Uropi hunowanzoenzanisa pakati pekuruboshwe uye nepamusoro hemispheres. Pamusoro pekunyora tomography (CT) scan iyo inotarisa pasi pauropi kubva kumusoro kwepamusoro, kune groove inotenderera pakati pemativi maviri europi iyo midline kumutumbi. Mutsipa wepelinha unobuda pakati-hutsika hwehuropi uye hunoenderera mberi pakati penhare.
Chimwe chinhu chinotenderera chinoitika apo chimwe chinhu chinokonzera iyi nzvimbo yakasikwa nzvimbo yeuropi kurudyi kana kuruboshwe. Icho chiri pamusoro pechiratidzo mushure mokutambudza musoro.
Midline Shift uye Intracranial Pressure
Uropi hunochengetedza hutano hwepanyama panguva dzose. Kazhinji kudzvinyirirwa mukati mehenya kune 5-15 mm / hg. Iri dambudziko rekutanga rinoshandiswa nehutachiona, maviri uye kubuda kweropa mukati mehenya rebony.
Kurwadziwa kwepamusoro kunogona kuwedzera pakarepo uye kuwedzera kuwedzera kusagadzikana kwechisimba (ICP). Kana pane dambudziko rine simba kumusoro, mishonga yeropa inoputika uye inopinda mukati uye yakapoteredza uropi. Sezvo mwoyo uchingoramba uchinyura ropa idzva muuropi, ropa rinowedzera riri kubuda kubva mumitsipa yeropa rinotanga kuwedzera. Izvi zvinomutsa hutano hwehuropi uye kukura kwekuwedzerwa kweropa, kunonzi hematoma , kunotanga kukwikwidza kuhupi hwehupi.
Zvimwe zvinokonzera kuwedzera ICP mushure mokumanikidzwa kwemusoro kunosanganisira kuputika kwehupomberi kune nzvimbo yekukuvadzwa, chiitiko chinonzi hydrocephalus iyo inounganidza hutachiona mumhepo dzemuuropi, uye utachiona.
Nharaunda inoshanduka inowanikwa apo kushungurudzika kunoitwa nekuvakwa kweropa nekuputika kwakapoteredza zvakakonzerwa nehupi tsvina zvine simba zvakakwana kuti zvibvise uropi hwose kubva panzvimbo. Izvi zvinonzi sechirwere chekukurumidzira uye chiratidzo chinotyisa.
Kuziva
Muedzo wakajairika wokuziva kuti midline inochinja ndiyo CT scan .
Zvisinei, pane dzimwe nguva, CT scan haigoneki nokuti murwere haana kugadzikana, kana kuti zviyero zvinowanzodiwa kuongorora kufambira mberi kweropa. Mumamiriro ezvinhu aya, mubhedha wemubhedha unogonawo kushandiswa kutsvaga uye kutarisa kushandiswa kwekuchinja kwe midline.
Pane zvitatu zvakakosha zvinongororwa paunenge uchitarisa kuvapo kwekatikati yekuchinja: septum pellucidum, yechitatu ventricle, uye pineal gland.
- The septum pellucidum : iyo yakakombera membrane iyo inomhanya zvakananga pasi nepakati peuropi
- Chechi yechitatu : nzvimbo yakazadzwa ne-cerebrospinal fluid iyo yakadzika mukati meuropi
- Iyo penial gland : gland ruduku rinenge riri shure kwechetoriki wechitatu
Nzvimbo dzezvikamu zvitatu zvehuropi dzinoshandiswa sezvinyorwa zvinotaridzirwa pane radiologic scan. Kana mumwe wavo ari kunze kwekuenzanirana, izvi zvinoratidza kuti kuomesa kune rumwe rutivi rweuropi kuri kukonzera uropi kubva panzvimbo.
Kurapa
Chirwere chinonyanya kukosha kana kuchinja kwepakati pekudenga kuripo kunoderedza kushungurudzika kunoita kuti uropi huve pakati. Kana kuunganidzwa kweropa ndicho chikonzero, chakadai se subdural hematoma, kuvhiyiwa kuchadikanwa kubvisa ropa ravha uye kumira kubuda ropa.
Antibiotics inoshandiswa kurapa utachiona uye steroid inogona kushandiswa kuderedza kupisa.
Prognosis
Tsvakurudzo dzinoverengeka dzakaongorora migumisiro ye midline kuchinja pane zvizere kwenguva yakareba. Sezvo pakati pekufamba kwepakati zvichiitika nekuda kwekubuda ropa uye kukumanikidza, kuwanda kweropa, nzvimbo yekukuvara, uye huwandu hwemhirizhonga hunowanikwa neuropi ndehuse hunokosha.
Apo uropi huchifambisa, izvi zvinokonzera kushungurudzika kune zvimwe zvivako sezvavanodhonza uye zvinodzingwa kunze kwenzvimbo yavo chaiyo. Iyo yakawanda midline inoshanduka, iyo inonyanya kuoma zvinetso uye inowedzera ngozi yekufa.
Sources:
Bartels, RH, & Meijer, FJ (2015). Midline shift in relation to thickness of traumatic acute subdural hematoma inofungidzira kufa. BMC Neurology , 15 1-6 6p. doi: 10.1186 / s12883-015-0479-x
Liu, R., Li, S., Su, B., Tan, CL, Leong, T., Pang, BC, & ... Lee, CK (2014). Kuziva kushandura uye kuverengera kwehupenzi pakati pekutsvaga kushandisa shanduko yemuenzaniso. Kushandiswa Kwemishonga yeMakemikari uye Mifananidzo , 38 1-14. doi: 10.1016 / j.compmedimag.2013.11.001