Wharanga matenga: whakarōpū. Head wharanga: tohumate, āwhina tuatahi me te maimoatanga

Head whara, kia kia rerekē rawa (tae atu te mate) ko tetahi o te take tino noa o te hauātanga i roto i taitamariki me te waenganui tau nga hopearaa o nei. Mō te hawhe o te wā katoa o te whara roro pāmamae. E ai ki ngā tatauranga, e pā ana ki 25-30% o wharanga katoa pūkete mō te mate roro. Tahi, pūkete enei take mo neke atu i te hawhe o nga mate. I muri mai i roto i te tuhinga, ko te whakarōpū o injuries, he whakaahuatanga o etahi o ratou.

Overview

i huaina whara roro pāmamae te te kino ki te wheua angaanga kiko ngohengohe ranei. Ko te whakamutunga, hei tauira, ngā nga meninges, raru ko, oko toto, me te tahi atu. E wehea wharanga matenga ki te maha ngā rōpū. Kia whakaaro tatou etahi o ratou i roto i ngā kōrero.

whakarōpū o wharanga

kia tuwhera kino. I roto i tenei take, ko reira aponeurosis i whati, me te kiri. Ka rite ki te raro o te mahi patunga rite te wheua kiko ranei, e takoto atu hohonu. Ongó whētuki whara āhuatanga Rura. Ka rite ki te take ngā taea te whakaaro otlikvorreya tika ki te wheua whati i roto i te turanga o te angaanga. Kia puta me te whara matenga kati. I roto i tenei take, kia pakaru te kiri, a ka mau te fascia tona tapatahi. Ano, i reira ko nga rōpū e whai ake nei:

• Tremors. Tenei whētuki o te matenga, e kore e nei āhuatanga e abnormalities tamau i roto i te roro. faaiteraa katoa o te kāwanatanga wā i muri mai (te tikanga e rave rahi ra) ngaro i runga i to ratou ake. He tohu atu tamau tohe, i reira te mea he whētuki matenga ake nui ki te kino roro pea. Ko te paearu matua mō te aromatawai o te kāwanatanga mahi puranga roanga (i hēkona ki haora) me te mea he ahua hohonu tuu muri mate wareware, me te mate o te mahara. I roto i kia tuhia nga tohu kore-motuhake ruaki, whakapairuaki, raruraru i roto i te mahi cardiac, blanching o te kiri.
• Kōpeketanga kanga whara roro, rangi, te tinana ke, kanokanototo.
• toto Subarachnoid.
• Haaparare i kino axonal.

I roto i te mahi, tuhia reira he rota o te wā ngā. Ngā, hei tauira, ka taea e kōpeketanga kanokanototo me contusion contusion ki toto subarachnoid me kōpeketanga, kino E ruia ana, me te whara, me ētahi atu. kino maha puta rite ki te hua o wharanga ki te mata.

contusion roro

Puta te reira i runga i te whakamārama o te whara matenga. Hono laiki 'Ko te takahi o te tapatahi o te taonga roro i te iti tetahi wāhi. Tikanga, puta tenei rohe i te mata o te tono kaha. Heoi, i reira he take te wahi puta te karawarawa i te taha ki te ritenga atu (i te protivoudara). I runga i te whakamārama o tenei āhua hinga wahi o te kiko roro, oko toto, nga here pūtau histological ki hanganga muri o te edema pāmamae. Ko te rohe o enei pāpaka rerekē. Rawa kino ko te taua whara upoko i roto i te tamaiti.

ngawari

whara upoko taua āhuatanga e momotu mahara mo te wā poto - ki runga ki te maha tekau o meneti. I muri i tona otinga he amuamu angamaheni o whakapairuaki. Ano, te mamae manawanui, me te āmai. He kia kia ruaki, i roto i ētahi wā tamau. I roto i ētahi wā, i reira te mea he bradycardia āhua - tukupu te auau ngakau ki 60, me te iti iho i te he meneti. kia waiho te manawanui he kukū, mate wareware retro- me anterograde - waimaero mahara i roto i te puka o te mate o te kaha ki te whakaora me te purei o te matauranga riro i mua. I muri i whara upoko ngawari tohua tachycardia (nui haere auau ngakau ki 90 bpm. / Min). kia whakaara ētahi tūroro i te pēhanga. I roto i tenei take i te pāmahana tinana me te respiration, te tikanga noho tonu. Ko nga tohu neurological, nga tohu e te nuinga o ngāwari huru. Hei tauira, kia wheako he manawanui ngoikore, te momoe, nystagmus clonic (biphasic naki nekehanga tumu o te kanohi). He he ano hoki te anisocoria iti, tohu meningeal, pyramidal iti hoki. Ēnei tohumate te tikanga regress i 2-3 wiki i muri i te wharanga upoko.

Āhuatanga o maumaui

I runga i te whakamārama o te whara kitea te microscopically tūkino medulla te hanganga iu. faaite te reira iho rite wāhi o ngawhatanga rohe, wāhi cortical maru iho, i roto i te taha ki te iti pakaruhanga toto subarachnoid pea. Te reira i, i roto i te tahuri, meinga e whaturama o nga oko pial. toto Subarachnoid ka ô i te toto te arachnoid me horahia i runga i nga poka basal, kapiti, me te moa roro. E nehenehe te reira rohe ranei whakakī i te wāhi katoa ki te hanganga o clots. whakawhanake Herenga rawa whakapeka. ohorere mana'o te manawanui he "whakatangi ki te matenga", hohoro puta photophobia, ruaki, ānini tino nanakia. Pea toutou haehae whānui. Ko te tikanga e kore e te te huru tahi e pāpāngia. Heoi, i te tohu tūponotanga meningeal. I roto i ngā, i reira kia kia he uaua kaki maro (i te tokonga ake o te matenga kore e taea pa ki kauwae o te manawanui whaturei) me whakatata pū tohumate (e kore e taea tika te piko turi i roto i reira, me te hip waewae). Ki te mea i reira he tohu o te riri meningeal puta rere toto meninges.

maru āhua

Tenei whara pane āhuatanga e te katinga auroa o te mahara (e rave rahi hāora). Te manawanui he mate wareware i tohua. He hoki tohu o te whara matenga e whai ake nei: ānini nui, ruaki toutou, disorders hinengaro. raruraru rangitahi pea i roto i ngā mahi faufaa. I roto i ngā, e taea te tohua reira bradycardia ranei tachycardia, nui haere te pēhanga, tachypnea (manawa tere ara pāpaku, kahore takahi auau me te uruhanga), kirika iti-kōeke (te nui haere te pāmahana tinana ki 37-37.9 deg.). Ko te kakau me te anga tohu o te dissociation o reflexes iohere me te reo uaua, faaiteraa pathological më auau. He feunga mārama tohu ngahunga. meinga tona huru e te localization o te whara. Kitea oculomotor me pupillary disorders, disorders kupu, tūtohutanga, paresis o nga topito me ētahi atu. āta, enei tohu i roto i toru ki te rima wiki mānia ki waho, kia rite ki te tikanga. Heoi, i roto i ētahi wā, whakaahuatia kua ora te pikitia haumanu roa nui. A, no te kitea maha whara o te pakeke āhua piere i te wheua o te turanga, me te calvarium, ngā toto subarachnoid. CT huringa ngahunga kitea rite inclusions pai tiketike-kiato ōrite kiato hua āhua ranei. hāngai ana tēnei ki te toto iti i roto i te rohe o te whara hemorrhagic ranei impregnation o kiko roro, kahore kinonga kerekere.

whara upoko Pākaha

I roto i tenei take, kite kanokanototo intracerebral i roto i rua matamata frontal rite iti nohanga toto i ngā pāpaka iaia te whaturama. hanga tenei he kōhao e kei toto coagulated wai ranei. Whara i roto i kino āhuatanga e whakaweto roa o mahara (e rave rahi wiki). E mea pinepine te motor excitation tohua. tohua hoki disorders o ngā mahi faufaa i roto i te tinana. Heoi, i roto i te rite ki te tohu toharite i roto i taimaha, he ake korerotia ratou. Hei tauira, i reira ko te mate o te mahi romahā roto i te ofatiraa o te ara manawataki me te whenua. kitea ana te manawanui te pyrexia, mana o te kakau tuatahi tohu neurological. I roto i ngā, tāutuhia horomia disorders, tere nekehanga o te kanohi, ptosis, ranei mydriasis, paresis kanohi, rigidity decerebrate, kaupapa, tupu inhibition ranei o reflexes, kiriuhi mucous, kiri, uaua, me te pera i runga i. tohu Neurological i roto i te wā tuatahi (i roto i te haora tuatahi ra ranei) ngoi ana nga tohu hemispheric rahi. kia wheako i te manawanui e alangá paresis, disorders subcortical o āhua uaua, me pera i runga i. I roto i ētahi wā, pea ngahunga whānui ranei hukihuki. Inenga faaiteraa ngahunga puta āta nui. Ko te ati o te taua whara upoko? Ka taea e te mau hopearaa e tino nui. E mea pinepine i reira Kua tohua pānga wäriu, te nuinga i roto i te mara o te hinengaro, me te nekeneke.

tohu CT

I roto i te whara nui i roto i te wahi tuatoru o nga take e korerotia i pāpaka wāhi i roto i te roro i roto i te puka o te kore-ōrite wāhi kiato ake i. I roto i tenei take, i reira he he whakarerekētanga o ngā rohe. Tohaina ngā wāhi ki te kiato nui, me te iti. I roto i te huru tino nui o te whakangaromanga whakahaua medulla me taea tae hohonu ki te pūnaha ventricular me karihi subcortical. whakaatu akiaki tirohanga he heke āta i roto i nga rohe taatiraa, ratou hononga me te panoni ki te puranga ōrite. mai te reira i ki 8 ranei 10 haora i muri i te raruraru. Ko pōturi inenga pānga tïpako karapotia pathological, e tohu ana i te aroaro o-resorbed kore clots wahia me te kiko i roto i te arotahi o te whara. I tenei wāhi, hei ratou āhua ravnoplotnymi karapoti taonga roro edematous. Te ngaro i muri i te 30-40 ra. pānga rōrahi tohu resorption me te hanganga o te tïpako hei utu o ngā wāhanga o te atrophy kōwhao whēwhē ranei.

Tūkino ki te posterior fossa hanganga

whakaaro ana tēnei lesion te ki hei te nui tino o whara matenga katoa. Hoki te āhuatanga te āhua e te tohu e whai ake nei: whārua o mahara, me te huinga o te kakau, cerebellar, kaka me tohu meningeal tika ki tere kōpeketanga me te waipiro tohanga disorders.

mehua haumanu ka whara

Ahakoa o te whānuitanga o te whara, kia whakaratohia te tiaki hauora manawanui. I roto i te take o te whara matenga o te pārurenga ki te kia kawea ki te hōhipera rite wawe tonu. Hoki te tātaritanga tika whakaatu te X-ray, me te CT. Me moenga okiokinga te manawanui. Ko tōna roanga ki ngawari - 7-10 ra, ki te toharite -. 14 ra. I roto i te take o nui whara roro pāmamae kia tangohia whakaora. timata rite wawe rite te wā mua hōhipera-a tonu ngā āhuatanga on-kāwanatanga ratou. Hei haerenga i te manawa, ko te tika ki te whakarite i te noa ripeka-whenua i roto i te wahi romahā o runga - wewete ratou i te hūpē, te toto, ruaki. whakamōhio te reira i te tau mahani rangi, whakamana te tracheostomy te (kiko tuaki me pukorokoro tāuta pūkawe ranei hanga rua tonu - stoma). whakamahia hoki inhalation te whakamahi i ranunga oxy-rangi. Ki te tika, te tono ventilation aunoa.

Therapy mō te pōro

Ki te mea i whakaritea e te manawanui he whara upoko, kia whakamana i te maimoatanga i roto i te fare ma'i neurosurgical. A, no te whakaatu pōro e rima moenga okiokinga. I roto i te ngaro o pōauautanga kia tukua ai te manawanui i te ra o te 7-10. Kei te whakaritea e te reira i te maimoatanga tūroro, te roanga o nei - ki runga ki te 14 nga ra. hāngai maimoatanga Medical mō te pōro e i te āhua mahi o te roro, te whakahaere mamae, ohoroa, manukanuka aueue. Tikanga, rongoā whakaritea ngā ngā hypnotics, sedatives me Pë. Ka rite ki Pë whakamahia drugs pērā i "Baralgin" "Pentalgin" maksigan "" sedalgin Reglan "me etahi atu. Kia Founga kia whakaritea hoki te whanoke." "Ki te sedatives ngā taua rongoā rite" Valocordin "" Corvalol " me te tahi atu phenobarbital kei. Hoatu infusions otaota (motherwort, valerian).

Taunakitia rite tranquilizers. Ēnei ngā, hei tauira, ngā taua māngai rite "Rudotel", "Nozepam", "Phenazepam", "Sibazon", "elenium" me etahi atu. I tua atu ki symptomatic maimoatanga i whakaritea pūkoro Akoranga me maimoatanga iaia. whai wāhi te reira ki te toe fakafoki atu tere, me te oti o te mahi roro ohorere, ārai ngā tohu postkommotsionnye. kia Wāhui tserebrotropnoy me therapy vasotropic i muri i 5-7 ra i muri i te wharanga. Pai io huinga nootropic (taero "Pikamilon" "aminolone", me ētahi atu) me te vasotropic (rongoā "Teonikol" stugeron "" Cavinton ") te tikanga ki te hinga faaiteraa asthenic e whakaritea tūroro complexes huaora." Centrum "" Complivit "" . Vitrum "me ētahi atu inu haeana e tūtohutia: te hua o Schisandra, Siberian ginseng wāhanga ginseng pakiaka. me mea e kore e te wiri puta tetahi pāpaka organic, kia tatou kōrero e pā ana ki atu nui ki te reira e tetahi huringa i runga i MRI CT ranei. i roto i te wharanga - roro whara.

wawaotanga operative

rapu pokanga wharanga aunoa. tohua pokanga te i roto i te take o te kuru whara ki te kiko roro. Tikanga, taua whara mīhini puta i roto i te pou pae tino, me te rohe o nga matamata frontal. Ka rite ki te tukanga hāparapara tavini trepanation osteoplastic. Ko te mahi, ko te ki te hanga i rua i roto i te wheua, ki te tomo ki roto ki te kōhao me detritus otinga te wīra o te konutai pūhaumāota (0.9%).

outlook

kino ngawari te tikanga hua tino pai (hoki tautukunga ki nga kupu tohutohu o te manawanui e pā ana ki te maimoatanga me te therapy). I huru āhua ko reira taea maha ki te whakatutuki i te ora tino me te faaho'iraa mai o te mahi pāpori, me te mahi o nga patunga. kia wheako ētahi tūroro meningitis me wairoro, whakapataritari asthenia, pōrearea iaia, te mamae, disorders o ruruku, pateko me ētahi atu tohu neurological. Ki te puipuitua o te whara nui i roto i te 30-50% o te wā puta te mate. I roto i te morehu he hauātanga rawa noa, e ko te take matua o disorders hinengaro, korero faufau me te nekeneke whakaoho, haurangi. I roto i te wharanga upoko tuwhera he pea pōauautanga inflammatory. I roto i ngā, i te mōrea tiketike o te whakawhanake i te whēwhē roro, ventriculitis, encephalitis, kakā. Hoki liquorrhea pea e tohu ana i te matamua o te inu cerebrospinal (CSF) i taiao ranei rua i hanga e tika ana ki ngā āhuatanga ngā i roto i te wheua o te tuaiwi me angaanga. Hawhe o nga aituā i roto i te upoko whara kiia hoki (RTA) aituā i runga i te rori.