Kutulutsa ubongo

Herniation wamaubongo ndikusuntha kwa minofu yaubongo kuchoka pamalo amodzi muubongo kupita ku wina kudzera m'makola ndi mipata yosiyanasiyana.

Herniation yaubongo imachitika pomwe china chake mkati mwa chigaza chimatulutsa zovuta zomwe zimasokoneza ma ubongo. Izi nthawi zambiri zimachitika chifukwa chotupa kwa ubongo kapena kutuluka magazi kuvulala pamutu, stroko, kapena chotupa chaubongo.

Herniation yaubongo imatha kukhala zoyipa zamatumbo muubongo, kuphatikiza:

• Chotupa cha ubongo cha metastatic
• Chotupa chachikulu chaubongo

Herniation waubongo amathanso kuyambitsidwa ndi zinthu zina zomwe zimayambitsa kukakamizidwa mkati mwa chigaza, kuphatikiza:

• Kutola mafinya ndi zinthu zina muubongo, nthawi zambiri zimachokera ku matenda a bakiteriya kapena mafangasi (abscess)
• Kutuluka magazi muubongo (kutaya magazi)
• Kupanga kwamadzimadzi mkati mwa chigaza komwe kumatsogolera kukutupa kwa ubongo (hydrocephalus)
• Sitiroko yomwe imayambitsa kutupa kwa ubongo
• Kutupa pambuyo pochiritsidwa ndi radiation
• Cholakwika pakapangidwe kaubongo, monga vuto lotchedwa Arnold-Chiari malformation

Kutulutsa ubongo kumatha kuchitika:

• Kuyambira mbali mpaka mbali kapena pansi, pansi, kapena pamiyendo yolimba ngati tentorium kapena falx
• Kudzera potsegula mafupa achilengedwe m'munsi mwa chigaza chotchedwa foramen magnum
• Kupyolera muzitseko zopangidwa panthawi ya opaleshoni ya ubongo

Zizindikiro zingaphatikizepo:

• Kuthamanga kwa magazi
• Kutulutsa kosasinthasintha kapena kosafulumira
• Mutu wopweteka kwambiri
• Kufooka
• Kumangidwa kwa mtima (osagunda)
• Kutaya chidziwitso, kukomoka
• Kuwonongeka kwamaganizidwe onse am'maganizo (kuphethira, kugundana, ndi ophunzira poyankha kuwala)
• Kumangidwa mwa kupuma (osapuma)
• Ophunzira ambiri (osakanikirana) osasuntha m'maso amodzi kapena onse awiri

Kuyezetsa magazi ndi ubongo kumawonetsa kusintha pakuchenjera. Kutengera kulimba kwa herniation komanso gawo laubongo lomwe likukakamizidwa, padzakhala mavuto ndi lingaliro limodzi kapena angapo okhudzana ndi ubongo ndi mitsempha.

Mayeso atha kuphatikiza:

• X-ray ya chigaza ndi khosi
• Kujambula kwa CT pamutu
• Kujambula kwa MRI pamutu
• Kuyesedwa kwa magazi ngati mukukayikira chotupa kapena matenda amwazi

Herniation yaubongo ndizachipatala mwadzidzidzi. Cholinga cha chithandizo ndikupulumutsa moyo wa munthuyo.

Pofuna kusinthira kapena kupewa ubongo, gulu lazachipatala lithandizira kutukuka ndi kukakamizidwa muubongo. Chithandizo chitha kukhala:

• Kuyika ngalande muubongo kuthandiza kuchotsa cerebrospinal fluid (CSF)
• Mankhwala ochepetsa kutupa, makamaka ngati pali chotupa muubongo
• Mankhwala omwe amachepetsa kutupa kwaubongo, monga mannitol, saline, kapena ma diuretics ena
• Kuyika chubu panjira yapaulendo (endotracheal intubation) ndikuwonjezera kupuma kuti muchepetse kuchuluka kwa kaboni dayokisaidi (CO₂) m'magazi
• Kuchotsa magazi kapena magazi kuundana ngati akukweza kupanikizika mkati mwa chigaza ndikupangitsa herniation
• Kuchotsa gawo la chigaza kuti ubongo upatse malo ambiri

Anthu omwe ali ndi vuto la ubongo ali ndi vuto lalikulu laubongo. Atha kukhala ndi mwayi wochepa wochira chifukwa chovulala komwe kumayambitsa herniation. Herniation ikamachitika, imachepetsanso mwayi wochira.

Maganizo ake amasiyanasiyana, kutengera komwe ubongo umatulukira. Popanda chithandizo, imfa imatha.

Pakhoza kuwonongeka mbali zina zaubongo zomwe zimayang'anira kupuma ndi magazi. Izi zitha kubweretsa imfa kapena kufa kwaubongo mwachangu.

Zovuta zingaphatikizepo:

• Imfa yaubongo
• Mavuto osatha komanso othandiza okhudza ubongo

Imbani 911 kapena nambala yadzidzidzi yakomweko kapena mutengereni munthuyo kuchipatala ngati atayamba kuchepa kapena zizindikilo zina, makamaka ngati pakhala pali kuvulala kumutu kapena ngati munthuyo ali ndi chotupa muubongo kapena vuto la mtsempha wamagazi.

Chithandizo mwachangu cha kukakamizidwa kopitilira muyeso ndi zovuta zina zimachepetsa chiopsezo cha ubongo.

Matenda a Herniation; Malangizo a Transtentorial; Uncal herniation; Kutsekemera kwa subfalcine; Kutulutsa tonsillar; Herniation - ubongo

• Kuvulala kwa ubongo - kutulutsa

• Ubongo
• Ubongo wa hernia

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Abambo L, Goldberg SA. Kusokonezeka mutu. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 34.

Stippler M. Craniocerebral zoopsa. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 62.