{"id":743,"date":"2010-10-06T13:05:11","date_gmt":"2010-10-06T05:05:11","guid":{"rendered":"http:\/\/drzubaidi.com\/blog\/?p=743"},"modified":"2019-09-30T09:41:22","modified_gmt":"2019-09-30T01:41:22","slug":"kecederaan-kepala-kanak-kanak-dan-ct-scan-otak","status":"publish","type":"post","link":"https:\/\/drzubaidi.com\/blog\/kecederaan-kepala-kanak-kanak-dan-ct-scan-otak\/","title":{"rendered":"Kecederaan Kepala Kanak-kanak dan CT SCAN Otak"},"content":{"rendered":"

\"\"<\/a><\/p>\n

Saya pernah ditanya oleh seorang ibu muda yang membawa anaknya yang baru belajar bertatih. Beliau bertanyakan tentang kesan sampingan terhadap \u2018kecederaan\u2019 kepala pada anaknya seminggu yang lalu.<\/p>\n

Bila saya meminta beliau menerangkan lebih jelas mengenai \u2019kecederaan\u2019 itu, beliau memberitahu hanyalah benjol kecil di dahi dan telah pun hilang.<\/p>\n

Berapa minggu selepas itu saya mendengar seorang rakan memberitahu ada satu kes yang dibawa ke hospital di mana seorang kanak-kanak berusia 3 tahun jatuh dari katil bertingkat dan meninggal dunia sebaik saja sampai di hospital.<\/p>\n

Kecederaan pada kanak-kanak yang berusia 6 tahun ke bawah amat kerap berlaku. Baru-baru ini saya merawat dua orang kanak-kanak yang cedera ketika bermain sesama sendiri. Seorang luka di dahi dan seorang lagi luka di dagu. Saya sendiri pernah luka di kening kiri ketika berumur 5-6 tahun ketika bermain berkejaran dengan kawan-kawan. Namun saya rahsiakan dari ibubapa saya kerana pendarahannya berhenti bila saya tekapkannya dengan ais. Lukanya juga tidak kelihatan kerana dilindungi oleh bulu-bulu kening.<\/p>\n

Kanak-kanak bermain mengikut kehendak naluri mereka dan mereka tidak dapat menimbangkan bahaya yang berada di hadapan mereka. Apatah lagi tubuh mereka yang kecil dan otot yang tidak kuat menyebabkan mereka agar sukar mengimbangkan badan. Kecederaan di kepala melibatkan benjol (haematoma<\/em>), luka (abrasion wound<\/em>) atau luka koyak (laceration wound<\/em>).<\/p>\n

Namun apa yang membimbangkan apabila kanak-kanak mengalami kecederaan di kepala, bukan setakat luka di situ, tetapi melibatkan pengsan dan tidak sedarkan diri. Ramai yang bimbangkan kalau-kalau kecederaan di kepala juga melibatkan kecederaan di otak.<\/p>\n

Saya pernah merawat seorang kanak-kanak yang berumur 10 tahun, bermain basikal dengan kawan-kawannya pada waktu maghrib. Akibat masalah brek, kanak-kanak itu terlanggar tiang lampu dan mengalami kecederaan luka (laceration<\/em> di kepala).<\/p>\n

Pendarahannya tidak berhenti semasa saya menjahit luka kanak-kanak itu. Namun apa yang saya perhatikan, sepanjang 30 minit \u00a0saya menjahit luka di kepalanya, kanak-kanak itu seolah-olah sedang tidur. Bila digerakkan dan diminta untuk membuka matanya, dia enggan seperti menyuruh kanak-kanak yang enggan bangun dari tidur yang lena.<\/p>\n

Lalu saya mencadangkan agar dihantarkan ke hospital untuk pemeriksaan CT scan otak supaya dapat dipastikan sama ada kecederaan luka di kepalanya melibatkan kecederaan otak. Alhamdulillah, feedback<\/em> yang saya terima seminggu selepas itu ketika ibubapanya mengunjungi saya, memberitahu tiada kecederaan otak yang serius, hanya gegaran otak.<\/p>\n

Jadi apakah semua kecederaaan kepala harus dilakukan CT scan otak?<\/p>\n

Sebelum saya menerangkan lebih lanjut elok juga kalau saya terangkan istilah awareness<\/em><\/strong>. Istilah ini digunakan untuk mengukur tahap kesedaran seseorang. Jika seseorang itu full awareness<\/em>, dia boleh bercakap dan menjawab soalan seperti orang yang normal.<\/p>\n

Namun bila tahap kesedarannya semakin menurun, dia mungkin bercakap seperti orang mabuk (drowsy)<\/em> atau mungkin seperti orang yang mengantuk mahu tidur atau lebih teruk ialah pengsan dan tidak sedarkan diri. Ini semua tanda-tanda tahap kesedaran yang tidak baik.<\/p>\n

Maka jika kanak-kanak mengalami kecederaan kepala akibat terjatuh, kemalangan jalanraya, atau semasa bermain, elok kita pastikan tahap kesedarannya.<\/p>\n

\"\"<\/a><\/p>\n

Kanak-kanak yang tidak mempunyai tahap kesedaran yang baik<\/span> seharusnya dihantar ke hospital untuk pemeriksaan CT scan otak. Ini termasuk pengsan dan tidak sedarkan diri. Atau mungkin setakat lemah atau seperti orang mengantuk.<\/p>\n

Bagitu juga jika kanak-kanak itu hanya pengsan melebihi 30 saat atau lupa apabila disoal namanya (amnesia<\/em>). Saya pasti ia melibatkan kecederaan otak sama ada hanya gegaran (concussion<\/em>) atau pun pendarahan otak (intra crnial bleeding<\/em>).<\/p>\n

Apa yang belaku adalah satu gegaran yang kuat berlaku pada otak dan boleh mengakibatkan kebocoran saluran darah dan akhirnya menyebabkan pendarahan dalam otak.<\/p>\n

Muntah yang berterusan<\/span> juga adalah tanda-tanda kecederaan otak. Kanak-kanak itu akan terus lemah dan muntah-muntah. Muntah ini disebabkan oleh tahap tekanan pada otak (intracranial pressure<\/em>) yang semakin tinggi akibat pendarahan di dalamnya.<\/p>\n

Tanda-tanda lain ialah kanak-kanak itu tidak boleh menggerakkan sebahagian badan atau sebahagian anggota<\/span>. Ini dinamakan focal neurological deficit <\/em>di mana kawasan otak yang mengawal bahagian yang tidak boleh bergerak itu mengalami kecederaan. Contohnya kanak-kanak itu tidak mampu menggerakkan kaki kanan atau pun tangan kanan.<\/p>\n

Selain itu terdapat kecederaan jelas yang menunjukkan kecederaan pada tengkorak<\/span>, sama ada boleh dilihat melalui luka di kepala atau pun melalui x ray tengkoraknya. X ray tengkorak hanya boleh melihat keretakan atau kecederaan pada tengkorak, tetapi tidak mampu melihat kecederaan pada otak, maka haruslah dihantar untuk pemeriksaan CT scan.<\/p>\n

Oleh itu setiap kanak-kanak yang mengalami kecederaan di kepala di samping mempunyai tahap kesedaran yang menurun, hilang ingatan, pengsan, muntah berpanjangan dan lemah, tidak dapat menggerakkan sebahagian tubuh dan mempunyai kesan kecederaan tengkorak yang jelas, ini menunjukkan kanak-kanak itu mempunyai risiko kecederaan otak. Cara terbaik untuk mendiagnosanya ialah dengan pemeriksaan CT scan otak.<\/p>\n

Baru-baru ini satu kajian di Britain telah mendapati 10% dari kanak-kanak yang cedera di kepala akibat terjatuh dan mempunyai tahap kesedaran yang baik\/normal juga menunjukkan tanda-tanda terdapat kecederaan otak apabila dilakukan pemeriksaan CT scan otak.<\/p>\n

Ini memeranjatkan dan membimbangkan ibubapa dan doktor. Walaupun kita menjangka kecederaan yang dialami oleh anak kita mungkin ringan, dia tidak mempunyai luka atau benjolan di kepala, tidak ada muntah dan tidak pengsan, masih ada kemungkinan ia mengalami kecederaan otak.<\/p>\n

Jadi bagaimana ibubapa hendak menghadapi kebimbangan ini? Bayangkan bila dihantar ke hospital (terutama hospital awam), kanak-kanak itu diberikan rawatan dan doktor yang bertugas d Jabatan Trauma dan Kecemasan mengatakan anak kita itu tidak perlu menjalani pemeriksaan CT scan otak.<\/p>\n

Saya mencadangkan dua pilihan, pertama kita bolehlah membawa anak ke hospital lain untuk mendapat pandangan kedua dan melakukan CT scan di sana. Jika kita mambawanya ke hospital sawsta semestinya permintaan kita ditunaikan dan saya rasa wang yang dikeluarkan untuk Ct scan otak berbaloi dengan nyawa anak kita.<\/p>\n

Cara kedua ialah dengan melakukan observation 24 hour<\/em>. Pemerhatian ini haruslah dilakukan sendiri oleh ibubapa dan jangan mengharapkan pembantu rumah atau pembantu di TASKA. Ini kerana mungkin mereka sibuk melakukan kerja-kerja lain atau pemerhatian mereka tidak sama dengan pemerhatian kita sebagai ibubapa. Jika tiada perubahan yang teruk kepada anak kita dalam masa 24 jam, selalunya kanak-kanak itu tidak mengalami kecederaan di otak.<\/p>\n

Jadi janganlah risau jika kecederaan di kepala telah berlaku melebihi 24 jam dan kanak-kanak itu mula bermain dengan rakan-rakan. Namun begitu bagi kanak-kanak atau bayi yang berumur 2 tahun ke bawah, ianya sangat berbeza.<\/p>\n

Bayi yang berumur 2 tahun ke bawah walaupun tidak menunjukkan tanda kecederaan saraf atau masalah kesedaran yang menurun, \u00a0tetapi kecederaan lebam di kepala (hematoma<\/em>) selalunya menandakan kecederaan dalam otak. Ini kerana tengkorak dan otak bayi itu lebih lembut dibandingkan dengan kanak-kanak berumur 6-12 tahun.<\/p>\n

Jadi bagi mereka lebam di kepala sudah cukup untuk membuktikan kecederaan otaknya. Maka ianya haruslah terus di bawa ke hospital dan dibuat pemeriksaan Ct scan otak.<\/p>\n

Ini kerana bayi sebegini sukar untuk diteliti tahap kesedarannya. Kanak-kanak itu mungkin disangkakan tidur sedangkan dia mengalami tahap kesedaran yang menurun akibat kecederaan otak.<\/p>\n

Wallahu a\u2019lam.<\/p>\n

Susunan : Dr Zubaidi Hj Ahmad (061010)<\/p>\n

 <\/p>\n

IKLAN<\/p>\n

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Untuk pembelian menggunakan kad kredit sila klik di bawah:<\/p>\n

\"[KLIK]\"<\/a>
Warisan tradisi silam kini dalam tangan anda<\/figcaption><\/figure>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Saya pernah ditanya oleh seorang ibu muda yang membawa anaknya yang baru belajar bertatih. Beliau bertanyakan tentang kesan sampingan terhadap \u2018kecederaan\u2019 kepala pada anaknya seminggu yang lalu. Bila saya meminta beliau menerangkan lebih jelas mengenai \u2019kecederaan\u2019 itu, beliau memberitahu hanyalah benjol kecil di dahi dan telah pun hilang. Berapa minggu selepas itu saya mendengar seorang 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Doktor telah melakukan pemeriksaan CT scan kepala dan mendapati terdapat sedikit darah beku. \u00a0Doktor pakar neusosurgeri di HKL mengatakan anak saya tidak memerlukan pembedahan kerana hanya mengalami keretakan pada tengkorak di\u2026","rel":"","context":"In "Bayi\/Kanak-kanak"","block_context":{"text":"Bayi\/Kanak-kanak","link":"https:\/\/drzubaidi.com\/blog\/category\/koleksi-artikel\/children\/"},"img":{"alt_text":"CTscan head","src":"https:\/\/i0.wp.com\/drzubaidi.com\/blog\/wp-content\/uploads\/2014\/04\/CTscan-head.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":7036,"url":"https:\/\/drzubaidi.com\/blog\/kesan-bayi-dan-kanak-kanak-jatuh-dan-terhentak-kepala\/","url_meta":{"origin":743,"position":1},"title":"KESAN BAYI DAN KANAK-KANAK JATUH DAN TERHENTAK KEPALA","author":"drzubaidi","date":"24\/01\/2015","format":false,"excerpt":"\u00a0 \"Salam doktor. Saya ingin bertanya, Bayi atau kanak-kanak sering terjatuh dan kerap terhentak kepala. 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