1
عمومی::
خونریزی، خونریزی، خونریزی، خونریزی، خونریزی
• Hemorrhagic stroke: Accounts for 13% of all strokes and occurs when a blood vessel in the brain suddenly ruptures into the surrounding tissue.
• CT scan: hemorrhage or no hemorrhage (Step 5)
Life-threatening arrhythmias can follow or accompany stroke, particularly intracerebral hemorrhage.
CT Scan: Hemorrhage or No Hemorrhage
mance and interpretation of a noncontrast CT scan to differentiate ischemic from hemorrhagic stroke.،This will reveal whether the vessel is blocked or leaking, or of abnormal form or position, resulting from displacement by a tumor or hemorrhage.
The CSF flows freely throughout the subarachnoid space; thus a subarachnoid hemorrhage, usually the result of leakage from an aneurysm in the region of Willis, is felt as a severe neckache or backache, reflecting the seepage of blood down to spinal cord regions.
A subdural hemorrhage results from tearing the bridging veins (Fig. 11) that connect the brain and dural sinuses.
In an epidural hemorrhage, blood collects between the dura and bone, the result of tearing arteries, particularly the middle meningeal artery which lies outside the dura and forms a groove in the cranial bone.
Epidural hemorrhage generally coincides with a skull fracture.،More than 30 years ago, a landmark article examining the relationship between cirrhosis, abdominal surgery, and outcomes demon- strated mortality rates approaching 80% in patients with cirrhosis and a prothrombin time more than 2.5 seconds longer than in control subjects who underwent cholecystectomy. ftese fatalities were attributable to intra-abdominal hemorrhage, progressive hepatic and renal failure, and upper gastrointestinal hemorrhage resulting from portal hypertension.
Hypotension secondary to hypovolemia, hemorrhage, and vaso- dilation all result in a decreased MAP, which diminishes nutritive hepatic artery and portal vein flow. ftis mechanism is also involved in some cases of liver failure observed after general anes- thesia or laparoscopic procedures in which hepatocyte hypoperfu- sion may not be as readily evident.
Tranexamic acid inhibits fibrinolysis by blocking a binding site on plasminogen and has been shown to reduce the risk of hemorrhage and death significantly in a study of more than 20,000 bleeding trauma patients. ftis trial, the CRASH-2 trial, demonstrated its mortality benefit without a significant increase in vascular occlusive events; however, the role of tranexamic acid outside of trauma is still being investigated.34
Hemorrhagic shock, trauma, wounds and incisions, drains, catheters, tubes, devitalized tissue, hematomas, immunosuppressants, and malnutrition are just some of the many reasons why surgical ICU patients have the greatest risk of infection among all critical care settings.
ICU patients who are at high risk for VTE but cannot be anticoagulated for an extended period, such as patients with hemorrhagic stroke, should receive an inferior vena cava filter. ftese filters do not prevent DVTs; they prevent large pulmonary embolisms, although small pulmonary embolisms may make it through to the lungs.،،Grand mal seizures Cerebral hemorrhage Hypovolemia
Finally, these patients have a higher risk of uterine atony and peripartum hemorrhage resulting from the smooth muscle- relaxant effects of magnesium therapy.
Conditions that complicate delivery include hemorrhagic complications, amniotic fluid embolism, uterine rupture, trial of labor after cesarean delivery, vaginal birth after cesarean delivery, abnormal presentations, and multiple births.
Obstetric Hemorrhage
Obstetric hemorrhage is a leading cause of maternal mor- bidity and intensive care unit (ICU) admission in the United States.
واژگان شبکه مترجمین ایران