Imithi Emisha Yokubuyisela Ubuchopho

Ukusheshisa okungazelelwe kwekhanda, okufana nokushaya ekhanda kungazelelwe, kungabangela ukulimala kwezicubu zobuchopho. Umthelela osheshayo wekhanda entweni enganyakazi noma ukwehla okungazelelwe nakho kuyimbangela evamile yokulimala kobuchopho okubuhlungu. Uma izicubu zobuchopho ezisohlangothini lomthelela noma kwelinye icala zishayisana nogebhezi oluqinile noluphumela ngaphandle, kujwayele ukulimala. Ukulimala kwe-acceleration-deceleration ngezinye izikhathi kubizwa ngokuthi ukulimala kwe-coup-contrecoup.

Ukubonakaliswa Komtholampilo

I-post-concussion syndrome ibhekisela esimweni lapho umuntu elahlekelwa ukwazi isikhashana ngemva kokungqubuzana, ngokuvamile alulame phakathi nemizuzu engu-30. Lapho siphaphama, isiguli singase singakhumbuli izimo zokulimala noma izehlakalo ezandulele ngokushesha. Izimpawu zingase zihlanganise ikhanda elibuhlungu, isicanucanu, isiyezi, ukucasuka, ukungazinzi ngokomzwelo, ukuntula ukuzethemba, ukuphazamiseka, kanye nezimpawu zesimiso sezinzwa ezizimele njengokumhlophe, ukujuluka okubandayo, umfutho wegazi ophansi, ukushaya kwenhliziyo kancane, nokuphefumula okungajulile.

I-coma ebangelwa ukulimala kwengqondo ebuhlungu ingahluka ngokuhamba kwesikhathi, kusukela esikhathini esifushane ukuya esikhathini eside. Phakathi nenqubo yokululama kusuka ku-coma kuya ekuqapheleni, iziguli zingase zibe nezikhathi zokulala, ukudideka, kanye ne-delirium. Izinga lokuqaphela liyashintshashintsha, kanti ezinye izikhathi ziba lula kanti ezinye ziba nzima.

I-Delirium ngokuvamile ivela ekushintsheni kokuphuma kwe-coma noma ukozela. Kwezinye izimo, ukuziphatha okuvezwa phakathi ne-delirium kungase kubonise umsebenzi wangaphambili wesiguli. Iziguli eziningi zingase zibonise ukumelana, ukuyaluza, nokungasebenzisani, kuyilapho ezinye zingase zibe nolaka. Izimpawu zingase zihlanganise ukubona izinto ezingekho okwesabekayo, futhi ezimweni ezimbi kakhulu, iziguli zingase zibe nokudideka okukhulu futhi zibonise nokuziphatha okunobudlova okungalawuleki. I-Delirium ingahambisana nezinye izimo ezishintshile zokuqaphela, njengokudideka nezimo ezifana nephupho.

I-traumatic amnesia syndrome ebangelwa ukulimala ekhanda ibonakala ngokwenziwa ngesisekelo sokukhohlwa, futhi iziguli zivame ukucasuka kalula. Ubude bayo bufushane uma kuqhathaniswa ne-alcohol amnestic syndrome.

I-Subdural hematoma ebangelwa ukulimala kwekhanda ingenzeka ngokushesha ngemva kokulimala, ngokuvamile iveza ubuhlungu bekhanda nokulala. Ngezinye izikhathi, kungase kube khona ukujabula kwemoto, futhi cishe ingxenye yeziguli ibonisa i-papilledema. Izici ze-hematoma engaphansi kwe-subdural engapheli zihlanganisa ukozela, ubuthuntu, ukukhubazeka kwenkumbulo, futhi ezimeni ezinzima, izimpawu eziphelele zokuwohloka komqondo. Ezinye iziguli zingase zandise kancane umfutho we-cerebrospinal fluid, ukwanda kwamaprotheni, nokubukeka okuphuzi.

Ifilimu ye-X-ray ecacile

Nquma ukuphuka, ukuhlukaniswa kwe-skull sutures, ukunqwabelana komoya ngaphakathi kwe-cranial, imizimba yangaphandle ye-intracranial.

Iskena se-CT

Indlela ebaluleke kakhulu, engabonisa ubukhona kanye nobukhulu be-hematomas, ukuqubuka, kanye ne-edema, kanye nokuphuka, i-pneumocephalus, njll. Uma kunesidingo, ukuskena okuningi okuguquguqukayo kungenziwa ukulandelela izinguquko esimweni. Kodwa-ke, kungase kube nama-pseudoshadows kanye nesithombe esingesihle endaweni ye-posterior fossa.

I-MRI

Nakuba kungavamile ukusetshenziswa esigabeni esibucayi, kufanele kucatshangelwe ezimweni lapho izilonda ku-posterior fossa zingabonakali kahle ku-CT. Ihlinzeka ngesithombe esingcono sezinhlaka ezithambile ze-intracranial uma kuqhathaniswa ne-CT futhi ingasetshenziswa ngemva kokuba isimo sizinzile ukuze kuhlolwe izinga lokulimala nokulinganisa ukubikezela.

I-Lumbar Puncture

Ingakwazi ukukala ingcindezi ye-intracranial futhi ihlaziye uketshezi lwe-cerebrospinal. Lapho ukopha kwe-intracranial kuhambisana nokopha kwe-subarachnoid, ukubhoboza i-lumbar kungakhulula uketshezi lwe-cerebrospinal olunegazi futhi kuyindlela yokwelapha ebalulekile.

I-Cerebral Angiography

Isetshenziswa kaningi ekuxilongeni ukuhlukumezeka kwe-cranial, kodwa kufanele isetshenziswe ngokushesha lapho kusolwa i-vascular pathology. Uma kungekho isithwebuli se-CT, singanquma ukuba khona kwe-hematoma esekelwe ku-vascular morphology.

Ezinye Izindlela Zokuxilonga

I-Ultrasound, i-electroencephalography (EEG), imaging ye-radionuclide, nezinye izindlela zinokubaluleka okulinganiselwe futhi azivamile ukusetshenziswa ngokuqondile ekuxilongeni ukulimala komgogodla nobuchopho.

Ngokusekelwe emlandweni wokulimala kwesiguli, kanye nokuhlolwa okuphelele komzimba wonke kanye nesimiso sezinzwa, ukutholakala kwe-cranial trauma kungase kutholakale kalula. Ukuhlolwa okukhulunywe ngakho ngenhla kungenziwa ukuze kuqinisekiswe ukuxilongwa.

Izinkinga

Ukulimala kobuchopho kuvame ukuphumela emazingeni ahlukene okukhubazeka okuhlala njalo. Lokhu kuncike kakhulu ekutheni umonakalo ubekwe endaweni ethile yobuchopho (okugxilwe kuyo) noma usabalele (ukusabalalisa). Izindawo ezihlukene zokulimala kobuchopho zingabangela izimpawu ezihlukene, zisize odokotela ekunqumeni indawo yokulimala. Izimpawu ezigxilile zihlanganisa ukungahambi kahle kokunyakaza, imizwa, inkulumo, ukubona, nokuzwa, kuyilapho ukulimala kobuchopho okusabalele kuvame ukuthinta inkumbulo, ukulala, noma kuholela ekudidekeni kanye nekhoma.

Ukulimala kanzima kobuchopho ngezinye izikhathi kungase kubangele i-amnesia, lapho iziguli zingakwazi ukukhumbula izehlakalo ngaphambi noma ngemva kokulahlekelwa ukwazi, nakuba labo ababuye baphaphame phakathi nesonto bavame ukukhumbula inkumbulo. Okunye ukulimala ebuchosheni, ngisho noma kuncane, kungaholela ku-post-traumatic syndrome, lapho iziguli ziba nekhanda elibuhlungu kanye nokukhubazeka kwenkumbulo isikhathi eside.

Ukulimala kanzima kobuchopho kungaholela ekunwebeni, ukusonteka, noma ukudabuka kwemizwa, imithambo yegazi, nezinye izicubu ezingaphakathi kobuchopho. Ukulimala kwezindlela ze-neural noma ukopha nokuvuvukala kungenzeka. Ukopha ngaphakathi kwe-intracranial nokuvuvukala kobuchopho kubangela ukwanda komthamo wokuqukethwe ngaphakathi kwe-cranial, kodwa ugebhezi ngokwalo alukwazi ukwanda ngokufanele. Ngenxa yalokho, ingcindezi ye-intracranial iyakhuphuka, iphinde ilimaze izicubu zobuchopho. Umfutho okhulayo we-intracranial uphushela ubuchopho phansi, kuphoqelele izicubu zobuchopho eziphezulu kanye ne-brainstem ezindaweni ezivulekile ezihlobene. Lesi simo sibizwa ngokuthi yi-brain herniation. I-cerebellum kanye ne-brainstem kungasuka ngezikhala ezingaphansi kogebhezi. Njengoba i-brainstem idlala indima ebalulekile ekugcineni ukuphefumula nokushaya kwenhliziyo, i-brain herniation ngokuvamile ingaba yingozi.