So mogya atɔ wo ntini bi mu wɔ w’amemene mu? (Cerebral Venous Sinus Thrombosis - CVST) Momma yensua ho ade.

So woanya tiyɛ a emu yɛ den a ɛte sɛ nea ɛreyɛ kɛse da biara da pɛn? Anaasɛ woanya tebea bi a ɛte sɛ akisikuru mpofirim? Ɛtɔ mmere bi a eyinom betumi ayɛ biribi a anibere wom ho sɛnkyerɛnne. Ɛnnɛ yɛbɛka tebea pɔtee biako a ebetumi de eyi aba ho asɛm, a ɛne mogya a ɛtɔ wɔ amemene no mu ntini kɛse bi mu.

Dɛn ne Amemene mu Ntini Mu Ntini a Ɛyɛ Fɛ (CVST)?

Sɛ yɛbɛka no tiawa a, Cerebral Venous Sinus Thrombosis , anaa CVST tiawa no yɛ mogya a ɛtɔ a ɛba mogya ntini kɛse bi mu, ntini bi, wɔ w’amemene mu. Eyi yɛ tebea a ɛntaa nsi, nanso ɛyɛ bɛyɛ 1% wɔ akisikuru a wonim nyinaa mu.

Fa no sɛ, sɛ mogya tu wɔ w’amemene mu ntini kɛse bi mu a, mogya no fi ase sen kɔ ɔkwan a ɛnteɛ so sen sɛ ɛbɛkɔ ɔkwan pa so. Eyi ma nhyɛso a ɛwɔ amemene no mu no yɛ kɛse, na ɛma amemene no hohoro. Eyi te sɛ nsu paipu a wɔasiw na ɛma nsu kɔ akyi.

Mpɛn pii no, mogya a ɛtɔ te sɛ eyinom betumi ayɛ w’amemene no mu ntini ahorow no mu:

• Sinus a ɛtrɛw
• Sagittal sinus a ɛkorɔn sen biara
• Sagittal sinus a ɛwɔ fam no
• Sigmoid ntini ahorow
• Cavernous sinus a ɛwɔ abon mu
• Wo cortex no mu ntini a emu dɔ

Hena na saa (CVST) tebea yi ka no kɛse?

Saa tebea yi (CVST) abu so wɔ mmea mu . Ɛtaa ba nnipa a wɔadi fi mfe 40 kosi 50 so kɛse, nanso ebetumi aba wɔ wɔn mmofraase, wɔ nkokoaa mpo mu .

Sɛ wowɔ tebea horow anaa asiane ahorow a edidi so yi mu biara a, ɛda adi sɛ wubenya CVST:

• Nephrotic syndrome - Eyi yɛ tebea a ɛfa asaabo ho.
• Kokoram tebea horow.
• Vasculitis - Eyi ye mogya ntini a ɛyɛ hyew.
• Sarcoidosis a ɛma obi nya ɔyare.
• Obolo.
• Covid-19 (`COVID-19`) yareɛ.
• Thrombophilia - Eyi yɛ tebea a wonya fi awo mu a ɛma wo mogya tu ntɛmntɛm.
• Mmɛn mu yare.

CVST abu so dɛn?

CVST yɛ tebea a ɛntaa nsi koraa ankasa . Nhwehwɛmufo bu akontaa sɛ ɛka nnipa baanu (`2`) kosi dunum (`15`) wɔ nnipa ɔpepem biara mu afe biara. Wɔsan nso bu akontaa sɛ mmofra ne nkokoaa ɔpepem biara mu bɛyɛ baason (`7`) nya CVST afe biara. Enti wubetumi ahu, ɛnyɛ nea abu so saa.

Nkɛntɛnso bɛn na CVST betumi anya wɔ me nipadua so?

Nsɛnnennen pii wɔ hɔ a ebetumi aba esiane CVST nti. Wɔne:

• Anisoadehu a wɔhwere.
• Intracerebral hemorrhage (`hemorrhage`) - kyerɛ sɛ mogya a ɛyera fi mogya ntini a apae mu.
• Tiyɛ a emu yɛ den.
• Gye no ɔhyɛ so.
• Tebea a ɛte sɛ ɔyare a ɛma obi hwe ase.

Dɛn ne CVST ho sɛnkyerɛnne ahorow?

CVST ho sɛnkyerɛnne betumi ayɛ soronko a egyina sɛnea mogya no mu yɛ den ne baabi a ɛwɔ amemene no mu so .

Nsɛnkyerɛnne titiriw a wobetumi ahu ne:

• Tiyɛ a ɛkɔ soro nkakrankakra, a emu yɛ den (eyi ne sɛnkyerɛnne a ɛtaa ba).
• Akisikuru a ɛma obi ho kyere no.
• Adwene mu tebea a ɛsakra ne/anaasɛ ntini mu yare foforo, te sɛ nea ɛba amemene mu mogya kɛse bi mu no.

Dɛn ne nneɛma a ɛde CVST ba?

Nneɛma pii wɔ hɔ a ebetumi ama CVST aba:

• Sɛ́ wonyinsɛn .
• Nnuru a wɔde siw awo ano (nnuru a wɔde siw nyinsɛn ano) a wɔde di dwuma.
• Akwanhyia a emu yɛ den bi a wobenya (trauma).
• Tebea bi a wonya fi awo mu a ɛma mogya no tu ntɛmntɛm, sɛ nhwɛso no, thrombophilia.
• Yareɛ bi a ɛba (sɛ nhwɛsoɔ no, COVID-19 yareɛ).

Afei nso, wɔabɔ amanneɛ sɛ nnipa kakraa bi pɛ na wɔanya CVST bere a wɔanya COVID-19 vaccine no akyi. Nanso, ɛho hia sɛ yɛkae sɛ eyi yɛ ade a ɛntaa nsi koraa .

Ɔkwan bɛn so na nnuruyɛfo hu sɛ obi anya CVST?

Wo duruyɛfo de amemene mu mfoniniyɛ nhwehwɛmu bedi dwuma de ahu sɛ wowɔ CVST anaa. Ɛho hia sɛ wohu yare no ntɛm na wɔakwati nsɛnnennen.

Nhwehwɛmu bɛn na wɔde hu CVST?

Sɛnea ɛbɛyɛ na woahu CVST no, wo duruyɛfo betumi ayɛ mfoninitwa nhwehwɛmu te sɛ:

• Amemene mu MRI (magnetic resonance imaging) sɔhwɛ a wɔde aduru a wɔde yɛ nneɛma a ɛne ne ho bɔ abira na ɛyɛe.
• Wɔde aduru a wɔde yɛ amemene CT (`Brain CT - computed tomography`) scan na ɛyɛ.
• Magnetic Resonance Venography (MRV), CT Venography (CT venography) anaa Amemene mu Ntini Ho Nhwehwɛmu (Amemene mu Ntini Ho Nhwehwɛmu).

Nea ɛka ho no, wobetumi ayɛ mogya mu nhwehwɛmu te sɛ hypercoagulability panel de ahwɛ sɛ ebia mogya a ɛtwetwe mogya no mu yare biara wɔ hɔ anaa.

Ɔkwan bɛn so na wɔsa CVST?

Akwan pii wɔ hɔ a wɔfa so sa CVST, a nea ɛka ho ne:

• Nnuru a ɛma mogya tu : Sɛ nhwɛso no, heparin. Wobetumi de eyinom ama bere a wɔyem mpo.
• Thrombolytics (nnuru a ɛma mogya tu).
• Sɛ ɔyare mmoawa bi na ɛde wo mogya a ɛtɔ a, wɔkyerɛw nnuru a ekum ɔyare mmoawa ma .
• Wɔ tebea horow a emu yɛ den yiye mu no, wɔyɛ oprehyɛn de yi mogya a ɛretu no (`Thrombectomy`) .
• Acetazolamide anaa aduruyɛ afoforo a wɔde bɛtew nhyɛso a ɛwɔ w’amemene mu (intracranial pressure) so.
• Sɛ akisikuru ba a, wɔma no nnuru a ekum akisikuru .

Ɛgyina nea ɛde wo CVST ba no so no, ebia ɛho behia sɛ wonom warfarin (e.g. Coumadin®, Jantoven®) anaa aduru a wɔde ano nom tẽẽ (e.g. Rivaroxaban, Apixaban anaa Dabigatran) asram abiɛsa kosi 12. Ebia ɛho behia sɛ nnipa a wɔwɔ tebea bi te sɛ thrombophilia nom warfarin nkwa nna nyinaa.

Dɛn ne nsɛnnennen anaa nsunsuanso bɔne a efi ayaresa no mu ba?

Sɛ worenom warfarin a, ɛho hia yiye sɛ wobɛnom dodow pɔtee a wɔakyerɛw ama wo no . Ɛno nti na wo duruyɛfo bɛhwɛ sɛnea wo mogya mu yɛ den daa no. Ɛsɛ sɛ dodow a wɔde ma wo no dɔɔso na ama mogya a ɛbɛtɔ a ebetumi apira wo no agyae, nanso ɛnsɛ sɛ ɛkɔ soro araa ma sɛ wotwa wo nsa anaa wo nan a, worentumi nnyae mogya a ɛbɛtɔ wo. Enti ɛsɛ sɛ wunya kari pɛ a ɛfata.

Ɛrenkyɛ na me ho atɔ me wɔ ayaresa akyi?

Sɛ wunya heparin, denam IV anaa injection so a, efi ase yɛ adwuma ntɛmntɛm yiye . Warfarin betumi agye bɛyɛ dapɛn biako ansa na ayɛ adwuma, enti wo duruyɛfo no bɛma woakɔ so anom heparin kosi sɛ ebefi ase ayɛ adwuma. Ɛno akyi no, wubetumi agyae heparin nom na woanom warfarin nkutoo.

Anaasɛ, sɛ wo duruyɛfo paw aduru a wɔde siw mogya a ɛtwetwe mogya ano tẽẽ a, ebetumi ayɛ wo mogya a ɛyɛ mmerɛw akodu dodow a wopɛ wɔ nnɔnhwerew kakraa bi mu. Bere a mogya no fi ase sɛe na nhyɛso a ɛwɔ amemene no mu no so tew no, nkakrankakra wubefi ase ate nka.

Mɛyɛ dɛn atumi atew asiane a ɛwɔ hɔ sɛ menya CVST no so?

Sɛ woanya CVST wɔ nyinsɛn mu a, nnuru a ekum mogya a ɛtwetwe mogya a wobɛnom wɔ nyinsɛn a edi hɔ no mu no betumi atew asiane yi so.

Nnuru a wɔde siw nyinsɛn ano a wɔnom nso yɛ asiane a ɛde CVST ba. Enti, wubetumi atew asiane yi so denam nnuru a wɔde siw awo ano a woremfa nni dwuma no so. Wubetumi de awo ano aduru a wɔde progestin nkutoo di dwuma mmom.

Sigaretnom bere a wɔrenom nnuru a wɔde siw awo ano nso ma asiane a ɛwɔ hɔ sɛ wobenya CVST no yɛ kɛse . Sɛ wokwati eyinom abien no nyinaa a, ebetumi aboa ma wɔasiw CVST ano.

Sɛ mewɔ (CVST) a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Bere bi a atwam no, nnipa a na wɔwɔ CVST no mu bɛyɛ 50% pɛ na wonyaa nkwa. Nanso seesei tebea no ye koraa.Mprempren nnipa dodow a wowuwu wɔ saa yare yi mu no sua koraa, efi 5% kosi 10%. Eyi fi mfoninitwa mfiri a ɛkɔ anim ne akwan a ɛkɔ akyiri a wɔfa so sa yare.

Nanso, CVST betumi asan aba bio . Ɛno nti na wo duruyɛfo bɛkyerɛw wo nnuru a ɛma mogya yɛ mmerɛw (ancoagulants).

Bere tenten ahe na (CVST) tebea no di?

(CVST) betumi atra hɔ nnɔnhwerew pii akosi adapɛn pii. Ɛda adi sɛ wo tebea no bɛkɔ akuw yi mu biako mu:

• Acute: Ɛkɔ nnɔnhwerew 48.
• Subacute: Bɛboro nnɔnhwerew 48, nanso ɛkɔ nnafua 30. (Eyi ne nea wɔtaa de di dwuma sen biara.)
• Nea enni sabea: Ɛtra hɔ ɔsram biako anaa nea ɛboro saa.

Dɛn ne anidaso a ɛwɔ hɔ ma (CVST) gyinabea?

Anidaso a ɛwɔ hɔ ma nnipa a wɔwɔ CVST a wohu wɔn yare no yiye na wɔsa wɔn yare no ye . Nanso, sɛ wɔanhu na wɔansa ntɛm a, ebetumi akum CVST. Ɛno nti na ɛho hia sɛ wohwehwɛ nnuruyɛfo afotu bere a sɛnkyerɛnne ahorow no da adi ara pɛ no.

Ɔkwan bɛn so na ɛsɛ sɛ mehwɛ me ho?

Sɛ woyɛ CVST wie a, wo duruyɛfo no bɛpɛ sɛ osiw wo kwan sɛ worennya mogya a ɛbɛtɔ bio. Eyi kyerɛ sɛ ebehia sɛ wokɔ so nom nnuru a ekum mogya a ɛtwetwe mogya anaa “mogya a ɛma mogya tu” te sɛ warfarin.

Ɛwom sɛ eyi bɔ wo ho ban fi mogya a ɛyɛ hu ho de, nanso ɛma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wo wɔ da biara da opira ketewaa bi mpo mu no yɛ kɛse. Enti, ɛsɛ sɛ wohwɛ yiye kɛse bere a wode nneɛma a ano yɛ nnam te sɛ nnade redi dwuma no . Ebia ɛbɛyɛ nea ahobammɔ wom sɛ wode anyinam ahoɔden afiri bedi dwuma sen sɛ wode bedi dwuma daa.

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn?

Ɛsɛ sɛ wokɔ wo duruyɛfo nkyɛn daa (ebia asram kakraa biara) bere a worenom nnuru a ɛma mogya tu (nnuru a ɛma mogya tu (anticoagulants) no. Sɛ wopa warfarin dodow bi a, frɛ wo duruyɛfo ntɛm ara.

Bere a woanya CVST akyi asram abiɛsa kosi asia no, ebia ɛho behia sɛ woyɛ CT scan anaa MRI foforo a wode aduru a wɔde yɛ ade di dwuma de hwɛ sɛnea mogya a ɛwɔ w’amemene mu no te.

Bere bɛn na ɛsɛ sɛ mekɔ baabi a wɔhwɛ wɔn a egye ntɛmpɛ?

Sɛ worenom Warfarin na wowɔ mogya a ɛretu wo ho sɛnkyerɛnne yi bi a, frɛ 1990 (Sri Lanka ambulance adwumayɛbea a ɛhwɛ ntɛmpɛ so) ntɛm ara, anaa kɔ ayaresabea dwumadibea a ɛhwɛ ntɛmpɛ a ɛbɛn wo no ntɛm ara sɛnea wubetumi :

• Mogya a ɛtɔ a wontumi nsiw ano .
• Tiyɛ a ɛyɛ hu yiye .
• Mogya kɔkɔɔ a ɛhyerɛn bere a ɔrefefe, ɔfe, anaa ɔrefefe.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Wubetumi abisa oduruyɛfo no nsɛm te sɛ eyinom:

• Dɛn nti na minyaa saa (CVST) tebea yi?
• Bere tenten ahe na ɛsɛ sɛ minya ayaresa?
• Asiane bɛn na ɛwɔ me sɛ menya CVST bio?

Esiane sɛ CVST betumi asan aba bio nti, ɛho hia sɛ wo ne wo duruyɛfo no kɔ so di akyi bere nyinaa. Wɔbɛpɛ sɛ wɔhwɛ hu sɛ worenom nnuru dodow a ɛfata na amma CVST ansi bio. Sɛ worenom nnuru a ɛma mogya tu a, ɛsɛ sɛ wokwati dwumadi ahorow a ebetumi ama woapirapira nso. Nneɛma a wɔde di dwuma da biara da te sɛ nnade ne nkankyee mpo betumi ama mogya atu. Enti ɛyɛ papa sɛ wode nneɛma foforo a ahobammɔ wom te sɛ anyinam ahoɔden afiri bedi dwuma.

Enti, nkrasɛm bɛn na ɛsɛ sɛ yɛkae fi saa asɛm yi mu?

Sɛ yɛbɛka no tiawa a, CVST yɛ tebea a ɛntaa nsi nanso anibere wom a mogya a ɛtɔ gu mogya ntini bi mu wɔ amemene no mu. Sɛ wuhu sɛnkyerɛnne ahorow te sɛ tiyɛ a emu yɛ den a emu yɛ den ne akisikuru a, kɔ oduruyɛfo nkyɛn ntɛm ara . Sɛ wohu yare no ntɛm na wɔsa no a, ebetumi ama nneɛma a eye. Nnuru a ɛma mogya yɛ mmerɛw ne ayaresa titiriw. Ɛsɛ sɛ wohwɛ yiye nso wɔ mogya a ɛbɛtɔ wo ho bere a worenom nnuru yi. Ɛho hia sɛ wonom wo nnuru sɛnea wo duruyɛfo ka kyerɛ wo no pɛpɛɛpɛ na wo ne wo duruyɛfo di akyi. Kae sɛ ɛnyɛ wo nko ara, na wo duruyɛfo wɔ hɔ sɛ ɔne wo bɛkasa na waboa wo.

` Cerebral venous sinus thrombosis, CVST, mogya a ɛtɔ wɔ amemene no mu, tiyɛ, nnuru a ɛma mogya yɛ mmerɛw, ɔyare a ɛma obi hwe ase, akisikuru