Loaʻa iā ʻoe kekahi manawa ke poʻo ʻeha me ke kumu ʻole? A i ʻole ua loaʻa koke iā ʻoe kahi hopu ʻana? Ua ʻōlelo paha kāu kauka i ka wā o ka scan lolo he ʻūlū koko liʻiliʻi kou i loko o kou lolo? He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe i kahi mea e like me kēia. Akā, mai hopohopo. ʻO ka hapa nui o ka manawa, ʻaʻole kēia he mea koʻikoʻi. I kēia lā, ke kamaʻilio nei mākou e pili ana i kēia 'pūpū lolo' a i kapa ʻia ʻo 'Cavernous Malformation' ma ke ʻano lapaʻau. E kamaʻilio maʻalahi kākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
He aha ka Cavernous Malformation?
I ka ʻōlelo maʻalahi, ʻo ka `Cavernous Malformation` he puʻupuʻu ʻano ʻē i hana ʻia e nā kīʻaha koko liʻiliʻi i loko o ko mākou kino, i kapa ʻia ʻo capillaries, e hui pū ana. Ua like ia me ka raspberry i ka nānā mua ʻana. I loko o kēia puʻupuʻu he nui nā lua liʻiliʻi i piha i ke koko.
E noʻonoʻo e pili ana i ia mea, ua hana ʻia ko kākou mau kīʻaha koko maʻamau me nā paia ikaika. Akā, ua lahilahi loa a nāwaliwali nā paia o nā kīʻaha koko i loko o kēia 'Cavernous Malformation'. A ʻaʻohe o lākou kākoʻo kūpono. Maanei e hoʻomaka ai ka pilikia. Ma muli o kēia mau paia nāwaliwali, i kekahi manawa he nui ka manawa e kahe ai kekahi koko mai kēia mau aa koko i loko o nā ʻiʻo a puni.
ʻIke pinepine ʻia kēia ʻano ma ko kākou lolo a me ke kaula kuamoʻo . ʻO ia ke kumu i kapa ʻia ai ʻo 'Cerebral Cavernous Malformation'. Eia nō naʻe, hiki ke ulu i kekahi manawa ma nā wahi e like me ka ʻili, ke akepaʻa, a me nā maka.
Ua kapa nā kauka i kēia kūlana ma nā inoa like ʻole. No laila, mai hopohopo inā ʻike ʻoe i kekahi o kēia mau inoa i kāu hōʻike, ua like ke ʻano o lākou a pau.
- Nā Ana ʻOle
- Nā Hemangioma Cavernous
- Nā maʻi ʻino o ka lolo
- Nā Angioma Cavernous
He mea weliweli maoli anei kēia mau Cavernous Malformations?
ʻO ka nīnau nui a ka poʻe he nui ke lohe lākou i kēia inoa, "He maʻi kanesa anei kēia? He mea weliweli anei kēia?" ʻO ka mea mua, ʻaʻole ia he maʻi kanesa .
Akā, inā he mea weliweli kēia kūlana a ʻaʻole paha, ʻokoʻa ia mai kēlā kanaka a kēia kanaka. Aia ia i kekahi mau kumu:
- Ka nui o ka puʻupuʻu: Pehea ka nui.
- Ka helu o nā puʻupuʻu: Ehia mau puʻupuʻu e like me kēia i loko o kou kino.
- Kahi: Ma hea i loko o ka lolo kahi i loaʻa ai?
- Ka pilikia o ke kahe ʻana o ke koko: Aia kahi manawa kūpono e pahū a hoʻoulu i ke kahe koko nui.
Ma muli o ka lahilahi o nā paia o kēia mau kīʻaha koko, aia ka pilikia o ke kahe ʻana o ke koko. Hiki i ke kahe ʻana o ke koko i loko o ka lolo ke hana i nā kūlana e like me nā hopu ʻana, ka maʻi lolo, a i ʻole ka hahau ʻana. Inā koʻikoʻi ke kahe ʻana o ke koko, hiki ke hoʻoweliweli i ke ola.
Eia nō naʻe, ʻo ka mea nui e pono ai ʻoe e hoʻomanaʻo ma ʻaneʻi, ʻo ka hapa nui o nā Cavernous Malformations ʻaʻole ia e hoʻoulu i nā pilikia nui . Noho ka nui o ka poʻe me ka ʻike ʻole ua loaʻa iā lākou.
No laila, i mea e ʻike pono ai i kou kūlana, ʻoi aku ka maikaʻi o ke kamaʻilio ākea me kāu kauka. E nānā ʻo ia i kāu hōʻike scan a wehewehe i nā pilikia e pili ana i kou kūlana.
He aha nā hōʻailona o kēia maʻi?
ʻAʻohe hōʻailona o ka hapa nui o ka poʻe me kēia maʻi. Akā inā loaʻa, he hōʻailona pinepine ia e kahe ana kahi koko liʻiliʻi mai ke kīʻaha koko. Hoʻomaka pinepine kēia mau hōʻailona ma waena o nā makahiki 20 a me 60.
Aia ma ka papa ma lalo nei kekahi o nā hōʻailona maʻamau.
| Hōʻailona | Wehewehena |
|---|---|
| Nā hopu ʻana | He hōʻailona kēia i ʻike pinepine ʻia. |
| ʻEha poʻo | ʻO ke poʻo ʻeha pinepine a ʻano ʻē paha. |
| Ka nāwaliwali o ke kino a i ʻole ka mae ʻana | Manaʻo o ka maeʻele a nāwaliwali paha ma kekahi ʻaoʻao o ka lima, ka wāwae, a i ʻole ka maka. |
| Nā pilikia ʻike | ʻIke pōwehiwehi, ʻike pālua, a i ʻole ka nalowale ʻana o ka ʻike. |
| Nā pilikia kaulike | Ka nalowale ʻana o ke kaulike a me ka hāʻule ʻana i ka wā e hele ana a kū ana paha. |
| Nā loli i ka moʻolelo | ʻŌlelo ʻino a paʻakikī paha ka loaʻa ʻana o nā huaʻōlelo. |
| Nā hiʻohiʻona ʻē aʻe | Pōniuniu, luhi, nalowale ka hoʻomanaʻo, pilikia ka lohe, haʻalulu. |
He aha ke kumu o kēia kūlana?
ʻO ka hapa nui o ka manawa, ma kahi o 80% o ka manawa, ʻaʻole ʻike nā kauka i ke kumu pololei o kēia mau 'Cavernous Malformations'. Loaʻa pinepine lākou.
Akā ma kahi o 20% o nā hihia, he loulou genetic kona. ʻO ia hoʻi, hiki ke hoʻoili ʻia ke kūlana mai kēlā hanauna a i kēia hanauna. Ua ʻike ʻia ʻekolu mau genes e hoʻokumu ana:
- ʻO ka `CCM1 (KRIT1)`
- ʻO ka `CCM2`
- ʻO ka `CCM3 (PDCD10)`
I ka ʻōlelo maʻalahi, ʻo kēia mau genes ka mea e hana ai i nā protein e kōkua i ka hoʻopili ʻana i nā cell i loko o ko mākou mau kīʻaha koko a mālama iā lākou i ikaika. Ke loaʻa kahi kīnā a ʻokoʻa paha i loko o kēia mau genes, lilo nā pilina ma waena o kēlā mau cell i nāwaliwali. ʻO ia ka manawa e hana ʻia ai kēia mau ʻūpā kīʻaha koko maʻamau ʻole a nāwaliwali.
Ua hoʻoilina ʻia kēia maʻi ma ke ʻano "Autosomal Dominant". ʻO ia hoʻi, hiki i ke keiki ke loaʻa kēia maʻi inā paha e hoʻoilina lākou i kekahi o nā genes kīnā mai ka makuahine a i ʻole ka makuakāne. Inā loaʻa iā ʻoe kēia maʻi genetic, aia he 50% ka manawa e hoʻoilina ai kāu keiki. Inā loaʻa i kekahi o kou ʻohana kēia maʻi a inā he ʻoi aku ma mua o hoʻokahi o kēia mau genes kekahi, ʻoi aku ka nui o ka manawa e pili ana i kahi kumu genetic.
Pehea e ʻike ai ke kauka i kēia?
I ka manawa pinepine, ʻike ʻia kēia maʻi ma ke ʻano ulia i ka wā o ka nānā ʻana i ka lolo no kekahi kumu ʻē aʻe, e like me ke poʻo ʻeha a i ʻole kahi ulia, a ma hope paha o ka ʻike ʻia ʻana o nā hōʻailona e like me ka hopu ʻana.
ʻO ka hoʻāʻo nui i hoʻohana ʻia e ʻike ai i kēia he MRI (Magnetic Resonance Imaging) .
- MRI maʻamau: Hiki i kēia ke ʻike maopopo i nā mea e like me kahi a me ka nui o ka puʻupuʻu.
- MRI Kūikawā (Susceptibility-Weighted Imaging): He scan ʻoi aku ka maʻalahi o kēia. Hiki iā ia ke ʻike i nā ʻōpū liʻiliʻi loa, a me nā koena o ke kahe koko liʻiliʻi ma mua. Hiki i kēia ʻike ke kōkua i kāu kauka e loaʻa kahi manaʻo o kou pilikia e hiki mai ana.
Eia kekahi, hiki ke hana i kahi hoʻokolohua genetic e nānā i ka mōʻaukala ʻohana a, inā pono, e hoʻoholo inā he ʻano genetic.
He aha nā lāʻau lapaʻau i loaʻa?
ʻAʻole pono ke ʻoki kino i nā kānaka a pau i ʻike ʻia he malformation cavernous. Aia ka lāʻau lapaʻau i kāu mau hōʻailona, kahi o ka puʻupuʻu, a inā he kahe koko.
1. Nānā ʻana
Inā ʻaʻohe ou hōʻailona a ʻaʻole hoʻi e kahe ana ke koko mai ka puʻu, e hahai pinepine kāu kauka i kahi ʻano "kali makaʻala".
- Nā scan MRI i nā manawa maʻamau: Hana ʻia nā scan ma kahi o hoʻokahi manawa i ka makahiki e nānā i nā loli i ka nui o ka puʻupuʻu a me ke kahe koko hou.
- Ka ʻike ʻana i nā hōʻailona: E hoʻomaopopo ʻia ʻoe e pili ana i nā hōʻailona e hopohopo ai a me ka wā e hoʻomaopopo koke ai i ke kauka.
2. Ka hoʻomalu ʻana i nā hōʻailona me ka lāʻau lapaʻau
Inā loaʻa iā ʻoe nā hōʻailona e like me ka hopu ʻana a i ʻole ke poʻo ʻeha ma muli o ka puʻupuʻu, e kuhikuhi kāu kauka i ka lāʻau lapaʻau e kāohi i kēlā mau hōʻailona. ʻAʻole e hoʻopau kēia mau lāʻau i ka puʻupuʻu, akā hiki iā lākou ke kōkua i ka kāohi ʻana i ka ʻoluʻolu ʻole e hoʻoulu ai.
3. Wehe ʻoki kino
ʻŌlelo ʻia ke ʻoki kino ma kekahi mau hihia kūikawā wale nō.
- Inā ua loaʻa iā ʻoe ma mua o hoʻokahi kahe koko me nā hōʻailona .
- Inā ua hoʻopilikia ke kahe koko i ka neurological (e.g., nalowale o ka ʻike ma kekahi ʻaoʻao o ke kino, nā loli i ka ʻike) a ke ʻino nei ke kūlana i kēlā me kēia lā.
- Inā loaʻa iā ʻoe kahi ʻōhū ʻaʻole hiki ke kaohi ʻia me ka lāʻau lapaʻau.
- Inā aia ka puʻupuʻu ma kahi e hiki ai ke wehe palekana me ka ʻole o ka hōʻino nui ʻana i ka lolo.
ʻO ka hoʻoholo e hana i ke ʻoki kino a i ʻole ʻaʻole na ke kauka neurosurgeon e hana ma hope o kahi kūkākūkā lōʻihi me ʻoe e pili ana i nā pono a me nā pōʻino o ke ʻoki kino.
He aha kaʻu e hana ai e hōʻemi i ka pilikia o ke kahe ʻana o ke koko?
ʻOiai ʻaʻohe ala e pale aku ai i ka hoʻokumu ʻia ʻana o kēia mau puʻupuʻu, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i ka pilikia o ke kahe ʻana o ke koko a i ʻole ka pahū ʻana. ʻO ia hoʻi ke mālama pono i kou olakino holoʻokoʻa.
- E mālama i ke koko olakino, ka cholesterol, a me nā pae kō koko .
- Inā ʻoe e lawe nei i kekahi mau lāʻau lapaʻau, e like me nā lāʻau hoʻokahe koko , e kamaʻilio me kāu kauka e pili ana i ka hiki iā lākou ke hoʻopilikia i kēia kūlana.
- E hoʻoikaika kino no 30 mau minuke ma ka liʻiliʻi i ka hapa nui o nā lā o ka pule.
- E pale loa i ka hoʻohana ʻana i nā huahana paka (puhipaka) .
- E hālāwai me ke kauka i ka manawa i hoʻonohonoho ʻia no ka nānā ʻana a nīnau inā he mau nīnau a hopohopo paha kāu.
Āhea wau e hele koke ai i ETU?
He mea nui loa kēia. Inā ʻike ʻoe he `Cavernous Malformation` kou, a ʻike koke ʻia nā hōʻailona ma lalo nei, mai hoʻonele i ka manawa a hele koke i ka Emergency Treatment Unit (ETU) o ka haukapila kokoke loa .
- Inā loaʻa iā ʻoe kahi hopu ʻana no ka manawa mua i kou ola.
- Inā manaʻo koke kekahi ʻaoʻao o ke kino (lima, wāwae, maka) e nalowale ana kona ikaika.
- Inā loli koke kou ʻike (e.g., ʻike ʻoe i hoʻokahi mea a laila ʻelua mau mea, a laila nalowale kou ʻike).
- He ʻeha poʻo koʻikoʻi a hiki ʻole ke hoʻomanawanui.
- Inā paʻakikī koke ka moʻolelo.
He mau hōʻailona paha kēia o ke kahe ʻana o ke koko i loko o ka lolo, hiki ke alakaʻi i ka hahau ʻana, no laila he mea nui e ʻimi koke i ka lāʻau lapaʻau.
Leka Lawe-Home
- ʻO ka "Cavernous Malformation" he ʻano ʻē ia o ke kūkulu ʻia ʻana o nā kīʻaha koko ʻaʻole ia he maʻi kanesa i loko o ka lolo a i ʻole ke kaula kuamoʻo. ʻO ka hapa nui o ka manawa, ʻaʻole ia he kūlana weliweli.
- Hiki i nā hōʻailona ke komo pū me ke poʻo ʻeha, nā ʻūlū, a me ka maneʻo ʻole o ke kino. Eia nō naʻe, ʻaʻole paha e ʻike kekahi poʻe i kekahi mau hōʻailona i ko lākou ola a pau.
- ʻO ke ala maikaʻi loa e hōʻoia pono ai i kēia maʻi ʻo ia ka hana ʻana i kahi scan MRI.
- Aia ka lāʻau lapaʻau i kāu mau hōʻailona, inā ʻoe e kahe ana ke koko, a me kahi o ka puʻupuʻu. ʻAʻole pono nā kānaka a pau i ke ʻoki ʻana.
- Inā ʻike ʻoe i nā hōʻailona e like me ka nalowale koke ʻana o ka ʻike ma kekahi ʻaoʻao o ke kino, nā hopu mua ʻana, a i ʻole nā ʻeha poʻo nui, e hele koke i ka Emergency Department (ETU).
- E kamaʻilio me kāu kauka e pili ana i nā nīnau, hopohopo, a kānalua paha āu e pili ana i kou kūlana. He mea nui loa ka loaʻa ʻana o ka ʻōlelo aʻoaʻo pololei mai ke kauka ma mua o ka hoʻoweliweli ʻana iā ʻoe iho ma ka ʻimi ʻana i ka ʻike ma ka pūnaewele.
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