I-hematoma ye-Epidural

I-epidural hematoma (EDH) yopha phakathi kwengaphakathi logebhezi nesembozo sangaphandle sobuchopho (esibizwa ngokuthi i-dura).

I-EDH ivame ukubangelwa ukuqhekeka kogebhezi ebuntwaneni noma ebusheni. Ulwelwesi olumboze ubuchopho alunamathele eduze kogebhezi njengoba lunjalo kubantu asebekhulile nezingane ezingaphansi kweminyaka engu-2. Ngakho-ke, lolu hlobo lokopha luvame kakhulu kubantu abasha.

I-EDH nayo ingenzeka ngenxa yokuqhekeka kwesitsha segazi, imvamisa umthambo. Umthambo wegazi bese wopha ungene esikhaleni esiphakathi kwesikhashana nogebhezi.

Imikhumbi ethintekile ivame ukudabuka ngokuqhekeka kogebhezi. Ukwephuka kuvame ukubangelwa ukulimala kabi ekhanda, njengalezo ezidalwa isithuthuthu, ibhayisikili, i-skateboard, ukugibela iqhwa, noma izingozi zezimoto.

Ukopha ngokushesha kubangela ukuqoqwa kwegazi (hematoma) elicindezela ebuchosheni. Ingcindezi engaphakathi kwekhanda (ingcindezi yangaphakathi, i-ICP) inyuka ngokushesha. Le ngcindezi ingaholela ekulimaleni okungaphezulu kobuchopho.

Xhumana nomhlinzeki wezokunakekelwa kwempilo nganoma yikuphi ukulimala ekhanda okuholela ekulahlekelweni okuncane kokukwazi, noma uma kukhona ezinye izimpawu ngemuva kokulimala ekhanda (noma ungalahlekanga).

Iphethini ejwayelekile yezimpawu ezibonisa i-EDH ukulahleka kokwazi, kulandelwe ukuqapha, bese kulahleka ukwazi futhi. Kepha leli phethini kungenzeka LINGABONI kubo bonke abantu.

Izimpawu ezibaluleke kakhulu ze-EDH yilezi:

• Ukudideka
• Isiyezi
• Ukozela noma izinga lokushintsha lokuqwashisa
• Umfundi okhulisiwe esweni elilodwa
• Ukuphathwa ikhanda (okunzima)
• Ukulimala ekhanda noma ukuhlukumezeka okulandelwa ukulahlekelwa ukwazi, isikhathi sokuqapha, bese ukuwohloka ngokushesha kubuyela ekuqulekeni
• Isicanucanu noma ukuhlanza
• Ubuthakathaka engxenyeni yomzimba, imvamisa ohlangothini oluhlukile ohlangothini nomfundi okhulisiwe
• Ukuquleka kungenzeka ngenxa yomthelela ekhanda

Izimpawu zivame ukwenzeka kungapheli imizuzu namahora ngemuva kokulimala ekhanda futhi zikhombisa isimo esiphuthumayo.

Kwesinye isikhathi, ukopha akuqali ngamahora ngemuva kokulimala ekhanda. Izimpawu zengcindezi ebuchosheni nazo azenzeki ngokushesha.

Ukuhlolwa kobuchopho kanye nesistimu yezinzwa (yezinzwa) kungakhombisa ukuthi ingxenye ethile yobuchopho ayisebenzi kahle (ngokwesibonelo, kungahle kube nobuthakathaka bengalo ngakolunye uhlangothi).

Ukuhlolwa kungakhombisa nezimpawu zokunyuka kwe-ICP, njenge:

• Ukuphathwa ikhanda
• Ubutabane
• Ukudideka
• Isicanucanu nokuhlanza

Uma kune-ICP eyandisiwe, kungadingeka ukuhlinzwa okuphuthumayo ukukhulula ingcindezi nokuvimbela ukulimala okuqhubekayo kobuchopho.

Isikrini se-CT scan esingaqhathanisi sizoqinisekisa ukuxilongwa kwe-EDH, futhi sizokhomba ngqo indawo eyi-hematoma nanoma yikuphi ukuphuka kogebhezi okuhambisana nakho. I-MRI ingaba wusizo ukukhomba ama-hematomas amancane we-epidural avela kuma-subdural.

I-EDH yisimo esiphuthumayo. Izinhloso zokwelashwa zifaka:

• Ukuthatha izinyathelo zokonga impilo yomuntu
• Izimpawu zokulawula
• Ukunciphisa noma ukuvimbela ukulimala unomphela ebuchosheni

Izinyathelo zokusekelwa kwempilo zingadingeka. Ukuhlinzwa okuphuthumayo kaningi kuyadingeka ukunciphisa ingcindezi ngaphakathi kobuchopho. Lokhu kungafaka ukubhola imbobo encane kugebhezi ukukhulula ingcindezi nokuvumela igazi likhiphe ngaphandle kogebhezi.

Ama-hematomas amakhulu noma amahlule aqinile egazi angadinga ukususwa ngokuvula okukhulu kugebhezi (i-craniotomy).

Imithi esetshenziswa ngaphezu kokuhlinzwa izohluka ngohlobo nobukhulu bezimpawu nokulimala kobuchopho okwenzekayo.

Imithi yokwelapha amagciwane ingasetshenziswa ukulawula noma ukuvimbela ukuquleka. Eminye imithi ebizwa ngama-hyperosmotic agents ingasetshenziselwa ukunciphisa ukuvuvukala kobuchopho.

Kubantu abanciphisa igazi noma abanezinkinga zokopha, izindlela zokwelashwa zokuvimbela ukopha okuqhubekayo zingadingeka.

I-EDH inengozi enkulu yokufa ngaphandle kokungenelela kokuhlinzwa ngokushesha. Ngisho nangokunakwa ngokushesha, ingozi enkulu yokufa nokukhubazeka isala.

Kukhona ingozi yokulimala unomphela kobuchopho, noma ngabe i-EDH ilashwa. Izimpawu (njengokuquleka) zingaqhubeka izinyanga ezimbalwa, noma ngabe uselashwa. Ngokuhamba kwesikhathi zingancipha kaningi noma zinyamalale. Ukuquleka kungaqala kuze kufike eminyakeni emi-2 ngemuva kokulimala.

Kubantu abadala, ukululama okuningi kwenzeka ezinyangeni eziyisithupha zokuqala. Imvamisa kuba nokuthuthuka okuthile eminyakeni emibili.

Uma kukhona ukulimala kobuchopho, ukululama okugcwele akunakwenzeka. Ezinye izinkinga zifaka phakathi izimpawu zaphakade, njenge:

• Herniation yobuchopho kanye nekhoma unomphela
• Ingcindezi ejwayelekile i-hydrocephalus, engaholela ekubeni buthakathaka, ikhanda, ukungazibambi, nobunzima bokuhamba
• Ukukhubazeka noma ukulahlekelwa umuzwa (okwaqala ngesikhathi sokulimala)

Iya egumbini labezimo eziphuthumayo noma ushayele ku-911 noma inombolo ephuthumayo yendawo uma kuvela izimpawu ze-EDH.

Ukulimala komgogodla kuvame ukwenzeka ngokulimala ekhanda. Uma kufanele unyakazise umuntu ngaphambi kokuba usizo lufike, zama ukugcina intamo yakhe inganyakazi.

Shayela umhlinzeki uma lezi zimpawu ziqhubeka ngemuva kokwelashwa:

• Ukulahleka kwememori noma izinkinga ukugxila
• Isiyezi
• Ubuhlungu bekhanda
• Ukukhathazeka
• Izinkinga zokukhuluma
• Ukulahleka kokunyakaza engxenyeni ethile yomzimba

Iya egumbini labezimo eziphuthumayo noma ushayele ku-911 noma inombolo ephuthumayo yendawo uma lezi zimpawu zikhula ngemuva kokwelashwa:

• Ukuphefumula kanzima
• Ukuquleka
• Abafundi abakhulisiwe bamehlo noma abafundi abalingani ngobukhulu
• Ukuphendula okunciphile
• Ukulahlekelwa ukwazi

I-EDH kungenzeka ingavikeleki uma sekwenzeke ukulimala ekhanda.

Ukwehlisa ingozi yokulimala ekhanda, sebenzisa imishini yokuphepha efanele (njengezigqoko eziqinile, amabhayisikili noma izigqoko zokuhamba ngezithuthuthu, namabhande esihlalo).

Landela izinyathelo zokuphepha emsebenzini nakwezemidlalo nakwezokungcebeleka. Isibonelo, ungagxili emanzini uma ngabe ukujula kwamanzi kungaziwa noma uma kungenzeka kube namatshe.

I-hematoma engaphandle; Ukopha okungaphandle; Ukuphuma kwegazi kwe-Epidural; I-EDH

I-National Institute of Neurological Disorders and Stroke iwebhusayithi. Ukulimala kwengqondo okubuhlungu: ithemba ngocwaningo. www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Traumatic-Brain-Injury-Hope-Through. Kubuyekezwe u-Ephreli 24, 2020. Kufinyelelwe ngoNovemba 3, 2020.

UShahlaie K, Zwienenberg-Lee M, Muizelaar JP. I-pathophysiology yomtholampilo yokulimala okubuhlungu kwengqondo. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans ne-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 346.

Ama-Wermers JD, uHutchison LH. Ukuhlukumezeka. Ku: Coley BD, ed. I-Caffey's Pediatric Diagnostic Imaging. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2019: isahluko 39.