Uma igama elithi "ukuhlukumezeka kwekhanda" (TC) lihambisana ngokoqobo nokushaqeka kogebhezi, kungakhathaliseki ukuthi linamandla kangakanani, ngokwemibandela yezokwelapha, ukuhlukumezeka kwekhanda kuhambisana nokushaqeka okukhulu okubangela ukuphazamiseka kokwazi, ngisho nakafushane. . Izimo eziningi zempilo zingaholela ekuhlukumezekeni kwekhanda (ezemidlalo, ezobuchwepheshe, imoto noma ingozi yomgwaqo omkhulu, izingozi zasekhaya, ukushaya, ukuwa, ukushaywa ekhanda, isibhamu, njll.).

EMINYE IMIQONDO EBALULEKILE

• Inertia yobuchopho

Ukuhlukumezeka kwekhanda kungaba mnene noma kube nzima, nabo bonke abangaba abaxhumanisi. Ubunzima bayo buncike ebukhoneni bezilonda ze-intracerebral noma ukuba khona kwe-extra-cerebral hematoma, ukopha okuphakathi kogebhezi nobuchopho. Ngokombono wokusebenza, ukulimala kobuchopho kuxhunyaniswa nezinqubo zokunciphisa ukusheshisa (okuyingozi kakhulu) okubhekene nokwelula, ukuchoboza kanye namandla okugunda ngaphakathi kobuchopho ngokwawo. Lawa mandla angakwazi ukwelula ama-neurons (amaseli obuchopho) kanye nezandiso zawo ze-axonal (“amakhebula”). Ngempela, ubuchopho obunzima obucishe bube yi-1400 amagremu bune-inertia yabo, ikakhulukazi njengoba ingaxhunywanga ngqo ethanjeni logebhezi. Ngomthelela onobudlova obanele, ubuchopho buhlasela ingaphakathi logebhezi emuva naphambili, noma ezinhlangothini, njengomzimba womuntu obhekane nokushesha okungazelelwe noma ukwehliswa, okufana nengozi engaphambili emotweni. . Lezi zindlela ezimbili zivame ukuhlotshaniswa nesimo se-blow and kick.

• Ukulahlekelwa ukwazi

Okulingana nokungqongqoza, ukuzamazama okukhulu kobuchopho kuzobangela ukumangala kobuchopho, okubangela ukulahlekelwa ukwazi, futhi okungenzeka kubangele ukulimala kobuchopho noma i-hematoma. Ngokuvamile, ukubuya kokwazi ngokushesha, kuba makhulu amathuba okubuyela kokujwayelekile ngaphandle kwemiphumela engemihle. Ngakolunye uhlangothi, ukulahleka okujulile nokuhlala njalo kokukhathazeka kukhathaza kakhulu futhi kungahle kuhambisane nokuba khona kokulimala kobuchopho. Nokho, ukubuyela ngokushesha kokujwayelekile akwanele ukukhipha ngokusemthethweni ubukhona bokulimala kobuchopho. Ngakho-ke, noma yikuphi ukulahlekelwa kokuqala kokuqaphela esimweni sokuhlukumezeka kufanele kubhekwe njengophawu lokungathí sina, kuze kube yilapho kufakazelwa ngenye indlela, futhi kuholele ekuqashweni okuseduze komtholampilo, ngisho nalapho kungabikho ukulimala okubonakalayo kobuchopho esigulini. I-CT scan noma i-MRI. Kepha qaphela, ukungabikho kokulahleka kokuqala akukwazi ukubhekwa njengophawu lwe-TC enobungozi noma. Ngempela, Ngokocwaningo olukhulu, lokhu kulahlekelwa kokwazi kokuqala kungase kungabi khona ku-50 kuya ku-66% ezimweni lapho isithwebuli sithola isilonda esingaphakathi.

• Ukuhlukana kwe-Skull

Ubukhulu bokulimala ekhanda abuncikile nje ekutheni ukuphuka kogebhezi kukhona noma cha. Ngokusobala, ukuphuka okubonakalayo ku-x-ray akufanele kube ukuphela kwepharamitha yobunzima bokuhlukumezeka kwekhanda, yingakho kungenziwanga ngokuhlelekile. Ngempela, uma ukuphuka kogebhezi kubonisa ukuhlukumezeka okunzima, okwanele ukuphula ithambo, ngokwalo akudingi ukwelashwa okuthile ngaphandle kwama-analgesics ukuzolalisa ubuhlungu. Ngakho-ke umuntu angahlushwa ukuphuka kogebhezi ngaphandle kokulimala kobuchopho noma i-hematoma. Umuntu angabuye ahlupheke nge-hematoma ye-intracranial engathí sina, futhi lokhu, lapho kungekho ukuphuka kwekhanda. Abanye baze bacabange ukuthi ukuphuka kuhambisana nokuhlakazeka kwegagasi lokushaqeka elizofiphala phezu kwendawo esikhundleni sokusabalala lijule ebuchosheni, ngaleyo ndlela livikele izakhi zobuchopho ezingaphansi, njengegobolondo. leqanda. Kodwa-ke, ukubhekwa komugqa wokuphuka, ikakhulukazi ezingeni lesikhashana, kufanele kukhuthaze ukuqapha ngenxa yengozi eyengeziwe yokuthuthukisa i-hematoma eyengeziwe (ingozi ephindwe ngo-25).

Izinhlobo eziningana zezilonda

• I-hematomas ye-Extracerebral

Akhiwe phakathi kobuso bangaphakathi bogebhezi kanye nobuso bobuchopho, lawa ma-hematoma e-extra-cerebral ahambisana nokuqoqwa kwegazi okuvame ukuxhunyaniswa nokudabuka kwemithambo ye-venous ehlinzeka ngolwelwesi oluthathu olumboze ubuchopho (ama-meninges) atholakala nje. ngaphansi kwethambo logebhezi. Izenzakalo zokusheshisa-nokwehla zingadala lezi zinyembezi. Lawa ma-meninges amathathu akha isivikelo sobuchopho esinganele uma kwenzeka kuba nokuhlukumezeka okukhulu.

Ngokwenza, sihlukanisa:

· I okuthiwa "subdural" hematomas, etholakala phakathi kwama-meninges amabili (i-arachnoid ne-dura, engaphandle). Kuxhunyaniswa nokudwengula kwe-venous noma imiphumela ye-cerebral contusion, i-hematoma ye-subdural ingenzeka ngokushesha ngemva kokulimala kwekhanda (ngokushesha i-coma) noma kamuva. Ukuhlinzwa kubalulekile ezimweni eziningi lapho kunengozi yokucindezelwa kobuchopho. Iqukethe ukukhishwa kwe-hematoma.

· I i-hematomas eyengeziwe, etholakala phakathi kwendawo yangaphakathi yethambo logebhezi kanye nesikhathi. Ikakhulukazi okwesikhashana, ama-hematomas angaphandle kwesikhashana axhumene nokuba khona kwesilonda somthambo ophakathi we-meningeal. Ngaphandle kokunye okuhlukile (i-hematoma ye-extra-dural yevolumu encane kakhulu futhi ibekezelelwa kahle isiguli), lolu hlobo lwe-hematoma ludinga ukungenelela okuphuthumayo (trepanation) okuhloswe ukukhipha leli qoqo legazi eliphinde lisongela ukucindezela ubuchopho.

• Izilonda ze-Intracerebral

Zihlanganisa izinhlobo eziningana zokuhlasela, zendawo noma ezisakazwayo, ezingahlotshaniswa futhi ezenza bonke ubunzima be-prognosis. Ukuhlukumezeka kwekhanda ngakunye kuqondile.

Ngakho-ke ukuhlukumezeka kwekhanda kungahambisana nengxenye yesekhondi ngokuthi:

·       I-Bruises ebusweni bengqondo. Zihambisana nokulimala okubangelwa ukuthintana kobuso bobuchopho nobuso bangaphakathi bethambo logebhezi, naphezu kwama-meninges. Ukungqubuzana kuthinta ingaphambili lobuchopho kanye nangemuva (ukubuyisela ukushaqeka) kanye nendawo yesikhashana. I-Hematoma, i-necrosis endaweni yokopha, i-edema noma i-hemorrhages encane ebusweni bobuchopho kungenzeka.

·       Ukulimala kwama-neurons, noma ukulimala kwe-axonal. Ngempela, izingqimba ezimbili ezihluke kakhulu ezakha ubuchopho futhi ezibizwa ngokuthi izinto ezimhlophe (phakathi nendawo) kanye ne-grey (ezimboza into emhlophe ngaphandle), azinakho ukuminyana okufanayo ngakho-ke, inertia ehlukile. Ngesikhathi somthelela, indawo yokuhlukaniswa kwezingqimba ezimbili izokwelulwa noma igundwe, kubangele umonakalo kuma-neurons adlula kuwo.

Noma kuhlehliswe ngemva kwemizuzu embalwa noma amahora, ngo:

·       Edema, ngamanye amazwi ukunqwabelana kwamanzi okuzokhuphula ingcindezi ngaphakathi kobuchopho futhi lokhu, eduze kwesilonda emahoreni alandela ingozi, ngengozi yokuthuthukisa umfutho wegazi ophezulu we-intracranial kanye nokucindezela isisindo sobuchopho ngakolunye uhlangothi (so- ebizwa ngokuthi "ukuzibandakanya" syndrome).

·       Ischemia, esaba kakhulu, ngamanye amazwi ukwehla kwe-oksijini emathisini obuchopho okuhlotshaniswa nokuncipha kwe-vascularization, kulandela ingozi noma ukuthuthukiswa kwe-edema yokucindezela. Ukulandelana kokusabela kwamakhemikhali e-biochemical kungaholela ekufeni kweseli lama-neurons ahilelekile.

·       Ukopha kwe-Intracerebral (hematomas)