Chizindikiro cha Zizindikiro Zambiri, MRI, ndi Lumbar Kuti Azindikire NPH
Mavuto ambiri a hydrocephalus ndikutambasula kwa malo omwe ali mu ubongo, otchedwa ventricles , omwe ali ndi cerebrospinal fluid - madzi omveka bwino omwe amatsuka ubongo ndi msana ndipo nthawi zambiri amatchedwa CSF.
Mavuto ambiri a hydrocephalus amachititsa kuti asamavutike kuyenda, kuganiza, ndi kulamulira chikhodzodzo. Zizindikiro zingasinthe pamene khungu la neurosurgeon limatulutsa shunt mu mphepo zam'mimba kuti CSF ifike m'mimba m'malo moyenda pansi pamphepete mwa msana.
Njira iliyonse yothetsera ubongo imakhala ndi chiopsezo china, komabe, ndi phindu la kuika mbola yotere ya NPH sikuti nthawi zonse imakhala yotsimikizika - choncho ndi NPH yofunika kwambiri. Ngakhale zitatha izi, odwala ena angapangitse zambiri ndi malo osungira malo kuposa ena.
Amatsenga Omwe Amagwira Ntchito Yopanikizika Hydrocephalus
Kodi mungaganize kuti mukupita opaleshoni yoopsa ya ubongo, osati kusintha chifukwa zizindikirozo zinalidi chifukwa cha matenda osiyanasiyana nthawi zonse? Izi ndi zophweka mosavuta ku NPH chifukwa zizindikiro zimakhala zofala kwa anthu achikulire chifukwa cha zifukwa zosiyanasiyana.
Kuvuta kuyenda, mwachitsanzo, kungakhale chifukwa cha msana wamtsempha , mavuto obisika , mavuto a masomphenya, kapena kupweteka kwa m'mimba. Kusagwedeza kwamtunda kumakhalanso kofala mu ukalamba pa zifukwa zosiyanasiyana. Kuvutika maganizo kungakhale chifukwa cha matenda aakulu monga matenda a Alzheimer's. Demoentiyo imatha kuonjezeranso mavuto oyendayenda, monga matenda a dementia a Lewy, matenda a Parkinson, kapena matenda a dementia.
Zambiri mwazimenezi zimatsutsidwa mosamalitsa ndi kafukufuku wamankhwala. Mwachitsanzo, Lewy thupi la matenda a maganizo kapena matenda a Parkinson amachititsa mavuto omwe amayenda, koma amakhala ndi mwayi wochepa kuposa wa NPH, ndipo nthawi zambiri amakhala ndi zinthu zina monga kuwonetsa zithunzi.
Vuto lina ndiloti kukhala ndi NPH sikulepheretsa anthu kukhala ndi matenda a dementia, makamaka matenda a Alzheimer's .
Pakati pa anthu 20 mpaka 60 peresenti ya anthu omwe anali ndi ubongo wambiri pa nthawi ya kusungunuka kwapezeka kuti ali ndi matenda a Alzheimer's. Anthu amene akuyembekeza kuona kuti matenda a dementia amatha kusamalidwa akhoza kukhumudwa chifukwa chakuti Alzheimer's sintha bwino ndi mankhwalawa.
Matenda a Neuropsychological ndi Laboratory
Njira yoyamba yopezera matenda a NPH ingayambe kuganizira za zizindikiro monga dementia. Kugwiritsidwa ntchito moyenera kudzaphatikizapo ma laboratory ophunzirira za magazi chifukwa cha zifukwa zomwe zingasinthe, monga vitamini B12 kusowa kapena matenda a chithokomiro.
Mayeso okhudza kupatsirana kwa m'mimba adzachitika kuti atsimikizire kukhalapo kwa mavuto amalingaliro, ngakhale kuti palibe mayeso omwe angathe kutsimikizira NPH. Njira zambiri zomwe zimagwirizana ndi NPH zimaphatikizapo kuchepetsa ntchito zomwe zasungidwa komanso kusagwira ntchito pazinthu zoyang'anira ndi ntchito yoyang'anira. Komabe, matenda ena a dementia, monga matenda a dementia kapena Lewy thupi laumtima, angayambitse kusintha kotere.
Maginito Resonance Imaging for Discovering NPH
Mwakutanthauzira, odwala omwe ali ndi vuto lachilengedwe la hydrocephalus adzakhala ndi zinyama zazikulu pamaphunziro a ubongo monga magnetic resonance imaging (MRI) kapena scanned computed tomography (CT) . Ventiricles nthawi zambiri zimakhala zazikulu ngati ubongo umafooka mu ukalamba wamba kapena ku dementias ina, koma mu NPH chikulumaliro chazowonjezereka sichifanana ndi cha ubongo wonse.
Izi ndizakuti, chinachake cha chiweruziro pa gawo la neuroradiologist ndi kuchiza dokotala, ndipo malingaliro angasinthe pa mfundo iyi. Zina zofalitsidwa za ventriculomegaly ziliko ndipo zingatsogolere malingaliro a dokotala nthawi zina, koma malangizo awa sagwirizanitsidwe.
Ma MRIs ena odwala omwe ali ndi NPH amasonyeza chizindikiro chochepa chomwe CSF ikuyenda kutaya kanjira kakang'ono kamene kamatchedwa njira ya Sylvia kudzera mu ubongo. Izi zikuganiziridwa kuti zikuyimira kuthamanga kwapamwamba. Ngakhale kuti zotsatirazi zikhoza kutchulidwa, maphunziro ambiri samasonyeza kuti pali mgwirizano woonekeratu pakati pa kupeza ndi kusintha kumene pambuyo pa ubongo.
MRI imathandizanso pofufuza zithunzithunzi zoyera zomwe zingakhale chifukwa cha matenda opatsirana. Kumbali ina, kusintha kwa ma signal pa MRI pafupi ndi zinyama zingathe kuimira matenda opatsirana kapena kutaya kwa madzi chifukwa cha NPH yokha. Kafukufuku ambiri awonetsa kuti sipangakhale phindu lokhala ndi zotsatira zabwino ndi kuthamanga ngati pali zilonda zambiri zoyera, ngakhale zofalitsa zimasiyana pa izi. Yankho lochepa loti anthu akudwala ndi zilonda zamtundu zingakhale chifukwa chakuti chizindikiro choyera chimaimira chitukuko cha NPH, kapena matenda ena, monga matenda a maganizo.
Kuchotsa CSF kuti Tipeze Kupanikizika Kwachilendo Hydrocephalus
"Nkhokwe ya golidi" ya matenda a NPH ndi kusintha kwa zizindikiro ndi ventricular shunting. Izi zimakhala zopanda phindu, ngakhale kuti pofuna kuti pakhale njira yoopsya ngati kusamalidwa dokotala ayenera kale kukhala wotsimikiza kwambiri kuti wodwalayo ali ndi NPH. Palibenso mgwirizano wa zomwe zimatanthawuza kusintha kwakukulu kwa zizindikiro, kapena nthawi yayitali bwanji kudikirira pambuyo pa kusungunuka kusanayambe kusintha kumeneku. Kuwonjezera apo, kuyankha kosauka kwa shunting kungakhale chifukwa cha mavuto opitirira matenda osokoneza bongo - mwachitsanzo, wodwalayo akhoza kukhala ndi umphawi wambiri waumtima.
Chifukwa chakuti malo opangira shunt ndi ovuta, njira zowonongeka za kuchotsedwa kwa CSF kawirikawiri amayesa kuyesa kutsimikiza kuti wodwalayo akukula bwino. Njirazi zimaphatikizapo kutsekedwa kwa lumbar kapena kukhetsa lumbar. Apanso, palibe chiwerengero cha zomwe zikutanthawuza kusintha kwakukulu, kusiya madokotala kudalira pa chiweruzo chawo ndi "malamulo ochepa".
Kuwombera kachipatala kungatheke ku ofesi ya udokotala ndipo kumaphatikizapo kuchotseratu kuchuluka kwa CSF (pakati pa masentimita 30 mpaka 50 masentimita). Kukula kofala kwambiri ndiko kuyenda kwa odwala, mofulumizitsa kuthamanga ndi kutalika kwake. Mayesero amalingaliro angapangidwenso, kuphatikizapo mayesero a chidwi ndi kukumbukira. Zowonjezera pa izi zimakhala mphindi makumi atatu ndi theka la ola pambuyo pa ndondomeko yomwe ikuwonetsa phindu lopewera.
Njira ina imaphatikizapo kutaya kanthawi kochepa pa malo omwe amapezeka, omwe CSF ikhoza kuyendetsa pafupifupi mamililimita 5 mpaka 10 pa ola limodzi. Kafukufuku wasonyeza kuti iyi ikhoza kukhala njira yabwino kwambiri yowonetsera anthu omwe angayankhe kuti asungunuke, ngakhale kuti kafukufuku wina akusonyeza kuti odwala ambiri omwe samasintha ndi kukwera angapitirizebe kuyenda bwino.
Njira zochepa zomwe zimagwiritsidwa ntchito pogwiritsa ntchito NPH zikuphatikizapo kuyendetsa galimoto kapena kuyesa kuyesa kuchepetsa, koma kusokonezeka kwa njirazi kumachepetsa kugwiritsa ntchito kwawo. Cisternography, yomwe imagwiritsa ntchito ma radioeotopes kuti ipitirize kufufuza kwa CSF, sinawonetsedwe kuti ziwonetseratu zotsatira ndi kusungidwa. Njira zina zamaganizo monga njira zamakono za MRI kapena mphotho imodzi ya CT (SPECT) imafuna kufufuza kwambiri kuti izi zitheke kuunika kwa NPH.
Pansi
Kuzindikira kwa NPH kumadalira mbiri yakale komanso kuunika kwa thupi kumayambitsa mavuto ena omwe angayambitse matenda a dementia, kusakhazikika kwa thupi, komanso kusamalidwa. MRI idzawonetsa zinyama zazikulu zomwe zimatengedwa mosiyana ndi ubongo wonse, ndipo zikhoza kupatulapo zina zomwe zingatanthauze zachipatala. Kuchotsa mimba kapena kukomoka komwe kumabweretsa kusintha kwazizindikiro ndikulingalira kwambiri kwa NPH yeniyeni yomwe ingapindule ndi kusungidwa kwa malo opatsirana ndi khunyu.
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KUDZIZIRANI: Zomwe zili pa tsamba ili ndi zolinga za maphunziro okha. Sitiyenera kugwiritsidwa ntchito ngati choloweza m'malo mwa chisamaliro cha munthu wodwala wovomerezeka. Chonde funsani dokotala wanu kuti apeze matenda ndi chithandizo cha chilichonse chokhudza zizindikiro kapena matenda .