Chifukwa Chachikulu cha Kumutu kwa Achinyamata
Idiopathic Intracranial Hypertension (IIH) ndi matenda omwe amayamba chifukwa cha kuwonjezeka kwa madzi a m'mphepete mwa ubongo kuzungulira ubongo, popanda chiwindi kapena matenda ena a ubongo. Kalekale amadziwika kuti pseudotumor cerebri. Zowonjezereka mwa amayi omwe ali ochepa kwambiri komanso pakutha kwawo.
Zizindikiro za IIH
Kusintha mutu ndi masomphenya ndizozizindikiro zozizwitsa zomwe zimapezeka mu IIH.
Poganizira za diso, madokotala adzawona papilledema -chikhalidwe chodziwika ndi kutupa kwa diso, chifukwa cha kuwonjezeka kwa ubongo. Amapezeka ndi dokotala panthawi yamafufuzidwe a ophthalmoscopic.
Zizindikiro zina (koma osati zosiyana) zomwe zimawonedwa kwa odwala omwe ali ndi IIH zikuphatikizapo:
- maonekedwe osakhalitsa amasintha
- Phokoso la pulsatile (kumva kumva phokoso kapena kupweteka kumutu)
- photopsia (kuzindikira kuwala kwa kuwala)
- ululu m'maso
- masomphenya awiri
- kutayika kwa masomphenya
Kodi Mutu Wachiwiri umamva bwanji?
Mutu wa IIH ukhoza kufanana ndi mutu wa mutu wa migraine kapena wachisokonezo , zomwe zimapangitsa kuti matendawa akhale ovuta. Komanso, palibe "mtundu umodzi wa mutu" womwe anthu omwe ali ndi IIH ali nawo. Izi zikunenedwa kuti mutu wachiwiri wa IIH ndi wovuta komanso ukupweteka, monga migraine. Ululu ukhoza kukhala pakatikati kapena nthawi zonse ndipo ukhoza kugwirizanitsidwa ndi kunyowa ndi / kapena kusanza. Nthawi zina, anthu omwe ali ndi mutu wa IIH amamva ululu m'maso mwawo komanso / kapena ululu ndi kuyenda kwa maso.
Kodi IIH imapezeka bwanji?
Ngati dokotala akukayikira IIH ndikuwona mauthenga ophatikizidwa pamaso, adzalamula kuti MRI ya ubongo ikhale yosiyana komanso yotsutsana ndi zomwe zimayambitsa vuto lanu lopanda mphamvu. Zomwe zimayambitsa matenda osokoneza bongo zimaphatikizapo (koma osangokhala):
- Matenda a mitsempha ya ubongo
- Chotupa cha ubongo kapena abscess (kusonkhanitsa kachilombo ka HIV)
- Zosokoneza hydrocephalus
- Kuchuluka kwa Madzi
- Kuthamanga Kwambiri Kwambiri
Ngati palibe chifukwa choyang'ana pa MRI, mudzakhala ndi mpata wokwanira kuti mutsimikizidwe kukakamizidwa kwakukulu komanso kuti musatuluke matenda pogwiritsa ntchito khungu la cerebrospinal kapena CSF. Mu IIH, palibe matenda, kotero chiwerengero cha CSF ndi chachilendo. Koma kupopera kwapopayi kumasonyeza vuto lotseguka kuposa 250 mmH2O, lomwe ndilo lingaliro la kuthamanga kwapamwamba kwambiri.
Kuchiza kwa IIH
Kuchiza kwa IIH kumafuna kutsata pafupi ndi katswiri wa zamagulu ndi opthamalogist. Chithandizo chachikulu cha IIH ndi mankhwala omwe amatchedwa acetazolamide, omwe amachepetsa kukula kwa CSF. Dokotala wanu angaganizire mankhwala ena ngati muli ndi sulfa zovuta kapena muli ndi pakati. Nthawi zina, pctures ndi corticosteroids zimagwiritsidwa ntchito panthaŵi yochepa kuti zithetse kuchepetsa mphamvu ya CSF-koma izi sizithetsa nthawi yayitali.
Ngati mutu wa munthu uli wosagwirizana ndi chithandizo chamankhwala ndipo / kapena akuvutika ndi kuperewera kwa masomphenya, opaleshoni amafunika. Njira yothandizira opaleshoni imaphatikizapo njira zotchedwa optic mitsempha yotsegula m'mimba (ONSF) ndi / kapena njira yothandizira CSF.
Mu kutsekemera kwa mitsempha ya operesi, kugwidwa kapena zenera kumapangidwira m'magetsi a mitsempha. Izi zimapangitsa CSF kukhetsa, kuchepetsa kupanikizika kwa mitsempha, kulola kuti masomphenya azibwezeretsedwa pang'ono. Kafukufuku amasonyeza kuti ONSF imathandiza kwambiri kusintha masomphenya, makamaka akachitidwa kale kuposa kale. Mu CSF shunting, madzi amtsempha amamasulidwa kupita kumbali zina za thupi, kachiwiri kuchepetsa kupweteka pa ubongo.
Mawu ochokera
Mutu wa IIH umasinthasintha ndipo umapangidwa ndi kuwonjezeka kwapopeni , kutanthauzidwa ndi papilledema pa kafukufuku wamaso. Chithandizo ndi chofunika komanso chofunika kwambiri kuti tipewe kuwona masomphenya ndipo tifunikira kutsatira mwatsatanetsatane ndi katswiri wanu wamaganizo ndi opthamalogist.
Zotsatira:
Lee AG & Wall M. Idiopathic osagwidwa ndi matenda oopsa (pseudotumor cerebri): Mankhwalawa ndi omwe amapezeka. Mu: UpToDate, Basow DS (ed), UpToDate, Waltham, MA, 2015.
Lee AG & Wall M. Idiopathic osagwidwa ndi matenda oopsa (pseudotumor cerebri): Matenda ndi mankhwala. Mu: UpToDate, Basow DS (ed), UpToDate, Waltham, MA, 2015.
National Institute of Neurological Disorders ndi Stroke. Pseudotumor Cerebri Information Page.
Obi EE, BKhani Lakhani, Burns J, & Sampath R. Optic mitsempha yothandizidwa ndi matenda opatsirana pogonana. Clin Neurol Neurosurg . 2015 Oct; 137: 94-101.
Pineles SL, Volpe NJ. Zotsatira Zakale za Mitsempha Yamagetsi Kutsegulira kwa Idiopathic Intracranial Hypertension: Zakale Zomwe Zidatetezera Zotsatira Zopindulitsa. Neuro-Ophthalmology. 2013; 37 (1): 12-19.