So woanya tiyɛ a emu yɛ den araa ma wuntumi nnyina ano pɛn? Ɛyɛɛ te sɛ nea anyinam abɔ wo ti, anaasɛ ɔtopae apae? Ɛtɔ mmere bi a, yesusuw saa nneɛma yi ho sɛ ɛyɛ tiyɛ a ɛfata ara kwa, nanso ebetumi ayɛ akwahosan tebea a emu yɛ den yiye ho sɛnkyerɛnne. Tebea a ɛte saa biako a ɛsɛ sɛ wɔde adwene si so ntɛm ara ne nea yɛreka ho asɛm nnɛ, “Amemene mu Ntini a Ɛma Ntini Mu .” Edin yi a wobɛte no betumi ayɛ hu, nanso ɛho hia paa sɛ wohu.
Sɛ yɛbɛka no tiawa a, dɛn ne ntini a ɛma mogya tu?
Fa no sɛ paipu bi wɔ hɔ a ɛde nsu kɔ. Saa paipu yi fã biako yɛ mmerɛw kakra, ɛyɛ dedaw. Afei, bere a nsu no sen ntɛmntɛm no, saa ɔfã a ɛyɛ mmerɛw no fi ase puw kakra, te sɛ balloon ketewaa bi. Sɛ biribi to mogya ntini, anaa ntini bi a ɛwɔ yɛn amemene mu a, saa ara na ɛba .
Amemene mu ntini a ɛma mogya tu, anaa sɛnea nnuruyɛfo frɛ no no, amemene mu ntini a ɛma mogya tu no yɛ ɔfasu a ɛyɛ mmerɛw a ɛwɔ ntini bi a atwa amemene no ho ahyia anaa nea ɛwɔ mu a ɛpuepue wɔ mogya nhyɛso ase, na ɛyɛ akisikuru.
Bere biara a yɛn koma bɛbɔ no, mogya sen fa amemene no ntini mu wɔ nhyɛso ase. Bere a nhyɛso yi kɔ so bɔ saa beae a ayɛ mmerɛw no, ɛyɛ kɛse nkakrankakra. Te sɛ sɛ yɛbɔ mframa kɔ balloon mu a, ɛyɛ teateaa na ɛyɛ kɛse. Dodow a ɛyɛ kɛse no, dodow no ara na ɛda adi sɛ ɛbɛpae.
Ɛwom sɛ saa ntini ahorow yi tumi ba amemene no mu baabiara de, nanso mpɛn pii no ɛba ntini akɛse a ɛwɔ yɛn ti nhwi ase no mu. Nnipa binom (bɛyɛ 10% - 30%) betumi anya aneurysm bɛboro biako. Nanso asɛmpa no ne sɛ saa ntini a ɛma mogya tu yi mu dodow no ara sua koraa. Wɔmfa sɛnkyerɛnne biara mma.
Bere a ntini a ɛma mogya tu no yɛ kɛse a ɛbɛma amemene no mu ntini anaa ntini a atwa ho ahyia no so nkutoo na sɛnkyerɛnne ahorow no fi ase da adi. Tebea a asiane wom sen biara ne bere a mogya a ɛkɔ ntini no mu no tu anaasɛ ɛpaapae koraa no. Eyi betumi ama mogya atɔ amemene no mu.
Eyi yɛ aduruyɛ mu tebea a egye ntɛmpɛ a ɛde nkwa to asiane mu. Dodow a ntini a ɛma mogya tu no kyɛ bere a apaapae akyi no, dodow no ara na asiane a ɛwɔ hɔ sɛ obewu anaasɛ wadi dɛm kɛse no yɛ kɛse.
Sɛ ntini a ɛma mogya tu no pae a, dɛn na ɛba?
Sɛ aneurysm bi pae a, mogya tu kɔ amemene no mu ntini a atwa ho ahyia no mu. Wɔfrɛ eyi mogya a ɛtɔ.Saa mogya yi de nhyɛso foforo ba amemene no mu ntini no so, na ɛma amemene no hohoro. Nsɛnkyerɛnne titiriw a ɛtaa ba esiane eyi nti ne nea yɛfrɛ no “aprannaa tiyɛ ,” tiyɛ a emu yɛ den mpofirim a wontumi nsusuw ho.
Ntini a ɛpaapae betumi de akwahosan ho haw ahorow a emu yɛ den aba, te sɛ:
- Subarachnoid Hemorrhage (SAH): Eyi yɛ mogya a ɛretu akɔ amemene no ne ntini teateaa a ɛkata amemene no so (arachnoid layer) ntam no. Saa mogya yi mu 90% fi ntini a ɛpaapae.
- Hemorrhagic Stroke : Akisikuru a mogya a ɛtɔ kɔ baabi a ɛda ti nhwi ne amemene no ntam no de ba.
Saa tebea horow yi betumi ama amemene no asɛe daa na ɛde nsɛnnennen afoforo a emu yɛ den aba .
| Nsɛnnennen a ɛba | Wɔakyerɛkyerɛ mu tiawa |
|---|---|
| Vasospasm a ɛma mogya tu | Mogya ntini a ɛwɔ amemene no mu no siw anaa ɛyɛ teateaa, na ɛma oxygen dodow a ɛkɔ amemene no mu no so tew. |
| Nsu a ɛwɔ amemene mu | Nhyɛso a ɛkɔ soro wɔ amemene no so esiane amemene mu nsu (CSF) anaa mogya a ɛboaboa ano wɔ amemene no ho nti. Yɛsan frɛ eyi "hydrocephalus." |
| Akisikuru a ɛma obi ho kyere no | Ɛlektrik dwumadi bi a wontumi nni so wɔ amemene no mu. Eyi betumi asɛe amemene no bio sɛ ntini bi mu paapae a. |
| Coma | Tebea a obi ntumi nhu hwee, te sɛ nna a emu yɛ den, a ebetumi atra hɔ adapɛn pii. |
| Owuo | Awerɛhosɛm ne sɛ, ntini a ɛpaapae no bɛyɛ 50% kowie owu mu. |
Henanom na wonya ntini mu yare? Ɛtaa ba dɛn?
Saa tebea yi betumi aba wɔ mfe biara mu, na obiara betumi anya bi. Nanso, nnipa a wɔadi fi mfe 30 kosi 60 wɔ asiane kɛse mu. Afei nso, nhwehwɛmu ada no adi sɛ saa tebea yi abu so kakra wɔ mmea mu sen mmarima mu.
Ɛwom sɛ wonni eyi ho nsɛm pɔtee biara wɔ Sri Lanka de, nanso wobu akontaa sɛ nnipa dodow a wɔwɔ aman te sɛ United States no mu bɛyɛ 6% wɔ ntini a ɛnyɛ nea ɛpaapae. Eyi kyerɛ sɛ eyi nyɛ nea ɛntaa nsi sɛnea obi besusuw no. Nanso, ntini a ɛpaapae no ntaa mma saa.
Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya ntini mu yare?
Eyi ho sɛnkyerɛnne gu ahorow gyina sɛ ebia ntini no mu apaapae anaasɛ ɛntetew so. Nsonsonoe yi a wobɛte ase no betumi aboa ma woagye wo nkwa.
| Nsɛnkyerɛnne a ɛkyerɛ sɛ mogya mu ntini a apaapae (asɛm a egye ntɛmpɛ!) . | Nsɛnkyerɛnne a ɛkyerɛ sɛ mogya mu ntini a ɛnpaapae (kɛse) no |
|---|---|
| Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, kɔ ayaresabea bi ETU ( Emergency Treatment Unit ) ntɛm ara! | |
| - a ɛyɛ tiyɛ a ɛyɛ hu sen biara, mpofirim wɔ m’asetra mu (Thunderclap Headache) . - a ɛyɛ akisikuru ne akisikuru - kɔn a ɛyɛ den, a entumi nkotow - a wohu a enni mu anaase anisoadehunu mmienu - a wontumi nhwe hann (Photophobia) . - a woanya fit (Seizure) . - a ehwe ase ne aniwa tuntum a ewo - yaw a ewo aniwa no atifi ne akyi - abasamtuo, ahomegyee a enni mu - a ɛyɛ mmerɛw anaa mmerɛwyɛ wɔ nipadua no fã bi mu - a woyera wo nhumu | - tipae (a etaa ba anaase bere ne bere mu) . - a esesa wo anisoadehunu mu - a ewo aniwa no anim - a ewo ti anaa anim - yaw a ewo aniwa no atifi ne akyi - ɛtɔ da bi a fit no ba. |
Ɛtɔ mmere bi a, ansa na aneurysm bi bɛpae no, ebetumi ama mogya kakra atu. Wɔfrɛ eyi sɛ sentinel bleed . Saa bere yi mu no, kɔkɔbɔ tiyɛ (sentinel headache) betumi aba nna anaa adapɛn bi ansa na kɛse no aba. Sɛ wowɔ tiyɛ a ɛyɛ soronko a emu yɛ den a, mmu w’ani ngu so da. Kɔ oduruyɛfo nkyɛn ntɛm ara.
Dɛn nti na saa ntini a ɛma mogya tu yi ba? Dɛn ne nneɛma a ɛde asiane ba?
Aneurysms ba bere a ntini a ɛwɔ amemene no mu no afasu yɛ teateaa na ɛyɛ mmerɛw no. Wɔtaa yɛ wɔ mmeae a ntini no nkorabata no yɛ. Ɛtɔ da bi a, wobetumi awo obi a ntini no fasu mu ayɛ mmerɛw. Nea ɛka ho no, nneɛma afoforo pii betumi aka eyi.
Nneɛma a efi awosu mu ba
Eyinom yɛ nneɛma a yentumi nni so na wonya fi awosu mu.
- Awosu mu tebea horow bi: Sɛ nhwɛso no, `Vascular Ehlers-Danlos syndrome`, `Autosomal dominant polycystic asaabo mu yare`, `Marfan yare`, `Fibromuscular dysplasia`.
- Arteriovenous malformation yɛ nkitahodi a ɛnteɛ a ɛda ntini ne ntini a ɛwɔ amemene no mu ntam.
- Sɛ abusua muni bi a ɔbɛn wo (ɛna, agya, onua) anya ntini mu yare a, wo nso wowɔ asiane kɛse mu.
Yɛn asetra kwan ne akwahosan tebea afoforo
Eyinom yɛ nneɛma a yebetumi asesa na yɛadi so.
- Sigaretnom: Eyi yɛ ɔtamfo titiriw a ɛsɛe ntini no afasu.
- Mogya Nhyɛso: Mogya mmoroso a wontumi nni so no ma nhyɛso ba ntini no afasu so bere nyinaa.
- Nnubɔne a wɔde di dwuma: Titiriw nnubɔne te sɛ cocaine.
- Nsã a wɔnom boro so.
Dɛn ne nneɛma a ɛma mogya mu ntini a ɛma mogya tu no pae?
Nneɛma koro no ara a ɛma mogya mu ntini a ɛma mogya tu no nso boa ma ɛpaapae. Nhwehwɛmufo gye di sɛ mogya mmoroso ne ade titiriw a ɛma mogya mu ntini no mu paapae. Sɛ mogya mmoroso kɔ soro a, mogya piapia ntini no afasu denneennen.
Sɛ mogya mmoroso kɔ soro mpofirim na ntini a ɛma mogya tu tumi pae a:
- Nkate a emu yɛ den, te sɛ adwennwen a ɛkɔ so anaa abufuw a ɛpae mpofirim.
- Mmɔdenbɔ a ɛhwehwɛ sɛ wɔma biribi a emu yɛ duru so (bere a wɔma nneɛma a emu yɛ duru so, retu dan mu nneɛma).
- Nim a wunim sɛ wowɔ mogya mmoroso nanso wonnom nnuru a ɛfata mma no.
Nea ɛka ho no, nneɛma te sɛ ntini a ɛma mogya tu no kɛse, ne nsusuwii, ne beae a ɛwɔ nso ka sɛ ebia ɛbɛpaapae anaasɛ ɛntetew.
Ɔkwan bɛn so na wobehu tebea yi?
Nnipa pii a wɔn ntini mu yare a ɛnpaapae no nnim mpo sɛ wɔwɔ bi. Mpɛn pii no, wohu wɔn wɔ akwanhyia mu bere a wɔreyɛ amemene no MRI anaa CT scan esiane biribi foforo nti.
Nanso, sɛ wuhu sɛnkyerɛnne ahorow a ɛkyerɛ sɛ ntini a apaapae (titiriw saa tiyɛ a emu yɛ den no) a, ɛsɛ sɛ wokɔ ayaresabea dan a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu ntɛm ara. Ɛhɔ no, nnuruyɛfo bɛyɛ nhwehwɛmu ahorow a ɛtoatoa so de ahu sɛ mogya retu anaa.
- CT (Computed Tomography) Scan: Eyi betumi ahwɛ ntɛm ara sɛ mogya retu amemene no mu anaa. Ɛtɔ da bi a wɔyɛ scan soronko bi a wɔfrɛ no `CT Angiogram (CTA)`, a ebetumi anya mogya ntini no ho mfonini a emu da hɔ.
- MRI (Magnetic Resonance Imaging) scan: Eyi betumi ama amemene ne mogya ntini ho mfonini a ɛkɔ akyiri yiye.
- Cerebral Angiography: Wɔ eyi mu no, oduruyɛfo a ɔyɛ ntini mu oprehyɛn de afiri ketewaa bi (catheter) fa asen anaa nsateaa mu, kyerɛ no kwan kɔ amemene no mogya ntini mu, na ɔhwɛ baabi a ntini no wɔ, ne kɛse, ne sɛnea ɛte pɛpɛɛpɛ.
- Cerebrospinal fluid (CSF) nhwehwɛmu: Sɛ wɔtow akyi berɛmo mu a, ebetumi ahu mogya a ɛretu amemene no ho.
Dɛn ne ayaresa ahorow no?
Botae titiriw a ɛwɔ ayaresa mu ne sɛ wobegyae mogya a efi ntini a ɛma mogya tu no mu no. Ntini a ɛpaapae yɛ aduruyɛ mu tebea a egye ntɛmpɛ a ɛhwehwɛ sɛ wɔyɛ no oprehyɛn ntɛm ara. Sɛ́ ebia wobɛsa ntini a emu apaapae anaasɛ worensa no gyina wo tebea no so.
Akwan titiriw a wɔfa so sa yare
1. Microvascular Clipping: Eyi yɛ oprehyɛn a wɔabue ano. Ntini mu oprehyɛn ho oduruyɛfo no yɛ tokuru ketewaa bi wɔ ti nhwi no mu na ɔkɔ baabi a ntini no mu ntini no wɔ. Afei, te sɛ ntama a wɔde kyekyere ntama no, wɔde dade ketewaa bi a wɔde kyekyere ntini no kɔn ho, na ɛma mogya a ɛkɔ mu no twa koraa.
2. Endovascular Coiling: Eyi hwehwɛ sɛ wotwa ketewaa bi. Wɔde afiri ketewaa bi (catheter) a wɔde fa asen anaa nsateaa mu hyɛ mu de waya nhama a ɛyɛ fɛ yiye hyɛ ntini no mu. Saa nhama yi ma mogya a ɛtɔ kɔ ntini no mu, na ɛma mogya a ɛkɔ mu no gyae.
3. Flow Diversion Stents: Wɔyɛ eyi nso a wɔmfa ntwa mu. Wɔde afiri bi a ɛte sɛ ahama (stent) hyɛ mogya ntini a ɛwɔ baabi a ntini a ɛma mogya tu no wɔ no mu. Eyi kyerɛ mogya no kwan fa ntini no mu tẽẽ, na ɛtwam wɔ ntini a ɛma mogya tu no ho.
Dɛn na woyɛ ma ntini a ɛnyɛ nea ɛpaapae?
Sɛ wowɔ ntini ketewaa bi a enni sɛnkyerɛnne biara na asiane foforo biara nni wo ho a, ebia wo duruyɛfo besi gyinae sɛ ɔrensa.
Nanso ɛno nkyerɛ sɛ ɛsɛ sɛ wo werɛ fi. Ɛho behia sɛ woyɛ scan daa na ama woahu sɛ nsakrae bi aba anaa. Afei nso, sɛ wonom sigaret a, wɔbɛtu wo fo sɛ gyae na hwɛ wo mogya mmoroso so .
Wogyina nneɛma pii so na esi gyinae sɛ wɔbɛyɛ oprehyɛn anaasɛ wɔrenyɛ no oprehyɛn, a nea ɛka ho ne mfe a woadi, w’akwahosan nyinaa, sɛnea ntini a ɛma mogya tu no kɛse ne beae a ɛwɔ, ne w’abusua abakɔsɛm. Wo ne wo duruyɛfo nka eyi ho nkɔmmɔ pefee.
Dɛn na wubetumi aka afa daakye ho?
Sɛ mogya mu ntini a apaapae a, nea ebefi mu aba no gyina mfe a woadi, w’akwahosan, mogya dodow a wobɛhwere, ne sɛnea wo nsa ka ayaresa ntɛmntɛm no so. Awerɛhosɛm ne sɛ, nnipa bɛyɛ 25% wuwu wɔ nnɔnhwerew 24 mu wɔ ntini a ɛpaapae akyi. Nnipa dodow a wowuwu no bɛyɛ 50% wɔ asram abiɛsa mu.
Wɔn a wonyaa wɔn ti didii mu no mu bɛyɛ 66% nya amemene mu yare bi a ɛtra hɔ daa. Nanso, sɛ wɔsa wɔn yare ntɛm na wɔsan siesie wɔn ho yiye a , ebinom ho tɔ wɔn a wonni dɛm kɛse anaasɛ wonni dɛm koraa.
Nanso, nnipa pii a wɔwɔ ntini nketenkete a mpaapae no tra ase kyɛ a wonni sɛnkyerɛnne biara anaa nkɛntɛnso biara a efi mu ba.
Nkrasɛm a Wɔde Kɔ Fie
- Amemene mu ntini a ɛyɛ mmerɛw yɛ mmerɛw wɔ mogya ntini bi a ɛwɔ amemene no mu a ɛbɔ te sɛ balloon.
- Tiyɛ a emu yɛ den mpofirim (‘aprannaa’ tiyɛ) yɛ sɛnkyerɛnne titiriw a ɛkyerɛ sɛ mogya mu ntini no mu apaapae. Eyi yɛ aduruyɛ mu asɛm a egye ntɛmpɛ. Kɔ ayaresabea bi Dwumadibea a Ɛhwɛ Nneɛma a Ɛho Hia Ntɛmntɛm (ETU) ntɛm ara.
- Ntini dodow no ara a mpaapae no mfa sɛnkyerɛnne biara mma na ebia ɛho renhia sɛ wɔsa yare.
- Mogya mmoroso a wubedi so, sigaretnom a wobɛkwati, ne nnubɔne a wobɛkwati ne nneɛma a eye sen biara a wubetumi ayɛ de atew asiane yi so.
- Sɛ wɔahu sɛ wowɔ ntini mu yare a, wo ne wo duruyɛfo nka asiane ahorow, ayaresa a wubetumi apaw, ne sɛnea wobɛyɛ no ho asɛm na ama woasisi gyinae a ɛfata.
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