Author/Editor		Grajn, Andrej; Strojnik, Tadej
Title		Poškodbe glave in možganov
Type		članek
Source		Med Mes
Vol. and No.		Letnik 2, št. 5
Publication year		2006
Volume		str. 149-61
Language		slo
Abstract		The following review article deals with traumatic brain injuries. Pathophysiologically it is important to distinguish brain damage that occurs at the moment of an impact (primary injury) and/or over the ensuing hours and days (secondary injury) because of mass lesion, brain oedema, brain ischemia. We present the morphology of head and brain injuries. Skull fractures, epidural, subdural and intracerebral haematoma and hemorrhagic contusion are briefly described. Pathophysiology and morphology of injuries represent the foundations for the principles of acute care in pre and in-hospital settings. The paper describes clinical examination, resuscitation ofblood pressure and oxygenation, transport to the hospital and documentation. Then we outline initial management and evaluation after admission with common indications for urgent neurosurgical procedures. In conclusion, we describe the treatment in the intensive care unit with emphasis on control of intracranial and cerebral perfusion pressure.
Summary		Pregledni članek obravnava travmatske poškodbe možganov. Patofiziološko pri poškodbi možganov ločimo primarno okvaro ob samem dogodku in sekundarno okvaro, ki se razvije kasneje predvsem zaradi intrakranialnih krvavitev in možganskega edema. Prikazana je morfologija poškodbe glave in možganov. Obdelani so zlomi lobanjskega svoda in baze, poškodbe žil (epiduralni hematom, subduralni hematom, intracerebralni hematom) ter poškodbe možganovine (obtolčenine, zmečkanine, difuzna aksonska poškodba). Sledi prikaz zdravljenja, ki temelji na etiopatogenezi in morfologiji obravnavane patologije. Namen takšne sestave prispevka je ustvariti bralcu predstavo o klinično-patoloških povezavah pri poškodbi glave in možganov. Pri zdravljenju je poudarek na nujnih ukrepih na terenu in po prihodu v bolnišnico. Opisana je klinična slika, ukrepi nujne medicinske pomoči, prevoz in dokumentacija. Predstavljeni so ukrepi in preiskave po prihodu v bolnišnico. Orisani so osnovni operativni postopki. Zabeležene so indikacije za nujne nevrokirurške posege. Prispevek je sklenjen s predstavitvijo zdravljenja v enoti intenzivne terapije, s poudarkom na nadzoru znotrajlobanjskega in možganskega prekrvavitvenega tlaka.
Descriptors		HEAD INJURIES BRAIN INJURIES SKULL FRACTURES HYPOTENSION ANOXEMIA CEREBRAL HEMORRHAGE HEMATOMA, SUBDURAL HEMATOMA, EPIDURAL EMERGENCY MEDICAL SERVICES GLASGOW COMA SCALE EMERGENCY SERVICE, HOSPITAL