Most of the cases of HED was trauma, sometimes the form of blunt trauma to the head. Patients can prove the existence of previous head injury, such as the scalp laserasi, cephalohematoma, or contusion. Systemic diseases sometimes appear in the examination. Based on the severity of impact, the patient sometimes does not appear lost consciousness, lost consciousness in a short period of time, or lost the awareness that prolonged (Ullman, 2006).
Sign and symptoms of HED include heavy headache, nausea, vomiting, and enlargement of the size of one or both pupil (ipsilateral or bilateral) in accordance with the direction of head trauma or a sudden weakness of arm or leg. The sign of a more dangerous HED is increasing degrees nervous, like croon, confused, or the inability to wake up from the situation does not realize that in the (comma). Because the brain controls all functions of the body, changes the pattern of breath can occur. Short of breath - a short, gasping breathing, or a very slow breath is a sign warning that someone needs help (Anonymous, 2007).
Alerts appear in the lucid intervals of 20 - 50% of patients with HED. Originally the head injury that occurred the decrease in awareness. Once again improved awareness, HED continues to cause mass bleeding is increased pressure intrakranial, decrease the level of awareness of, and may cause the emergence herniasi syndrome (Ullman, 2006).
In the patients with hypertension intrakranial a heavy, a sign - a sign Cushing response may appear. Trias Cushing include the classic systemic hypertension, bradikardi, and respiratory depression. The response was usually start to appear when the brain perfused decrease because of the increased pressure intrakranial (Ullman, 2006).
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