the Hematoma - the limited congestion of blood at the closed and open damages of bodies and fabrics with rupture (wound) of vessels; the cavity containing liquid or curtailed krov.

Klassifitsirujut a hematoma depending on localisation (subserous, subduralnaja, intramuscular, etc.) is thus formed Relations to a blood vessel gleam (pulsing, not pulsing), statuses of the streamed blood (curtailed, infected, nagnoivshajasja). The basic symptoms of the hematoma located in hypodermic kletchatke and muscles, are: a pain, presence of the limited swelling, infringement of function of corresponding muscles, change of colour of a skin from lilovo-red to flavovirent, increase of local temperature is frequent. At a hematoma of internal bodies on the foreground symptoms sdavlenija poslednih.

the Hematoma intrabrain traumatic act. Accurate definition of concept «a hematoma intrabrain traumatic» does not exist now because of proceeding evolution of sights on patogenez process (synonyms - traumatic vnutrimoshchgovoe a hemorrhage [TVK], gemorragichesky a brain bruise). Usually the diagnosis put on the basis of a computer tomography (KT) a brain, the raised density revealing the centre in parenhime moshchga at the patient with CHMT (many authors do not switch on in this concept the centres less than 1 sm in the maximum measurement). The hemorrhage centres reveal in the zones of a brain most suffering at acceleration/delay, - poljusy and bazalnye surfaces of frontal, temporal and occipital shares more often. Usually TVK calls smaller mass effect, than followed expect at the given volume. TVK tends to progressive increase within several days after a trauma that reveal on consistently spent control KT. In some cases the hemorrhage develops otsrochenno, in that case it name - later TVK. KT, spent in some months after a trauma, reveals the minimum changes in substance of a brain (or in general their absence).

Sharp traumatic subduralnaja a hematoma - a blood congestion in space between an internal leaf of a firm brain cover and arahnoidalnoj a brain cover. At patients with sharp traumatic subduralnoj a hematoma usually find out considerably bolshee primary damage of a brain, than in patients epiduralnoj a hematoma, therefore results of treatment of this group of patients are much worse. As there is chronic subduralnaja a hematoma which usually arises at pozhiliyh people (middle age - 63 years). Less than at 50 % from them in the anamnesis it is possible to reveal cranial-mozgovoju a trauma. In 20-25 % of cases chronic subduralnaja the hematoma happens dvustoronnej.

the Hematoma epiduralnaja - a local congestion of blood in space between an internal surface of a skull and an external leaf of a firm brain cover (epiduralnoe space).

hematoma Treatment

Lechenie small hematomas the conservative: mestno a cold and a pressing bandage, analgetiki, and in some days after a trauma - physiotherapeutic procedures. At the big hematomas evacuation of liquid blood by a puncture with the subsequent imposing of a pressing bandage is shown. In case of bleeding renewal hematoma opening, bandaging of a bleeding vessel or imposing of a vascular seam is shown. At a suppuration of hematomas its opening and drenirovanie is shown. At not complicated hematomas the forecast, as a rule, blagoprijatnyj.

the Hematoma intrabrain traumatic . Treatment in most cases the conservative: support vitalnyh functions; correction of intracranial pressure for the purpose of its maintenance below 25 mm hg (mannitol, ventrikuljarnyj a drainage, barbituraty, hyperventilation). At occurrence of a disposition and vklinenija (or obvious threat of their development) it is shown operative vmeshatelstvo.

Sharp traumatic subduralnaja a hematoma . In most cases at sharp subduralnoj emergency operative intervention - kraniotomija, hematoma removal is necessary for a hematoma. The absolute indication to operation - a hematoma in the thickness more than 1 sm according to a computer tomography. In the postoperative period intensive therapy with support vitalnyh functions and the level control vnutrecherepnogo pressure (than 25 mm hg should sostovljat less) is necessary - mannitol, ventrikuljarnyj a drainage, barbituraty, giperventiljatsija.

the Hematoma epiduralnaja . It is In most cases shown urgent operative vmeshatelstvo.