha lincane futhi livela kancane. Lolu hlobo lwe-submatural hematoma luvame ukubonwa kubantu abadala asebekhulile. Lezi zingase zingabonakali izinsuku eziningi kuya emavikini futhi zibizwa ngokuthi ama-hematomas angapheli.

Nganoma iyiphi i-hematoma engaphansi, imithambo emincane ephakathi kobuso bengubo nengubo yayo yangaphandle (isikhathi) iyeluleka futhi idabuke, ivumela igazi ukuba liqoqane. Kubantu abadala asebekhulile, imithambo ivame ukwelulwa ngenxa yokuncipha kobuchopho (i-atrophy) futhi ilimala kalula.

Amanye ama-hematomas angaphansi komhlaba avela ngaphandle kwesizathu (ngokuzenzekelayo).

Lokhu okulandelayo kwandisa ingozi ye-hematoma engaphansi komhlaba:

• Imithi enciphisa igazi (njenge-warfarin noma i-aspirin)
• Ukusetshenziswa kotshwala isikhathi eside
• Izimo zezokwelapha ezenza igazi lakho livale kahle
• Ukulimala okuphindaphindiwe kwekhanda, njengokuwa
• Mncane kakhulu noma umdala kakhulu

Ezinganeni nasezinganeni ezincane, i-hematoma engaphansi komhlaba kungenzeka ngemuva kokuhlukunyezwa kwezingane futhi ijwayele ukubonakala esimweni esibizwa nge-shaken baby syndrome.

Ngokuya ngosayizi we-hematoma nalapho icindezela khona ebuchosheni, noma yiziphi zalezi zimpawu ezilandelayo zingavela:

• Inkulumo edidekile noma edidekile
• Izinkinga ngokulinganisela noma ukuhamba ngezinyawo
• Ubuhlungu bekhanda
• Ukungabi namandla noma ukudideka
• Ukuquleka noma ukulahlekelwa ukwazi
• Isicanucanu nokuhlanza
• Ubuthakathaka noma ukuba ndikindiki
• Izinkinga zombono
• Izinguquko zokuziphatha noma i-psychosis

Ezinganeni, izimpawu zingabandakanya:

• Ama-fontanelles aqhamukayo (izindawo ezithambile zogebhezi lwengane)
• Ama-suture ahlukanisiwe (izindawo lapho kutholakala khona amathambo ogebhezi)
• Izinkinga zokondla
• Ukuquleka
• Ukukhala okuphezulu, ukucasuka
• Ukukhulisa usayizi wekhanda (umjikelezo)
• Ukwanda kokulala noma ukukhathala
• Ukuphalaza okuqhubekayo

Thola usizo lwezokwelapha ngokushesha ngemuva kokulimala ekhanda. Ungalibali. Abantu abadala asebekhulile kufanele bathole ukunakekelwa kwezokwelapha uma bekhombisa izimpawu zezinkinga zememori noma ukwehla kwengqondo, noma ngabe kubonakala sengathi abanakho ukulimala.

Umhlinzeki wezokunakekelwa kwempilo cishe uzo-oda ukuhlolwa kwengqondo kwe-imaging, njenge-CT noma i-MRI scan, uma kukhona ezinye zezimpawu ezibalwe ngenhla.

I-hematoma engaphansi kwesimo esiphuthumayo.

Ukuhlinzwa okuphuthumayo kungadingeka ukunciphisa ingcindezi ngaphakathi kobuchopho. Lokhu kungabandakanya ukubhola imbobo encane kugebhezi ukukhipha noma yiliphi igazi nokususa ingcindezi ebuchosheni. Ama-hematomas amakhulu noma amahlule egazi aqinile kungadingeka ukuthi asuswe ngenqubo ebizwa nge-craniotomy, edala ukuvuleka okukhulu kogebhezi.

Imithi engasetshenziswa incike ohlotsheni lwe-subdural hematoma, ukuthi zimbi kangakanani izimpawu, nokuthi kungakanani ukulimala kobuchopho okwenzekile. Imithi ingafaka:

• I-diuretics (amaphilisi wamanzi) nama-corticosteroids ukunciphisa ukuvuvukala
• Imithi elwa nokuquleka ukulawula noma ukuvimbela ukuquleka

I-Outlook incike ohlotsheni nasendaweni yokulimala kwekhanda, ubukhulu beqoqo legazi, nokuthi ukwelashwa kuqala kanjani ngokushesha.

Ama-hematomas amancane asemadolobheni anamazinga aphezulu okufa nokulimala kwengqondo. Ama-hematomas angapheli asezindlini anemiphumela engcono ezimweni eziningi. Izimpawu zivame ukuphela ngemuva kokukhishwa kwegazi. Ukwelashwa ngokomzimba kwesinye isikhathi kuyadingeka ukusiza umuntu ukuthi abuyele ezingeni lakhe elijwayelekile lokusebenza.

Ukuquleka kaningi kwenzeka ngesikhathi amafomu e-hematoma, noma kufika ezinyangeni noma eminyakeni ngemuva kokwelashwa. Kodwa imithi ingasiza ekulawuleni ukuquleka.

Izinkinga ezingaba nomphumela zifaka:

• I-Brain herniation (ingcindezi ebuchosheni obunzima ngokwanele ukubanga ikhoma nokufa)
• Izimpawu eziqhubekayo njengokulahleka kwememori, isiyezi, ikhanda, ukukhathazeka, nobunzima bokugxila
• Ukuquleka
• Ubuthakathaka besikhathi esifushane noma baphakade, ukuba ndikindiki, ukukhuluma kanzima

I-submatural hematoma iyisimo esiphuthumayo sezokwelapha. Shayela u-911 noma inombolo yakho ephuthumayo yasendaweni, noma uye egumbini lezimo eziphuthumayo ngemuva kokulimala ekhanda. Ungalibali.

Ukulimala komgogodla kuvame ukwenzeka ngokulimala ekhanda, ngakho-ke zama ukugcina intamo yomuntu inganyakazi uma kufanele uyihambise ngaphambi kokuba usizo lufike.

Njalo sebenzisa imishini yokuphepha emsebenzini nokudlala ukunciphisa ingozi yokulimala ekhanda. Isibonelo, sebenzisa izigqoko ezinzima, amabhayisikili noma izigqoko zokuhamba ngesithuthuthu, namabhande esihlalo. Abantu abadala kufanele baqaphele ikakhulukazi ukugwema ukuwa.

Ukopha okungaphansi; Ukulimala okubuhlungu kwengqondo - i-hematoma engaphansi; I-TBI - i-hematoma engaphansi; Ukulimala kwekhanda - i-submatural hematoma

• Ukuhlinzwa kobuchopho - ukukhishwa

• I-hematoma engaphansi
• Ukwanda kwengcindezi yokungasebenzi

UPapa L, Goldberg SA. Ukuhlukumezeka ekhanda. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 34.

Ukuhlukumezeka kukaStippler M. Craniocerebral. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 62.