Syringomyelia

Syringomyelia ndi chotengera cha cerebrospinal fluid (CSF) chomwe chimapangidwa mumtsempha wamtsempha. Popita nthawi, zimawononga msana.

Chotupa chodzaza madzi chimatchedwa syrinx. Kapangidwe ka madzimadzi amtsempha kumatha chifukwa cha:

• Zolakwika zakubadwa (makamaka chiari malformation, momwe gawo laubongo limakankhira pansi pamtsempha m'munsi mwa chigaza)
• Matenda a msana
• Mimba ya msana

Chotupa chodzaza madzi nthawi zambiri chimayambira m'khosi. Imakula pang'onopang'ono, ikukakamiza msana ndikuwononga pang'onopang'ono.

Kuyamba kwa syringomyelia nthawi zambiri kumakhala pakati pa zaka 25 mpaka 40. Amuna amakhudzidwa kwambiri kuposa akazi.

Ngati vutoli limachitika chifukwa cha zolakwika zobadwa, sipangakhale zizindikilo mpaka zaka 30 mpaka 40. Zizindikiro za syringomyelia nthawi zambiri zimawoneka pang'onopang'ono ndipo zimaipiraipira pazaka zambiri. Pankhani yovulala, kuyamba kwa zizindikilo kumatha kukhala miyezi iwiri kapena itatu yakubadwa. Ngati pali zizindikiro, zitha kuphatikiza:

• Mutu
• Scoliosis (mwa ana)
• Kutaya minofu (kuwononga, kuperewera), nthawi zambiri mmanja ndi mmanja
• Kutayika kwa malingaliro m'miyendo yam'mwamba
• Kuchuluka kwa malingaliro m'miyendo m'munsi
• Spasms kapena kukakamira mwendo kapena dzanja ndi dzanja lamanja
• Kutayika kwa minofu, kutaya mphamvu yogwiritsira ntchito mikono kapena miyendo
• Dzanzi lomwe limachepetsa kumva kupweteka kapena kutentha; amachepetsa mphamvu yakumverera pakhungu likukhudzidwa; imapezeka m'khosi, m'mapewa, m'mwamba, ndi thunthu mumtundu wofanana ndi Cape; ndipo pang'onopang'ono zimaipiraipira pakapita nthawi
• Kupweteka pansi mikono, khosi, kapena pakati kumbuyo kapena miyendo
• Kufooka (kuchepa mphamvu ya minofu) m'manja kapena m'miyendo
• Kupsa kopweteka kapena kuvulala kwa dzanja
• Kuvuta kuyenda kapena zala kuyenda mwa ana
• Mayendedwe osalamulirika amaso (nystagmus)
• Zomwe zimakhudza mitsempha kumaso ndi kumaso (Horner syndrome)

Wopereka chithandizo chamankhwala ayesa thupi ndikufunsa za zizindikilozo, akuyang'ana zamanjenje. Mayeso omwe angachitike ndi awa:

• MRI ya mutu ndi msana
• Spinal CT scan ndi myelogram (itha kuchitika ngati MRI sichingatheke)

Palibe mankhwala odziwika a syringomyelia. Zolinga zamankhwala ndikuletsa kuwonongeka kwa msana kuti kuwonjezeke ndikukweza magwiridwe antchito.

Kuchita opaleshoni kungafunike kuti muchepetse kupsinjika kwa msana. Thandizo lakuthupi ndi pantchito lingafunike kuti minofu igwire bwino ntchito.

Ventriculoperitoneal shunting kapena syringosubarachnoid shunting ingafunike. Imeneyi ndi njira yomwe catheter (yopyapyala, yosinthira chubu) imayikidwa kuti ithetse madzi.

Popanda chithandizo, vutoli limatha kukula pang'onopang'ono. Popita nthawi, zimatha kuyambitsa chilema chachikulu.

Kuchita maopareshoni nthawi zambiri kumalepheretsa vutoli kukulira. Ntchito yamanjenje idzasintha mwa anthu 30% omwe achita opaleshoni.

Popanda chithandizo, vutoli limatha kubweretsa ku:

• Kutaya kwamanjenje kumagwira ntchito
• Kulemala kwamuyaya

Mavuto omwe angakhalepo pa opaleshoni ndi awa:

• Matenda
• Zovuta zina za opaleshoni

Itanani omwe akukuthandizani ngati muli ndi zizindikiro za syringomyelia.

Palibe njira yodziwika yotetezera vutoli, kupatula kupewa kuvulala kwa msana. Kuchiritsidwa nthawi yomweyo kumachepetsa vutoli kukulirakulirakulirabe.

Syrinx

• Mitsempha yapakati

Batzdorf U. Syringomyelia. Mu: Shen FH, Samartzis D, Fessler RG, olemba. Buku la Cervical Spine. Philadelphia, PA: Elsevier Saunders; 2015: mutu 29.

Benglis DM, Jea A, Vanni S, Shah AH, Green BA. Syringomyelia. Mu: Garfin SR, Eismont FJ, Bell GR, Fischgrund JS, Bono CM, olemba. Rothman-Simeone ndi Herkowitz a The Spine. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 94.

Roguski M, Samdani AF, Hwang SW. Syringomyelia wamkulu. Mu: Winn HR, mkonzi. Opaleshoni ya Youmans ndi Winn Neurological. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: chap 301.