Migumisiro Yekuwedzera Kwekunyanya Kuita Intracranial muBongo
Ndezvipi zvinorevei kana munhu akawedzera kuomeswa kwechisimba? Ndezvipi zviratidzo zvekumanikidzirwa kwepamusoro kwechisimba, chii chinokonzera, uye chinoshandiswa sei? Ndezvipi zvinogona kuitika kune uropi kana kukanganiswa mumusoro kuchiramba kwakakwirira?
Yakawanda Intracranial Pressure - Tsanangudzo
Kunyanya kushamwaridzana ndechimwe chekudzvinyirira muuropi uye nepamusoro pemvura yakasvibira.
Apo izvi zvinomanikidzwa zvinowedzera nokuda kwechimwe chikonzero-kunyangwe nemhaka yeropa muuropi (hemorrhage), utachiona, kana kukuvadzwa musoro - uropi inogona kutambura kukuvara kwakanyanya. Ichokwadi, iyo yakakwirira yakamanikidzwa kudzvinyirira ndeimwe yezvinotyisa zvinotyisa zvekukuvara kweuropi. Ngatitsanangurirei nei.
The Brain, Cerebrospinal Fluid, uye Intracranial Pressure
Dhehenya, kana iwe uchifunga pamusoro paro, harisi chikuru. Mune mashoma masendimita masendimita emapfupa akafukidzira ndeyezvinhu zvose zvaunorangarira, humwe humwe hutsika hunhu humwe, humwe unyanzvi hunokosha kana matarenda, ose akabatanidzwa mune zvishoma mapaundi anokosha europi.
Sezvishoma sezvakaitwa iyo nzvimbo, uropi inofanira kugovana nayo. Mvura yakasvibhenesa (CSF) inopoteredza uropi, kuvhara nekudzivirira huropi kubva pakuputira kune dhehenya nejolt yese yemusoro wako. Ropa rinopinda mukati mechivako ichocho, zvakare, kugovera uropi ne oxygen inofarira uye kubvisa uropi hwezvinokonzerwa nevhudzi.
Zvimwe zvikamu zvemuviri zvinofanira kugovera nzvimbo pamwe chete, asi nzvimbo idzi hadzina kuvharwa zvakasimba zvakadai seuropi. Pano pane mashomanana mashomanana akabuda muhomwe iyo iyo mitsipa uye rwonzi rwepelinha rinogona kufamba. Zvimwe kunze kweiyo, hapana nzira mukati kana kunze kweiyo nzvimbo isina kubatira.
Zvose izvi zvakanaka zvakakwana muupenyu hwezuva nezuva.
Icho chinhu chakanakisisa chepfungwa dzedu dzakachengetedzwa zvakasimba nemhando iyi yemahombekiti echisikigo, kana tinogona kutarisana nemhando dzose dzekukuvara kweuropi. Zvinetso zvinomuka, zvakadaro, kana chimwe chezvinhu zvitatu zvikuru zvemukati nzvimbo isingada nzvimbo. Izvi zvinosanganisira:
- Intracranial ropa
- Brain tissue
- Cerebrospinal fluid
Kana chimwe chinhu chichida nzvimbo yakawanda, chimwe chinhu chinofanira kupa. Pakutanga, zviito zvekubhadhara zvinowanikwa pakati pezvinhu izvi zvitatu. Kana izvi zvisingachagoneki, zvisinei, sezvo izvi zviri kuitika mukusungirirwa kwakaoma kwehenya, kusagadzikana kunotanga kukura nokukurumidza.
Chii Chinokonzera Kuwedzerwa Kwepfungwa Intracranial?
Kune dzimwe nzira dzakasiyana-siyana dzakasiyana uye nzira dzinogona kuguma nekuwedzera kwekusagadzikana kwechisimba.
Dzimwe nguva, chimwe chinhu chiri mumusoro icho chisingafaniri kuvapo. Mienzaniso inosanganisira kuora kweuropi , ropa nekuda kwekushaya ropa muuropi. Dzimwe nguva utachiona kana kuputika kunokonzera kupfugama uye kuputika muuropi.
Dzimwe nguva, nzira inowanzoita mvura inoshanduka mukati uye kunze kwebasa risina kuvhiringidzika inoparadzaniswa. Semuenzaniso, CSF inowanzoyerera ichibva mumhepo inenge iri pakati peuropi kuburikidza nemashoma mashoma anozivikanwa seforamina. Kana iyi CSF inoyerera ichivharwa nenzira yakati, uye CSF inoramba ichigadzirwa, kushivirira kunovaka.
Zvimwe zvinokonzera njodzi yekumanikidzirwa kwepamusoro kwechisimba zvinosanganisira:
- Head trauma
- Mishonga yakadai semakumbo emakumbo kana metastases kuuropi kubva mune dzimwe mvere
- Hemorrhage, ingava intracerebral hemorrhage kana subarachnoid hemorrhage
- Ischemic stroke
- Hydrocephalus
- Zvirwere zvakadai semaminingitis uye encephalitis
Dzimwe nguva pane kuwedzerwa kwekushanda kwepfungwa pasina zvikonzero zvisingazivikanwi. Izvi zvinotumidzwa se "idiopathic" yakakwirira yakamanikidzwa kudzvinyirira.
Ndezvipi Zviratidzo Nezviratidzo zveKudzvinyiriridza Kwakawedzerwa?
Kushanda kunowanzoita kushanda kune imwe nzvimbo pakati pemamiriyoni 8 kusvika ku20 emu mercury (mm Hg). Chero zvinopfuura izvi uye zvivako muuropi zvingatanga kuchinja.
Imwe yezvigadziriswa zvekutanga kuti uchinzwe kushungurudzika mishonga inozivikanwa sevanhu vanopoteredza uropi. Kunyange zvazvo uropi pachahwo husina marwadzo ekugamuchira, meninges anogona kupisa pamarwadzo anorwadza anokonzera kuora musoro kunotyisa.
Kunyanya kushanda kwechisimba kunowanzokonzera kuora musoro kwepamusoro kana kunzwa kwekumanikidzwa mumusoro kana wakarara pasi; nokuti kukwirira kunomanikidzika kunomanikidzwa nekusimuka uye kunowedzera kuparara nekunyengera pasi. Kuramba kunobvumira mamwe emhirizhonga kuburuka pasi mumutsara wemusana, asi kuisa zvakanyanyisa kunze kwekunetseka, zvichikonzera kukwirira kwakapoteredza uropi.
Chimwe chigadziro chinogona kuchinjwa zvishoma nezvishoma sokuti kusagadzikana kwemhepo kunokonzerwa nemaputi, mitsipa inofamba kubva kumashure kweziso (retina) kunharaunda yeuropi apo chiratidzo chinoshandurwa (the occipital lobes). Vanhu vane ICP yakakwirira vanogona kutanga kunyunyutira nekusvibiswa kwemaonero avo sezvo maziso e-optic akaparara. Kuwedzera kune kurasikirwa kwekuona, kune nguva yakawanda yekuona kurasikirwa kwenyika uye chiremba angatora papilledema pane kuongorora fundoscopic-apo chiremba anoshandisa chimbo chiri pedyo nechiridzwa chinotarisa munzeve dzako kutarisa retina-yeziso. Kana kusamanikidzwa kwepamberi kusati kwagadziriswa munguva yakawanda, nguva yekurasikirwa kwemaono kunogona kuguma.
Zvimwe zviratidzo zvekuwedzera kusagadzikana zvinogona kusanganisira kunyorera uye kurutsira, kuchinja maitiro, uye kugumburwa. Kuchinja kwehutano hwepfungwa, sekunyengera uye pakupedzisira coma chiratidzo chikuru.
Mucheche, chiratidzo chekuwedzera kwechisimba chinoputika isimbianelle (nzvimbo yakanyorova) uye dzimwe nguva kuparadzana kwe sutures (mumapapiro pamusoro wekona remwana.)
Zvinetso zveKuwedzera Kwekutsvaga Kunetseka
Kunyanya pamusoro pekushandiswa kweropa remusana (uye kukanganisa kunokonzera kuonekwa) ndiyo iyo ICP inogona kukanganisa uropi pachake. Kana zvipingamupinyi zvikwira mukati memhehenya, uropi hunogona kushandiswa kune imwe nzvimbo yakadzvinyirirwa. Irobes yeuropi inopatsanurwa nezvidimbu zvakasimba zvezviviri. Semuenzaniso, kuruboshwe rworuboshwe rwakaparadzana kubva kunzvimbo yakarurama kumusoro kweuropi nemhuka inonzi falx cerebri. Kana ropa riri kuruboshwe rwemaodzanyemba rinokonzera kukwana kwakakwana, rinogona kukonzera uropi hwemaodzanyemba kwemaodzanyemba pasi pehutumbwe cerebri, kupwanya hutu hwehupi uye kudzivisa mitsipa yeropa. Kuora kwehupombwe uye kurohwa kunogona kuitika.
Saizvozvowo, cerebellum inoparadzaniswa nehupi hwehupi hwose nehutachiona. Kana kudzvinyirirwa kunowedzera pamusoro pechinyorwa ichocho, hutachiona hwehupi hunogona kuderedzwa pasi kuburikidza nemuduku muduku pedyo neuropiyo, zvichikonzera kusagadzikana kwehutano hwehuropi. Izvi zvinogona kukonzera kuora mwoyo, coma, nekufa.
Kuongororwa Kuwedzerwa Kwekunyanya Kufuridzira
Kuwedzera kwepakamanikidzwa kushandiswa kunogona kuongororwa nenzira dzakasiyana-siyana. Zviratidzo zvinotaurwa pamusoro apa zvinogona kuratidza kuti kudzvinyirirwa kwakakwirira. Chimwe chekuongorora cheziso chinogona kubudisa papilledema. Mutsipa wepamusoro unogonawo kupa ruzivo pamusoro pekumanikidzika, asi izvi zvinogona kuva nengozi kana kudzvinyirirwa kwakanyanya.
Nzira yakatendeseka yakawanda yekuyera kusagadzikana kwepfungwa ndeyokuisa muchengeti pasi pehenya. Iyi nzira inopa kuverenga kunoramba kwechinhu chisingaiti. Nekuvhiyiwa kweuropi kana kuti nekukuvadza kwehupfungwa kunokonzera kusanganisa kushandiswa kwemaitiro kunowanzoiswa pakarepo.
Kurapa Kwokusarudza Kuwedzerwa Kuwedzera Kunetseka
Ikozvino inofanirwa kuve yakajeka kuti kukwirira kwepamusoro kwechisimba kunogona kuva nengozi. Zvisinei, vana vezveuroyogori vane ruzivo rwakanyanya pakuongorora uye kazhinji vachirapa chirwere ichi, icho chinowanzobatwa neurological complication kune vakawanda vanorwara zvikuru.
Kazhinji yenguva, kushamwaridzana kwemasimba kunopfuura 20 kusvika ku25 kunoshungurudzwa.
Nenzira yakanaka, maurotorio ane nzira dzakasiyana-siyana dzokugadzirisa yakakwirira ICP apo nguva yacho iri yezvakakosha. Kunyange zvazvo hapana chakavimbiswa, kupindira kwenguva yakakodzera kunogona kudzivirira kukanganisika kukuru.
Chinangwa chekutanga ndechekugadzirisa murwere, kupa zvekare kana zvichidiwa, uye kubvisa marwadzo. Kana kuwedzerwa kwemaitiro mashomanana chete, akareba sekusimudzidza musoro kunogona kuderedza kusagadzikana kwechisimba kune imwe diki kuburikidza nekubvumira ropa mumutsipa kuti ridzokere zvakare mumoyo.
Nhanho inotevera ndeyokuwedzera nzvimbo muuropi yehutano hwemutsipa. Mhinduro dzakadai se mannitol kana hypertonic saline dzinowanzopiwa apo dzinotora mvura mumvura uye kure neuropi. Steroid inogonawo kuderedza kuzvimba muuropi. Mishonga yakadai seacetazolamide inogona kuderedza kushandiswa kwemakemikari. Kana murwere ari penzizi, chirwere chekufema chinowanzowedzerwa zvakare. Chikamu chechitatu kurapwa kunogona kusanganisira hypothermia, kuderedza muviri, kana craniectomy. Chirwere chekudzivirira chinosanganisira kubvisa chikamu chedehenya kuitira kuti uropi huwedzere nzvimbo yekuwedzera sezvo ichikurira.
Dzidza zvakawanda pamusoro pekurapa uye kurapwa kwekumanikidzirwa kwepamusoro .
Mafungiro eEvated Intracranial Pressure
Kufananidzira kwekumanikidzika kwepamusoro kunogona kusiyana zvakasiyana-siyana, zvichienderana nechinokonzera chinokonzera, kukwirira kwekumanikidzwa kuchikwira, uye kwenguva yakareba sei kusangana kunoramba kuchikwidziridza. Ichatarisirawo pane zvinorapwa zvinoshandiswa.
Pasi Pepamusoro Pamusoro Pokufungidzirwa Kuwedzera Kwekutsvaga
Kuwedzerwa kusimba kwechisimba kunowanzobatana uye kwakakomba kunetseka kwemamiriro akawanda anokanganisa uropi. Izvozvo zvakati, kutaridzirwa kwekutanga uye kushungurudzwa kunogona kufamba nenzira yakareba mukuderedza zvinetso. Kana iwe uri kutarisana nekunetseka uku nemunhu waunoda, bvunza mibvunzo. Chero upi neupi hwehutano hunogona kuva hunotyisa, asi izvo zvinoita kuti tikwanise kufunga uye kudzidza nekurota zvinotonyanya kunyanya kuzvidya mwoyo. Kunzwisisa zviri kuitika uye izvo zvinotevera zvinogona kuitika zvinogona kukubatsira kurarama apo iwe unotarisana nechinetso ichi chakaoma.
Sources
- Czosnyka, M., Pickard, J., naL. Steiner. Nheyo dzeIntracranial Pressure Kuongorora nekurapa. Handbook of Clinical Neurology . 2017. 140: 67-89.
- de Oliveira Manoel, A., Goffi, A., Zampieri, F. et al. Icho Chinyorwa Chekuchengetedza Kuchengetedza Kwemazuva Ano Intracranial Hemorrhage: A Contemporary Review. Kutarisira Kunokosha . 2016. 20: 272.
- Kasper, Dennis L .., Anthony S. Fauci, naStephen L .. Hauser. Harrison's Principles of Internal Medicine. New York: Mc Graw-Hill Dzidzo, 2015. Print.