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Znotrajmožganska krvavitev Sklici | Navigacijski meni"Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association"44621312602263710.1161/str.0000000000000069"Intracranial hemorrhage"34438672297464810.1016/j.emc.2012.06.003Imaging of the Brain, Expert Radiology Series,1: Imaging of the BrainArhivirano2926242910.1055/s-0037-1608777

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krvavitevmožganovinomožganske prekatesimptomiglavobolbruhanjeokrnjena zavestotrdelost vratuvročinamožganska poškodbaanevrizmaarteriovenska nepravilnostmožganski tumorpovišan krvni tlakamiloidozaalkoholizemnizke vrednosti holesterolazdravil za redčenje krvikokainaračunalniško tomografijoishemična možganska kapintenzivne negesistoličnega tlakakrvnega sladkorjaventrikularna drenažakortikosteroidi









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Znotrajmožganska krvavitev


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Znotrajmožganska krvavitev
Sinonimi
možganska krvavitev, intracerebralna krvavitev, cerebralna krvavitev

Intracerebral hemorrage (CT scan).jpg

Posnetek računalniške tomografije spontane znotrajmožganske krvavitve, ki se širi v stranski možganski prekat.
Specializacija
nevrokirurgija
Simptomi
glavobol, oslabelost polovice telesa, bruhanje, krči, okrnjena zavest, otrdelost vratu, vročina[1][2]
Vzroki
možganska poškodba, anevrizma, arteriovenska nepravilnost, možganski tumor[1]
Dejavniki tveganja
povišan krvni tlak, amiloidoza, alkoholizem, znižan holesterol, zdravila za redčenje krvi, kokain[2]
Diagnostične metode
slikanje z računalniško tomografijo[1]
Diferencialne diagnoze
ishemična možganska kap[1]
Zdravljenje
nadzorovanje krvnega tlaka, operativni poseg, ventrikularna drenaža [1]
Prognoza
dobra prognoza pri 20 % bolnikov[2]
Pogostost
2,5 na 10.000 ljudi na leto[2]
Smrti
44 % jih umre v roku enega meseca[2]

Znotrajmožganska ali intracerebralna krvavitev (tudi samo možganska krvavitev) pomeni krvavitev v možganovino.[3] Gre za obliko znotrajlobanjske (intrakranialne) krvavitve. Običajno krvavitev prizadene tako možganovino kot možganske prekate;[1] krvavitev v možganski prekat imenujemo intraventrikularna krvavitev.[4] Pojavijo se lahko naslednji simptomi: glavobol, oslabelost polovice telesa, bruhanje, krči, okrnjena zavest in otrdelost vratu.[2] Pogosto se pojavi tudi vročina.[1] Pogosto simptomi s časom postajajo hujši.[1]


Med možnimi vzroki znotrajmožganske krvavitve so možganska poškodba, anevrizma, arteriovenska nepravilnost in možganski tumor.[1] Najpomembnejša dejavnika tveganja za samoodsebno (spontano) znotrajmožgansko krvavitev sta povišan krvni tlak in amiloidoza.[2] Drugi dejavniki tveganja so še alkoholizem, nizke vrednosti holesterola, uporaba zdravil za redčenje krvi ter zloraba kokaina.[2] Diagnoza praviloma temelji na slikanju z računalniško tomografijo.[1] S podobnimi znaki in simptomi kot znotrajmožganska krvavitev se kaže tudi ishemična možganska kap.[1]


Zdravljenje poteka v enotah intenzivne nege.[1] Smernice za obravnavo bolnika z znotrajmožgansko krvavitvijo priporočajo znižanje krvnega tlaka, in sicer na vrednost sistoličnega tlaka največ 140 mmHg.[1][5] Čim prej je treba izničiti učinek zdravil za redčenje krvi, ki jih bolnik morebiti uporablja, ter zagotoviti raven krvnega sladkorja v normalnih mejah.[1]Za ublažitev možganskega edema se lahko kirurško opravi ventrikularna drenaža, kortikosteroidi pa se ne smejo uporabiti.[1] V določenih primerih se lahko krvavitev kirurško odstrani.[1]


Znotrajmožganska krvavitev letno prizadene okoli 2,5 na 10.000 ljudi.[2] Pogostejša je pri moških in pri starostnikih.[2] Okoli 44 % bolnikov umre v roku enega meseca od nastopa znotrajmožganske krvavitve.[2] Dobro prognozo ima okoli 20 % bolnikov.[2]



Sklici |




  1. ↑ 1,001,011,021,031,041,051,061,071,081,091,101,111,121,131,141,15 Hemphill JC, 3rd; Greenberg, SM; Anderson, CS; Becker, K; Bendok, BR; Cushman, M; Fung, GL; Goldstein, JN; Macdonald, RL; Mitchell, PH; Scott, PA; Selim, MH; Woo, D; American Heart Association Stroke, Council; Council on Cardiovascular and Stroke, Nursing; Council on Clinical, Cardiology (julij 2015). "Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association". Stroke: A Journal of Cerebral Circulation 46 (7): 2032–2060. PMC 4462131. PMID 26022637. doi:10.1161/str.0000000000000069. 


  2. ↑ 2,002,012,022,032,042,052,062,072,082,092,102,11 Caceres, JA; Goldstein, JN (avgust 2012). "Intracranial hemorrhage". Emergency Medicine Clinics of North America 30 (3): 771–794. PMC 3443867. PMID 22974648. doi:10.1016/j.emc.2012.06.003. 


  3. ↑ https://www.termania.net/slovarji/slovenski-medicinski-slovar/5523768/krvavitev?query=krvavitev&SearchIn=All, Slovenski medicinski e-slovar, vpogled: 10. 3. 2019.


  4. ↑ Naidich, Thomas P.; Castillo, Mauricio; Cha, Soonmee; Smirniotopoulos, James G. (2012). Imaging of the Brain, Expert Radiology Series,1: Imaging of the Brain (angleščina). Elsevier Health Sciences. str. 387. ISBN 978-1416050094. Arhivirano iz prvotnega spletišča dne 2. 10. 2016. 


  5. ↑ Ko, SB; Yoon, BW (december 2017). "Blood Pressure Management for Acute Ischemic and Hemorrhagic Stroke: The Evidence". Seminars in Respiratory and Critical Care Medicine 38 (6): 718–725. PMID 29262429. doi:10.1055/s-0037-1608777. 









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