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From head trauma to coma: Do you know the mysterious phenomenon of 'talk and death'?
Experiences of dizziness and loss of consciousness can be common signs after any head trauma. However, in this case, there is a condition called intracranial dural hematoma, which often leads to the so-called "talk and die" phenomenon. This phenomenon refers to the fact that after a head injury, a patient may first regain consciousness and then quickly fall into a coma. This has surprised and confused many medical professionals, and has also triggered in-depth research and exploration of this phenomenon.
What is intracranial dural hematoma?
Intracranial dural hematoma refers to bleeding between the dura mater that surrounds the brain (dura mater) and the skull. When this bleeding occurs in the spinal canal of the spinal cord, it is called spinal intracranial dura mater. hematoma.
This condition usually occurs after head trauma and is associated with the urgency of increased intracranial pressure.
Symptoms and manifestations
People who experience intracranial dural hematoma usually experience a brief period of wakefulness after the injury. This phenomenon is due to the accumulation of blood compressing intracranial structures, which may compress the third cranial nerve and cause the pupil on the injured side to be fixedly dilated. In addition, symptoms such as the following may occur:
- Severe headache
- Confusion
- Vomiting
- Unable to move limbs
If left untreated, intracranial dural hematoma may cause brainstem compression and even be life-threatening.
Causes and pathophysiology
The main cause of intracranial dural hematoma is head trauma, especially damage to the temporal bone. This condition most commonly occurs in traffic accidents, fights, or accidental falls. Under the action of mechanical force, the arteries bleed rapidly, causing high-pressure blood to flow into the skull.
According to epidemiological statistics, the incidence of intracranial dural hematoma is approximately 10% of all head trauma.
Diagnostic methods
The diagnosis of intracranial dural hematoma usually relies on CT scan or MRI examination. These tests can clearly show the presence and accumulation of hematomas.
Intracranial dural hematomas often appear convex on images because their expansion is limited by gaps in the skull and can extend into the brain.
Treatment methods
Intracranial dural hematoma usually requires emergency surgery. Surgery, in the form of burr holes or craniectomy, is designed to rapidly reduce intracranial pressure. If surgery is delayed, it could result in irreversible brain damage or death. For bleeding less than 30 ml, conservative treatment can be considered if there are no significant neurological symptoms. However, a high degree of vigilance is still required as the hematoma may grow rapidly in a short period of time.
Prognosis
The prognosis of intracranial dural hematoma often depends on the Glasgow Coma Score at the time of injury. Generally speaking, if there is a significant period of wakefulness after the injury, the prognosis is relatively good. Otherwise, if you are already unconscious after being injured, the situation may be relatively unfavorable.
Epidemiology
Statistics show that approximately 2% of head trauma and 15% of fatal head trauma involve intracranial dural hematoma. The condition is more common in teenagers and young adults, and is more common in men than women.
Faced with the critical situation of intracranial dural hematoma, the medical community needs faster response time, timely diagnosis and effective treatment options to save lives. Faced with the fragility of life and death, is this an arrangement of fate or a choice that we can control?
