Knowledge about blood clot in brain after car accident.

Intracranial hematoma is a common secondary injury of craniocerebral trauma, which can be divided into epidural hematoma, subdural hematoma, intracerebral hematoma and ventricular hematoma according to different parts. What you're talking about may be a ventricular hematoma. There are two kinds of traumatic intraventricular hemorrhage: one is primary intraventricular hemorrhage, which is caused by shearing deformation of the ventricular wall and tearing the ependymal vessels when the brain tissue moves violently in the front and back direction due to violence; The second is traumatic intracerebral hematoma, which breaks into the ventricle and is called secondary intraventricular hemorrhage. The incidence of this disease accounts for 1.2% of severe craniocerebral injury. 7.1% of patients with severe craniocerebral trauma underwent CT scanning. Clinically, in addition to brain compression, increased intracranial pressure and obvious disturbance of consciousness, there are also central high fever, lasting above 4℃, shortness of breath, denervation rigidity and pupil changes, which are easily confused with brain stem injury and hypothalamic injury. The exact diagnosis depends on CT examination. It can be seen that obvious high-density shadow fills part of the ventricular system, and there are few people who have massive hemorrhage to form a whole ventricular cast. The amount of intraventricular hemorrhage, the severity of primary brain injury, the age of the patient, whether there is early ventricular system expansion and other factors directly affect the prognosis. The mortality rate is 31.6%-76.6%, and survivors often have functional defects and mental retardation. Treatment: This disease is often complicated with severe brain contusion and laceration and/or hematoma in other parts, which is more harmful than intraventricular hemorrhage. Ventricular drainage should be performed at the same time as primary and secondary injuries, or after removing intracranial hematoma and crushing brain tissue, the ventricle should be opened to discharge blood clots that cause ventricular obstruction. Usually, a small amount of intraventricular hemorrhage can be absorbed by itself, and even a small amount of blood clots can be liquefied in about 1 days, so the cerebrospinal fluid can be cleared by using lumbar puncture to drain bloody cerebrospinal fluid several times; If there is a large amount of ventricular hemorrhage and the whole ventricular system is filled, it is necessary to perform ventriculotomy or borehole irrigation and drainage. The former is usually performed at the same time during the operation, while the latter is feasible to puncture the bilateral frontal ventricles and wash them alternately with equal amount of normal saline to drain the accumulated blood as far as possible. If necessary, urokinase can also be used to dissolve blood clots, so as to reduce ventricular dilatation and hydrocephalus, and at the same time reduce the compression on the lower thalamus and the upper brain stem, thus avoiding the secondary damage of ischemia and hypoxia in the gray matter nuclei in this area.