Yaxuwa axonal rauni: Bayyanar cututtuka, da ãyõyinMu, kuma ganewar asali

girman kwanyar rauni zai iya kai ga tsanani lalacewar kwakwalwa, da launin toka al'amarin. Su, bi da bi, zai iya sa da ci gaban mai tsanani da kuma sau da yawa komowar cututtuka da ke barazana mutum rayuwa. Next, la'akari da daya daga wadannan sakamakon - yaxuwa axonal rauni, abin da shi ne, fiye da hatsarin irin wannan jiha.

Overview

Da farko muna bukatar bayar da taƙaitaccen rarrabuwa na da matakai na kwanyar raunin:

• Easy. Wannan rauni ne tare da wani kadan rauni, kuma mai girgizawa.
• Average. A wannan yanayin, da mataki na raunin da ya faru da halin da tsakaitãwa.
• Tã. A wannan mataki, da squeezing da kuma yaxuwa axonal kwakwalwa rauni. Rauni yayin da saka wani inertial hali.

description

Yaxuwa axonal rauni (WCT) ne m halaka matakai na jijiya Kwayoyin tare da m kananan hemorrhages. Bisa ga asibiti, pathological mayar da hankali ne kafa a kan iyakar m da fari al'amarin. Yaxuwa axonal rauni (WCT) muhimmanci rage ingancin rayuwa da hankulansu aiki na azabtar. A haƙuri da yanayin, babu shakka, za a iya daukan mai tsanani. Wannan shi ne yafi saboda gaskiyar cewa akwai barazana ga rayuwarsa. Lokacin da rauni auku bruising, kumburi tasowa, akwai wani subdural hygroma. Gaji da damuwa da CSF outflow daga na ramin zuciya zone, sau da yawa gano bakin ciki karaya. Wadannan mamaki faruwa kafin tasowa yaxuwa axonal kwakwalwa lalacewa. Raunin yawanci haka mai tsanani da cewa ba a dukkan lokuta, yana yiwuwa ya mayar da tsohon jikinsa aiki. A aka azabtar ne da wuya, kamar yadda yi nuna, shi ya kõmo zuwa ta gabata al'ada jihar. Bayan da magani da kuma fi na marasa lafiya da yaxuwa axonal kwakwalwa raunin bukatar ganin likita a kai a kai. Dubawa ne zama dole don sarrafa jiki yanayin da farkon ganewa na tabarbarewar.

Yaxuwa axonal rauni: cututtuka, da ãyõyinMu, ganewar asali

Ta yaya wani pathological yanayin? Mutane da yawa kwakwalwa rauni, yaxuwa axonal rauni musamman, tare da shafe tsawon coma. Wannan yanayin ya auku a lokacin da ya samu rauni cikin kwanyar. Bugu da kari, akwai wani gagarumin canji a tsoka sautin. Yaxuwa axonal rauni ciwo tare meningeal da kuma babban bayyananen kara. Tana da wani kaifi karu a matsa lamba da kuma auka. A haƙuri katse da ayyukan dukkan tunani tankuna. Coma iya zama quite tsawo, na asibiti hangen nesa a cikin irin wannan halin da ake ciki, a matsayin mai mulkin, ba sosai m. Akwai yiwuwar cewa haƙuri iya mutuwa, kuma ba tare da ya farka,. A wani labari, da mãsu haƙuri kulawa don fita daga cikin coma, amma bayan wani isasshe tsawon lokaci. Suma zai iya wuce 2-3 makonni. Coma iya a tare da canje-canje a cikin cerebral hemispheres na kwakwalwa ayyuka. A wannan yanayin, da mãsu haƙuri yana da halayyar zafi.

vegetative jihar

Yaxuwa axonal rauni na kwakwalwa halin da m canji a asibiti hoto. Saboda haka, coma iya shiga cikin wani vegetative jihar ko transistor. Asibiti, yaxuwa axonal kwakwalwa lalacewar bayyana a cikin hanyoyi daban-daban. Duk da yake wasu m nuni da isasshe high gudu. Vegetative jihar halin da aikin cire hašin a yankin na cerebral hemispheres. Yana iya dage watanni da dama. A wani vegetative jihar, akwai alamun aikin hanawa a subcortical-kara Tsarin kwakwalwa. Cuta a cikin muhimmanci matakai tsokani bayyanar bulbar, pupillary da kuma sauran irin wannan nuni. Lokacin da canza tsoka sautin pozdnotonicheskie faruwa da kuma m m martani. Wadannan sun hada da, musamman, sun hada da cramps a cikin manya da ƙananan wata gabar jiki, da kara mawadãta daga cikin ƙungiyoyi da kansa rusuna, hannuwa rawar jiki, hadaddun postures na jiki. Kamar yadda aka ambata a sama, da na asibiti manifestations bambanta sosai da sauri. Domin awa, misali, iya fuskanci daban-daban pathological reflexes. A gano canje-canje a cikin vegetative jihar marasa lafiya bayyana dyskinesia, ataxic Gait, akwai magana da hankulansu cuta. Daga cikin karshen, shi ne ya kamata a lura aspontannost, ɓacin hankali, halin kirki ci.

The m Hakika na pathological tsari

Yaxuwa axonal kwakwalwa rauni daban-daban ma'ana miƙa mulki daga dogon coma a wani m vegetative jihar dõgẽwa. An nuna wannan ta sabon bayyananen, wanda bai wanzu kafin. Alal misali, haƙuri iya unduly mayar da hankali duba flicker ko amsa kiran waje samuwar kasashe. Idan vegetative jihar ci gaba na dogon lokaci, shi saukar sabon alamun cutar. A musamman, akwai tamowa carpal tsoka fibrillation reshe tsokoki. A wannan yanayin akwai wani m ci gaba paroxysmal jihohi. Sun gabatar tachycardia, yankin Flushing, hauhawar jini, da kuma sauran mahaukaci bayyanar cututtuka. Daga bisani alama deterioration. Yaxuwa axonal rauni yanzu tare da tsoka stiffness, discoordination, gipomimiya, oligofaziey, bradykinesia, discoordination, ataxia. Shi ne m ga haƙuri da ciwon kai. Fara wajen samar da emetic ciwo, akwai matsaloli tare da karkatar da kai da kuma kafa kari, akwai m wuyansa tsokoki. Mutane da yawa marasa lafiya halin hyperthermia (cortical shanyewar jiki lura daga isasshe kaifi karuwa a yawan zafin jiki) ptyalism, ta ƙara sweating. Saboda haka, za mu iya cewa yaxuwa axonal rauni tsokani komowar pathological tafiyar matakai a cikin jiki.

jarrabawa na haƙuri

Yaxuwa axonal rauni da aka gano na musamman ta hanyar CT da MRI. Wadannan dabaru damar da nazari na gani kallo na mahaukaci karuwa a jikin hyperemia ko edema saboda matsawa na ventricles. Rubuta da kuma sauran aggravated bayyanar cututtuka. Da taimakon CT kwararru suna da damar kimanta da na asibiti hoto da kuma yin ƙiyashi untuk nan gaba. MRI nuna duk pathological canje-canje, tsokane ta m ko m zub da jini da bi yaxuwa axonal rauni. Har na wani pathological yanayin da aka kaddara ma a kan tushen da Magnetic rawa tomographic karatu. A sakamakon ba da damar a zabi mafi kyau duka far ga mãsu haƙuri. M lifiya a kan tushen lumbar huda. Wannan hanya ne musamman da muhimmanci ga farkon ganewa na subarachnoid hemorrhage. Tare da wannan huda nuna predominance high intracranial matsa lamba. Wannan hanya da aka contraindicated a marasa lafiya tare da intracranial girma matakai da suka haddasa kwakwalwa sāke wuri.

CT results a cikin wani m lokaci

Yaxuwa axonal kwakwalwa lalacewar halin da alama karuwa a sashin jiki ko matsakaici girma. Har ila yau, ƙuntatawa an lura, da kuma a wasu lokuta cikakken matsawa III da kuma a kaikaice ventricles, ramukan da convexital tushe da kuma subarachnoid sarari. Canje-canje a cikin nama yawa, kamar yadda mai mulkin, da normodensitivnym hali, amma za a iya lura da karuwa ko raguwa. A fari al'amari, tarin rubuce-rubuce callosum, kara da subcortical Tsarin sukan sami kananan mai da hankali hemorrhages. Don Allah ku yi sani cewa CT hoto na haƙuri iya zama a cikin shekaru kewayon nagartacce. Muhimmancin marasa lafiya da suke nuna wani yaxuwa axonal rauni daga cikin kwakwalwa, halin da ci gaban atrophic tsari. A musamman, shi ne lura ventriculomegaly, fadada convexital muhimmi da subarachnoid sarari. A baya lokaci bayan rauni (bayan game da 3-4 makonni) ne sau da yawa lura jari na cerebrospinal ruwa a cikin frontal yankunan, interhemispheric fissure (a cikin agara sassa musamman). Yana za a iya shafe ta a cikin shakka daga karfafawa da shafi tunanin mutum da kuma neurological matsayi. Wannan shi ne kai tsaye ba da shaida na dawo da girma bayan kwakwalwa lalacewa. Traumatic kwakwalwa rauni a yara fiye da sau da yawa kuma mafi alhẽri daga manya ba a far.

Binciken na da CT

A cewar juna na iya zama wajen yin hukunci a gaban ko babu intracranial hauhawar jini. Idan CT ba fassara tank tushe da ventricle, ko ba manifestations na babban matsawa na high yiwuwa ich. Wannan na iya zama quite m shigarwa bincike intracranial matsa lamba da kuma ta m gyara. Idan CT ne a fili a bayyane CSF outflow fili, musamman na ventricle da tafkunan ruwa, ICP, mafi m cikin rami. Shi ne da wuya cewa matakan da nufin a ta raguwa, zai zama da amfani ga wanda aka azabtar. Marasa lafiya nuna wani gagarumin osmotic homeostasis cuta lalacewa ta hanyar wani primary ko sakandare lalacewar kara da hypothalamic-pituitary Tsarin. A marasa lafiya da matsakaici hyperosmolar jihar lura mafi m sakamakon, tare da mafi furta sau da yawa sosai mutuwa ya auku.

pathogenesis

Macroscopic jarrabawa ya nuna babu nama hallakaswa canje-canje a cikin muhimmi da kuma m saman. A lokaci guda a cikin fari al'amari akwai yankunan da zurfin raunuka. Su kuma za a iya gano gida hemorrhages a fagage daban-daban na kwakwalwa. Yana za ma a duba histologically. Yana iya gane gaban "axonal bukukuwa." Wadannan abubuwa sune yankunan da discontinuity a cikin jijiya endings. Bugu da kari, histological jarrabawa saukar canje-canje cylinders hallakaswa harafin da kunno kai varicose thickenings. A watan bayan da bacewar da bukukuwa rauni da kuma yaduwa na macrophages a canji zone. Bugu da ari canje-canje faruwa a cikin myelin daina kai hare hare, ci gaba pathological tafiyar matakai a neurons na gefe sassa na juyayi tsarin. Har ila yau, ci gaba da jijiya da kuma laka zaruruwa.

Jiyya: Overview

Marasa lafiya da suka nuna yaxuwa axonal rauni, magani da ake sa wani hadadden da ya hada da hanyoyin da dama. A musamman, marasa lafiya bukatar gudanar da shafe tsawon inji iska (iska) a cikin matsakaici hyperventilation yanayin. Sanya multimodality far hada da yin amfani da vasoactive kwayoyi da kuma nootropics, rike da kwanciyar hankali a tafiyar matakai na rayuwa ta amfani da bincike (enteral) da kuma parenteral abinci mai gina jiki. M baki ne yawanci ba sa domin babu substrate, wanda shi ne za a cire. M magudi kuxi ganewa na sauran munanan ci gaba da samar da high matsa lamba a kan kwakwalwa da kuma da aka gyara. Saboda babban abin da ya faru na extracranial rikitarwa (na huhu da kuma pyoinflammatory, zai fi dacewa) kunshe a cikin warkewa hanya na antibacterial kwayoyi da kuma immunocorrecting ayyukan.

A makirci warkewa shisshigi

Marasa lafiya da yaxuwa axonal kwakwalwa rauni asibiti a wani asibiti. The kafa hadaddun na matakan da warkewa da kuma rehabilitative yanayi. A makirci, musamman, shi ya hada da:

• Ventilator don kula da barga aiki na numfashi tsarin.
• Tube ciyar.
• M kula magani.
• Rike al'ada ruwa da kuma electrolyte balance.
• A wasu lokuta, da yin amfani da neurotransmitters, da biogenic stimulants.
• Warkewa bada, inganta zaman majalisar na al'ada aiki na da wata gabar jiki, da rigakafin cututtuka na gidajen abinci.
• Jawabin far zaman for murya aiki karfafawa.

Bayan aiki na bukatar ba wani sauri dawo lokaci bayan shafe tsawon asibiti. Don daidaita tsakiya m tsarin, kwakwalwa rama domin illa aiki, hanzarta da taki na fi ya zama alƙawari na jijiyoyin bugun gini da neuroprotective jamiái. Yana iya kuma bukatar yin amfani da biogenic stimulants, kwayoyi shafi nama metabolism kuma, bisa ga alamomi, neurotransmitters (yana nufin "Madopar", "L-Dopa," "Lac" da sauransu), da kuma anticholinesterase kwayoyi. Idan Dap ne babu bukatar nada hormonal far.

Outlook

Yiwuwar magani marasa lafiya da WCT zai dogara ne a kan girma da lalacewar axons, gaban edema, da yiwuwar shiga cikin pathological tafiyar matakai extracranial. A dauke da fitar da wani tasiri hadaddun warkewa shisshigi a takaice dai lokaci m sakamako ne mafi kusantar. Tare da ci gaba na tsawon lokaci coma kara hadarin rikitarwa. Lokacin da mikawa shi qara da alama na m sakamakon, bi da bi, rage da yiwuwar dawo da. Daidai da muhimmanci shi ne zurfin da coma. The mutum shi ne, da muni da sakamako. A babba za a iya dauke da yiwuwar cikakken ko m dawo da rasa shafi tunanin mutum da ayyuka a cikin komawa da baya daga neurological cuta, har ma a lokuta da lalacewar inda haƙuri bayan wani dogon coma kafa vegetative matsayi zaunanniya daga 'yan makonni zuwa watanni. Wannan sabon abu iya nuna wani alama na reversibility da kuma diyya neurotransmitter da kuma tsarin cuta cewa underlie m disturbances na aikin aiki a kwakwalwa bayan yaxuwa axonal rauni.