Mutsara wezviratidzo, MRI, uye Lumbar Nguva yekuona NPH
Kazhinji kushungurudzika hydrocephalus inokurudzirwa kwepakati muuropi, inonzi ventricles , ine cerebrospinal fluid - inoyerera inonaya iyo inoshambidza uropi nemutsara wemutsva uye inowanzonzi chidimbu cheScF.
Kazhinji kushungurudzika hydrocephalus kunokonzera kuoma kufamba, kufunga, nekudzora bladder. Zviratidzo zvinogona kuvandudzika apo inonzi neurosurgeon inotanga kuvhara inonzi shunt mumhepo inofamba kuitira kuti CSF inopinda mudumbu panzvimbo yekuyerera pasi pemutsara wemupfupa.
Chero maitiro eurosurgicism anotakura mungozi, asi, uye zvakakosha zvekuisa stent yakadaro yeNPH haisi nguva dzose-saka iyo inokosha NPH inonyatsoongororwa. Kunyangwe mushure mekunge danho iri, vamwe varwere vanogona kuvandudza zvimwe nekugadziriswa kwepamusoro kune vamwe.
Kuvhiringidzika Kunowanzokanganiswa Hydrocephalus
Iwe unogona kufungidzira uchienda kuburikidza nekuvhiyiwa kweuropi hunopisa, uye kwete kuvandudza nokuti zviratidzo zvacho chaizvoizvo zvichibva kune chirwere chakasiyana-siyana nguva dzose? Iyi inongova nyore muNPH nokuti zviratidzo zvakajairika kune vanhu vakwegura nekuda kwezvikonzero zvakasiyana-siyana.
Kuoma kunofamba, somuenzaniso, kunogona kunge kwakakonzerwa nemupfupa stenosis , zvinetso zvekudzivirira, zvinetso zvekuona, kana chirwere chepuropaiti. Urinary incontinence inowanikwawo zvikuru mukukwegura kwezvikonzero zvakasiyana-siyana. Kukanganisa kwepfungwa kunogona kunge kuripo nekuda kwekuvhiringidzika kwakajairika kwakadai sechirwere cheAlzheimer. Dzimwe dhementias inogonawo kuwedzera mungozi yekufamba matambudziko, akadai seLyy body dementia, Parkinson's disease dementia, kana kuora mwoyo kwepfungwa.
Zvakawanda zvezvizvi zvinomiririra zvinogona kunyatsosarudzwa nekuongororwa kwakaitwa kurapwa. Semuenzaniso, Lewy muviri wekutenda kwepfungwa kana chirwere chePasinson chinogona kukonzera matambudziko akafanana ekufamba, asi inowanzova nehana shoma kupfuura yeNPH, uye inowanzove nezvimwe zvinhu zvakadai sekuona maziso.
Imwe dambudziko ndechokuti kuva neNPH hakudziviri vanhu kuti vave nehuwandu hwemagumisiro ekuwedzera, kunyanya chirwere cheAlzheimer .
Pakati pe20 kusvika ku60 kubva muzana yevanhu vakave nehupi hwepfungwa panguva yekusagadzikana kwakawanikwa kuti vane chirwere cheAlzheimer's. Vaya vane tariro yekuona kuora mwoyo nekugadzirisa nekugadziriswa kunogona kunge vakaodzwa mwoyo sezvo Alzheimer isinganatsiri neyeurosurgery.
Neuropsychological and Laboratory Test
Nhanho dzokutanga mukuongororwa kweNPH dzinogona kutarisa zviratidzo zvakadai sedhementia. Kushanda kunowedzera kuchabatanidza ma laboratory zvidzidzo zveropa nekuda kwezvimwe zvinokonzera zvinokonzerwa, zvakadai sehutamu B12 kana chirwere chetachiona.
Miedzo yeurouropsychological ichaitwa kuitira kusimbisa kuvepo kwezvinetso zvekuziva, kunyange pasina kuongorora kumwe kunogona kusimbisa NPH. Nzira dzakawanda dzinopindirana neNPH dzinosanganisa kunonoka pamabasa akanguva uye kushanda zvakanaka pamabasa ekucherechedza uye masimba ekushanda. Mimwe dambudziko, kunyange zvakadaro, dzakadai sevascular dementia kana Lewy muviri wekuora mwoyo, zvinogona kukonzera kuchinja kwakafanana pakuedzwa.
Magnetic Resonance Imaging kuti Uongorore NPH
Nenzira, varwere vane huwandu hwemhepo inokonzerwa nemhepo inonzi hydrocephalus vachave nemagetsi makuru ekudzidza zvakadai se magnetic resonance imaging (MRI) kana kuti computed tomography (CT) scan . Ventricles inowedzera kukura sezvinongoita uropi mukukwegura kwakanaka kana mune rimwe dambudziko rekushaya simba, asi muNPH chirongwa chokuwedzera chinenge chisina kuenzana neicho cheumwe uropi hwose.
Izvi, zvisinei, chimwe chinhu chekutonga chinoshevedza chikamu che neuroradiologist uye kurapa chiremba, uye pfungwa dzinogona kusiyanisa pane iyi pfungwa. Zvimwe zvakabudisa zviyero zve ventriculomegaly zviriko uye zvinogona kutungamirira kukurudzira kwachiremba pane dzimwe nguva, asi izvi zvinotungamirirwa hazvibvumirwi zvachose.
Mamwe MRIs mune varwere vane NPH kuratidzwa chiratidzo chechidiki chakakonzera apo CSF inoyerera ichikanda kiteshi kaduku kunonzi Sylvian aqueduct kuburikidza ne brain brain. Izvi zvinofungidzirwa kuti zvinomiririra kukwira kuderera velocity. Kunyange zvazvo izvi zvingawanikwa zvinogona kutaurwa, zvidzidzo zvakawanda hazviratidze kuwirirana zvakajeka pakati pekutsvaga nekuvandudzwa mushure mekushaya mishonga.
MRI inobatsirawo pakuongorora mishonga yechena mutsvuku inogona kunge yakakonzerwa nehosha yevascular. Kune rumwe rutivi, chiratidzo chinoshandiswa paMRI pedyo nemhepo dzinogona kureva zvirwere zvevascular kana kubuda kwemvura nekuda kweNPH pachayo. Zviongorori zvizhinji zvakaratidza kuti pane zvishoma zvingave zvakanaka kuti zvive nemigumisiro yakanaka nekudzima kana kune mishonga yakawanda yenyaya, asi mabhuku akasiyana pane izvi zvakare. Kupindura kuderedzwa pakuvhara muvarwere vane mutsara mutsvuku kungangodaro nokuti mutsara weganda mumiriri unomirira chikwata chepamusoro cheNPH, kana chirwere chakasiyana-siyana, sechirwere chemaitiro chemaitiro.
Kubvisa CSF kuti iongorore Kazhinji Kunetseka Hydrocephalus
Iyo "yegoridhe" yekutarisa NPH ndiyo kuvandudza zviratidzo ne ventricular shunting. Uyu mutemo unenge usina zvazvinobatsira, zvakadaro, sezvo uchirumbidza nzira inopisa yakafanana nekudzivisa kuiswa chiremba chiremba anofanira kunge atova nechivimbo chikuru chokuti murwere ane NPH. Pano panewo chibvumirano chechinhu chinotsanangura kuchinja kukuru kwezviratidzo, kana kuti kwenguva yakareba sei kumirira mushure mekuvhara mberi kwekuvandudzwa kwacho kunofanira kuonekwa. Uyezve, kupindura mashoma pakuvhara kunogona kunge kuripo nekuda kwezvinetso zvisingagoni kuongororwa - somuenzaniso, murwere anogona kuwedzera kuora mwoyo.
Nemhaka yekuti shunt yekuisa mari inopesana, nzira dzisinganyanyi kurwisa dzekubudiswa kweCSF dzinowanzotanga kuedza kutanga kuratidza mukana wekuvandudza kwechiremba nekuvhara. Aya maitiro anosanganisira kuvharwa kwekambarasi kana kukonzera. Zvakare, zvisinei, hapana chimiro chezvinojekesa kuwedzera kukuru, zvichisiya vanachiremba kuvimba pamutongo wavo uye "mashoma emitemo."
Kushandiswa kwechimbichimbi kunogona kuitwa muhofisi yechiremba uye kunosanganisira kubviswa kwemazana akawanda e CSF (pakati pe 30 kusvika 50 cubic centimeters). Kuvandudzika kunowanzoitika mukufamba kwevarwere, nekukurumidzira gait kasi uye kwenguva refu yakareba. Kuongororwa kwepfungwa kunogona kuitwawo, kusanganisira kuongorora nekuyeuka. Kuvandudzwa kweizvi kunopera maminitsi makumi matatu kusvika hafu yeawa mushure mekunge nzira yacho inogona kuratidza kubatsirwa kusinga.
Nzira yakasiyana inosanganisira kuisa kwechinguva chiduku munzvimbo ye lumbar, iyo iyo CSF inogona kuvhiringidza kusvika pamamiriyoni mashanu kusvika ku10 paawa. Dzidzo dzakaratidza kuti iyi inogona kuva nzira yakanakisisa yekucherechedza avo vanozobvuma kuvhara, kunyange zvimwe zviongorori zvinoratidza kuti varwere vakawanda vasingagadziri nekudhonza vanogona kungovandudza nekutsvaga.
Nzira shoma dzinoshandiswa zvakanyanya-shandiswa yekuongorora NPH dzinosanganisira kushandiswa kwechisimba chekuongororwa kana kuongororwa kweSCF kudyidzana, asi kusagadzikana kwemitemo iyi kunogadzirisa kushandiswa kwavo. Cisternography, iyo inoshandisa radioisotopes kuti iongorore CSF inoyerera, haina kuonekwa kuti inofanotaura zviitiko ne shunt kuiswa. Dzimwe nzira dzekufungidzira dzakadai semishonga mitsva yeMRI kana kuti imwe photon inokonzerwa CT (SPECT) inoda kuongorora zvakare kuti iite kuti inogona kubatsira muNPH kuongorora.
Pasi Pasi
Kuongororwa kweNPH kunobva mukunyatsocherechedza uye kuongorora kwepanyama kunotanga kusabvisa zvimwe zvinetso zvinogona kuita kuti tende rimwechete rekushaya mungozi, gadziriro dzisina kusimba, uye urinary incontinence. MRI icharatidza mabhizimusi makuru akanzi akaenzana nehumwe hwose hweuropi, uye anogona kupfuudza zvimwe zvingave zvingave zvitsanangudzo zvezvechiremba. Chirwere chinoputika kana chinokanganisa chinokonzera kuvandudza zviratidzo kunonyanya kukurudzira kweNPH yechokwadi iyo inogona kubatsirwa nekudzivisa kuiswa neurosurgeon.
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ZVINOKUDZIDZA: Mashoko ari panzvimbo ino ndeongangwa dzekudzidzisa chete. Icho hachifaniri kushandiswa sechinzvimbo chekuchengetedza iwe pachako nechiremba ane chiremba. Ndapota ona chiremba wako kuti aongororwe uye kurapwa chero kupi zvako pamusoro pezviratidzo kana chirwere chechiremba .