Kutaya magazi kwa Subarachnoid

Kutaya magazi kwa Subarachnoid ndiko kutuluka magazi m'dera pakati pa ubongo ndi ziwalo zochepa zomwe zimaphimba ubongo. Malowa amatchedwa subarachnoid space. Kutuluka m'magazi kwa subarachnoid ndizadzidzidzi ndipo kumafunika thandizo lachipatala mwachangu.

Kutaya magazi kwa Subarachnoid kumatha kuyambitsidwa ndi:

• Kuthira magazi kuchokera kumtunda wamagazi wotchedwa arteriovenous malformation (AVM)
• Kusokonezeka kwa magazi
• Kutuluka magazi kuchokera mu ubongo aneurysm (malo ofooka pakhoma la chotengera chamagazi chomwe chimapangitsa kuti magazi azituluka kapena buluni)
• Kuvulala pamutu
• Chifukwa chosadziwika (idiopathic)
• Kugwiritsa ntchito ochepetsa magazi

Kutaya magazi kwa Subarachnoid komwe kumachitika chifukwa chovulala kumawonekera mwa achikulire omwe agwa ndikumenya mutu. Mwa achinyamata, chovulala chofala kwambiri chomwe chimayambitsa kukha mwazi kwa subarachnoid ndikuwonongeka kwamagalimoto.

Zowopsa ndi izi:

• Kutsekeka kwapadera muubongo ndi mitsempha ina yamagazi
• Fibromuscular dysplasia (FMD) ndi zovuta zina zamagulu
• Kuthamanga kwa magazi
• Mbiri ya matenda a impso a polycystic
• Kusuta
• Kugwiritsa ntchito mankhwala osokoneza bongo monga cocaine ndi methamphetamine
• Kugwiritsa ntchito oonda magazi monga warfarin

Mbiri yolimba yabanja yokhudzana ndi matenda amthupi imathanso kuonjezera ngozi yanu.

Chizindikiro chachikulu ndikumutu koopsa komwe kumayamba mwadzidzidzi (komwe kumatchedwa mutu wa bingu). Nthawi zambiri zimakhala zoyipa pafupi ndi kumbuyo kwa mutu. Anthu ambiri nthawi zambiri amawafotokozera ngati "mutu wowawa kwambiri kuposa kale lonse" ndipo mosiyana ndi mtundu wina uliwonse wamutu wowawa. Mutu ukhoza kuyamba pambuyo pongomva kapena kumamveka pamutu.

Zizindikiro zina:

• Kuchepetsa kuzindikira komanso kukhala tcheru
• Kusasangalala kwamaso pakuwala kowala (photophobia)
• Kusintha kwa umunthu komanso umunthu, kuphatikiza kusokonezeka komanso kukwiya
• Zilonda zam'mimba (makamaka kupweteka kwa khosi ndi kupweteka kwamapewa)
• Nseru ndi kusanza
• Dzanzi mbali ina ya thupi
• Kulanda
• Khosi lolimba
• Mavuto amawonedwe, kuphatikiza masomphenya awiri, mawanga akhungu, kapena kutaya masomphenya kwakanthawi diso limodzi

Zizindikiro zina zomwe zingachitike ndi matendawa:

• Eyelid akugwera
• Kusiyana kwa kukula kwa ophunzira
• Kuuma modzidzimutsa kwa msana ndi khosi, ndikuphimba kumbuyo (opisthotonos; sizachilendo)

Zizindikiro zimaphatikizapo:

• Kuyezetsa thupi kumatha kuwonetsa khosi lolimba.
• Kuyezetsa kwa ubongo ndi zamanjenje kumatha kuwonetsa zizindikilo zakuchepa kwa mitsempha ndi ntchito yaubongo (focal defic neurologic deficit).
• Kuyesedwa kwa diso kumatha kuwonetsa kuchepa kwamaso. Chizindikiro cha kuwonongeka kwamitsempha yama cranial (m'malo ovuta, palibe zovuta zomwe zingawonekere poyesa maso).

Ngati dokotala akuganiza kuti muli ndi kukha magazi kwa subarachnoid, mutu wa CT scan (wopanda utoto wosiyanasiyana) udzachitika nthawi yomweyo. Nthawi zina, kusinkhasinkha kumakhala koyenera, makamaka ngati pangakhale magazi ochepa. Ngati CT scan ndi yachilendo, kupindika kwa lumbar (tapampopi) kumatha kuchitika.

Mayesero ena omwe angachitike ndi awa:

• Cerebral angiography yamitsempha yamagazi yaubongo
• CT scan angiography (pogwiritsa ntchito utoto wosiyanitsa)
• Transcranial Doppler ultrasound, kuti muwone kuthamanga kwa magazi m'mitsempha ya ubongo
• Kujambula kwamaginito (MRI) ndi magnetic resonance angiography (MRA) (nthawi zina)

Zolinga zamankhwala ndi:

• Pulumutsa moyo wako
• Konzani chifukwa cha magazi
• Pewani zizindikiro
• Pewani zovuta monga kuwonongeka kwa ubongo kosatha (sitiroko)

Opaleshoni itha kuchitidwa ku:

• Chotsani magazi ambiri kapena muchepetse kuthamanga kwaubongo ngati kukha mwazi kumachitika chifukwa chovulala
• Konzani aneurysm ngati kukha magazi kumachitika chifukwa cha kutuluka kwa magazi

Ngati munthuyo akudwala kwambiri, opareshoni imayenera kudikirira mpaka munthuyo atakhazikika.

Kuchita opaleshoni kungaphatikizepo:

• Craniotomy (kudula bowo mu chigaza) ndi kudula kwa aneurysm, kuti mutseke aneurysm
• Kukutira kwamitsempha: kuyika ma coil mu aneurysm ndi stents mumtsuko wamagazi kuti mutseke ma coil kumachepetsa chiopsezo chakutuluka magazi

Ngati palibe aneurysm yomwe ikupezeka, munthuyo amayenera kuyang'aniridwa ndi gulu lazachipatala ndipo angafunikire kuyesedwa kambiri.

Chithandizo cha chikomokere kapena kuchepa kwachangu kumaphatikizapo:

• Kukhetsa chubu choyikidwa muubongo kuti muchepetse kupanikizika
• Thandizo lamoyo
• Njira zotetezera njira yapaulendo
• Kuyika kwapadera

Munthu amene amadziwa bwino angafunike kugona tulo tofa nato. Munthuyo adzauzidwa kuti apewe zinthu zomwe zitha kuwonjezera kukakamiza mkati mwamutu, kuphatikiza:

• Kupindika
• Kupanikizika
• Kusintha mwadzidzidzi

Chithandizo chingaphatikizepo:

• Mankhwala operekedwa kudzera mu mzere wa IV wothandizira kuthamanga kwa magazi
• Mankhwala oletsa kupindika kwa mtsempha wamagazi
• Mankhwala opha ululu ndi mankhwala oletsa nkhawa kuti muchepetse kupweteka kwa mutu komanso kuchepetsa kupanikizika mu chigaza
• Mankhwala oteteza kapena kugwidwa ndi khunyu
• Chofewetsa chopondapo kapena mankhwala ofewetsa tuvi tolimba kuti tipewe kupsinjika m'matumbo
• Mankhwala oteteza khunyu

Momwe munthu amakhalira ndi subarachnoid hemorrhage amatengera zinthu zingapo, kuphatikiza:

• Malo ndi kuchuluka kwa magazi
• Zovuta

Ukalamba ndi zizindikiro zowopsa zimatha kubweretsa mavuto.

Anthu amatha kuchira atachiritsidwa. Koma anthu ena amafa, ngakhale atalandira chithandizo.

Kutuluka magazi mobwerezabwereza ndi vuto lalikulu kwambiri. Ngati matenda a ubongo amatuluka magazi kachiwirinso, malingaliro ake amakhala oyipa kwambiri.

Kusintha kwa kuzindikira ndi kukhala tcheru chifukwa chakuchepa kwa magazi m'mimba kumatha kukulira ndipo kumatha kukomoka kapena kufa.

Zovuta zina ndizo:

• Zovuta za opaleshoni
• Zotsatira zamankhwala
• Kugwidwa
• Sitiroko

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati inu kapena munthu wina yemwe mumamudziwa ali ndi zizindikilo zotuluka m'mimba.

Njira zotsatirazi zitha kuthandiza kupewa kukha magazi m'mitsempha yamagazi:

• Kuleka kusuta
• Kuchiza kuthamanga kwa magazi
• Kuzindikira ndikuchiza bwino aneurysm
• Kusagwiritsa ntchito mankhwala osokoneza bongo

Kukha magazi - subarachnoid; Kutuluka magazi kwa Subarachnoid

• Mutu - zomwe mufunse dokotala wanu

Mayer SA. Matenda a hemorrhagic cerebrovascular. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 408.

Szeder V, Tateshima S, Duckwiler GR. Matenda a intracranial ndi kukha magazi kwa subarachnoid. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 67.