Patophysiology and Diagnosis of EDH & Basic Principles

8/15/2019 Patophysiology and Diagnosis of EDH & Basic Principles

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PATOPHYSIOLOGY AND DIAGNOSIS OF EDH & BASICPRINCIPLES OF DEPRESSED FRACTUREMANAGEMENT


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THE ANATOMY


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Mechanis

m ofInjury

IMPACT

BLUNT PENETRATING

1. HIGHVEL!IT"

#. L$VEL!IT"

1. %TAB$UN&

#. GUN%HT

'. THER%


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EPIDURAL HEMATOMA

Accumulation of loo! in t"#$ot#ntial %$ac# #t##n !u'a mat#'

an! on#


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PATHOPHYSIOLOGY

Di%%#ction of t"# !u'a f'om t"# inn#' tal#ma( occu' )'%t* follo#! ( l##!in+ in t"#%$ac# t"u% c'#at#!

Sou'c# of l##!in+ , -./ f'om a't#'ial!i%'u$tion* #%$#ciall( of t"# mi!!l#m#nin+#al a't#'(0 Ra'#l( f'om 1#nou% %inu%0


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!MPRE%%IN(MI&LINE%HI)T * MA%% E))E!T%"MPTM% AN& %IGN%


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CLINICAL FINDING

23456/ "a1# t"i% cla%%ical$'#%#ntation ,

B'i#f $o%t t'aumatic lo%% of

con%ciou%n#%% 7LOC8 follo#! ( a

9Luci! int#'1al: fo' %#1#'al "ou'0 T"#n* otun!ation* cont'alat#'al"#mi$a'#%i%* i$%ilat#'al $u$illa'(

!ilatation


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OTHER CLINICAL F; MAY PRESENTS ,

H#a!ac"#

#'no"an?%

$"#nom#non8* a fal%# locali=in+ %i+n B'a!ica'!ia i% a lat# )n!in+%

H($o1ol#mia ma( # $'#%#nt in infant


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TREATMENT

20 A* B* C* D

50 O(+#nation

0 H#a! u$ 33

0 I


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TREATMENT

NON SURGICAL* If ,

Small l#%%ion 7 J 2 cm maimalt"icn#%%8 non acut# EDH it" minimal

n#u'olo+ical %i+n%%(m$tom% an! no#1i!#nc# of "#'niation


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SURGICAL BY CRANIOTOMYE


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DELAYED EPIDURAL HEMATOMA 7DEDH8

An EDH i% not $'#%#nt on t"# initial CT*ut i% foun! in %u%#u#nt CT0 423/ ofall EDH

Ri% F , Lo#'in+ ICP #it"#' m#!icall(o' %u'+icall( "ic" '#!uc#%tam$ona!in+ ##ct* Ra$i!l( co''#ctin+

%"oc* Coa+ulo$at"i#% >#( to D , Hi+" in!# of %u%$icion


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DEPRESSED S>ULL FRACTURE

Classified as Simple (Closed) and Compound(Open) Fracture


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P'#%%in+ in#t#'natal# of t"#%ull at t"#

%it# of inu'(

St'ain fo'c#of int#'nal

tal#

Fo'c#inc'#a%#

#c##!% t"#ca$ailit( of

on#!#fo'mation

)RA!TURE


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T"i% t($# of f'actu'# occu' if t"#ma+nitu!# of #n#'+( of t'auma i%'#lati1#l( i++#' toa'!% t"#t'auma?% a'#a "ic" i% '#lati1#l(%mall#' 7#* "amm#'* oo!* %ton#*

$i$#* #tc8 In $lain %ull ;4'a( ill a$$#a' !oul#

!#n%it(?% a'#a


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SIGNSSYMPTOMS

H#a!ac"#

LOC

Ma%% ##ct

Com$'#%%ion ##ct

Si+n% Inf#ction* locall( o' %(%t#mic


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CONSER


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SURGICAL MANAGEMENT IN DEPRESSED S>ULLFRACTURE

If !#$'#%%#! i% mo'# t"an cal1a'ia t"icn#%% T"o%# not m##in+ t"# c'it#'ia fo' t"' con%#'1ati1#

t'#atm#nt

T"# P'inci$l#% of %u'+#'( ,20 D#'i!#m#nt of %in #!+#%

50 El#1ation of on# f'a+m#nt%

0 R#$ai' of !u'al lac#'ation

0 D#'i!#m#nt of !#1itali=#! 'ain.0 R#con%t'uction of t"# %ull

0 Sin clo%u'#

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Patophysiology and Diagnosis of EDH & Basic Principles