He ʻūpā koko weliweli anei kēia ma ke poʻo? Hiki paha i kēia ke Cavernous Sinus Thrombosis?

Ua loaʻa anei iā ʻoe kahi ʻeha liʻiliʻi o ka maka a i ʻole kahi pilikia sinus i hoʻoulu ai i kou ʻeha poʻo nui? Ua pehu anei kou mau maka a paʻakikī ke ʻike? Hoʻowahāwahā mākou i kēia mau mea i kekahi manawa, akā hiki iā lākou ke lilo i mea weliweli loa a pono e mālama koke ʻia. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi maʻi koʻikoʻi i ʻike ʻole ʻia e ka poʻe he nui, i kapa ʻia ʻo Cavernous Sinus Thrombosis .

He aha kēia thrombosis sinus cavernous?

I ka ʻōlelo maʻalahi, ʻo Cavernous Sinus Thrombosis ka wā e hana ʻia ai kahi ʻaʻa koko i loko o nā hakahaka liʻiliʻi i loko o kou poʻo, ma hope o kou mau maka, ma lalo o kou lolo i kapa ʻia ʻo 'Cavernous Sinuses' . E noʻonoʻo i kēia mau sinuses e like me nā ana liʻiliʻi kahi e hui pū ai nā aʻa he nui. He nui nā aʻa nui e hoʻokahe i ke koko mai kou maka a me kou lolo e holo ana ma o kēia mau mea. ʻO ka 'Jugular Vein', kahi aʻa nui i kou ʻāʻī, ua pili pū ʻia i kēia mau sinuses cavernous. No laila, inā hana ʻia kahi ʻaʻa koko i loko o kēia aʻa (pinepine ʻia e kahi maʻi), e ālai ka ʻaʻa koko i ke kahe ʻana o ke koko mai kou lolo. He mea weliweli loa kēia, no ka mea hiki ke hōʻeha lōʻihi i kou lolo, nā maka, a me nā aʻalolo. He kūlana kēia e hiki ke hoʻoweliweli i ke ola inā ʻaʻole mālama koke ʻia.

Pehea ka maʻamau o kēia ʻano?

ʻOiaʻiʻo, he mea kākaʻikahi loa kēia maʻi i kapa ʻia ʻo Cavernous Sinus Thrombosis . ʻO ia hoʻi, ʻaʻole ia he mea i ʻike pinepine ʻia. He mea paʻakikī ke ʻōlelo pololei i ka nui o nā hihia i hōʻike ʻia i kēlā me kēia makahiki, ua haʻahaʻa loa ia. Akā ʻo ka nūhou maikaʻi, ma hope o ka ʻike ʻia ʻana o nā antibiotics , ua emi nui ka nui o nā hōʻike o kēia maʻi. No ka mea, hiki ke ho'ōla ʻia nā maʻi, ʻo ia ke kumu nui o kēia mau ʻōpū koko, me nā antibiotics, ʻaʻole i lilo kēlā mau maʻi i mea koʻikoʻi.

He aha nā hōʻailona o kēia? Pehea e ʻike ai?

ʻO ka mea weliweli loa e pili ana i kēia, ʻo ia ka hiki ke ʻoi aku ka wikiwiki o nā hōʻailona. ʻO kekahi o nā hōʻailona nui e hiki mua mai ana, ʻo ia ka ʻeha poʻo nui. ʻAʻole like kēia me ka ʻeha poʻo maʻamau. ʻO ia kekahi mea ʻaʻole e emi iho ma hope o ka lawe ʻana i nā lāʻau hōʻeha, a e ʻoi aku ka ʻino i kēlā me kēia lā. Hiki ke hele koke mai a koʻikoʻi, a i ʻole hiki ke hoʻonui mālie i kekahi mau lā. ʻIke pinepine ʻia kēia ʻeha a puni kekahi maka, a puni nā maka ʻelua, a ma hope paha o nā maka.

Hoʻokumu ʻia kēia mau hōʻailona e ka piʻi ʻana o ke kaomi i loko o ka sinus cavernous ma muli o kahi ʻūpā koko. E makaʻala e ʻike inā loaʻa iā ʻoe kēia mau hōʻailona:

• He ʻeha ʻeha nui a ʻoi hoʻi, ʻaʻole e nalo mau ma hope o ka lawe ʻana i ka lāʻau lapaʻau.
• Ka pehu ʻana o kekahi a ma hope paha o nā maka ʻelua, i kekahi manawa me ka manaʻo o nā maka puʻupuʻu.
• Ke kulou ʻana o nā lihilihi maka, me he mea lā ua pani hapa ʻia ka maka ('nā lihilihi maka droopy').
• Ke ʻeha nui nei i ka hoʻāʻo ʻana e hoʻoneʻe i kekahi a i ʻole nā ​​​​maka ʻelua.
• ʻAʻole hiki ke hoʻoneʻe i kekahi a i ʻole nā ​​maka ʻelua, paʻa i kekahi ʻaoʻao.
• ʻIke pōwehiwehi, nalowale o ka ʻike maopopo.
• Ke ʻike pālua nei.
• Ka maneʻo a i ʻole ka nalowale o ka ʻike ma ka maka, ʻoi aku hoʻi a puni nā maka.
• Wela loa.
• Hiki i kekahi poʻe ke loaʻa i nā ʻōhū.

He mea nui loa: Inā ʻaʻole mālama ʻia, hiki i ka thrombosis sinus cavernous ke ʻoi aku ka ʻino, e hoʻoulu ai i ka mea maʻi e huikau a hiamoe. Hiki i kēia ke alakaʻi i ka coma a me ka make. No laila, he mea nui loa e ʻimi i ke kōkua lapaʻau i ka wā e ʻike ai ʻoe i kēia mau hōʻailona, ​​​​ma mua o ka holomua ʻana o ke kūlana i kēia manawa.

Pehea ka wikiwiki o kēia hana?

ʻO ka maʻamau, loaʻa ka thrombosis sinus cavernous i 5 a 10 mau lā ma hope o kahi maʻi i mālama ʻole ʻia ma kou maka a i ʻole ke poʻo (no ka laʻana, he sinus, niho, a pepeiao paha). ʻO ka hōʻailona mua he poʻo ʻeha. Hiki ke hele koke mai nā hōʻailona o ka maka (e like me ka pehu ʻana, ka pehu ʻana) ma hope koke iho o ke poʻo ʻeha, a i ʻole e ulu mālie paha.

He aha ke kumu o kēia? No ke aha lā kēia e hana nei?

E noʻonoʻo i kēia ʻano. Loaʻa iā ʻoe kahi puʻupuʻu liʻiliʻi ma kou maka, ma ka ʻaoʻao o kou ihu paha, a i ʻole ma kou lehelehe luna. A i ʻole he ʻeha niho kou. ʻAʻole ʻoe e nānā nui iā ia, me ka manaʻo, 'He mea liʻiliʻi wale nō ia, e nalo wale nō ia.' Akā, ʻo ka maʻi bacteria ma kēlā wahi liʻiliʻi e alakaʻi pinepine ai i kēia kūlana weliweli i kapa ʻia ʻo Cavernous Sinus Thrombosis . ʻO ia hoʻi, hele mai ia ma ke ʻano he pilikia o kahi maʻi.

ʻO ka mea e hana ʻia nei: Hoʻopili ke koko i loko o kou mau aʻa sinus cavernous i ka hoʻāʻo ʻana e pale i ka laha ʻana o ka maʻi. He ʻano pale ia o ke kino. Akā, ma kahi o ka hoʻōki ʻana i ka laha ʻana o ka maʻi, hoʻopaʻa kēia ʻaʻa koko i ka maʻi. A laila pau ke kahe ʻana o ke koko mai ka lolo. Hoʻonui kēia i ke kaomi i loko o ka sinus cavernous, e hana ana i nā hōʻailona i ʻōlelo ʻia ma mua.

ʻO nā ʻano maʻi e hoʻopilikia nui i kēia:

• Nā maʻi sinus (sinusitis). Nā maʻi i loko o nā lua a puni ka ihu.
• ʻO nā paila a i ʻole nā ​​​​furuncles e hana ana ma lalo o ka ʻili ma ka maka, ʻoi aku hoʻi a puni ka ihu a me ka lehelehe luna.
• Nā ʻōpū niho.
• Nā maʻi pepeiao, ʻoi aku hoʻi nā maʻi pepeiao waena.

I ka hapanui o nā hihia, ma kahi o 70% o nā hihia, ʻo ke kumu ka bacteria 'Staphylococcus aureus' . He bacteria maʻamau loa kēia. Ma waho aʻe o kēlā, hiki i nā ʻano bacteria ʻē aʻe a me kekahi mau ʻano fungi ke hana i nā maʻi e hoʻoulu ai i ka thrombosis cavernous. I kēia manawa, ua hōʻike ʻia kekahi mau hihia o ka thrombosis sinus cavernous e pili ana me ka maʻi 'COVID-19' .

I ka liʻiliʻi loa, hiki ke hana ʻia kēia ʻūpā koko ma muli o kahi ʻeha poʻo nui, ma mua o kahi maʻi.

Pehea e ʻike ai nā kauka i kēia?

Hiki ke paʻakikī iki ka ʻike ʻana, no ka mea, ua like kona mau hōʻailona me nā maʻi maʻamau ʻē aʻe, e like me ka maʻi maka, ka migraine, a i ʻole nā ​​​​maʻi neurological ʻē aʻe.

Eia nō naʻe, ma muli o kāu mau hōʻailona, ​​​​ʻoiai inā loaʻa iā ʻoe kahi maʻi maka a sinus paha a i ʻole ua loaʻa iā ʻoe i hoʻokahi i hala koke aku nei, manaʻo paha kāu kauka he thrombosis sinus cavernous .

Hiki ke hana ʻia hoʻokahi a ʻoi aku paha o kēia mau hoʻokolohua e hōʻoia i ka hōʻailona:

• Nā hoʻāʻo kiʻi.
• MRI (Magnetic Resonance Imaging): ʻAe kēia iā ʻoe e ʻike maopopo i ka lolo a me ka ʻāpana sinus cavernous, he mea nui loa ia no ka ʻike ʻana inā he ʻūpē koko.
• ʻO ke kiʻi ʻana o ka `CT` (Computed Tomography): Hiki i kēia ke nānā i nā ʻōpū koko a me nā hōʻailona o ka maʻi.
• MRV (Magnetic Resonance Venogram me MRI): ʻO kēia ke ala maʻalahi loa e ʻike ai i kēia maʻi. Ma kēia MRV, hoʻokomo ke kauka i kahi wai kūikawā (contrast dye) i loko o kou aa koko. A laila hiki i ka MRI ke ʻike maopopo i ke kahe koko a me nā mea e ālai ana i loko o nā aa koko.
• Hoʻāʻo moʻomeheu bacteria. E hoʻāʻo kāu kauka i kou koko a i ʻole nā ​​​​wai kino ʻē aʻe (e like me ke wai mai kou sinuses a i ʻole ka pus mai kahi ʻeha) e ʻike inā he bacteria a i ʻole nā ​​​​​​mea pathogens ʻē aʻe e hoʻoulu ai i ka maʻi. Hiki i kēia ke kōkua i ka ʻike ʻana i ka bacteria pololei a kuhikuhi i ka antibiotic kūpono.
• ʻO ke kī ʻana o ka iwi kuamoʻo / lumbar puncture. Hiki i kēia hoʻāʻo ke ʻike inā ua pālahalaha ka maʻi i nā membrane e uhi ana i ka lolo a me ke kaula spinal (meninges). Inā loaʻa, ua kapa ʻia ʻo meningitis . He pilikia weliweli ka meningitis o ka thrombosis sinus cavernous. Ma kēia hoʻāʻo, hoʻokomo ke kauka i kahi nila lahilahi i loko o kou kua haʻahaʻa a lawe i kahi laʻana o ka wai spinal. Hoʻāʻo ʻia ka wai no ka bacteria a me nā hōʻailona ʻē aʻe o ka maʻi.

He mea nui: No ka mea, he maʻi hoʻoweliweli ola ka thrombosis sinus cavernous a holomua wikiwiki hoʻi, hiki i ke kauka ke hoʻomaka i ka lāʻau lapaʻau ma muli o ke kānalua ma mua o ka hōʻoia piha ʻia ʻana o ka hōʻailona. No ka mea, he mea nui kēlā me kēia kekona ma ʻaneʻi.

He aha nā lāʻau lapaʻau no kēia? Hiki ke ho'ōla ʻia?

ʻAe, hiki i ka mālama koke a kūpono ke kāohi i kēia kūlana a hoʻopakele i nā ola. Eia nō naʻe, inā lohi ka mālama ʻana, hiki ke ʻoi aku ka ʻino o ke kūlana. E hoʻokomo ʻia paha ʻoe i ka ʻāpana mālama koʻikoʻi (ICU) o ka haukapila.E ʻae ʻia ʻoe. A laila hiki i nā kauka a me nā limahana kahu maʻi ke nānā pono iā ʻoe i nā hola he 24 o ka lā.

Eia nā lāʻau lapaʻau nui:

• Nā lāʻau antibiotic. ʻO kēia ka lāʻau lapaʻau nui. E hoʻomaka kāu kauka iā ʻoe i nā lāʻau antibiotic intravenous (IV) kiʻekiʻe e pepehi i ka maʻi e hoʻoulu ai i ke koko. E like me ka mea i ʻōlelo ʻia ma mua, he hana lōʻihi kēia, no laila e hāʻawi ʻia paha iā ʻoe nā lāʻau antibiotic ma mua o ka hiki ʻana i nā hoʻokolohua diagnostic ke kuhikuhi i ke kumu pololei o ka maʻi (bacteria a fungus paha). I mea e palekana ai, e hāʻawi ʻia iā ʻoe nā lāʻau antibiotic ākea e hiki ke pepehi i nā ʻano bacteria like ʻole (ʻoi aku ka bacteria maʻamau e like me S. aureus) . Ma hope, ke hoʻi mai nā hopena o ka moʻomeheu, hiki ke hoʻololi ʻia ʻoe i kahi antibiotic kūpono. Pono ʻoe e hoʻomau i kēia lāʻau lapaʻau ma ka haukapila no kekahi mau pule.
• Nā lāʻau hoʻokahe koko (anticoagulants). Hiki ke hāʻawi ʻia iā ʻoe nā lāʻau hoʻokahe koko (nā lāʻau hoʻokahe koko) e like me ka heparin e pale ai i ka nui ʻana o ke koko, e hoʻoheheʻe mālie iā ia, a e pale i ka hoʻokumu ʻana o nā koko hou.
• Hiki ke hāʻawi ʻia nā anticoagulants (nā mea hoʻokahe koko) ma ke ʻano intravenous a i ʻole subcutaneously. Pono ʻoe e lawe i kēia mau mea hoʻokahe koko ma ke ʻano pila no kekahi mau mahina ma hope o ka lāʻau mua.
• ʻO nā Corticosteroids. Hiki i kāu kauka ke kuhikuhi i nā steroids e hōʻemi i ka pehu a me ka mumū e hoʻoulu ai i ke kaomi i loko o kou sinuses. Eia nō naʻe, hāʻawi wale ʻia kēia mau mea ma hope o kou hoʻomaka ʻana i nā antibiotics e kāohi i ka maʻi a ua kaohi ʻia ka maʻi.
• ʻOki kino. I kekahi mau hihia, pono paha ke ʻoki kino e hoʻomaʻemaʻe i ke kumu o ka maʻi (e like me ka maʻi sinus, ka abscess niho) a wehe i kekahi pus a i ʻole kekahi wai ʻē aʻe i hōʻiliʻili ʻia. Hiki i kēia ke kōkua i ka kaohi ʻana i ka maʻi me ka wikiwiki.

He aha kā mākou e manaʻo ai inā hana ʻia kēia? He aha nā pilikia?

Ma mua o ka ʻike ʻia ʻana o nā lāʻau antibiotic, he mea make pinepine ka thrombosis sinus cavernous. Akā i kēia manawa, me ka holomua o ka ʻepekema lapaʻau, ʻoi aku ma mua o 70% o ka poʻe i loaʻa i kēia maʻi e ola ana. He hoʻokō nui kēlā.

Eia nō naʻe, inā ola lākou, hiki i nā poʻe he nui ke loaʻa nā pilikia no ka mea he ʻano kēia e hoʻopilikia ai i ka lolo a me nā aʻalolo. No ka laʻana, ma kahi o 20% o ka poʻe i hoʻōla ʻia mai ka thrombosis sinus cavernous e hoʻomau paha i nā pilikia ʻike (ʻike maka ʻole, makapō) a me nā pilikia neurological (maneʻe o ka maka, paʻakikī i ka neʻe ʻana i ko lākou mau maka) .

ʻO nā pilikia ʻē aʻe e hiki ke hana ʻia:

• ʻO ka ʻeha poʻo pinepine.
• Ka nalowale piha ʻana o ka ʻike ma kekahi a i ʻole nā ​​maka ʻelua.
• Nā hopu ʻana o ka epileptic mau loa.
• ʻO ka meningitis (ka maʻi o nā membrane e uhi ana i ka lolo).
• Sepsis (ka laha ʻana o ka maʻi i ke koko).

ʻO kekahi mea ʻē aʻe, ʻo ka loaʻa ʻana o ka thrombosis sinus cavernous e hoʻolilo iā ʻoe i ka pilikia o ka hoʻomohala ʻana i nā clots koko weliweli ʻē aʻe, e like me nā clots koko i kou mau wāwae ( Deep Vein Thrombosis - DVT ), nā clots koko e hele ana i kou mau māmā ( Pulmonary Embolism - PE ), a i ʻole nā ​​clots koko e hana ana ma kahi ʻē aʻe o kou lolo ( Stroke ).

No laila, he mea nui e wehe me kāu kauka e pili ana i nā pilikia e hiki mai ana o kou kūlana. He mea nui hoʻi e ʻike i nā hōʻailona hōʻike o nā pilikia i hiki iā ʻoe ke pale aku iā lākou i ka wā hiki.

Āhea ʻoe e ʻimi koke ai i ke aʻo lapaʻau?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻimi koke i ke kōkua lapaʻau me ka hoʻokaʻulua ʻole:

• He ʻeha ʻeha nui ʻaʻole e nalowale ma hope o ka lawe ʻana i ka lāʻau hoʻomaha ʻeha, a e lilo ana i mea ʻino aʻe.
• Inā hele pū ka ʻeha poʻo me ka ʻeha e ʻoi aʻe ka ʻeha ke moe ʻoe i lalo a kūlou paha.
• Inā hoʻomaka kekahi a i ʻole nā ​​maka ʻelua e ʻike i ka ʻeha, ka pehu, ka ʻulaʻula, a i ʻole ka pehu ʻana.
• Inā ʻoe e maʻi loa, nāwaliwali, a hiamoe loa paha.
• Inā pilikia ʻoe i ka hanu ʻana.
• Inā loaʻa iā ʻoe ke kuni kiʻekiʻe, nā anu, a me ka haʻalulu.

ʻO nā hōʻailona e like me kēia e hōʻike ana he hiki mai paha kahi kūlana pilikia.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Inā haʻi aku kāu kauka iā ʻoe ua loaʻa iā ʻoe kēia maʻi, e hopohopo paha ʻoe. Akā, no ka hoʻomaha ʻana i kou manaʻo a loaʻa kahi ʻike maopopo i kou kūlana a me ka mālama ʻana, mai poina e nīnau i kāu kauka i kēia mau nīnau:

• He aha kaʻu mea? Pehea ke koʻikoʻi o kēia?
• He aha ke ʻano o ka lāʻau lapaʻau e pono ai iaʻu? Pehea ka lōʻihi?
• He aha nā hopena ʻaoʻao o kēia mau lāʻau lapaʻau?
• ʻEhia ka lōʻihi o koʻu noho ʻana ma ka haukapila?
• He aha nā manawa kūpono e loaʻa ai iaʻu nā pilikia lōʻihi mai kēia ʻōpū koko? He aha lākou? Hiki ke pale ʻia?
• He aha nā hoʻololi e pono iaʻu e hana i koʻu ola o kēlā me kēia lā ma muli o kēia mau pilikia?
• He aha nā manawa kūpono e loaʻa hou ai iaʻu kēia maʻi? He aha kaʻu e hana ai e pale aku ai?
• He aha nā mea e pono iaʻu e mālama ma hope o koʻu hoʻi ʻana i ka home?

He mea nui loa iā ʻoe nā pane i kēia mau nīnau.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

Hiki ke hopohopo ke ʻike he mea maʻamau e like me ka maʻi sinus a i ʻole kahi puʻupuʻu liʻiliʻi ma kou maka e alakaʻi i kahi ʻaʻa koko e hoʻoweliweli i ke ola. ʻO ka thrombosis sinus cavernous - kahi ʻaʻa koko e hana ʻia ma kou maka a i ʻole ke poʻo ma muli o kahi maʻi - he ʻano kakaikahi loa ia. No laila, ʻaʻole paha he hōʻailona kou poʻo poʻo a ʻeha paha ka maka o kahi mea ʻoi aku ka koʻikoʻi. He hōʻailona paha ia o kahi mea ʻaʻole koʻikoʻi.

Eia nō naʻe, ʻo ka mea nui e hoʻomanaʻo mau ai, ʻo ia ka mālama ʻana i kekahi maʻi - ʻaʻohe mea liʻiliʻi paha - me ka wikiwiki a me ke kūpono. E makaʻala loa i nā maʻi e kū mai ana ma ka maka, ka ihu, ka waha, a me nā wahi maka. Hiki i kēlā ʻano mālama koke ke pale aku i ia ʻano maʻi koʻikoʻi mai ka ulu ʻana. No laila, he mea naʻauao ke ʻimi i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē, ʻoiai inā he liʻiliʻi lākou. E hoʻolohe i nā hōʻailona a kou kino e hāʻawi nei iā ʻoe!

ʻO ka Thrombosis Sinus Cavernous, ke koko i loko o ka lolo, ka maʻi poʻo, ka maʻi maka, ka ʻeha poʻo nui, ka pehu ʻana o nā maka, nā lāʻau antibiotic, nā maʻi neurological