{"id":29592,"date":"2019-09-16T16:50:22","date_gmt":"2019-09-16T15:50:22","guid":{"rendered":"https:\/\/cram.org\/?page_id=29592"},"modified":"2019-09-16T16:50:24","modified_gmt":"2019-09-16T15:50:24","slug":"traumatisme-cranial","status":"publish","type":"page","link":"https:\/\/cram.org\/ca\/clinica-i-rescat\/medicina-i-cirurgia\/traumatisme-cranial\/","title":{"rendered":"Traumatisme cranial"},"content":{"rendered":"

TRAUMATISME CRANIAL<\/strong><\/h1>\n<\/div>
<\/div><\/div><\/div><\/div><\/div>

DADES<\/strong><\/h2>\n<\/div>
  • <\/i><\/span>
    Esp\u00e8cie: Caretta Caretta<\/span><\/div><\/li>
  • <\/i><\/span>
    Nom: Page<\/span><\/div><\/li>
  • <\/i><\/span>
    Longitud: 53 cm<\/span><\/div><\/li>
  • <\/i><\/span>
    Pes: 26 kg<\/span><\/div><\/li>
  • <\/i><\/span>
    Lloc de recollida: Palam\u00f3s<\/span><\/div><\/li>
  • <\/i><\/span>
    Data: 25\/05\/2008<\/span><\/div><\/li><\/ul>
    <\/div><\/div><\/div>

    HIST\u00d2RIA<\/strong><\/h2>\n<\/div>

    Page va ser recollida per uns particulars que la van trobar surant prop del port de Palam\u00f3s.<\/p>\n<\/div><\/div><\/div>

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    <\/path><\/svg><\/div>
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    EXAMEN F\u00cdSIC<\/strong><\/h2>\n<\/div>

    Presentava una fractura oberta i infectada a nivell de l’os nasal, amb gran quantitat de teixit necr\u00f2tic que obstru\u00efa el pas de l’aire, per la qual cosa l’animal respirava per la boca. A m\u00e9s, es podia observar inflamaci\u00f3 a nivell de l’articulaci\u00f3 humeroradicubital esquerra, dolor i crepitaci\u00f3 a l’extensi\u00f3-flexi\u00f3. L’animal estava feble, per\u00f2 l’exploraci\u00f3 neurol\u00f2gica va ser normal, tots els seus reflexos eren positius.<\/p>\n<\/div>

    DIAGN\u00d2STIC<\/strong><\/h2>\n<\/div>

    Es va realitzar una exploraci\u00f3 radiol\u00f2gica completa i es van observar una fractura oberta i profunda en l’os nasal i una fractura tancada completa en el radi i c\u00fabit esquerres, a m\u00e9s de p\u00e8rdua de la densitat \u00f2ssia en la cortical del radi. Quan la resoluci\u00f3 de la inflamaci\u00f3 va permetre obtenir radiografies de qualitat, es va comprovar que Page presentava osteomielitis (inflamaci\u00f3 del teixit ossi) en l’extremitat anterior esquerra. Es va ratificar el diagn\u00f2stic mitjan\u00e7ant TAC (Tomografia Axial Automatitzada) i es va poder saber mitjan\u00e7ant aquest sistema que la infecci\u00f3 no estava activa en aquest moment, per\u00f2 m\u00e9s de la meitat de l’os havia desaparegut a conseq\u00fc\u00e8ncia d’aquesta. A m\u00e9s, es van prendre mitjan\u00e7ant punci\u00f3-aspiraci\u00f3 amb agulla fina mostres del teixit inflamatori de l’articulaci\u00f3 per a cultiu microbiol\u00f2gic i saber quin bacteri estava provocant la infecci\u00f3, per\u00f2 no es van obtenir resultats concloents. A nivell hematol\u00f2gic, es va observar una disminuci\u00f3 del recompte de gl\u00f2buls blancs, t\u00edpic d’infeccions cr\u00f2niques. La bioqu\u00edmica sangu\u00ednia era normal. Mitjan\u00e7ant exploraci\u00f3 ecogr\u00e0fica, es va poder comprovar que Page era una femella.<\/span><\/p>\n<\/div>

    <\/div><\/div><\/div>

    TRACTAMENT<\/strong><\/h2>\n<\/div>

    Fins que va comen\u00e7ar a menjar per si mateixa, despr\u00e9s d’uns 12 dies des del seu ingr\u00e9s se li va administrar fluidoterapia via intracel\u00f3mica. A m\u00e9s, es van administrar antiinflamatoris injectables durant la primera setmana de la seva estada en el centre de recuperaci\u00f3 per a evitar el dolor i afavorir l’exploraci\u00f3 radiol\u00f2gica. Donada la gravetat d’una lesi\u00f3 com l’osteomielitis i per a evitar el seu agreujament, se li va administrar una combinaci\u00f3 d’antibi\u00f2tics durant m\u00e9s de dos anys a intervals de diversos mesos, deixant una petita pausa entre ells. La ferida nasal es curava cada dia durant els tres primers mesos, retirant el teixit necr\u00f2tic que s’anava formant, per a evitar que es necros\u00e9s tamb\u00e9 l’os. A m\u00e9s, s’emplenava la cavitat amb pomada antibi\u00f2tica per a afavorir la regeneraci\u00f3 del teixit sa i es cobria amb silicona, evitant aix\u00ed la contaminaci\u00f3 de la mateixa en el tanc.<\/p>\n<\/div><\/div><\/div>

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    EVOLUCI\u00d3<\/strong><\/h2>\n<\/div>

    L’osteomielitis, que va comen\u00e7ar en l’aleta anterior esquerra arran de la fractura nasal, es va estendre a totes les extremitats en un per\u00edode d’uns dos anys i fins i tot va donar lloc a septic\u00e8mia (pres\u00e8ncia de bacteris en sang). El bacteri identificat en hemocultiu va ser Pseudomonas fluorescens. Finalment, va acabar responent favorablement al tractament antibi\u00f2tic i, despr\u00e9s d’una temporada de rehabilitaci\u00f3 i exercicis en un tanc des de la seva completa recuperaci\u00f3, va poder ser alliberada 3 anys despr\u00e9s de la seva entrada en el centre de recuperaci\u00f3.<\/p>\n<\/div>

    <\/div><\/div><\/div><\/div><\/div>
    <\/div>
    <\/div><\/div>
    <\/div><\/div><\/div>
    <\/div><\/div><\/div>

    COMENTARIS<\/strong><\/h2>\n<\/div>

    L’osteomielitis i septic\u00e8mia s\u00f3n malalties molt greus que s’estenen amb facilitat, podent fins i tot acabar amb la vida de l’animal. Solen comen\u00e7ar arran d’una ferida contaminada i \u00e9s molt important identificar l’agent infecci\u00f3s que les produeix per a seleccionar l’antibi\u00f2tic espec\u00edfic per a acabar amb elles.<\/p>\n<\/div>

    <\/div><\/div><\/div>

    INFORMACI\u00d3 COMPLEMENT\u00c0RIA<\/strong><\/h2>\n<\/div>
    \"\"<\/div><\/div>
    <\/div>
    \n

    Lesi\u00f3 del cap en entrar al centre, abans de ser netejada.<\/p>\n<\/div><\/div><\/div>

    \"\"<\/div><\/div>
    <\/div>
    \n

    Lesi\u00f3 despr\u00e9s de 2 mesos de cures di\u00e0ries.<\/p>\n<\/div><\/div><\/div>

    <\/div><\/div>
    <\/div><\/div><\/div>
    \"\"<\/div><\/div>
    <\/div>
    \n

    Lesi\u00f3 del cap despr\u00e9s d’1 any. Es pot veure que est\u00e0 pr\u00e0cticament tancada.<\/p>\n<\/div><\/div><\/div>

    \"\"<\/div><\/div>
    <\/div>
    \n

    Lesi\u00f3 del cap abans de ser alliberada, completament tancada.<\/p>\n<\/div><\/div><\/div>

    <\/div><\/div>
    <\/div><\/div><\/div>
    \"\"<\/div><\/div>
    <\/div>
    \n

    Radiografia de l’aleta davantera dreta. Pot observar-se la p\u00e8rdua de la primera falange del primer dit.<\/p>\n<\/div><\/div><\/div>

    \"\"<\/div><\/div>
    <\/div>
    \n

    Radiografia de l’aleta davantera dreta abans de l’alliberament.<\/p>\n<\/div><\/div><\/div>

    <\/div><\/div>
    <\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":5110,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":"","_members_access_role":[],"_members_access_error":""},"class_list":["post-29592","page","type-page","status-publish","hentry"],"yoast_head":"\nTraumatisme cranial - CRAM<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cram.org\/ca\/clinica-i-rescat\/medicina-i-cirurgia\/traumatisme-cranial\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Traumatisme cranial - CRAM\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cram.org\/ca\/clinica-i-rescat\/medicina-i-cirurgia\/traumatisme-cranial\/\" \/>\n<meta property=\"og:site_name\" content=\"CRAM\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/fundacioncram\" \/>\n<meta property=\"article:modified_time\" content=\"2019-09-16T15:50:24+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/cram.org\/wp-content\/uploads\/2013\/12\/logo-CRAM.png\" \/>\n\t<meta property=\"og:image:width\" content=\"420\" \/>\n\t<meta property=\"og:image:height\" content=\"79\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@crampress\" \/>\n<meta name=\"twitter:label1\" content=\"Temps estimat de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"19 minuts\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/cram.org\\\/ca\\\/clinica-i-rescat\\\/medicina-i-cirurgia\\\/traumatisme-cranial\\\/\",\"url\":\"https:\\\/\\\/cram.org\\\/ca\\\/clinica-i-rescat\\\/medicina-i-cirurgia\\\/traumatisme-cranial\\\/\",\"name\":\"Traumatisme cranial - 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