scalp avulsion
Introduction
Introduction to scalp avulsion The large scalp avulsion from the cap-like aponeurosis is called scalp avulsion, which is caused by the hair being entangled by the machine, and the high-speed blunt object tangential strike can also be caused. The patient has a large amount of bleeding, often accompanied by shock. The avulsion is often between the cap-like diaphragm and the periosteum of the skull, and sometimes the entire scalp is even avulsed together with the frontal muscle, diaphragm or periosteum. This type of injury is characterized by more blood loss and infection. If the treatment is not timely, it may endanger life or cause necrosis of the skull. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: shock anemia
Cause
Cause of scalp avulsion injury
Cause:
The scalp avulsion injury is caused by mechanical force, which causes the large scalp to be ablated from the lower layer of the aponeurosis or the periosteum of the skull.
Prevention
Scalp avulsion injury prevention
In the machinery industry, especially in lathe workshops, it is easy to cause scalp avulsion due to the worker's hair twisting into the rotating machine. This kind of work injury comes suddenly, and the symptoms are serious, which often makes people feel helpless, but in case of accidents, emergency care should be done correctly.
In the event of such an accidental trauma, the caregiver should not panic, and should immediately open the machine knife to stop the machine and organize the manpower to rescue the patient.
The scalp avulsion injury is forcibly pulled by the hair. Generally, the large scalp can be abutted from the lower layer of the cap-like aponeurosis together with the periosteal layer. Therefore, it is necessary to cover the head wound with a sterile dressing or a cleaning sheet in time, and pressurize the bandage.
Complication
Scalp avulsion injury Complications, shock anemia
1. The scalp infection of acute scalp infection is mostly caused by improper treatment in the initial stage of injury. It often occurs in the subcutaneous tissue. There are red, swollen, hot and painful parts in the skin. The ear, the back of the ear or the suboccipital lymph nodes are swollen and tender due to the scalp. There is a fibrous septum connected with the aponeurosis of the cap, so the tension in the inflammatory zone is high, the patient often suffers from pain, and is accompanied by poisoning symptoms such as chills and fever in the whole body. In severe cases, the infection can invade the skull or the skull through the blood vessel.
2. Capular subarachnoid abscess The subarachnoid tissue is loose, and purulent infection is easy to spread, but it is often limited to the attachment edge of the aponeurotic aponeurosis. Abscesses originate from scalp hematoma infection or skull osteomyelitis after injury, and occasionally caused by scalp infusion or puncture in children. Patients with capsular subarachnoid abscess often show swelling of the scalp, pain, or edema of the eyelids. In severe cases, systemic poisoning may occur.
Symptom
Symptoms of scalp avulsion injury Common symptoms Scalp avulsion injury Scalp tearing scalp Irregular rupture shock
1. The scalp is avulsed from the aponeurotic aponeurosis. Sometimes the entire scalp and even the frontal muscles, diaphragm, and periosteum are avulsed together, and the skull is exposed.
2. The amount of bleeding is large, often accompanied by shock.
3. Skull exposure can be complicated by skull infection or necrosis.
Examine
Scalp avulsion injury check
1. History of the disease asks about the time of injury, the cause of injury, the condition of injury, whether there is coma and near forgotten after injury, the length of coma, the middle or the waking period, whether there is vomiting and its frequency, whether there is any size Incontinence, with or without convulsions, seizures, physical exercise, and what kind of treatment. Whether there is alcoholism, mental disorders, epilepsy, high blood pressure, heart disease, stroke and so on before the injury.
2, the nervous system examination focuses on the detection of consciousness, pupils, limb activities, pyramidal tract signs and meningeal irritation signs.
3, head examination of scalp injuries, eyelids, conjunctiva and mastoids with or without congestion, ear, nose, throat with or without bleeding and cerebrospinal fluid outflow.
4. Vital signs focus on changes in breathing, pulse and blood pressure.
5, systemic examination of the presence of maxillofacial, thoracic and abdominal organs, pelvis, spine and limb injuries. More attention should be paid to combined injuries when there is hypotension and shock.
Diagnosis
Diagnosis and differentiation of scalp avulsion injury
1, the skull X-ray film examination suspected skull fracture should be taken positive and lateral slices. The occipital force was injured and the amount of the pillow (Tang's position) was taken. Suspected optic nerve injury, optic nerve hole film, eyelid fracture, Korot's patch.
2, lumbar wear to understand the extent of subarachnoid hemorrhage and intracranial pressure. Severe traumatic intracranial hypertension or obvious signs of cerebral palsy are contraindicated.
3, CT scan is an important basis for the diagnosis of craniocerebral injury. Can display skull fracture, brain contusion, intracranial hematoma, subarachnoid hemorrhage, ventricular hemorrhage, gas cranial, cerebral edema or brain swelling, cerebral cistern and ventricle compression displacement deformation, midline structure displacement. CT examination should be performed when the condition changes.
4, MRI patients with acute craniocerebral injury usually do not have MRI. However, MRI is often superior to CT scan in patients with stable axonal injury, cerebral hemisphere, brainstem, focal contusion and small hemorrhage, and islet subacute intracranial hematoma.
