Manejo Del Tec en Pediatria (Pptminimizer)

8/17/2019 Manejo Del Tec en Pediatria (Pptminimizer)

1/23

MANEJO DELMANEJO DELTEC ENTEC EN

PEDIATRIA PEDIATRIA ABELARDO CAVERO GARAY ABELARDO CAVERO GARAY

NEUROCIRUJANONEUROCIRUJANO ABRIL, 2007 ABRIL, 2007


2/23

ESCALA DE COMA DE GLASGOW (NiñosESCALA DE COMA DE GLASGOW (Niñosgrandes)grandes)

APERTURA OCULAR APERTURA OCULAR Espon!neaEspon!nea "" A# ##a$ado % A# ##a$ado % A# A#

do#ordo#or &&Ning'na Ning'na

RESPUESTA ER*AL +a,#a orienadoRESPUESTA ER*AL +a,#a orienado

-- +a,#a desorienado " +a,#a desorienado " er,a#i.a er,a#i.a % % Ge$idos Ge$idos & & Ning'na Ning'na

RESPUESTA MOTORA O,ede/e 0rdenes 1RESPUESTA MOTORA O,ede/e 0rdenes 1 Lo/a#i.a e# do#or -Lo/a#i.a e# do#or -

Reira de# do#or "Reira de# do#or " 2#e3i0n anor$a#2#e3i0n anor$a#%% E3ensi0n anor$a# &E3ensi0n anor$a# &

Ning'na Ning'na


3/23


4/23

TEC LEETEC LEE

Glasgow: 14 – 15 !"#os$Glasgow: 14 – 15 !"#os$ E%a&'" "'!(ol)g*+o &"*&o$E%a&'" "'!(ol)g*+o &"*&o$ -ala( la +a.'/a$-ala( la +a.'/a$

E%a&'" g'"'(al$E%a&'" g'"'(al$ D's+a(#a( a#ologa o#'"+*al&'"#' g(a'$D's+a(#a( a#ologa o#'"+*al&'"#' g(a'$ R% ' +("'o o 3AC +'('.(al +o"*+*o"al$R% ' +("'o o 3AC +'('.(al +o"*+*o"al$

Al#a +o" *"*+a+*o"'s$ Al#a +o" *"*+a+*o"'s$ os*#al*/a+*)" .('' +o" a EV +o"*+*o"al$os*#al*/a+*)" .('' +o" a EV +o"*+*o"al$ I"*+*a( *'#a ('+o/&'"#'$I"*+*a( *'#a ('+o/&'"#'$


5/23

TEC MODERADOTEC MODERADO

Glasgow: 61 !"#osGlasgow: 61 !"#os A B C ' la ('a"*&a+*)"$ A B C ' la ('a"*&a+*)"$ E%a&'" "'!(ol)g*+o &"*&o$E%a&'" "'!(ol)g*+o &"*&o$ E%a&'" g'"'(al$E%a&'" g'"'(al$ Colo+a( a EV, 8*(a#a+*)", a"alg9s*+os$Colo+a( a EV, 8*(a#a+*)", a"alg9s*+os$ ol*+*#a( 3AC +'('.(al +o" '"#a"a )s'a$ol*+*#a( 3AC +'('.(al +o" '"#a"a )s'a$ R% ' +ol!&"a, #)(a%, a.o&'"$R% ' +ol!&"a, #)(a%, a.o&'"$ ' 8os*#al*/a +o" *"*+a+*o"'s$' 8os*#al*/a +o" *"*+a+*o"'s$


6/23

TEC GRAETEC GRAE

Glasgow: 6 ; !"#osGlasgow: 6 ; !"#os A B C ' la ('a"*&a+*)"$ A B C ' la ('a"*&a+*)"$ E%a&'" "'!(ol)g*+o &"*&o$E%a&'" "'!(ol)g*+o &"*&o$

E%a&'" g'"'(al$E%a&'" g'"'(al$ Colo+a( a EV, 8*(a#a+*)", a"alg9s*+os,Colo+a( a EV, 8*(a#a+*)", a"alg9s*+os,

*!(9#*+o, a"#*!l+'(oso, so"a "asogs#(*+a


7/23

TIPOS DE TRAUMATIPOS DE TRAUMA

00: 3(a!&a#*s&o s!'(=+*al ' la 00: 3(a!&a#*s&o s!'(=+*al ' la+a.'/a$+a.'/a$

01: '(*a ' la +a.'/a$ 01: '(*a ' la +a.'/a$ 02: >(a+#!(a ' 8!'sos 'l +("'o < la 02: >(a+#!(a ' 8!'sos 'l +("'o < la

+a(a$+a(a$ 0: L!%a+*)", 'sg!*"+' < #o(+'!(a ' 0: L!%a+*)", 'sg!*"+' < #o(+'!(a '

a(#*+!la+*o"'s < ' l*ga&'"#os ' laa(#*+!la+*o"'s < ' l*ga&'"#os ' la+a.'/a$+a.'/a$

04: 3(a!&a#*s&o ' "'(*os +(a"'al's$ 04: 3(a!&a#*s&o ' "'(*os +(a"'al's$


8/23

TIPOS DE TRAUMATIPOS DE TRAUMA

05: 3(a!&a#*s&o 'l o?o < la )(.*#a$ 05: 3(a!&a#*s&o 'l o?o < la )(.*#a$ 0@: 3(a!&a#*s&o *"#(a+(a"'al$ 0@: 3(a!&a#*s&o *"#(a+(a"'al$

07: 3(a!&a#*s&o o( alas#a&*'"#o 07: 3(a!&a#*s&o o( alas#a&*'"#o' la +a.'/a$' la +a.'/a$ 0;: A&!#a+*)" #(a!&#*+a ' 0;: A&!#a+*)" #(a!&#*+a '

a(#' ' la +a.'/a$a(#' ' la +a.'/a$ 0: O#(os #(a!&a#*s&os < los "o 0: O#(os #(a!&a#*s&os < los "o

's'+*=+aos ' la +a.'/a$'s'+*=+aos ' la +a.'/a$


9/23

2RACTURAS2RACTURAS

D'.*o a !" gol' !'(#' '" la +a.'/aD'.*o a !" gol' !'(#' '" la +a.'/as' !'' (a+#!(a( 'l +("'o, a '+'ss' !'' (a+#!(a( 'l +("'o, a '+'ss' ('!*'(' +o(('++*)" !*((g*+a,s' ('!*'(' +o(('++*)" !*((g*+a,

+o&o '" alg!"as (a+#!(as '(*&*as$+o&o '" alg!"as (a+#!(as '(*&*as$ La (a+#!(a +(a"'a"a 's 'l aoLa (a+#!(a +(a"'a"a 's 'l ao

(*&a(*o, s* #*'"' !" 8'&a#o&a(*&a(*o, s* #*'"' !" 8'&a#o&a

'*!(al !'' ll'a( a !" ao'*!(al !'' ll'a( a !" aos'+!"a(*o +o&o !"a 8'("*a +'('.(al$s'+!"a(*o +o&o !"a 8'("*a +'('.(al$


10/23

2RACTURAS2RACTURAS

Las (a+#!(as ' +("'o, aLas (a+#!(as ' +("'o, a '+'s ('!*'('" +o(('++*)" '+'s ('!*'('" +o(('++*)"!*((g*+a, +o&o alg!"as!*((g*+a, +o&o alg!"as(a+#!(as '(*&*as$(a+#!(as '(*&*as$

La (a+#!(a, 'l 8'&a#o&aLa (a+#!(a, 'l 8'&a#o&a'*!(al o 'l ''&a'*!(al o 'l ''&a+'('.(al so" aos+'('.(al so" aos(*&a(*os, !' !''(*&a(*os, !' !''ll'a( a !" aoll'a( a !" aos'+!"a(*o +o&o !"as'+!"a(*o +o&o !"a8'("*a +'('.(al$8'("*a +'('.(al$

http://compare.buscape.com.ar/redirect_prod?id=5805&raiz=3473&prod_id=191520&emp_id=53100&pos=0&az=1e08d1e5e028818a412dacc5231b8ba0&cn=1352696706&nc=1904121715320061207045344


11/23

DA7O PRIMARIODA7O PRIMARIO

O+!((' '" 'l &o&'"#o *"*+*al 'lO+!((' '" 'l &o&'"#o *"*+*al 'l3EC$3EC$

No s' !'' '*#a($No s' !'' '*#a($

>(a+#!(a ' +("'o$>(a+#!(a ' +("'o$ '&a#o&a '*!(al$'&a#o&a '*!(al$


12/23

+EMATOMAS+EMATOMAS Dao (*&a(*o:Dao (*&a(*o:

'&a#o&a'&a#o&a'*!(al$'*!(al$

Dao s'+!"a(*o:Dao s'+!"a(*o:'("*a +'('.(al'("*a +'('.(al


13/23

DA7O SECUNDARIODA7O SECUNDARIO

O+!((' +o&o +o"s'+!'"+*a 'l aoO+!((' +o&o +o"s'+!'"+*a 'l ao(*&a(*o$(*&a(*o$

' !'' '*#a( o &*"*&*/a( +o"' !'' '*#a( o &*"*&*/a( +o"#(a#a&*'"#o a'+!ao$#(a#a&*'"#o a'+!ao$

3*os ' 8'("*a+*)" +'('.(al$3*os ' 8'("*a+*)" +'('.(al$

I"a(#o &'s'"+'l*+o$I"a(#o &'s'"+'l*+o$


14/23

+ERNIAS CERE*RALES+ERNIAS CERE*RALES 88 '("*a ' la'("*a ' la

+*(+o"ol!+*)" 'l+*(+o"ol!+*)" 'l+*"g!lo$+*"g!lo$

2$ '("*a ' la2$ '("*a ' la+*(+!"ol!+*)"+*(+!"ol!+*)"a(a8*o+a&al$a(a8*o+a&al$

$ '("*a ' las$ '("*a ' lasa&galasa&galas

+'('.'losas$+'('.'losas$ '("*a+*)" #(a"sala('("*a+*)" #(a"sala(


15/23

RANGOS DE PICRANGOS DE PIC

Re/i9n na/idos:Re/i9n na/idos: 10 a 20 && '10 a 20 && '

2O2O

0$7 6 1$5 && gF0$7 6 1$5 && gF

La/anes:La/anes: 20 a ;0 && ' 2O20 a ;0 && ' 2O1$5 6 @ && gF1$5 6 @ && gF

Niños $a5ores:Niños $a5ores: 40 a 100 && '40 a 100 && '2O2O 6 7$5 && gF 6 7$5 && gF


16/23

EDEA CEREBRALEDEA CEREBRAL

asog9ni/o: asog9ni/o: O+!((' '" #!&o('s, o(O+!((' '" #!&o('s, o(a!&'"#o ' la '(&'a.*l*a +a*la(,a!&'"#o ' la '(&'a.*l*a +a*la(,

+o&(o&'#' *"*+*al&'"#' la s!s#a"+*a+o&(o&'#' *"*+*al&'"#' la s!s#a"+*a.la"+a$.la"+a$ Cio03i/o:Cio03i/o: ' ('s'"#a '" 3EC o(' ('s'"#a '" 3EC o(

al#'(a+*)" ' la .o&.a NaHH A3-asa,al#'(a+*)" ' la .o&.a NaHH A3-asa,a'+#a la s!s#a"+*a .la"+a < la s!s#a"+*a g(*s$a'+#a la s!s#a"+*a .la"+a < la s!s#a"+*a g(*s$

Inersi/ia#:Inersi/ia#: -o( &*g(a+*)" ' LCR a #(a9s-o( &*g(a+*)" ' LCR a #(a9s'l '9"*&o '" 8*(o+'al*a$'l '9"*&o '" 8*(o+'al*a$


17/23

+IPERTENSION+IPERTENSIONENDOCRANEANA ENDOCRANEANA

Ca!sa ' la 8*'(#'"s*)" '"o+(a"'a"aCa!sa ' la 8*'(#'"s*)" '"o+(a"'a"aI"'++*)", #!&o('s, 3(a!&aFI"'++*)", #!&o('s, 3(a!&aF

3*'&o ' *"s#ala+*)" 'l +!a(o3*'&o ' *"s#ala+*)" 'l +!a(o

Ag!o, s!.ag!o, +()"*+oFAg!o, s!.ag!o, +()"*+oF Es#ao ('*o 'l '"+9aloEs#ao ('*o 'l '"+9alo

Vol!&'", 'las#*+*a,Vol!&'", 'las#*+*a,aa#a.*l*a, a"a#o&aFaa#a.*l*a, a"a#o&aF

E%*s#'"+*a ' o#(as s*#!a+*o"'s ag(aa"#'sE%*s#'"+*a ' o#(as s*#!a+*o"'s ag(aa"#'s*o%*a o *s!'&*a, o#(os*o%*a o *s!'&*a, o#(os

a+#o('sF$a+#o('sF$


18/23

CURA DE AUMENTO DE PICCURA DE AUMENTO DE PIC

-('s*)"-('s*)" 40 40

00

2020

1010 10 20 0 40 5010 20 0 40 50 Vol!&'" Vol!&'"


19/23

LE; DE MONRO < =ELL; LE; DE MONRO < =ELL;

CON3INEN3E: C("'oCON3INEN3E: C("'o

CON3ENIDO:CON3ENIDO:

1$1$ E"+9alo: ;0 KE"+9alo: ;0 K

2$2$ L!*o +9alo (a!'o: 10 KL!*o +9alo (a!'o: 10 K

$ a"g(': 10 K$ a"g(': 10 K

L'< ' o"(o – 'll


20/23

TRATAMIENTO MEDICOTRATAMIENTO MEDICOGENERALGENERAL

-os*+*)" 'l a+*'"#'-os*+*)" 'l a+*'"#' V'"#*la+*)" V'"#*la+*)"

Vol'&*a Vol'&*a a"*#ol: 0$25 g( g os*sa"*#ol: 0$25 g( g os*s Co(#*+o*'s "o s' '.'" !sa($Co(#*+o*'s "o s' '.'" !sa($

Ba(.*#(*+osBa(.*#(*+os O%g'"o$O%g'"o$


21/23

TRATAMIENTOTRATAMIENTO>UIR?RGICO>UIR?RGICO

El #(a#a&*'"#o &9*+o !'' s'(El #(a#a&*'"#o &9*+o !'' s'(s!=+*'"#' a(a ('!+*( la 8*'(#'"s*)"s!=+*'"#' a(a ('!+*( la 8*'(#'"s*)"*"#(a+(a"'a"a o 'l ''&a +'('.(al$*"#(a+(a"'a"a o 'l ''&a +'('.(al$

' o'(a" las l's*o"'s !' (o!+'"' o'(a" las l's*o"'s !' (o!+'"''+#o ' &asa, g'"'(al&'"#' los''+#o ' &asa, g'"'(al&'"#' los8'&a#o&as ' &s ' 0 ++$ ' ol!&'"$8'&a#o&as ' &s ' 0 ++$ ' ol!&'"$

* "o 8a< 8'&a#o&a, s' !'' !sa( la* "o 8a< 8'&a#o&a, s' !'' !sa( la

+*(!ga a(a ('!+*( la -IC, +o&o !"a+*(!ga a(a ('!+*( la -IC, +o&o !"a+ala('+#o&a, o +olo+a( !" ('"a?' '+ala('+#o&a, o +olo+a( !" ('"a?' 'LCR$LCR$


22/23

Co$enario @na#Co$enario @na#

Los "*os +o" 3EC g(a' #*'"'" &a


23/23

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Manejo Del Tec en Pediatria (Pptminimizer)