hypothalamus injury refers to the process of brain injury, skull fracture or head because of violence against direct harm arising from the hypothalamus specific clinical syndrome. Hypothalamus is the autonomic nervous system important subcortical center, and the activities of the body organs, endocrine, metabolism, body temperature regulation and to maintain an important relationship between consciousness and sleep. Therefore, clinical manifestations of hypothalamus injury often Shigeatsu. Simply less hypothalamus injury, most with severe brain contusion and (or) associated with brain stem injury.[Cause]
fibrosis syndrome is caused by what the?
idiopathic in most cases, a small number of cases is secondary. The causes are: ① drugs such as β-blockers, methyldopa, nitrofurantoin Britain and other drugs. ② autoimmune rheumatic diseases such as systemic lupus erythematosus, rheumatoid arthritis. ③ a variety of malignant tumors such as lymphoid malignancies, gastrointestinal cancer, sarcoma, carcinoid tumors and breast cancer. ④ physical and chemical factors such as ionizing radiation, inhalation of harmful gases or acids, alkalis and organic solvents. ⑤ consanguineous marriage. ⑥ idiopathic fibrosis syndrome.
(B) the pathogenesis
thickening of diseased tissue fibrosis syndrome, a sense of touch of a rubber-like, after the peritoneum of the order at the sacral promontory, and even more around the rectum, can also be found in the upper mediastinum and thyroid, etc.. Early pathological changes of a chronic inflammatory infiltration, with scattered microscopic fat island, surrounded by inflammatory infiltration foci, containing lymphocytes, monocytes, plasma cells, multinucleated giant cells and a small amount of Xiaocheng fiber cells, inflammatory foci There are scattered between the adipose tissue inflammation. With the progress of the disease, can be gradually typical granulomatous changes, this time more pronounced increase in fibroblasts, capillary proliferation, collagen fiber formation, but the reduction of inflammatory cells, individual cases can still occur vasculitis change, namely, occur within a small vein granulomatous inflammation. pathological changes in the latter part of the main fibrous tissue, the original organization of the cell components decrease or lack of vascular tissue was significantly reduced, occasionally visible calcification.[Sign]
fibrosis syndrome, early symptoms?
1. retroperitoneal fibrosis disease early, around the aorta and superior mesenteric retroperitoneal mild chronic inflammatory infiltration stage, the patient may be asymptomatic, diagnosed only by biopsy. With the progress of fibrosis, may be back, costal pain, general malaise, weight loss, fever, and sometimes severe wasting disease showed clinical manifestations, even life-threatening. retroperitoneal fibrosis and organ mass extrusion, compression symptoms may occur, such as ureteral displacement, obstruction, urinary retention. However, the symptoms of disease caused by the ureter, renal insufficiency until the performance can be found. Fibrosis inferior vena cava can occur, but rarely cause obstruction of the inferior vena cava. gastrointestinal symptoms of nausea, vomiting, abdominal pain, upper abdominal pain or whole, can be seen occasionally gastrointestinal bleeding, constipation or diarrhea. abdominal examination may touch the mass.
2. mediastinal fibrosis mediastinal and anterior mediastinum if the formation of dense collagen fibers, may compress the aorta, trachea, and pericardium, etc., but mainly the superior vena cava obstruction The cause of the symptoms, that face, neck, upper extremity swelling, and conjunctival hyperemia, so that these parts appear non-pitting edema, neck and upper extremity venous expansion.
3. other organ systems fibrosis fibrosis of this disease involving the thyroid gland, called Riedel (Riedel) thyroiditis, mainly with different degrees of suffocation, difficulty swallowing or cervical discomfort. physical examination is normal or moderately enlarged thyroid gland size, texture hard, severe adhesion with the surrounding tissue, normal or low thyroid function. Fibrosis, such as involving the orbit, the formation of orbital pseudotumor, can of unilateral exophthalmos.
positioning of the syndrome and the lack of specific clinical features, it is difficult to diagnose. Only by pyelography or superior vena cava angiography, in order to be the initial diagnosis, re-laparotomy or thoracotomy biopsy biopsy before being diagnosed.[Aftertreat]
fibrosis syndrome ate?[Prevent]
how to prevent damage to the hypothalamus?
hypothalamus injury treatment when non-surgical treatment, should minimize brain damage after a series of pathophysiological reactions, close observation with or without secondary intracranial hematoma, maintain the body's physiological balance of internal and external environment and the prevention of complications from occurring. Unless there are secondary intracranial hematoma or surgical intracranial hypertension is difficult to contain, in general, do not need surgical treatment.
non-surgical treatment: hypothalamus injury occurred on the occasion, which is the beginning of secondary brain damage, the two are closely linked and reinforce each other, so as soon as possible and reasonable treatment is to reduce disability rates and lower mortality point. The purpose of non-surgical treatment, the first is to prevent brain injury after a series of pathophysiological changes increased brain damage, followed by a good internal environment, so that part of the recovery of damaged brain cells function. Therefore, the correct treatment should not only focus on the brain, but also take into account the body ① General treatment: light and part of the trauma response for the smaller medium-sized hypothalamus injury patients, mainly symptomatic treatment, prevention and treatment of brain edema, close observation of the disease, in a timely manner for intracranial pressure monitoring and / or review the CT scan. In a coma for medium and heavy patients, in addition to non-surgical treatment, care should be strengthened.[Treat]
fibrosis syndrome, pre-treatment precautions?
treatment of fibrosis is mainly caused by obstruction of adjacent organs. Early stage, such as glucocorticoid prednisone daily 30 ~ 60mg, 3 times orally, continuous application of 6 months to 1 year. cyclosporine and azathioprine can be severe, but drug treatment is ineffective.
(b) the prognosis
retroperitoneal fibrosis associated with ureteral obstruction, such as early surgery to remove the obstruction, and with drug treatment, multi-function can be restored. With unilateral lesions, about 25% of patients can spread to the contralateral side. Surgery can cause death.
hypothalamus damage should be how?
isolated and confined to the hypothalamus the primary injury is extremely rare in the head trauma suffered in the process, often multiple sites of injury, so the diagnosis of hypothalamus injury by other parts of the brain damage often symptoms caused by the interference, as long as clinically hypothalamus with one or both of the performance of injury, should think of the hypothalamus on the possibility of damage, especially near the saddle area and skull fracture, they should be vigilant.[Diff]
hypothalamus damage following needs to be done to identify.
hypothalamic damage is often associated with severe brain injury, brain stem injury or intracranial hypertension also associated with clinical manifestations of complex, often cross-reference to the wrong, it is less simple typical cases. As long as there is generally some signs on behalf of hypothalamus injury, damage can be considered associated with this department by CT and mri significantly improve the diagnosis of hypothalamus injury, but sometimes the third ventricle near the focal hemorrhage, often difficult due to the volume effect of CT images on the display, so the mri is still better for the hypothalamus, even if only a small scattered punctate bleeding is also able to show, in the acute phase T1-weighted images as low signal in T2-weighted images are showed equal signal sub-acute and chronic phase T1-weighted images hemorrhage to clear high signal, but also conducive to identification.
isolated and confined to the hypothalamus the primary injury is extremely rare in the head trauma suffered in the process, often multiple sites of injury, so the diagnosis of hypothalamus injury are often other parts of the brain damage caused by the interference of the symptoms, clinical or both as long as have a performance of hypothalamus injury, they should think of the possibility of damage to the hypothalamus, in particular, saddle area and near the base of the skull fracture, the more should be vigilant.[Disease]
hypothalamus damage related diseases
Non-firearms craniocerebral firearm wound open brain injury intracranial hypertension syndrome in children with brain stem glioma brain stem glioma tumor hypothalamic hamartoma in children with brain stem injury in hypothalamic hamartoma brain contusion disease hypothalamus hypothalamus damage to the hypothalamus syndrome
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