I hinga tāu tamaiti i a ia e tākaro ana? Tērā pea i paheke koe, i taka atu i tō pahikara, ā, i pā tō upoko ki tētahi wāhi? I te nuinga o te wā, kāore tātou e aro nui ki ngā mea pēnei, me te whakaaro, "Āe... he paku noa iho te pakaru." Engari i ētahi wā, ahakoa he whara iti noa iho o te upoko, ka arahi pea ki tētahi mea kino ka pā ki tō oranga. I tēnei rā, e kōrero ana tātou mō tētahi āhuatanga ka puta i tētahi wā pēnei, ā, ka tino morearea mēnā kāore e tere te rongoā. I roto i te rongoā, ka kiia tēnei he Epidural Hematoma, he EDH rānei hei whakarapopototanga.
He aha te Epidural Hematoma (EDH)?
Whakaarohia tō tātou roro he mea tino utu nui, he pakarukaru hoki. Kei reira tō tātou angaanga kaha hei tiaki i a ia. Engari i waenganui i te angaanga me te roro e toru atu ngā paparanga tiaki. Ka kiia ēnei e tātou ko ngā meninges. O ēnei paparanga e toru, ko te paparanga matotoru rawa, i raro tonu i te angaanga, e kiia ana ko te dura mater.
Ina pāngia te upoko e te whiu kaha, ka pakaru pea te uaua toto i roto i te angaanga, he uaua toto, he uaua toto rānei. Ina pakaru, ka tīmata te turuturu o te toto. Ka kohia tēnei toto ki te wāhi iti i waenganui i te angaanga me te dura mater, te uhi o waho o te roro. Ka kiia tēnei kohinga toto he 'Epidural Hematoma (EDH)'.
He rite ki te wai e turuturu ana i waenganui i te paparanga paraikete me te pakitara, e pupuhi ana me te mea he mirumiru. I te tipu haere o tēnei toto totoka, ka tīmata te pana ki roto, arā, ki tō tātou roro. Ka taea e tēnei pana te whakararu i te roro. He mate tino kino tēnei e hiahia ana kia rongoatia wawetia.
Ka kiia hoki tēnei āhuatanga ko te 'Extradural Hematoma'. Ko te tikanga, ka mōhiotia anō tēnei ko te 'Traumatic Brain Injury (TBI)', he whara roro i puta mai i te whara o te upoko.
He pēhea te kino o tēnei āhuatanga?
Ae, he mate kino te 'Epidural Hematoma (EDH)' ka mate pea . Ki te kore e rongoatia tonutia, ka taea e ia te whara tonu i te roro, te mate rānei. E ai ki ngā pūrongo, tata ki te 15% o te hunga e pāngia ana e tēnei mate ka mate. Nō reira, ehara i te mea pai kia kaua e aro noa ki te whara o te upoko.
Kia maumahara tonu ko tetahi whara o te upoko, ahakoa te iti, ka taea te kino. Rapua tonutia he awhina hauora, ina koa mēnā he huringa whanonga i muri i te aituā.
Ko wai te mea tino mōrearea?
Ahakoa ka pā tēnei āhuatanga ki te tangata kua whara te upoko, he nui ake te mōrearea o ētahi tāngata.
- Rangatahi: He mea tino noa tēnei āhuatanga i waenga i te hunga rangatahi.
- Ngā tāngata he whati angaanga: He nui ake tēnei mōrearea i roto i ngā aituā e pā ana ki ngā whati angaanga.
- Ngā kaitākaro: Ko te hunga e tākaro ana i ngā hākinakina, inā koa ko te eke pahikara, te reti reti, te whutupōro, me te kirikiti, he nui ake te mōrearea ki ngā aituā.
- Ngā aituā motuka: Ka puta pea tēnei āhuatanga i ngā whara o te upoko i roto i ngā aituā motuka, motopaika rānei, he mea tino noa tēnei i Sri Lanka.
- Tāne: E whā ngā wā ka nui ake te tūponotanga o te tāne ki te pāngia e te EDH i ngā wāhine.
Kāore i te tino kitea tēnei āhuatanga i roto i ngā tamariki kei raro iho i te rua tau te pakeke me te hunga neke atu i te 60 tau te pakeke.
He aha ngā tohu o tēnei? Me pēhea te mōhio ki tēnei?
Ko te mea tino mōrearea, tino ahurei hoki mō tēnei ko te āhua o te putanga mai o ngā tohu. I te nuinga o te wā, engari ehara i te katoa, ka kitea tēnei tauira:
1. Te ngaronga o te māramatanga tuatahi: I muri tonu i te whara o te upoko, ka ngaro te māramatanga mō ētahi hēkona, meneti rānei.
2. Wā Mārama: Kātahi ka hoki anō tō māramatanga, ka kōrero noa me te mea kāore he hē, ā, ka pai tō āhua mō ētahi haora. Ka kiia tēnei wā ko te 'Wā Mārama'. Koinei te wā tino morearea me te wā tinihanga . Nā te mea ki te kawe koe i te tūroro ki te kāinga me te whakaaro kei te pai ia, ka waiho hei raruraru nui.
3. Te tere o te hekenga o te hauora: I muri i ētahi haora, ina tīmata te toto kua kohia ki roto ki te pēhi i te roro, ka kino haere te āhua o te tūroro. Tērā pea ka ngaro anō tōna māramatanga, ā, ka taka ki te koma.
Haunga tēnei tauira matua, ka puta pea ēnei tohu i roto i ngā meneti ki ngā hāora i muri i te aituā.
| Tohu | Whakaahuatanga |
|---|---|
| Te ānini nui | Kāore i rite ki te mamae upoko noa, he mamae upoko kino rawa atu e kore e taea te manawanui. |
| Whakapairuaki me te ruaki | Whakapairuaki me te ruaki, kāore he take mārama. |
| Te whakanui ake i te karu pango o tetahi kanohi | Ki te titiro koe ki ngā kamo o ngā kanohi e rua, ka kite koe he nui ake tētahi i tētahi. He tohu tēnei kei te pēhanga te roro. |
| Pōhēhētanga | Ka ngaro tō mahara kei hea koe, ko te wā, me te mea i tupu, ā, ka pōuri koe. |
| Hurihanga o te kōrero | Kāore e taea te whakapuaki mārama i ngā kupu. |
| Te whanoke me te māhunga | Tērā pea tetahi taha o te tinana, hei tauira te ringa me te waewae matau, e ahua ana me te mea kei te ngaro tōna ora. |
Ki te kino haere te āhua...
Ki te kore te toto e mutu, ā, ki te kore e rongoatia, ka piki ake te pēhanga ki te roro, ā, ka kino haere ngā tohu.
- Ngā mate hopuhopu
- Te uaua ki te manawa
- Te ngaronga o te mahi a te roro
- Āhua koma
- Te mate i te mutunga
He aha te take o tēnei?
Ko te tino take he whara o te upoko . Tata ki te 75% o ngā mate EDH ka haere tahi me te whati angaanga. Ko te tino take ko te whati o te wheua temporal, inā koa kei runga ake i te taringa, ka pakaru te uaua meningeal waenga, he uaua toto e rere ana i roto.
Engari he tino onge te puta mai o tēnei āhuatanga mō ētahi atu take, kāore he mōrearea.
- Mate/whewhe
- Ngā mate toto totoka (Coagulopathy)
- Ngā pukupuku roro toto
- Ngā hapa o te toto
Me pēhea te tautuhi a ngā tākuta i tēnei?
Ina kawea te tangata ki te hōhipera i muri i te whara o te upoko, ina koa mēnā kei a rātou ngā tohu kua whakahuatia i mua ake nei, ka tere te whakahaere a ngā tākuta i ētahi whakamātautau.
- Matawai CT (Tomography Rorohiko): Koinei te tikanga matua, te tikanga tere hoki. He rite ki te tango pikitia X-ray toru-ahu (3D) o roto o te upoko. Ka taea e tēnei te kite mārama i te wāhi kei reira te toto totoka, tōna rahi, me te nui o te pēhanga e pā ana ki te roro.
- Matawai MRI (Whakaahua Āhua Aukume):He whakamātautau anō hoki tēnei hei tirotiro i roto i te roro. He taipitopito ake i te matawai CT, engari ko te tikanga koinei te matawai tuatahi ka mahia i roto i te āhuatanga ohorere.
- Ngā whakamātautau toto: I ētahi wā ka mahia hoki ngā whakamātautau toto hei tirotiro mēnā he raruraru totoka.
Me pēhea te rongoā? Me mahi pokanga?
He āhuatanga ohorere hauora te hematoma epidural e hiahia ana kia pokanga tonutia . Ki te kore e whakamama te pēhanga ki te roro, ka pā mai pea te kino tuturu o te roro, te mate rānei. Ko te whakatau kia pokangahia ka ahu mai i ngā āhuatanga pēnei i:
- He tino mamae te upoko o te tūroro.
- Te ngoikore o te mahi a te roro (te ngaronga o te mahara, te pōhēhē).
- I kitea he toto totoka nui (hematoma) i te matawai CT.
Pokanga
E rua ngā tikanga pokanga matua.
1. Te Tangohanga i te Angaanga me te Whakawātea i te Hematoma: Koinei te tikanga tino noa. I roto i tēnei tikanga, ka tangohia e te taote pokanga he wāhanga iti o te angaanga mō te wā poto, ā, ka tangohia katoatia te toto toto i roto. Ka tautuhia te oko toto ka mutu, ā, ka honoa anō te wāhanga kua tangohia o te angaanga ki tētahi pine iti.
2. Ngā Pūwero: Ko tētahi atu tikanga ko te keri i tētahi, i ētahi rānei pūwero iti ki te angaanga, ka ringihia te toto mā roto i aua pūwero. Ka taea e tēnei tikanga te whakaiti tere i te pēhanga ki te roro. I ētahi wā ka waihohia he ngongo ki tōna wāhi mō ētahi rā i muri i te pokanga hei tango i ngā toto e kohia tonutia ana.
Maimoatanga Tūpato
I ētahi wā, ki te iti rawa te toto totoka, kāore e tino pēhi ana i te roro, ā, kāore hoki he tohu kino o te tūroro, ka whakatau pea ngā tākuta kia kaua e pokanga. I roto i ēnei āhuatanga, ka puritia te tūroro ki te wāhanga tiaki nui (ICU) ā, ka tirotirohia tata mā te whakamahi i ngā karapa CT auau kia kite ai mēnā kei te nui haere te toto totoka. Ka taea e ō tātou tinana te mimiti anō i te iti o te toto i roto i te wā.
Ētahi atu maimoatanga
I muri i te pokanga, ka hoatu ngā rongoā pēnei i te "mannitol, hypertonic saline" hei whakaiti i te pupuhi me te pēhanga i roto i te roro. Waihoki, nā te mea he tūponotanga ka pāngia te roro e ngā mate haurangi i muri i ngā whara o te mahunga, ka tohua ētahi rongoā hei ārai i aua whara.
Mena he kino kei te roro, tera pea e hiahiatia ngā maimoatanga whakaora pēnei i te whakaora tinana, te whakaora mahi, me te whakaora kōrero hei āwhina i te tūroro kia ora.
He aha te rerekētanga i waenga i te Hematoma Epidural me te Hematoma Subdural?
Kua rongo pea koe i te 'Subdural Hematoma'. Ahakoa he toto toto kei roto i te roro e rua, he mārama ngā rerekētanga i waenganui i ngā mea e rua. He mea nui anō hoki kia mōhio koe ki tēnei.
| Āhuatanga | Te Hematoma Epidural (EDH) | Hematoma o raro i te dural |
|---|---|---|
| Te wāhi e kohia ai te toto | Kei waenganui i te angaanga me te uhi o waho o te roro (dura mater). | Kei waenganui i te Dura Mater me te hipoki tuarua i raro iho (Arachnoid). |
| Ko te oko toto e hua ai | He maha ngā wā nā te pakaru o te uaua. He tere te toto. | He maha ngā wā nā te pakaru o te uaua. Ka āta haere te toto. |
| Ka puta ngā tohu | Ka puta wawe mai (i roto i ētahi haora) i muri i te aituā. | Tērā pea ka āta puta mai (ahakoa i muri i ngā rā, i ngā wiki rānei). |
| Ko te nuinga o te wā ka puta | Mō ngā rangatahi, i roto i ngā aituā e whati ai te angaanga. | He mea noa i roto i te hunga kaumātua (ka mimiti te roro i a ia e pakeke haere ana, ka puta te vasoconstriction) |
| Te tere whakaora | He teitei te auau whakaora mēnā ka kitea me te rongoā wawetia . | He teitei ake te auau mate i tō te Epidural Hematoma. |
Me aha mēnā ka pāngia te mahunga o te tangata e ēnei tohu?
Koinei te wāhanga tino nui. Mena kei a koe, kei tētahi rānei e mōhio ana koe, tētahi o ēnei tohu i muri i te pānga o tōna mahunga,Kawea ia ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera tata tonu.
- Ki te ngaro tō māramatanga (ahakoa mō te hēkona kotahi)
- Mena he nui tō mamae o te upoko
- Ki te mea ka pōrearea te kōrero
- Ki te pōhēhē koe, ki te hiamoe rānei
- Mena ka puta te ruaki
- Mena he rerekē ngā mowhiti pango o ngā kanohi e rua (mēnā he nui ake tētahi)
- Mena he pōuri tōu, he uaua rānei ki te hikoi
- Ki te mea kei te ahua kore ora tetahi taha o te tinana
- Mena ka puta he hopuhopu
Kia maumahara, ko tētahi tohu matua o te 'Epidural Hematoma' ko te kino haere o te āhua i muri i te whara o te upoko, kātahi ka pai ake mō tētahi wā. Nō reira, kaua e noho noa ki te kāinga me te whakaaro, "Kua pai inaianei." Me toro atu ki te tākuta.
Kāore e taea te ārai i ngā aituā pēnei?
Kāore e taea e tātou te ārai i ngā aituā 100% o te wā, engari he maha ngā mea ka taea e tātou te mahi hei whakaiti i te mōrearea.
- Mauria he potae: Ina eke motopaika, pahikara rānei, ina takaro rānei i ngā hākinakina pēnei i te whutupōro, te kirikiti rānei, kia tika te potae e mau ana.
- Mauria he whitiki nohoanga: Mauria he whitiki nohoanga i ngā wā katoa kei roto koe i te waka.
- Whakamahia ngā taputapu haumaru: Me mau ngā potae haumaru tika mēnā kei te mahi koe i ngā wāhi teitei, i roto i te umanga hanga, i tētahi atu mahi rānei ka tūpono ki tō mahunga.
- Āta karohia te ruku ki ngā wāhi kāore e mōhiotia: Āta karohia te ruku ki ngā awa me ngā manga iti kāore e mōhiotia, kei reira pea ngā toka, ngā arai rānei.
Karere Tangohia ki te Kāinga
- He mate kino te Epidural Hematoma (EDH) e whakaemi ana te toto i waenganui i te angaanga me te uhi o waho o te roro, ka pēhi i te roro.
- Ko tētahi o ngā tohu tino mōrearea o te whara o te roro ko te wā poto o te kore mohio, ā, muri iho ka ora ake mō ētahi haora, kātahi ka kino haere te āhua (Lucid Interval).
- Ko te ānini nui, te ruaki, te kanohi pango nui, te pōhēhē, me te kōrero koretake, he tohu ēnei e hiahia ana kia aro wawe atu.
- Kaua e warewarehia tetahi whara o te upoko, ahakoa te iti. Mena kei a koe tetahi o ngā tohu o runga ake nei, haere tonu ki te Tari Urupare (ETU) o te hōhipera.
- Ki te kitea wawe te toto totoka, ā, ka tangohia mā te pokanga, he tino teitei te tūponotanga ka ora katoa. Ka mōrearea pea te ora i te whakaroa.
- Tiakina tō mahunga i ngā aituā kino pēnei mā te whakamahi i ngā potae tiaki me ngā whitiki nohoanga.
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