epidural hematoma 8-15

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    COASS RADIOLOGI

    RSUD AMBARAWA

    EPIDURAL HEMATOMA

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    EPIDURAL HEMATOMA DEFINISI

    Epidural hematm ! Perdaraha" #a"$ terleta% a"taradurameter da" tula"$& 'ia(a"#a (um'er perdaraha""#aadalah r'e%"#a Arteri me"i"$ea media )pali"$ (eri"$*&+e"a dipli,a )leh %are"a ada"#a -ra%tur %al.aria*& +e"a

    emmi(aria/ dapat 'era(al dari pem'uluh arteri& #aitu a%i'at -ra%tur

    li"ier diata( parietal0tempral #a"$ me"#ila"$ arterime"i"$ea media

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    EPIDURAL HEMATOMA

    Perdaraha" 'ia(a"#a ter1adi de"$a" -ra%turte"$%ra% 'a$ia" tempral parietal #a"$me"#e'a'%a" la(era(i pada arteri atau .e"ame"i"$ea media/

    2eadaa" i"i me"$a%i'at%a" terpi(ah"#aperle%ata" a"tara dura de"$a" %ra"ium da"me"im'ul%a" rua"$ epidural/

    Perdaraha" #a"$ 'erla"1ut a%a" mema%(a dura

    u"tu% terpi(ah le'ih la"1ut& da" me"#e'a'%a"hematma me"1adi ma((a #a"$ me"$i(i rua"$

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    EPIDEMIOLOGIDap345 674th

    8ara"$ 67th da" 934th

    La%i:la%i ! perempua" ;

    >45 'erl%a(i di re$i tempparietal dima"a-ra%tur tula"$ mele?ati arteri me"i"$ea media

    =45 EH -r"tal @ %(ipital

    =45 EH a%i'at perdaraha" .e"a di re$iparietal:%(ipital atau -((a p(teriRe"tura"&trauma %epala ! pada %e,ela%aa"& ter%e"a leh'e"da #a"$ (a"$at %era(

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    ETIOLOGITrauma merupa%a" pe"#e'a' tipi%al dari EDH/ Trauma

    'ia(a"#a merupa%a" trauma tumpul pada %epalaa%i'at (uatu (era"$a"& 1atuh& atau %e,ela%aa"/

    Etil$i"#a dapat (uatu pe"#a%it i"-e%(i pada %epala&mal-rma(i .a(%uler dari duramater& da" a%i'at (uatumeta(ta(i( dari tumr $a"a( terte"tu/

    'erl%a(i di daerah tempraparietal& di ma"a 'ila'ia(a"#a ter1adi -ra%tur ,al.aria #a"$ 'era%i'at

    r'e%"#a arteri me"i"$ea media atau ,a'a"$:,a'a"$"#a

    =45 EDH 'erl%a(i di -r"tal maupu" %(ipital/

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    Ge1ala 2li"i(Ge1ala %li"i( #a"$ %ha( adalah ! Lu,id I"ter.al )ada"#a -a(e (adar

    dia"tara 7 -a(e tida% (adar %are"a 'ertam'ah"#a .lume darah*

    Gela1a pali"$ me""1l #aitu pe"uru"a" %e(adara" (e,arapr$re(i-

    A"am"e(i( ! ri?a#at ,idera %epala de"$a" pe"uru"a"

    %e(adara"Ta"da Dia$"(ti% 2li"i% Epidural Hematma

    =/ Lu,id i"ter.al )*

    7/ 2e(adara" ma%i" me"uru"

    / Late hemipare(e %"tralateral le(i

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    GE8ALA LAIN !

    Bi"$u"$ Pe"$lihata" %a'ur

    Su(ah 'i,ara

    N#eri %epala #a"$ he'at

    2eluar ,aira" darah dari hidu"$ atau teli"$a

    Nampa% lu%a #a"$ dalam atau $re(a" pada %ulit %epala Mual

    Pu(i"$

    Ber%eri"$at

    Pu,at

    Pupil a"i(%r& #aitu pupil ip(ilateral me"1adi mele'ar ) pupil a"i(%rde"$a" ree%( ,aha#a me"uru"*

    %elemaha" re(p"( mtri% %"tralateral

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    Pat(il$iPerdaraha" rua"$ epidural hematma me"de(a% durameterme"1auhi tula"$ %epala 1i%a hematm mem'e(ar !

    Me"de(a% di daerah tempral me"#e'a'%a" te%a"a" padal'u( temprali( ta% %earah 'a?ah da" dalam 'a$ia"medial l'u( me"$alami her"ia(i di 'a?ah pi"$$ira" te"trium

    Te%a"a" dari her"ia(i u"%u( pda (ir%ula(i arteria #a"$me"$uru( -rmati" reti%ulari( di medulla 'l"$atame"#e'a'%a" hila"$"#a %e(adara"/

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    Dia$"(i(

    Dida(ar%a" $e1ala %li"i( (erta pemeri%(aa" pe"u"1a"$(eperti -t R"t$e" %epala da" CT (,a" %epala/

    Me(%ipu" -t radil$i (%ull atau te"$%ra% (eri"$dila%u%a" u"tu% me"$e.alua(i (e'uah -ra%tur te"$%ra%

    CT (,a" merupa%a" piliha" primer dalam hal

    me"$e.alua(i trauma %epala/

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    CT:SCAN

    A ""di(pla,ed li"ear -ra,turei( pre(e"t i" the le-t

    temprparietal re$i"/

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    hiperde"( )perdaraha"*

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    CT:S,a" ! le(i 'i%".e%( de"$a" de"(ita(ti"$$i #a"$ hm$e"# pada CT (,a"

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    Ri$ht tempral epidural hematma ?ith midli"e (hi-t/ Patie"t(huld 'e ta%e" immediatel# t the perati"$ rm -r"eur(ur$er#/ Thi( ma# reuire emer$e"t tra"(prt t atrauma ,e"ter r ther -a,ilit# ?ith a "eur(ur$e"a.aila'le/

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    A" epidural hematma dem"(trate( the ,la((i, le"ti,ular,"$urati" that .erlie( the lateral a(pe,t - the le-ttempral l'e/ Area( - dimi"i(hed atte"uati" i" thehematma (u$$e(t "$i"$ hemrrha$e/

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    MRI ! hiperi"te"( 'i%".e%( me"$$e(er durameter& 'eradadia"tara tula"$ @ duramater

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    Dia$"(i( Ba"di"$

    =/ Su'dural Hematma Perdaraha" #a"$ ter1adi dia"tara duramater da"

    ara,h"id& a%i'at r'e%"#a .e"a 1em'ata"/ Ge1ala%li"i("#a adalah !

    : (a%it %epala

    %e(adara" me"uru" 0 :

    Pada pemeri%(aa" CT (,a" ta% didapati $am'ara"hiperde"( )perdaraha"* dia"tara duramater da"ara%h"id& umum"#a r'e%a" dari 'rid$i"$ .ei" da"

    tampa% (eperti 'ula" (a'it/

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    7/ Su'ara%h"id hematma

    Ge1ala %li"i("#a #aitu !: %a%u %udu%

    "#eri %epala

    'i(a didapati $a"$$ua" %e(adara"

    pada pemeri%(aa" CT (,a" ta% didapati perdaraha")hiperde"(* di rua"$ (u'ara%h"id/

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    Pe"atala%(a"aa"Terapi medi%ame"t(a !deameta(" )de"$a" d(i( a?al =4 m$ %emudia"dila"1ut%a" < m$ tiap 3 1am*& ma""itl 745 )d(i( =:m$0%$BB0hari* #a"$ 'ertu1ua" u"tu% me"$ata(i edema,ere'ri #a"$ ter1adi

    Fe"iti" ! prla%(i( %e1a"$

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    Terapi perati- ! Opera(i di la%u%a" 'ila terdapat ! +lume hamatm

    9 4 ml ) %epu(ta%aa" lai" 9