I-vertex yakha ingxenye ephezulu yogebhezi, engabizwa nangokuthi i-sinciput. Ngakho-ke i-vertex ingaphezulu kwekhanda, ingxenye engenhla yebhokisi le-cranial, ebantwini kepha nakuwo wonke ama-vertebrate noma naku-arthropods. I-vertex, ebizwa nangokuthi i-skullcap, yakhiwe ngamathambo amane kubantu.

I-vertex yakha, ngama-vertexes, kufaka phakathi umuntu, kanye nezinambuzane, phezulu kogebhezi. Kwesinye isikhathi ibizwa ngokuthi i-cranial cap, i-vertex, ngakho-ke, ku-anatomy, ingxenye ephezulu yebhokisi le-cranial: ingaphezulu lekhanda. Kubizwa nangokuthi i-sinciput.

Ku-anatomy, kubantu, i-cranial vertex inamathambo amane ogebhezi:

• ithambo elingaphambili;
• amathambo amabili e-parietal;
• l'os occipital. 

Lawa mathambo ahlanganiswe ndawonye ngama-suture. I-coronal suture ixhuma amathambo angaphambili kanye ne-parietal, i-sagittal suture itholakala phakathi kwamathambo amabili we-parietal, kanti i-lambdoid suture ijoyina amathambo e-parietal ne-occipital.

Njengazo zonke izicubu zamathambo, i-vertex iqukethe izinhlobo ezine zamaseli:

• ama-osteoblasts;
• ama-osteocyte;
• amaseli akhelene;
• ama-osteoclasts. 

Ngaphezu kwalokho, isibalo sayo esingaphandle kwamangqamuzana siyabalwa, sinikeza lesi sicubu isimo saso esiqinile. Ngaphezu kwalokho, lokhu kwenza kube lula kuma-x-ray, ngaleyo ndlela kuvumele ukutadishwa kwamathambo nge-x-ray.

I-vertex ibamba iqhaza ekuvikeleni ubuchopho, engxenyeni yayo ephezulu. Eqinisweni, i-vertex iyisicubu sethambo, ngakho-ke isicubu samathambo, inomsebenzi wokusebenza.

Ngempela, izicubu zethambo zingenye yezinto ezingamelana kakhulu emzimbeni, ngakho-ke iyakwazi ukumelana nezingcindezi zemishini. Le yindlela i-vertex edlala ngayo indima yayo yokuvikela ebuchosheni ezingeni eliphezulu lekhanda.

I-hematoma eyengeziwe engaphandle

I-pathology ethinta i-vertex yenziwa yi-hematoma engaphandle, evame ukulandela ukushaqeka okukhulu okuholele ekuqhekekeni komthambo osemanzini. Le hematoma empeleni yakhiwa iqoqo legazi elitholakala phakathi kwethambo logebhezi nedura, noma ungqimba olungaphandle kakhulu lwama-meninges, imvilophu evikela ubuchopho. Ngakho-ke kungukuchithwa kwegazi phakathi kwelinye lamathambo ogebhezi elenza i-vertex kanye nobude besikhathi sobuchopho.

I-hematoma eyengeziwe engaphandle kwesizinda eyenzelwe i-vertex ayivelakancane, iphesenti elincane kuphela lawo wonke ama-hematomas angaphandle. Ngempela, lolu hlobo lwe-hematoma luthinta kuphela i-vertex ku-1 kuye ku-8% wawo wonke amacala we-extra-dural hematoma. Kungabangelwa ukukhala esonweni se-sagittal, noma ama-hematomas angaphandle kwe-vertex avela ngokuzenzekelayo nawo achaziwe ezincwadini.

I-hematoma eyengeziwe engaphandle (i-EDH) ye-vertex inezici zomtholampilo ezingafani, ngakho-ke ukwenziwa kwendawo okwenziwe ngayo izilonda kuyinkimbinkimbi. Le nkinga ingaba nzima noma ingapheli.

Umsuka wokopha ungaxhunyaniswa, njengoba sekushiwo, ukudabula esonini se-sagittal, kepha imbangela yokopha nayo ingaba yimithambo yegazi. Izimpawu ezivame kakhulu ikhanda elibuhlungu, elihambisana nokuhlanza.

Ngaphezu kwalokho, amacala e-EDH we-vertex ahlotshaniswa ne-hemiplegia, paraplegia, noma i-hemiparesis. Le hematoma eyengeziwe engaphandle kwendlu ye-vertex ihlala ingavamile.

Ezinye izifo

Ezinye izifo ezingathinta i-vertex yizifo zethambo, ezinjengezicubu ezinobungozi noma ezinobungozi, isifo sikaPaget noma ngisho nokuqhekeka, lapho kwenzeka ukuhlukumezeka. Ama-tumors noma ama-pseudotumors we-cranial vault, ikakhulukazi, yizilonda ezivame ukuhlangana nazo enkambisweni yamanje futhi ukutholakala kwazo kuvame ukukhohlakala. Banobungozi kakhulu.

I-hematoma eyengeziwe engaphandle esendaweni esezingeni le-vertex, ngokuya ngosayizi we-hematoma, isimo somtholampilo sesiguli nokunye okutholwe ngemisebe ehambisana nakho, kungaphathwa ngokuhlinzwa. Ukunakekelwa okukhulu kufanele kuthathwe ngesikhathi sokuhlinzwa, ngoba ukudabuka ku-sagittal sinus kungaholela ekulahlekelweni kwegazi okuphawulekayo ngisho nase-embolism.

Obunye ubuthakathaka be-vertex buzophathwa ngezidakamizwa zokwelapha ubuhlungu, noma ngokuhlinzwa, noma, uma kwenzeka kuba nesimila, ngokuhlinzwa, noma ngamakhemikhali nange-radiotherapy uma kuba nesimila. kubi kwaleli thambo.

Ukuxilongwa kwe-hematoma eyengeziwe engaphandle kwesizinda esezingeni le-vertex kungadala ukudideka kokuxilonga. I-CT scan (i-computed tomography) yekhanda ingasiza ekuxilongweni. Kodwa-ke, kufanele kuqashelwe ukuthi ungenzi iphutha nge-artefact noma i-hematoma engaphansi.

Eqinisweni, i-MRI (magnetic resonance imaging) iyithuluzi lokuxilonga elingcono elingakuqinisekisa lokhu. Ukuxilongwa kusenesikhathi kanye nokwelashwa okusheshayo kwe-hematoma engaphandle kungasiza ekwehliseni ukufa kanye nokugula okuxhunyaniswe nalesi sifo esingajwayelekile.

Ngokuthola ezinye izifo zamathambo, isithombe somtholampilo sihlala sihlotshaniswa namathuluzi we-imaging ukuze kutholakale ukuphuka noma ukuqhekeka, noma isimila esibi noma esibi, noma isifo sikaPaget.

Icala lokuqala le-extra-dural vertex hematoma labikwa ngo-1862, nguGuthrie. Ngokuqondene necala lokuqala elichazwe ezincwadini zesayensi lapho i-MRI isetshenziselwe ukuxilongwa kwe-hematoma eyengeziwe engaphandle kwendlu ye-vertex, isukela ngonyaka we-1995.

Ekugcineni, kwavela ukuthi i-pathophysiology ye-hematoma ethinta i-vertex yehluke kakhulu kunaleyo yama-hematomas angaphandle kwesizinda atholakala kwezinye izingosi zogebhezi: impela, ngisho negazi elincane lingadinga ukuhlinzwa. , lapho i-hematoma itholakala ku-vertex, kanti ngasikhathi sinye i-hematoma encane, engenazimpawu etholakala kwezinye izindawo zogebhezi kungenzeka ingadingi ukuhlinzwa.