Akakufunsani choipa axonal: Zizindikiro, zizindikiro ndi matenda

mwakayakaya cranial kungachititse kuti kuwononga kwambiri ubongo, imvi kanthu. Nawonso, angachititse chitukuko cha matenda aakulu ndipo nthawi zambiri sizingasinthe zimene zingawononge moyo wa munthu. Kenako, tione imodzi mwa mavuto awa - akakufunsani choipa axonal, chimene icho chiri, kuposa kuopsa okhumudwa.

mwachidule

Choyamba tiyenera kupereka Gawo mwachidule magawo kuvulala chigaza:

• Easy. choipa ichi limodzi ndi choipa pang'ono ndi concussion.
• Avereji. Pankhaniyi, mlingo wa kuvulala yodziwika monga zolimbitsa.
• Lolemera. Pa nthawi imeneyi, akamalimbikira ndipo akakufunsani axonal choipa ubongo. Ngozi atavala makhalidwe inertial.

mafotokozedwe

Akakufunsani axonal choipa (WCT) ndi yaikulu chiwonongeko njira ya maselo mitsempha ndi kukha magazi osakhala yaing'ono. Malinga ndi matenda, cholinga pathological aumbike pa malire a nkhani imvi ndi woyera. Akakufunsani choipa axonal (WCT) kwambiri amachepetsa khalidwe la moyo ndi ntchito maganizo a wovulalayo. alili, mosakaika, tinganene kuti kwambiri. Izi zili choncho makamaka chifukwa chakuti pali loopsa kwambiri moyo wake. Pamene choipa amapezeka kufinya, kutupa akufotokozera, pali subdural hygroma. Posasangalala CSF outflow kwa woyendera nthambi yamitsempha yamagazi, kawirikawiri wapezeka maganizo wovulala. zinthuzo zimachitikira pamaso osauka akakufunsani axonal ubongo. Kuvulala zambiri kwakuti si m'zochitika zonse n'zotheka kuti abwezeretse akale ntchito thupi. Wozunzidwayo ndi kawirikawiri ikusonyeza kumapeto, limabwerera ku uliri yapita yachibadwa. Pambuyo mankhwala ndi dokotala konzanso odwala ndi akakufunsani kuvulala axonal ubongo muyenera kukaonana ndi dokotala nthawi zonse. Chavuta ndi zofunika kuchepetsa matenda thupi ndi kuzindikira mwamsanga kuwonongeka.

Akakufunsani choipa axonal: zizindikiro, zizindikiro, matenda

Kodi chikhalidwe pathological? Ambiri ubongo choipa, akakufunsani axonal choipa makamaka pamodzi ndi chikomokere yaitali. chikhalidwe Izi zimachitika panthawi zoipa achigaza. Komanso, pali kusintha minofu kamvekedwe. Akakufunsani axonal choipa syndrome limodzi meningeal ndi mawonetseredwe aakulu mapulaniwo. Papita kuchepa lakuthwa mu kuthamanga ndi kugwa. Wodwala anasiya ntchito za akasinja onse amaganiza. Chikomokere kungakhale yaitali ndithu, matenda madokotala ananena zawo zimenezo, monga ulamuliro, si yabwino kwambiri. Pali kuthekera kuti wodwalayo mungafe, ndipo popanda ayambirenso kutsitsimuka. Mu chitsanzo china, wodwalayo amalowerera kutuluka chikomokere, koma patapita nthawi mokwanira yaitali. Samakumbukira ukhoza masabata 2-3. Chikomokere akhozanso kukopeka ndi kusintha mu hemispheres oziziritsa ntchito ubongo. Pankhaniyi, wodwalayo ululu khalidwe.

boma vegetative

Akakufunsani axonal kuvulala kwa ubongo yodziwika ndi kusintha mofulumira mu chithunzi matenda. Choncho, chikomokere mukhoza kupita mu khalidwe vegetative kapena transistor. Kukomoka, akakufunsani axonal ubongo m'njira zosiyanasiyana. Ngakhale ena kusonyezedwa ena taphunzira ndi mathamangidwe mokwanira mkulu. boma Vegetative amakhala ndi disconnection zinchito m'dera la hemispheres ubongo. Zimakhala angakhale kwa miyezi ingapo. Pa boma vegetative, pali zizindikiro za zinchito kuwonongeka mu nyumba subcortical-tsinde la ubongo. Matenda mu njira zofunika amakwiya maonekedwe bulbar, pupillary ndi zina kusonyezedwa ofanana. Pamene kusintha minofu kamvekedwe pozdnotonicheskie zimachitika ndi samveka ayankhe zozitetezera. Zikuphatikizapo, makamaka monga omangana mu miyendo chapamwamba ndipo m'munsi, kuwonjezeka matalikidwe kayendedwe ka mutu wake yoweramitsidwa, manja kunthunthumira, kugwedeza zovuta za thupi. Monga tanena, mawonetseredwe matenda zosiyanasiyana mofulumira kwambiri. Kwa ola limodzi, mwachitsanzo, akhoza kuona osiyana bongo pathological. Kudziwa kusintha odwala vegetative boma limapezeka dyskinesia, ataxic gait, pali mawu ndi mavuto a m'maganizo. Mwa iwowa, ndi Dziwani aspontannost, amnesia, kutopa abwino.

Njira zina za ndondomeko pathological

Akakufunsani axonal ubongo choipa osiyana zomveka kusintha kuchokera chikomokere wautali kulimbikira vegetative boma chosakhalitsa. Zimenezi zikusonyezedwa ndi mawonetseredwe latsopano limene kulibe pamaso. Mwachitsanzo, kuleza mtima mosayenera kuganizira Mwachidule kukulowa kapena anatani zimene zikuchitika kunja. Ngati boma vegetative amapitirizabe kwa nthawi yaitali, chinavumbula zizindikiro latsopano la matenda. Makamaka, pali zakudya m'thupi carpal minofu fibrillation nthambi minofu. Pankhaniyi pali mofulumira patsogolo paroxysmal limati. Zoperekazo tachycardia, ankatenthetsa, oopsa, ndi zizindikiro zina nthenda. Kenako amalembedwa kuwonongeka. Akakufunsani choipa axonal tsopano limodzi ndi minofu stiffness, discoordination, gipomimiya, oligofaziey, bradykinesia, discoordination, ataxia. Ndi kawirikawiri kwa mutu wodwalayo. Ayamba kukhala syndrome emetic, pali mavuto ndi kuweramira mutu ndi mwendo yophunzitsa, pali ouma khosi minofu. odwala ambiri yodziwika hyperthermia (yokhudza kotekisi zikwapu anati kwa kuwonjezeka mokwanira lakuthwa kutentha) ptyalism, kuchuluka thukuta. Choncho, tinganene kuti akakufunsani axonal choipa amakwiya sizingasinthe njira pathological mu thupi.

Kuphunzira mtima

Akakufunsani choipa axonal ndi wapezeka yekha mwa CT ndi Kujambula. njira izi kulola phunziro zithunzi ananena kuwonjezeka nthenda m'thupi hyperemia kapena edema chifukwa psinjika a ventricles lapansi. Wolembedwa ndi zizindikiro zina kukula. Mothandizidwa ndi akatswiri CT mwayi uwu wa kufufuza chithunzi matenda ndi kupanga Mapa tentative m'tsogolo. Kujambula zikusonyeza kusintha pathological onse, chikwiyire ndi magazi tsankho kapena yaikulu kuti ayende akakufunsani axonal choipa. Mmene chikhalidwe pathological anatsimikiza komanso pamaziko a maginito kumveka kuwerenga tomographic. Zotsatira kulola kusankha mulingo woyenera mankhwala wodwala. Zolondola matenda pamaziko lumbar puncture. Ndondomeko n'chofunika kwambiri kuti kuzindikira mwamsanga kukha mwazi subarachnoid. Ndi puncture izi zikusonyeza predominance mkulu intracranial kuthamanga. Ndondomeko contraindicated odwala ndi njira intracranial buku kuti chifukwa ubongo dislocation.

CT zimachititsa nthawi pachimake

Akakufunsani axonal ubongo yodziwika ndi kuwonjezeka zikusintha chiwalo kapena buku zolimbitsa. Komanso, chiletso zimawonedwa, ndi zina kwathunthu psinjika III ndi ventricles lateral, zitsime convexital m'munsi ndi malo subarachnoid. Kusintha minofu osalimba, monga ulamuliro, ndi khalidwe normodensitivnym, koma zingaoneke kuchuluka kapena kuchepa. Mu nkhani woyera, corpus callosum, mapulaniwo ndi nyumba subcortical nthawi zambiri amapezeka yaing'ono kukha magazi focal. Chonde kudziwa kuti CT chithunzi wodwala akhoza kukhalabe mu m'badwo osiyanasiyana mfundo. Mphamvu za odwala amene anasonyeza akakufunsani axonal kuvulala kwa ubongo, yodziwika ndi chitukuko cha ndondomeko atrophic. Kwenikweni, amatchuka ventriculomegaly yolalikira convexital woyambira ndi malo subarachnoid. Pa nthawi patatha choipa (pambuyo za 3-4 masabata) kawirikawiri anati kudzikundikira madzimadzi cerebrospinal m'madera mazunzo, interhemispheric fissure (ziwalo zake zapambuyo makamaka). Iwo akhoza kuchotsedwa mu njira ya olimba m'maganizo ndi udindo ubongo. Uwu ndi umboni zotsalira za buku kuchira pambuyo kuwonongeka kwa ubongo. Mantha ubongo choipa ana kawirikawiri komanso kuposa akulu kupereka mankhwala.

Anapeza pa CT

Malinga chitsanzo zikhoza kukhala ziri kuweruza kukhalapo kapena kusapezeka kwa oopsa intracranial. Ngati CT si anawamasulira thanki m'munsi ndi ventricle, kapena mawonetseredwe panopa psinjika awo aakulu wa mkulu Mwina ICH. Izi zikhoza kukhala abwino kwambiri unsembe kafukufuku intracranial kuthamanga ndi chilangizo chake wotsatira. Ngati CT ndi kuoneka bwino CSF outflow thirakiti, makamaka kwa ventricle ndi zitsime, ICP, zambiri mwa una. N'zokayikitsa kuti miyeso umalimbana lawo Ndikulichepetsa, adzakhala zothandiza wovulalayo. Odwala anasonyeza chidwi osmotic homeostasis matenda oyambitsidwa ndi chachikulu kapena yachiwiri kuwonongeka tsinde ndi nyumba hypothalamic-pituitary. Odwala ndi hyperosmolar zolimbitsa boma anati zakambidwa yabwino kwambiri, ndi zambiri kutchulidwa zambiri munthu amafa.

pathogenesis

Macroscopic mupeza palibe minofu zowononga kusintha woyambira ndi pamalo akunja. Pa nthawi yomweyo mu nkhani woyera pali mbali ya zotupa kwambiri. Iwo akhoza wapezeka kukha magazi m malo osiyanasiyana ubongo. Kudzakhala komanso kuyezedwa histologically. Iwo akhoza kudziwa kumene kuli "mipira axonal." Zinthu zimene zimapanga madera discontinuity mu molekezera mitsempha. Komanso, histological Kupenda anaulula kusintha zonenepa zowononga chikhalidwe ndi akutulukira thickenings varicose. A mwezi kutha kwa mipira choipa ndi kuchuluka kwa macrophages mu zone zosinthidwa. kusintha Komanso chidzachitika myelin m'chimake, kupitiriza njira pathological mu manyuroni a mbali zotumphukira ya ubongo. Komanso kukhala ndi mitsempha ndi msana ulusi chingwe.

Chithandizo: mwachidule

Odwala amene anasonyeza akakufunsani axonal choipa, chithandizo akapatsidwa kuipidwa monga njira zingapo. Makamaka, odwala amafunika kuchita yaitali makina mpweya (mpweya) mu zolimbitsa mode hyperventilation. Anatumizidwa multimodality mankhwala kupanga ntchito mankhwala vasoactive ndi nootropics, kukhala bata mu njira kagayidwe kachakudya ntchito kafukufuku (enteral) ndi zakudya parenteral. Opaleshoni alowererepo nthawi sanagaŵiridwe chifukwa palibe gawo lapansi, amene kuchotsedwa. Opaleshoni mpheto zopindulitsa kudziwika kuvutika ena patsogolo kupereka kuthamanga pa ubongo ndi zigawo zake. Chifukwa kufala kwa mavuto extracranial (m'mapapo mwanga ndi pyoinflammatory, makamaka) m'gulu njira achire mankhwala antibacterial ndi immunocorrecting ntchito.

Chiwembu zikunena achire

Odwala akakufunsani axonal choipa ubongo m'chipatala m'chipatala. Kukhazikitsidwa kwa zovuta kwa njira ya achire ndi rehabilitative chikhalidwe. Mu chiwembu ndi, makamaka, kumaphatikizapo:

• Othandizira kukhalabe ntchito khola a dongosolo kupuma.
• Chubu kudya.
• odwala kwambiri mankhwala.
• Kukhalabe yachibadwa madzimadzi ndi electrolyte bwino.
• Nthawi zina, ntchito timene, ndi ogalamutsa biogenic.
• Achire kokoka, umathandiza resumption a uziyenda yachibadwa ya nthambi, kupewa matenda zimfundo ndi.
• magawo lolankhula pa ntchito mawu olimba.

Pambuyo ntchito zimafuna osati mwamsanga kuchira nthawi pambuyo hospitalization yaitali. Ziziyenda chapakati mantha dongosolo, ubongo zoperewerazo ntchito mkhutu, imathandizira pa mayendedwe a konzanso ayenera kuika mtima ndi wothandizila neuroprotective. Lusoli kugwiritsa ntchito ogalamutsa biogenic, mankhwala zokhudza kagayidwe minofu ndiponso malinga ndi zizindikiro, timene (kutanthauza "Madopar", "L-Dopa," "Lac" ndipo ena), ndi mankhwala anticholinesterase. Ngati DAP palibe chifukwa choti poika mankhwala m'thupi.

kaonedwe

Mwina odwala mankhwala ndi WCT kudzadalira kukula kwa zowonongeka axons, pamaso pa edema, kuthekera kuloŵa pathological njira extracranial. Pogwira wogwira mtima zikunena zovuta achire mu nthawi yochepa yabwino zotsatira zambiri. Ndi anapitiriza yaitali chikomokere kumaonjezera ngozi ya mavuto. Pamene paradaiso kumachititsa wa zakambidwa chowawa, motero, yafupika ndi kuthekera kuchira. Ofunika ndipozama ndi chikomokere. Ikakhala yolemera ndi, zoipa zotsatira. chachikulu tinganene kuti n'zotheka kuchira bwino kapena tsankho la anataya ntchito maganizo mgwirizano wa matenda a ubongo, ngakhale milandu kuwonongeka kumene mtima patapita chikomokere yaitali anapanga udindo vegetative wosatha ku masabata angapo miyezi. zodabwitsazi kungasonyeze imabwera reversibility ndi malipiro mtundu ndi matenda structural kuti chimayambitsa chisokonezo mukusowa ntchito zinchito mu ubongo pambuyo akakufunsani choipa axonal.