Ukuqothulwa kobuchopho

I-Brain herniation ukuguquguquka kwezicubu zobuchopho kusuka endaweni eyodwa ebuchosheni kuye kwenye ngokusebenzisa amafolda ahlukahlukene nokuvuleka.

Ukuqothulwa kobuchopho kwenzeka lapho okuthile ngaphakathi kogebhezi kukhiqiza ingcindezi ehambisa izicubu zobuchopho. Lokhu kuvame ukubangelwa ukuvuvukala kobuchopho noma ukopha ekulimaleni kwekhanda, isifo sohlangothi noma isimila sobuchopho.

I-Brain herniation ingaba umphumela ohlangothini wezicubu ebuchosheni, kufaka phakathi:

• Isigaxa sobuchopho seMetastatic
• Isigaxa sobuchopho esiyinhloko

I-Herniation yobuchopho nayo ingabangelwa ezinye izinto eziholela ekwandeni kwengcindezi ngaphakathi kogebhezi, kufaka phakathi:

• Ukuqoqwa kobomvu nokunye okwenziwe ebuchosheni, imvamisa kusuka ekuthelelekeni kwegciwane noma ukhunta (ithumba)
• Ukopha ebuchosheni (ukopha)
• Ukwakhiwa koketshezi ngaphakathi kogebhezi okuholela ekuvuvukeni kobuchopho (i-hydrocephalus)
• Ukushaywa unhlangothi okubangela ukuvuvukala kobuchopho
• Ukuvuvukala ngemuva kokwelashwa ngemisebe
• Iphutha ekwakhiweni kobuchopho, njengesimo esibizwa ngokuthi yi-Arnold-Chiari malformation

Ukuqothulwa kobuchopho kungenzeka:

• Ukusuka ngapha nangapha noma phansi, ngaphansi, noma ngaphesheya kolwelwesi oluqinile njenge-tentorium noma i-falx
• Ngokuvulwa kwamathambo emvelo phansi kogebhezi okuthiwa i-foramen magnum
• Ngokuvuleka okwenziwe ngesikhathi sokuhlinzwa kobuchopho

Izimpawu nezimpawu zingafaka:

• Umfutho wegazi ophezulu
• I-pulse engavamile noma ehamba kancane
• Ikhanda elibuhlungu
• Ubuthakathaka
• Ukuboshwa kwe-Cardiac (akukho pulse)
• Ukulahlekelwa ukwazi, ikhoma
• Ukulahlekelwa yizo zonke izingqondo ze-brainstem (blinking, gagging, kanye nabafundi abasabela ekukhanyeni)
• Ukuboshwa kokuphefumula (akukho ukuphefumula)
• Abafundi abanzi (abahluziwe) futhi akukho ukunyakaza kwelinye lamehlo noma omabili

Ukuhlolwa kwesistimu yobuchopho nenzwa kubonisa izinguquko ekuqapheleni. Ngokuya ngobunzima be-herniation nengxenye yobuchopho ecindezelweyo, kuzoba nezinkinga ngombono owodwa noma ngaphezulu ohlobene nobuchopho nemisebenzi yezinzwa.

Ukuhlolwa kungafaka:

• I-X-ray yogebhezi nentamo
• I-CT scan yekhanda
• Ukuskena kwe-MRI kwekhanda
• Ukuhlolwa kwegazi uma kusolwa ithumba noma isifo sokopha

I-Brain herniation iyisimo esiphuthumayo sezokwelapha. Inhloso yokwelashwa ukusindisa impilo yomuntu.

Ukusiza ukubuyisela emuva noma ukuvimbela i-herniation yobuchopho, iqembu lezokwelapha lizokwelapha ukuvuvukala okwandayo nengcindezi ebuchosheni. Ukwelashwa kungafaka:

• Ukufaka idreyini ebuchosheni ukusiza ukususa i-cerebrospinal fluid (CSF)
• Imithi yokwehlisa ukuvuvukala, ikakhulukazi uma kukhona isimila ebuchosheni
• Imithi eyehlisa ukuvuvukala kobuchopho, njenge-mannitol, i-saline, noma amanye ama-diuretics
• Ukubeka ithubhu emoyeni (endotracheal intubation) nokwandisa izinga lokuphefumula ukunciphisa amazinga e-carbon dioxide (CO₂) egazini
• Ukususa amahlule egazi noma egazi uma bekhulisa ingcindezi ngaphakathi kogebhezi futhi kubangele ukuqubuka
• Ukususa ingxenye yogebhezi ukunikeza ubuchopho indawo ethe xaxa

Abantu abane-herniation yobuchopho balimala kanzima ebuchosheni. Kungenzeka ukuthi sebenethuba eliphansi lokululama ngenxa yokulimala okubangelwe i-herniation. Lapho i-herniation ivela, yehlisa nethuba lokululama.

Umbono uyahlukahluka, kuya ngokuthi ubuchopho buvela kuphi ebuchosheni. Ngaphandle kokwelashwa, ukufa kungenzeka.

Kungaba khona umonakalo ezingxenyeni zobuchopho ezilawula ukuphefumula nokugeleza kwegazi. Lokhu kungaholela ekufeni noma ekufeni kobuchopho ngokushesha.

Izinkinga zingafaka:

• Ukufa kobuchopho
• Izinkinga ezihlala njalo futhi ezibalulekile ze-neurologic

Shayela u-911 noma inombolo ephuthumayo yasendaweni noma umyise egumbini lezimo eziphuthumayo esibhedlela uma eba nokuncipha kokuqwashisa noma ezinye izimpawu, ikakhulukazi uma kube nokulimala ekhanda noma uma umuntu enesimila ebuchosheni noma inkinga yomthambo wegazi.

Ukwelashwa okusheshayo kokunyuka kwengcindezi yokungasebenzi kanye nokuphazamiseka okuhlobene nakho kunganciphisa ubungozi be-herniation yobuchopho.

Isifo se-Herniation; Ukuqothulwa kweTransstentorial; I-Uncal herniation; I-Subfalcine herniation; Ukuqothulwa kwamathoni; Herniation - ubuchopho

• Ukulimala kobuchopho - ukukhishwa

• Ubuchopho
• Ingqondo yobuchopho

I-Beaumont A. Physiology yomfutho we-cerebrospinal fluid kanye nengcindezi engasebenzi. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans ne-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 52.

UPapa L, Goldberg SA. Ukuhlukumezeka ekhanda. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 34.

Ukuhlukumezeka kukaStippler M. Craniocerebral. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 62.