ʻO ka vertex ka hapa o luna o ka iwi poʻo, a hiki ke kapa ʻia ʻo ia hoʻi: No laila ʻo ka piko ka piko o ke poʻo, ka ʻaoʻao luna o ka pahu cranial, i loko o nā kānaka akā i nā vertebrates āpau a i ʻole nā ​​arthropods. ʻO ka vertex, i kapa ʻia ʻo ka iwi poʻo, i hana ʻia i ʻehā mau iwi i loko o nā kānaka.

ʻO ia ka vertex, ma nā vertexes, me ke kāne, a me nā mea kolo, ka piko o ka iwi poʻo. I kekahi manawa kapa ʻia ka pāpale cranial, no laila ka vertex, ma ka anatomy, ka ʻaoʻao luna o ka pahu cranial: ʻo ia ka ʻaoʻao o luna o ke poʻo. Kāhea ʻia ʻo ia ʻo faamaoni.

I ka anatomy, i loko o nā kānaka, ʻehā mau iwi o ka iwi poʻo o ka cranial vertex.

• ka iwi lae;
• nā iwi hua ʻelua;
• lʻos occipital. 

Pili kēia mau iwi i nā sutures. Hoʻohui ka suture coronal i nā iwi o mua a me parietal, aia ke sitture sagittal ma waena o nā iwi parietal ʻelua, a hui pū ke suture lambdoid i nā iwi hua.

E like me nāʻiʻo iwi āpau, loaʻa i ka vertex ʻehā mau ʻano o nā hunaola:

• osteoblast;
• osteosit;
• nā palena palena;
• osteoclasts. 

Hoʻohui ʻia, helu ʻia kāna matrix extracellular, e hāʻawi ana i kēia kiko i kona ʻano paʻa. Eia hou, hana kēia i mea opaque i nā kukuna x, no laila e ʻae ana i ke aʻo ʻana i nā iwi e ka x-ray.

Komo ka vertex i ka pale o ka lolo, ma kona ʻaoʻao luna. I ka ʻoiaʻiʻo, ʻo ka vertex kahi aʻa iwi, no laila he iwi iwi, he hana mechanical kāna.

ʻOiaʻiʻo, ʻo ka iwi o ka iwi kekahi mea kūpaʻa i ke kino, no laila hiki iā ia ke kū i ke kaumaha mechanical. Pēlā e hana ai ka vertex i kāna hana pale i ka lolo ma ka pae o ka piko o ke poʻo.

Hematoma keu-dural

Hoʻokumu ʻia kahi pathology e pili ana i ka vertex e ka extradural hematoma, kahi e ukali pinepine ai i kahi haʻalulu nui e hopena ana i ka haki ʻana o kahi aʻa i luna o ka meninges. Hoʻokumu ʻia kēia hematoma e kahi hōʻiliʻili o ke koko ma waena o ka iwi o ka iwi poʻo a me ka dura, a i ʻole ka papa waho o nā meninges, kahi envelope e pale ai i ka lolo. No laila he effusion o ke koko ma waena o kekahi o nā iwi o ka iwi poʻo e pili ana i ka piko a me ka dura o ka lolo.

He laha ʻole ka hematoma keu-dural localized i ka vertex, he hapaʻuʻuku wale nō ia o nā hematomas keu. ʻOiaʻiʻo, hoʻopili wale kēia ʻano hematoma i ka piko ma 1 a 8% o nā hihia āpau o ka hematoma keu. Hiki ke kumu ʻia e kahi waimaka i loko o ka sinus sagittal, ʻoiai ʻo nā hematomas extradural o ka vertex e hōʻike wale nei i hōʻike ʻia i loko o nā puke.

ʻO ka hematoma keu (dural dural) (EDH) o ka vertex he mau ʻano olakino nonspecific, no laila paʻakikī ka localization maʻi o nā leona. Hiki i kēia pathology ke koʻikoʻi a lōʻihi paha.

Hiki ke hoʻopili ʻia ke kumu o ke kahe ʻana, e like me ka mea i ʻōlelo ʻia, i kahi waimaka i loko o ka sinus sagittal, akā ʻo ke kumu o ke kahe e hiki ke lilo i mea ākea. ʻO nā ʻōuli maʻamau ka ʻeha poʻo loa, e pili pū me ka luaʻi.

Eia hou, ua pili nā hihia o EDH o ka piko me hemiplegia, paraplegia, a i ʻole hemiparesis. ʻO kēia hematoma keu-dural o ka vertex e laha mau nei.

Nā pathology ʻē aʻe

ʻO nā pathologies ʻē aʻe e hiki ke hoʻopili i ka vertex nā pathology iwi, e like me nā tumign benign a malignant paha, ka maʻi o Paget a i ʻole nā ​​haki, i ka hanana o ka ʻeha. ʻO nā tumors a pseudotumors paha o ka waihona cranial, ʻo ia hoʻi, he mau leona i ʻike pinepine ʻia i ka hana o kēia manawa a me ka ʻike pinepine ʻia. He benign lākou.

Hiki ke mālama ʻia kahi hematoma keu-dural ma ka pae o ka piko, e like me ka nui o ka hematoma, ke kūlana olakino o ka mea maʻi a me nā hopena radiological e pili pū ana. Pono e mālama nui i ka wā o ke ʻoki ʻana, ʻoiai ka waimaka o ka sinus sagittal hiki ke alakaʻi i ka nui o ke kahe o ke koko a me ka embolism.

E mālama ʻia nā pathologies ʻē aʻe o ka vertex ma o nā lāʻau e mālama ai i ka ʻeha, a i ʻole ke ʻano o ke ʻoki ʻana, a i ʻole, i ka hihia o kahi tumo, ma ke ʻoki ʻana, a i ʻole chemotherapy a me radiotherapy i ka hihia o kahi tumo. malignant o kēia iwi.

ʻO ke kuhi o kahi hematoma keu-dural e waiho ana ma ka pae o ka piko hiki ke hana i ka huikau diagnostic. Hiki i kahi CT scan (compute tomography) o ke poʻo ke kōkua i ke kuhi. Eia naʻe, pono e mālama pono ʻaʻole e kuhihewa me kahi artefact a i ʻole hematoma subdural.

ʻO ka ʻoiaʻiʻo, ʻo MRI (magnetic resonance imaging) kahi mea hana diagnostic ʻoi aku ka maikaʻi e hiki ai ke hōʻoia i kēia. ʻO ke kuhi mua a me ka mālama wikiwiki ʻana i ka hematoma extradural hiki ke kōkua i ka hōʻemi ʻana i ka make a me ka maʻi e pili ana i kēia ʻano maʻi maʻamau.

No ke kuhi o nā pathology iwi ʻē aʻe, pili pinepine ʻia ke kiʻi olakino me nā mea hana kiʻi e ʻike ai i ka haki a i ʻole ka māwae, a i ʻole ka maʻi ʻino a malignant paha, a i ʻole ka maʻi o Paget.

ʻO ka hihia mua o ka extra-dural vertex hematoma i hōʻike ʻia ma 1862, e Guthrie. No ka hihia mua i wehewehe ʻia i loko o nā puke ʻepekema kahi i hoʻohana ʻia ai ka MRI i ke kuhi o kahi hematoma keu o ka vertex, ua hoʻomaka ʻia ia mai ka makahiki 1995.

ʻO ka mea hope loa, ua hoʻololi ʻia ka pathophysiology o kahi hematoma e pili ana i ka piko ʻokoʻa ʻokoʻa loa ia me nā hematomas keu-dural ma nā pūnaewele ʻē aʻe o ka iwi poʻo. , ke loaʻa ka hematoma i ka piko, ʻoiai i ka manawa like hematoma liʻiliʻi, asymptomat aia ma nā wahi ʻē aʻe o ka iwi poʻo paha e koi ʻole ai i ke ʻoki.