{"id":146,"date":"2020-02-03T08:44:35","date_gmt":"2020-02-03T06:44:35","guid":{"rendered":"https:\/\/roneuro.ro\/blog\/traumatismele-cranio-cerebrale\/"},"modified":"2024-08-01T15:06:35","modified_gmt":"2024-08-01T13:06:35","slug":"ce-sunt-traumatismele-craniocerebrale","status":"publish","type":"post","link":"https:\/\/roneuro.ro\/blog\/ce-sunt-traumatismele-craniocerebrale\/","title":{"rendered":"Ce sunt traumatismele craniocerebrale?"},"content":{"rendered":"\n<h2>Ce sunt traumatismele craniocerebrale?<\/h2>\n<p><strong>Traumatismele craniocerebrale (TCC) <\/strong>sunt leziuni care apar la nivelul scalpului, craniului, creierului, \u021besuturilor \u0219i vaselor de s\u00e2nge de la nivelul capului. Leziunile la cap sunt, de asemenea, denumite \u00een mod obi\u0219nuit leziuni cerebrale sau leziuni cerebrale traumatice, \u00een func\u021bie de amploarea traumatismului cranian. Cei mai mul\u021bi dintre noi au suferit, cel pu\u021bin o dat\u0103, o lovitur\u0103 la cap. Adesea, ne accident\u0103m \u00een cursul activit\u0103\u021bilor obi\u0219nuite \u0219i nu neap\u0103rat datorit\u0103 unui sport de performan\u021b\u0103 sau a unui comportament riscant. Traumatismele craniocerebrale reprezint\u0103 o patologie complex\u0103 care ridic\u0103 numeroase probleme, at\u00e2t \u00een faza<strong> acut\u0103<\/strong>, dar mai ales \u00een cea de <strong>recuperare<\/strong>.<\/p>\n<p>TCC-urile se pot reflecta prin schimb\u0103ri \u00een comportamentul oculomotor, urm\u0103rirea ocular\u0103 devenind un instrument eficient pentru monitorizare. Institutul RoNeuro utilizeaz\u0103 un sistem Tobii TX300 pentru a evalua aceste mi\u0219c\u0103ri oculare. Pentru mai multe informa\u021bii v\u0103 invit\u0103m s\u0103 urm\u0103ri\u021bi interviul video cu dr. Emanuel \u0218tef\u0103nescu, coordonatorul departamentului de eyetracking.<\/p>\n<p style=\"text-align: center;\"><iframe title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/U5ArYC4JAKg?si=zEvr9pIzrN5K7X1p\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2>Care sunt cauzele traumatismele craniocerebrale?<\/h2>\n<p>Un TCC afecteaz\u0103 modul \u00een care func\u021bioneaz\u0103 creierul. Aceasta poate avea diverse cauze (vezi figura de mai jos). <strong>Accidentarea prin c\u0103dere reprezint\u0103 <\/strong><strong>jum\u0103tate din spitaliz\u0103rile legate de TCC.<\/strong><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-960 aligncenter\" src=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale.jpeg\" alt=\"\" width=\"900\" height=\"412\" title=\"\" srcset=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale.jpeg 1600w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale-300x137.jpeg 300w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale-1024x469.jpeg 1024w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale-768x352.jpeg 768w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale-1536x704.jpeg 1536w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale-750x344.jpeg 750w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Cauzele-traumatismelor-craniocerebrale-1140x522.jpeg 1140w\" sizes=\"(max-width: 900px) 100vw, 900px\" \/><\/p>\n<h2>C\u00e2nd ar trebui s\u0103 m\u0103 prezint la urgen\u021be dup\u0103 un traumatism craniocerebral?<\/h2>\n<p>\u00cen cazul \u00een care prezenta\u021bi unul dintre urm\u0103toarele simptome, este necesar s\u0103 v\u0103 prezenta\u021bi de urgen\u021b\u0103 la medic:<\/p>\n<ul>\n<li>fractur\u0103 a craniului;<\/li>\n<li>hemoragie de la nivelul nasului, gurii sau urechilor;<\/li>\n<li>s\u00e2ngerare masiv\u0103 la nivelul zonei lovite;<\/li>\n<li>pierderea st\u0103rii de con\u0219tien\u021b\u0103;<\/li>\n<li>durere puternic\u0103 de cap asociat\u0103 cu ame\u021beal\u0103, somnolen\u021b\u0103 sau grea\u021b\u0103 cu v\u0103rs\u0103turi, paralizie, probleme de coordonare, de vorbire sau de vedere.<\/li>\n<\/ul>\n<p>\u00cen primele ore sau zile de la producerea unui traumatism, pot s\u0103 apar\u0103 simptome\/semne noi, complica\u021bii neprev\u0103zute, iar starea se poate agrava brusc, evolu\u00e2nd \u00een unele cazuri p\u00e2n\u0103 la moarte subit\u0103.<\/p>\n<p>Medicul urgentist \u00eempreun\u0103 cu neurologul \u0219i neurochirurgul pot aprecia dac\u0103 sunt necesare investiga\u021bii suplimentare, dac\u0103 pacientul necesit\u0103 supraveghere medical\u0103 \u00een spital sau poate chiar o interven\u021bie neurochirurgical\u0103.<\/p>\n<p>\u00cen cazul pacien\u021bilor care sunt externa\u021bi la domiciliu, se recomand\u0103 ca apropia\u021bii s\u0103 urmareasc\u0103 starea acestora timp de 24-72 de ore de la producerea traumatismului. Dac\u0103 apar modific\u0103ri \u00een starea de s\u0103n\u0103tate a pacientului, este necesar s\u0103 se prezinte din nou la medic.<\/p>\n<h2>Resurse \u0219i suport pentru pacien\u021bi<\/h2>\n<p><strong>A\u021bi suferit un traumatism cranio-cerebral? <\/strong>Programa\u021bi-v\u0103 acum pentru evaluare la un medic neurolog contact\u00e2nd recep\u021bia Institutului <strong>RoNeuro<\/strong> la num\u0103rul de telefon<strong> <a href=\"tel:+40374462222\">0374 46 2222<\/a><\/strong>, luni \u0219i mar\u021bi \u00eentre orele <strong>08:00 &#8211; 19:00<\/strong>, iar de miercuri p\u00e2n\u0103 vineri \u00eentre orele <strong>08:00 &#8211; 18:00. <\/strong><\/p>\n<p>La momentul program\u0103rii, pute\u021bi opta \u0219i pentru consulta\u021bie neurologic\u0103 gratuit\u0103, decontat\u0103 prin Casa Na\u021bional\u0103 de Asigur\u0103ri de S\u0103n\u0103tate. Mai mult, pot fi efectuate program\u0103ri online.<\/p>\n<p style=\"text-align: center;\"><a style=\"background-color: #6852ed; color: white; text-decoration: none; border: none; padding: 10px 20px; cursor: pointer; display: inline-block;\" href=\"https:\/\/www.roneuro.ro\/progamari.html\">Program\u0103ri online aici!<\/a><\/p>\n<p>Locui\u021bi \u00eentr-o zon\u0103 izolat\u0103 sau nu v\u0103 pute\u021bi deplasa la clinic\u0103? RoNeuro ofer\u0103 \u0219i op\u021biunea de <strong><a href=\"https:\/\/www.roneuro.ro\/telemedicina.html\" target=\"_blank\" rel=\"noopener\">telemedicin\u0103<\/a>.<\/strong><\/p>\n<h2>Care sunt tipurile traumatismelor craniocerebrale?<\/h2>\n<p>Exist\u0103 trei tipuri principale de TCC:<\/p>\n<ul>\n<li>TCC u\u0219or sau como\u021bie cerebral\u0103;<\/li>\n<li>TCC moderat;<\/li>\n<li>TCC grav.<\/li>\n<\/ul>\n<p>Dac\u0103 \u00een cazul traumatismelor severe situa\u021bia e clar\u0103 \u2013 simptomele sunt suficient de semnificative \u00eenc\u00e2t s\u0103 determine pacien\u021bii s\u0103 se prezinte \u00eentr-un serviciu de urgen\u021be, \u00een cazul traumatismelor minore sau moderate (cea mai des \u00eent\u00e2lnit\u0103 categorie), lucrurile nu mai sunt \u00eentotdeauna at\u00e2t de evidente.<\/p>\n<p><strong>Leziunile axonale difuze<\/strong> reprezint\u0103 ruperea fibrelor nervoase lungi de leg\u0103tur\u0103 ale creierului (axoni). Acestea apar atunci c\u00e2nd creierul este r\u0103nit \u00een timp ce se deplaseaz\u0103 \u0219i se rote\u0219te \u00een interiorul craniului \u0219i provoac\u0103 de obicei com\u0103 \u0219i leziuni la mai multe p\u0103r\u021bi ale creierului. Modific\u0103rile sunt adesea microscopice, ceea ce reprezint\u0103 o problem\u0103 deoarece nu pot s\u0103 nu fie evidente la tomografia computerizat\u0103 sau la imagistica prin rezonan\u021b\u0103 magnetic\u0103 [3].<\/p>\n<p>TCC mai pot fi clasificate \u00een:<\/p>\n<ul>\n<li><strong>Leziunile cerebrale primare<\/strong> &#8211; leziuni bru\u0219te \u0219i profunde, care apar \u00een momentul impactului (accident de ma\u0219in\u0103, r\u0103nire prin \u00eempu\u0219care, c\u0103dere).<\/li>\n<li><strong>Leziunile cerebrale secundare<\/strong> &#8211; modific\u0103rile care evolueaz\u0103 pe o perioad\u0103 de ore sau zile dup\u0103 leziunea cerebral\u0103 primar\u0103. Aceasta includ modific\u0103ri celulare, chimice, tisulare sau ale vaselor de s\u00e2nge din creier care contribuie la distrugerea \u021besutului cerebral.<\/li>\n<\/ul>\n<h2>Care sunt persoanele cele mai predispuse la este mai predispus traumatisme craniocerebrale?<\/h2>\n<p>Oricine poate suferi un traumatism craniocerebral, dar anumite grupuri prezint\u0103 un risc mai mare de a muri sau de a se confrunt\u0103 cu probleme de s\u0103n\u0103tate pe termen lung:<\/p>\n<ul>\n<li>minorit\u0103\u021bile rasiale \u0219i etnice;<\/li>\n<li>membrii serviciilor militare \u0219i veteranii;<\/li>\n<li>persoanele care se confrunt\u0103 cu lipsa de ad\u0103post;<\/li>\n<li>persoanele care se afl\u0103 \u00een centre de corec\u021bie \u0219i de deten\u021bie;<\/li>\n<li>supravie\u021buitorii violen\u021bei din partea partenerului;<\/li>\n<li>persoanele care locuiesc \u00een zonele rurale [4].<\/li>\n<\/ul>\n<p><strong>Adul\u021bii \u00een v\u00e2rst\u0103 au mai multe \u0219anse de a fi spitaliza\u021bi \u0219i de a muri \u00een urma unui TCC \u00een compara\u021bie cu toate celelalte grupe de v\u00e2rst\u0103<\/strong>. TCC pot fi ratate sau diagnosticate gre\u0219it la adul\u021bii \u00een v\u00e2rst\u0103, deoarece simptomele se suprapun cu alte afec\u021biuni medicale comune \u00een r\u00e2ndul acestora, cum ar fi demen\u021ba.<\/p>\n<p>Medicamentele anticoagulante \u0219i antiplachetare pot cre\u0219te riscul de s\u00e2ngerare la nivelul creierului \u00een urma unui TCC. S\u00e2ngerarea intracranian\u0103 dup\u0103 un TCC poate expune o persoan\u0103 la riscul unor leziuni mai grave sau la deces.<\/p>\n<h2>Ce \u0219tim despre traumatismele craniocerebrale la copii?<\/h2>\n<p>Traumatismele craniocerebrale <strong>reprezint\u0103 principala cauz\u0103 de deces \u0219i invaliditate la copii. <\/strong>TCC pediatric are caracteristici specifice din cauza diferen\u021belor anatomice \u0219i fiziologice legate de v\u00e2rst\u0103 [5].<\/p>\n<p>\u00cen toate grupele de v\u00e2rst\u0103, ratele de inciden\u021b\u0103 a TCC sunt mai mari la b\u0103ie\u021bi dec\u00e2t la fete. <strong>B\u0103ie\u021bii (0-9 ani) au o probabilitate de 1,4 ori mai mare dec\u00e2t fetele de a avea un TCC. Raportul cre\u0219te la 2,2 pentru copiii mai mari \u0219i adul\u021bii tineri (10-20 de ani)<\/strong> [6].<\/p>\n<p>Impactul func\u021bional al TCC la copii poate fi diferit de cel al adul\u021bilor, deoarece creierul acestora este \u00eenc\u0103 \u00een curs de dezvoltare. Este posibil ca unii copii s\u0103 nu prezinte efecte imediate ale TCC, dar s\u0103 \u00eent\u00e2mpine provoc\u0103ri mai t\u00e2rziu \u00een dezvoltarea lor, \u00een special pe m\u0103sur\u0103 ce cresc cerin\u021bele academice. Aceste dificult\u0103\u021bi pot afecta rezultatele educa\u021bionale, prieteniile,\u00a0 participarea la \u0219coal\u0103 \u0219i \u00een comunitate \u0219i calitatea vie\u021bii. Sechelele TCC pediatrice pot s\u0103 apar\u0103 \u0219i\/sau s\u0103 persiste p\u00e2n\u0103 la v\u00e2rsta adult\u0103 [6].<\/p>\n<h2>Care este impactul mondial al traumatismelor craniocerebrale?<\/h2>\n<p>Traumatismele cerebrale reprezint\u0103 o cauz\u0103 major\u0103 de dizabilitate \u0219i principala cauz\u0103 de mortalitate \u00een r\u00e2ndul tinerilor.<\/p>\n<p>TCC reprezint\u0103 o problem\u0103 medical\u0103 \u0219i de s\u0103n\u0103tate public\u0103 urgent\u0103. Povara TCC este deosebit de important\u0103 \u00een \u021b\u0103rile cu venituri mici \u0219i mijlocii, care se confrunt\u0103 cu o preponderen\u021b\u0103 mai mare a factorilor de risc pentru TCC \u0219i care au sisteme de s\u0103n\u0103tate insuficient preg\u0103tite [1].<\/p>\n<p>TCC sunt responsabile pentru <strong>8,1 milioane de ani tr\u0103i\u021bi cu dizabilit\u0103\u021bi<\/strong>, cu o rat\u0103 global\u0103 a dizabilit\u0103\u021bii de <strong>111 la 100.000 de locuitori<\/strong> [2].<\/p>\n<p><img decoding=\"async\" class=\"wp-image-962 aligncenter\" src=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial.jpeg\" alt=\"\" width=\"900\" height=\"412\" title=\"\" srcset=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial.jpeg 1600w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial-300x137.jpeg 300w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial-1024x469.jpeg 1024w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial-768x352.jpeg 768w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial-1536x704.jpeg 1536w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial-750x344.jpeg 750w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/TCC-la-nivel-mondial-1140x522.jpeg 1140w\" sizes=\"(max-width: 900px) 100vw, 900px\" \/><\/p>\n<h2>Concluzii<\/h2>\n<p>Traumatismele craniocerebrale reprezint\u0103 o problem\u0103 semnificativ\u0103 de s\u0103n\u0103tate public\u0103, av\u00e2nd consecin\u021be devastatoare pentru persoanele afectate \u0219i familiile acestora. De\u0219i s-au f\u0103cut progrese considerabile \u00een diagnosticarea \u0219i tratamentului TCC, exist\u0103 \u00eenc\u0103 lacune importante \u00een \u00een\u021belegerea mecanismelor de recuperare \u0219i gestionarea complica\u021biilor pe termen lung.<\/p>\n<h2>Referin\u021be<\/h2>\n<ol>\n<li>Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007;22(5):341-53. PMID: 18162698.<\/li>\n<li>James SL, Theadom A, Ellenbogen RG, Bannick MS, Montjoy-Venning W, Lucchesi LR, Abbasi N. <a href=\"https:\/\/www.hopkinsmedicine.org\/health\/conditions-and-diseases\/traumatic-brain-injury\" target=\"_blank\" rel=\"noopener\">Global, regional, and national burden of traumatic brain injury and spinal cord injury<\/a>, 1990-2016: A systematic analysis for the Global Burden of Disease study 2016. Lancet Neurology. 2019;18(1):56\u201387.<\/li>\n<li><em>Traumatic brain injury<\/em>. Johns Hopkins Medicine. (n.d.).<\/li>\n<li>Centers for Disease Control and Prevention. (2023, April 20). <a href=\"https:\/\/www.cdc.gov\/traumaticbraininjury\/get_the_facts.html#:~:text=People%20most%20commonly%20get%20TBIs,of%20the%20TBI%2Drelated%20hospitalizations&amp;text=Firearm%2Drelated%20suicide%20is%20the,deaths%20in%20the%20United%20States\" target=\"_blank\" rel=\"noopener\"><em>Get the facts about TBI<\/em><\/a>. Centers for Disease Control and Prevention.<\/li>\n<li>Araki T, Yokota H, Morita A. Pediatric Traumatic Brain Injury: Characteristic Features, Diagnosis, and Management. Neurol Med Chir (Tokyo). 2017 Feb 15;57(2):82-93. doi: 10.2176\/nmc.ra.2016-0191. Epub 2017 Jan 20. PMID: 28111406; PMCID: PMC5341344.<\/li>\n<li>American Speech-Language-Hearing Association. (n.d.). <a href=\"https:\/\/www.asha.org\/practice-portal\/clinical-topics\/pediatric-traumatic-brain-injury\/#collapse_6\" target=\"_blank\" rel=\"noopener\"><em>Pediatric traumatic brain injury<\/em><\/a>. American Speech-Language-Hearing Association.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Ce sunt traumatismele craniocerebrale? Traumatismele craniocerebrale (TCC) sunt leziuni care apar la nivelul scalpului, craniului, creierului, \u021besuturilor \u0219i vaselor de s\u00e2nge de la nivelul capului. Leziunile la cap sunt, de asemenea, denumite \u00een mod obi\u0219nuit leziuni cerebrale sau leziuni cerebrale traumatice, \u00een func\u021bie de amploarea traumatismului cranian. Cei mai mul\u021bi dintre noi au suferit, cel [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":548,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jnews-multi-image_gallery":[],"jnews_single_post":{"source_name":"","source_url":"","via_name":"","via_url":"","override_template":"0","override":[{"template":"1","single_blog_custom":"","parallax":"1","fullscreen":"1","layout":"right-sidebar","sidebar":"default-sidebar","second_sidebar":"default-sidebar","sticky_sidebar":"1","share_position":"top","share_float_style":"share-monocrhome","show_share_counter":"1","show_view_counter":"1","show_featured":"1","show_post_meta":"1","show_post_author":"1","show_post_author_image":"1","show_post_date":"1","post_date_format":"default","post_date_format_custom":"Y\/m\/d","show_post_category":"1","show_post_reading_time":"0","post_reading_time_wpm":"300","show_zoom_button":"0","zoom_button_out_step":"2","zoom_button_in_step":"3","show_post_tag":"1","show_prev_next_post":"1","show_popup_post":"1","number_popup_post":"1","show_author_box":"0","show_post_related":"0","show_inline_post_related":"0"}],"override_image_size":"0","image_override":[{"single_post_thumbnail_size":"crop-500","single_post_gallery_size":"crop-500"}],"trending_post":"0","trending_post_position":"meta","trending_post_label":"Trending","sponsored_post":"0","sponsored_post_label":"Sponsored by","sponsored_post_name":"","sponsored_post_url":"","sponsored_post_logo_enable":"0","sponsored_post_logo":"","sponsored_post_desc":"","disable_ad":"0"},"jnews_primary_category":{"id":"","hide":""},"jnews_override_counter":{"override_view_counter":"0","view_counter_number":"0","override_share_counter":"0","share_counter_number":"0","override_like_counter":"0","like_counter_number":"0","override_dislike_counter":"0","dislike_counter_number":"0"},"footnotes":""},"categories":[6],"tags":[],"class_list":["post-146","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neurologie"],"_links":{"self":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/146","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/comments?post=146"}],"version-history":[{"count":8,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/146\/revisions"}],"predecessor-version":[{"id":1125,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/146\/revisions\/1125"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/media\/548"}],"wp:attachment":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/media?parent=146"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/categories?post=146"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/tags?post=146"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}