Ukopha okungaphansi kwe-Subarachnoid

Ukopha okungaphansi kwe-Subarachnoid kuphuma egazini phakathi kobuchopho nezicubu ezincane ezimboze ubuchopho. Le ndawo ibizwa ngokuthi i-subarachnoid space. Ukopha kwe-Subarachnoid kuyisimo esiphuthumayo futhi kudinga usizo lwezempilo ngokushesha.

Ukopha okungaphansi kwe-Subarachnoid kungadalwa yi:

• Ukopha okuvela ochungechungeni lwemithambo yegazi okuthiwa i-arteriovenous malformation (AVM)
• Ukuphazamiseka kwegazi
• Ukopha okuvela kwi-aneurysm ye-cerebral (indawo ebuthakathaka odongeni lomthambo wegazi obangela ukuthi umkhumbi wegazi uqhume noma ibhaluni liphume)
• Ukulimala ekhanda
• Isizathu esingaziwa (idiopathic)
• Ukusetshenziswa kwama-thinner egazi

Ukopha okungaphansi kwe-Subarachnoid okubangelwa ukulimala kuvame ukubonwa kubantu asebekhulile abalele bashaya amakhanda abo. Phakathi kwabancane, ukulimala okuvame kakhulu okuholela ekwehliseni ukopha okungaphansi komhlaba yingozi yezimoto.

Izingozi zifaka:

• I-aneurysm engaphazamiseki ebuchosheni nakweminye imithambo yegazi
• I-Fibromuscular dysplasia (FMD) nokunye ukuphazamiseka kwezicubu
• Umfutho wegazi ophezulu
• Umlando wesifo sezinso se-polycystic
• Ukubhema
• Ukusetshenziswa kwezidakamizwa ezingekho emthethweni ezifana ne-cocaine ne-methamphetamine
• Ukusetshenziswa kwabanciphisi begazi njenge-warfarin

Umlando oqinile womndeni wama-aneurysms nawo ungakhuphula ubungozi bakho.

Uphawu oluyinhloko ikhanda elibuhlungu eliqala ngokuzumayo (okuvame ukubizwa ngokuthi yi-thunderclap headache). Kuvame ukuba kubi kakhulu ngemuva kwekhanda. Abantu abaningi bavame ukuyichaza ngokuthi "yikhanda elibi kakhulu" futhi ngokungafani nolunye uhlobo lobuhlungu bekhanda. Ikhanda lingaqala ngemuva kokuvela noma ukugqabhuka komuzwa ekhanda.

Ezinye izimpawu:

• Ukwehla kokuqwashisa nokuqwashisa
• Ukungakhululeki kwamehlo ekukhanyeni okukhanyayo (photophobia)
• Ukushintsha kwesimo nobuntu, kufaka phakathi ukudideka nokucasuka
• Ubuhlungu bemisipha (ikakhulukazi ubuhlungu bentamo nobuhlungu behlombe)
• Isicanucanu nokuhlanza
• Ukuba ndikindiki engxenyeni yomzimba
• Ukudlikiza
• Intamo eqinile
• Izinkinga zombono, kufaka phakathi ukubona kabili, izindawo ezingaboni, noma ukulahleka kombono wesikhashana esweni elilodwa

Ezinye izimpawu ezingase zivele ngalesi sifo:

• Ijwabu lehla
• Umehluko wosayizi wabafundi
• Ukuqina okungazelelwe komhlane nentamo, ngokugoqa emuva (opisthotonos; akuvamile kakhulu)

Izimpawu zifaka:

• Ukuhlolwa komzimba kungakhombisa intamo eqinile.
• Ukuhlolwa kwesistimu yobuchopho nenzwa kungakhombisa izimpawu zokwehla kwezinzwa nokusebenza kobuchopho (ukugxila kokushodayo kwe-neurologic).
• Ukuhlolwa kwamehlo kungakhombisa ukwehla kwamehlo. Uphawu lokulimala kwezinzwa ze-cranial (ezimeni ezinzima, azikho izinkinga ezingabonakala ekuhlolweni kwamehlo).

Uma udokotela wakho ecabanga ukuthi une-subarachnoid hemorrhage, i-head CT scan (ngaphandle kwedayi ehlukile) izokwenziwa ngaso leso sikhathi. Kwezinye izimo, ukuskena kujwayelekile, ikakhulukazi uma kube negazi elincane kuphela. Uma i-CT scan ijwayelekile, kungenziwa i-lumbar puncture (umpompi womgogodla).

Olunye uvivinyo olungenziwa lubandakanya:

• I-Cerebral angiography yemithambo yegazi yobuchopho
• I-CT scan angiography (kusetshenziswa udayi wokuqhathanisa)
• I-Transcranial Doppler ultrasound, ukubheka ukugeleza kwegazi emithanjeni yobuchopho
• I-Magnetic resonance imaging (MRI) ne-magnetic resonance angiography (MRA) (ngezikhathi ezithile)

Izinhloso zokwelashwa uku:

• Londoloza impilo yakho
• Lungisa imbangela yokopha
• Yehlisa izimpawu
• Vimbela izinkinga ezifana nokulimala kobuchopho unomphela (unhlangothi)

Ukuhlinzwa kungenziwa ku:

• Susa amaqoqo amakhulu egazi noma unciphise ingcindezi ebuchosheni uma ukopha kungenxa yokulimala
• Lungisa i-aneurysm uma ukopha kungenxa yokuqhuma kwe-aneurysm

Uma umuntu egula kakhulu, ukuhlinzwa kungadingeka ukuthi kulinde aze azinze ngokwengeziwe.

Ukuhlinzwa kungabandakanya:

• I-Craniotomy (ukusika imbobo kugebhezi) nokusikwa kwe-aneurysm, ukuvala i-aneurysm
• Ukugoqeka kwe-Endovascular: ukubeka amakhoyili ku-aneurysm kanye nama-stents esitsheni segazi ukukhipha amakhoyili kunciphisa ubungozi bokuqhubeka kwegazi

Uma kungatholakali i-aneurysm, umuntu kufanele abhekwe ngeso lokhozi yithimba lezokunakekelwa kwempilo futhi angadinga izivivinyo eziningi zokucabanga.

Ukwelashwa kwe-coma noma ukwehla kokuqapha kubandakanya:

• Ukukhipha ishubhu okubekwe ebuchosheni ukukhulula ingcindezi
• Ukusekelwa kwempilo
• Izindlela zokuvikela umgudu womoya
• Ukuma okukhethekile

Umuntu owaziyo kungadingeka ukuthi abe esembhedeni oqinile. Umuntu uzotshelwa ukuthi agweme izinto ezingakhuphula ingcindezi ngaphakathi kwekhanda, kufaka phakathi:

• Ukugoba
• Ukuhlunga
• Ukushintsha ngokungazelelwe isikhundla

Ukwelashwa kungafaka futhi:

• Imithi enikezwa ngomugqa we-IV ukulawula umfutho wegazi
• Imithi yokuvikela imithambo yegazi
• Ama-painkillers nemithi elwa nokukhathazeka ukudambisa ikhanda nokunciphisa ingcindezi kugebhezi
• Imithi yokuvikela noma yokwelapha ukuquleka
• Izithambisi zesitulo noma ama-laxatives ukuvimbela ukuhlunga ngesikhathi sokuhamba kwamathumbu
• Imithi yokuvikela ukuquleka

Ukuthi umuntu ophethwe yi-subarachnoid hemorrhage wenza kahle kangakanani kuncike ezintweni ezahlukahlukene, kufaka phakathi:

• Indawo nenani lokopha
• Izinkinga

Ukuguga nezimpawu ezinzima kakhulu kungaholela kumphumela ompofu.

Abantu bangalulama ngokuphelele ngemuva kokwelashwa. Kepha abanye abantu bayafa, noma belashwa.

Ukopha okuphindaphindiwe kuyinkinga enkulu kakhulu. Uma i-cerebral aneurysm yopha okwesibili, umbono uba mubi kakhulu.

Izinguquko ekwazini nasekuqapheliseni ngenxa yokopha okungaphansi kwesifo sangasese sangasese zingase zibe zimbi kakhulu futhi ziholele ekuqulekeni noma ekufeni.

Ezinye izinkinga zifaka:

• Izinkinga zokuhlinzwa
• Imiphumela emibi yezokwelapha
• Ukuquleka
• Unhlangothi

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma wena noma umuntu omaziyo enezimpawu zokopha okungaphansi kwesifo se-subarachnoid.

Izinyathelo ezilandelayo zingasiza ekuvikeleni ukopha okungaphansi kwesibeletho:

• Ukuyeka ukubhema
• Ukwelapha umfutho wegazi ophezulu
• Ukukhomba nokuphatha ngempumelelo i-aneurysm
• Ukungasebenzisi izidakamizwa ezingekho emthethweni

Ukopha - i-subarachnoid; Ukopha kwe-Subarachnoid

• Ukuphathwa ikhanda - ukuthi yini okufanele uyibuze udokotela wakho

Mayer SA. Isifo se-hemorrhagic cerebrovascular. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 408.

USzeder V, uTateshima S, uDuckwiler GR. Ama-aneurysms we-Intracranial kanye ne-subarachnoid hemorrhage. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 67.