Ua ʻike anei ʻoe e pili ana i kēia pōʻai liʻiliʻi i loko o ka lolo? (Pōʻai o Willis) E kamaʻilio kākou e pili ana i kēia!

Ua lohe paha ʻoe i ka 'Circle of Willis'? Malia paha ua haʻi aku kāu kauka iā ʻoe e pili ana i ia mea, a ua ʻike paha ʻoe iā ia ma kekahi hōʻike lapaʻau. He ʻāpana koʻikoʻi loa ia o ko kākou lolo. Ua like ia me kahi ʻōnaehana palekana liʻiliʻi. No laila, e kamaʻilio pōkole kākou e pili ana i ke ʻano o kēia '(Circle of Willis)' a me kāna hana, ʻae?

He aha ka 'Circle of Willis'?

ʻAe, he aha ka `(Circle of Willis)`? I ka ʻōlelo maʻalahi, he ʻōnaehana ia o nā kīʻaha koko i loaʻa ma lalo pono o ko kākou lolo, ma ke kumu. Ua like kona ʻano me ke apo, a i ʻole he ʻano ʻelima ʻaoʻao (`(Pentagon)`) . ʻElua mau kīʻaha koko nui e hoʻolako i ko kākou lolo me ke koko maʻemaʻe a waiwai i ka oxygen. ʻO kekahi ka ʻōnaehana `(Internal Carotid Artery)` , a ʻo kekahi ka ʻōnaehana `(Vertebral Artery)` . No laila, ʻo kēia `(Circle of Willis)` kahi e pili ai kēia mau kīʻaha koko nui ʻelua. ʻO ka `(Internal Carotid Artery)` ka mea nui e hoʻolako i ke koko i ke alo o ka lolo, a ʻo ka `(Vertebral Artery)` ka mea nui e hoʻolako i ke koko i ke kua o ka lolo.

Ua kapa ʻia kēia ʻo ke 'apo o Willis' ma muli o ka mea anatomista ʻo Thomas Willis. ʻO ia ka mea nāna i kōkua iā mākou e ʻike i nā mea he nui e pili ana i kēia ʻano. Ua kapa ʻia hoʻi ia ma nā inoa ʻē aʻe, no ka laʻana:

• `(Poepoe ʻAʻa lolo)` (Poepoe ʻAʻa lolo)
• `(Willis Polygon)` (Willis Polygon)
• `(Ka Loop o Willis)` (Ka Loop o Willis)

Ua like kēia me kahi 'palekana' no ko kākou lolo, he ʻano palekana. E noʻonoʻo, inā ua hōʻino ʻia kekahi o kēia mau kīʻaha koko nui ʻelua, no ka laʻana, ma muli o ka pahū ʻana o ke kīʻaha koko i loko o ka lolo (Brain Aneurysm) a i ʻole ka hahau ʻana, hiki i ke ala ʻē aʻe ke hoʻolako i kekahi koko i kēlā ʻāpana i hōʻino ʻia o ka lolo ma o kēia (Circle of Willis). ʻAʻole anei he mea kupaianaha kēlā?

Ua like anei nā kānaka a pau (Circle of Willis)? A i ʻole he mau ʻokoʻa?

Akā eia ka mea. ʻAʻole i loaʻa i nā kānaka a pau kahi "Circle of Willis" kūpono. Wahi a nā kānaka noiʻi, ʻaʻole i piha pono ka hapalua o ka heluna kanaka. ʻO ia hoʻi, aia paha he mau loli liʻiliʻi o ke ʻano i loko. Ke hana ʻia kēlā, kapa mākou ia he "Incomplete Circle of Willis" .

ʻElua mau loli maʻamau, ʻoi aku hoʻi i loko o ke kīʻaha koko i kapa ʻia ʻo Anterior Communicating Artery, aia ma ke alo o ka Circle of Willis:

• ʻO ka Fenestration: Hiki i kēia ke hoʻopilikia a hiki i ka 21% o ka heluna kanaka. ʻO ka fenestration ka wā e māhele ai kahi kīʻaha koko i ʻelua, hele i kahi mamao pōkole, a laila hui hou. Ua like ia me ke alanui e māhele ana i ʻelua a laila hui hou.
• `(Pālua)` (Pālua):Hoʻopilikia kēia i kahi 18% o nā kānaka. ʻO ke ʻano o ka "Duplication" ʻelua mau kīʻaha koko e hoʻomaka kaʻawale ana e hui pū e hana i hoʻokahi kīʻaha koko.

I kēia manawa, ke noʻonoʻo nei paha ʻoe, 'Pehea inā ʻaʻole i piha kaʻu Circle of Willis?' Mai hopohopo. ʻOiai inā ʻaʻole i piha kāu Circle of Willis, hiki iā ʻoe ke ola i kahi ola olakino me ka ʻole o nā pilikia. ʻAʻole ia e hoʻopilikia nui i ka hana o kou lolo. Eia nō naʻe, inā loaʻa iā ʻoe kahi maʻi cerebrovascular, e like me ka hahau ʻana, a laila ʻoi aku ka koʻikoʻi o nā hopena o kēlā hemahema. ʻAʻole kēia he mea hiki iā mākou ke hoʻololi me ka manaʻo. Hoʻoholo ʻia kēia e ke ʻano o ka hana ʻia ʻana o ko mākou mau kīʻaha koko i ka wā embryonic , ʻo ia hoʻi, ʻoiai mākou i loko o ka ʻōpū.

Pehea ka maʻamau o kahi (Circle of Willis) i hoʻopau ʻole ʻia?

No laila, pehea ka maʻamau o kēia `(Circle of Willis)` piha ʻole? ʻOiaʻiʻo, manaʻoʻiʻo nā kānaka noiʻi he mea maʻamau loa ia. Akā, he paʻakikī ke ʻōlelo pololei i ka maʻamau. No ka mea, ʻaʻole i loaʻa i nā kānaka a pau kahi hoʻāʻo `(Scan)` o ka lolo. Me ia `(Scan)` wale nō hiki ke ʻike pololei ʻia ke ʻano o kēia `(Circle of Willis)`. Wahi a nā haʻawina like ʻole, hiki ke piha ʻole kēia `(Circle of Willis)` ma waena o 50% a me 90% o nā pākeke . ʻO ia hoʻi, loaʻa i ka hapa nui o ka poʻe me nā ʻano like ʻole.

He aha maoli ka hana a ka Pōʻai o Willis?

E kamaʻilio hou kākou e pili ana i ke kuleana o kēia `(Circle of Willis)`. E noʻonoʻo iā ia he `(Traffic Roundabout)` kahi e hui pū ai nā alanui he nui.

Ua like kēlā me kēia aʻa e hana ana i ka `(Circle of Willis)` me ke alanui. ʻElua `(Alanui Nui)` nui, ʻo ia hoʻi, nā alanui ʻelua e lawe ana i ka nui o ke koko. ʻO ia ka ʻōnaehana `(Internal Carotid Artery)` i ʻōlelo ʻia ma mua, a me ka ʻōnaehana `(Vertebral Artery)`. Hoʻohui pū nā alanui liʻiliʻi ʻē aʻe o ka `(Circle of Willis)`, e hana ana i kahi pōʻai e hoʻopili ai i kēlā mau alaloa nui ʻelua a e ʻae i ke koko (ʻo ia hoʻi ke kaʻa) e kahe.

ʻO ka pōmaikaʻi o kēia, inā loaʻa kahi 'alanui' a i ʻole 'ulia' koke ma kēlā alaloa nui (ʻo ia hoʻi, kahi kīʻaha koko nui e hoʻolako ana i ke koko i ka lolo), hiki i ke alaloa ʻē aʻe ke hoʻouna i kekahi koko i ka ʻāpana i hoʻopilikia ʻia o ka lolo ma o kēia pōʻai. I ka ʻōlelo maʻalahi, ʻo ka loaʻa ʻana o kahi `(Circle of Willis)` piha ʻo ia hoʻi aia kekahi ala hou (`(Detour Route)`) hiki ke hoʻohana ʻia inā loaʻa kekahi ālai a pilikia paha.

Inā loaʻa iā ʻoe kahi `(Circle of Willis)` piha, hiki iā ia ke pale iā ʻoe mai kekahi mau maʻi koʻikoʻi. ʻOi aku hoʻi nā maʻi e hoʻopilikia ana i nā kīʻaha koko ma kēia `(Circle of Willis)`. Eia kekahi laʻana:

• Nā waihona momona i loko o nā kīʻaha koko (Atherosclerosis)
• Ke kahe ʻana o ke koko i loko o ka lolo (e.g., ma muli o kahi ʻeha (Intracranial Hemorrhage))
• ʻO ka maʻi Carotid Artery / Carotid Artery Stenosis
• Ka mumū ʻana o nā kīʻaha koko i loko o ka lolo (Central Nervous System Vasculitis)
• ʻO ka haki ʻana o ke kīʻaha koko i loko o ka lolo (Ruptured Brain Aneurysm)
• Hahau
• ʻO ka Transient Ischemic Attack (TIA) a i ʻole ka mini-stroke

Eia nō naʻe, inā loaʻa iā ʻoe kahi "Circle of Willis" piha ʻole, ʻaʻole hana pono ka hana pale o kēlā pōʻai. A laila, i nā maʻi e pili ana i nā kīʻaha koko o ka lolo e like me kēia, ʻoi aku ka kiʻekiʻe o ka pilikia o nā hopena koʻikoʻi, ʻoi aku hoʻi i ka hihia o ka hahau ʻana.

Aia ma hea kēia (Circle of Willis)?

Makemake paha ʻoe e ʻike pono i kahi o kēia `(Circle of Willis)`. Aia ia ma ka `(Base of your Brain)`, ma kahi hakahaka ma waho iki o ka ʻiʻo lolo (`(Subarachnoid Space)`). Aia ia a puni ke kumu o ko kākou `(Pituitary Gland)`, ma lalo pono o ka `(Hypothalamus)`. Eia kekahi, hele kekahi o ko kākou mau aʻalolo cranial (`(Cranial Nerves)`) kokoke i kēia `(Circle of Willis)`.

Āhea wau e nīnau ai i ke kauka e pili ana i kēia (Circle of Willis)?

I kēia manawa, ke noʻonoʻo nei paha ʻoe, 'Āhea wau e lohe ai e pili ana i kēia `(Circle of Willis)` mai kaʻu kauka?' ʻĀ, aia paha kekahi mau kumu no kēlā:

• Inā loaʻa iā ʻoe kahi aneurysm lolo: ʻO ka Circle of Willis kekahi o nā wahi maʻamau i ka lolo kahi e ulu ai nā aneurysms. Wahi a nā kānaka noiʻi ma kahi o 85% o nā aneurysms intracranial e kū mai ana ma kahi o ke kahe koko ma mua o ka Circle of Willis.
• Inā loaʻa iā ʻoe kahi hahau: Hiki ke loaʻa kahi hahau ma muli o kahi ālai ʻana a i ʻole ke kahe ʻana o ke koko i loko o kahi kīʻaha koko ma ka Circle of Willis.
• Inā loaʻa iā ʻoe ka maʻi Moyamoya: He maʻi lolo laha ʻole kēia. Hana ʻia ia i ka wā e emi mālie ai a ālai ʻia paha nā kīʻaha koko i loko o kou Circle of Willis, ka mea e hoʻolako ana i ke koko i mua o kou lolo.
• Inā loaʻa iā ʻoe ka 'Subclavian Steal Syndrome': Hana ʻia kēia ke ʻoki ʻia a ālai ʻia paha kou 'Subclavian Artery' (ke axillary artery). A laila 'ʻaihue' ia i kekahi o ke koko e pono e hele i kou lolo ma o kou 'Vertebral Artery' (kahi kīʻaha koko nui ma ka 'Circle of Willis').
• Inā hana ʻia ke ʻoki ʻana ma kou lolo: I ka wā o ke ʻoki ʻana ma kēia ʻāpana o kou lolo - no ka laʻana, e mālama i kahi aneurysm a i ʻole kahi pilikia me kāu pituitary gland - aia kahi pilikia liʻiliʻi o ka hōʻino ʻana i kāu Circle of Willis a me nā ʻāpana koʻikoʻi a puni ia. Inā hōʻino ʻia ka Circle of Willis ponoʻī, hiki iā ia ke hana i kahi ālai ʻana i ke kahe koko i ka lolo (Brain Ischemia) a i ʻole ka nalowale piha ʻana o ke kahe koko (Infarction).
• Inā ʻoe e hana i kahi scan lolo:Inā loaʻa iā ʻoe kahi scan lolo, e like me ka angiogram cerebral a i ʻole ka MRI lolo (Magnetic Resonance Imaging), hiki i kāu hōʻike ke komo pū me nā kikoʻī e pili ana i ka Circle of Willis a me kona ʻano.

He aha ka mea e hana ʻia inā ua ālai ʻia ka (Circle of Willis)?

E noʻonoʻo i ka mea e hiki mai ana inā he poloka ma kekahi wahi o kēia `(Circle of Willis)`. ʻO ka mea paha, inā hana ʻia kēlā, hiki ke loaʻa kahi `(Stroke)`. Eia naʻe, e like me kaʻu i ʻōlelo ai ma mua, inā loaʻa iā ʻoe kahi `(Circle of Willis)` piha, hiki iā ia ke pale iā ʻoe i kekahi ʻano mai nā hōʻailona koʻikoʻi o ka hahau ʻana.

He aha ke ʻano o ka "Circle of Willis Syndrome"?

Ua kapa pū kekahi mau kauka a me nā kumu lapaʻau i ka `(Moyamoya Disease)` i ʻōlelo mua ʻia ʻo `(Circle of Willis Syndrome)`. ʻO kekahi inoa no `(Moyamoya Disease)` ʻo `(Spontaneous Occlusion of the Circle of Willis)`.

He aha kā kākou e hana ai e mālama i ke olakino o kēia (Circle of Willis)?

No laila, he aha kā mākou e hana ai e mālama i kēia "Circle of Willis" koʻikoʻi a me nā kīʻaha koko ʻē aʻe i loko o ka lolo i ke olakino? ʻO ka mea nui loa, ʻo ia ke kāohi i nā kumu pilikia no ka hoʻomohala ʻana i ka maʻi cerebrovascular inā loaʻa iā ʻoe. ʻO kēia mau kumu pilikia:

• Ke koko kiʻekiʻe
• Kolesterol kiʻekiʻe
• ʻO ka maʻi diabetes (Diabetes Mellitus)
• Maʻi puʻuwai
• Ke kaumaha mau loa
• Momona
• Ka maʻi puhi paka / hoʻohana nikotine
• Ka maʻi hoʻohana ʻona

He mea nui loa e kamaʻilio me kāu kauka e pili ana i nā ala e mālama ai i kēia mau kūlana.

E hoʻomanaʻo kākou (Leka Lawe-Home)

ʻAe, he aha nā mea nui e lawe ʻia mai ka mea a mākou i kamaʻilio ai i kēia lā?

He ʻōnaehana kupaianaha o nā kīʻaha koko ka "Circle of Willis" ma ke kumu o ko kākou lolo e hoʻolako ana i ke koko i ka lolo. Ua like ia me kahi ʻupena palekana.

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ʻAʻole i loaʻa i nā kānaka a pau kēia piha, a he mea maʻamau ia. ʻAʻohe mea e hopohopo nui ai inā ʻaʻole i piha, akā i kekahi mau maʻi lolo, ʻoi aku ka kiʻekiʻe o ka pilikia.

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ʻO ka mea nui loa, ʻo ia ke ola ʻana i kahi ʻano e mālama ai i ke olakino o nā kīʻaha koko o ko kākou lolo a pale aku i nā maʻi e like me ka hahau ʻana. ʻO ia hoʻi ka hoʻomohala ʻana i nā ʻano maikaʻi a me ka kaohi ʻana i nā mea pilikia i ʻōlelo ʻia ma luna.

He nui ka poʻe i lohe ʻole paha e pili ana i kā lākou `(Circle of Willis)`. Eia nō naʻe, inā he maʻi lolo kou, e like me ka `(Aneurysm),` ua haʻi aku paha kekahi kauka iā ia.Inā ʻōlelo kāu kauka i kahi huaʻōlelo lapaʻau āu i maopopo ʻole ai, mai makaʻu e noi i kahi wehewehe. Loaʻa iā ʻoe nā kuleana āpau e ʻike i ka mea e hana nei i loko o kou kino.

ʻApo o Willis, ke kahe ʻana o ka lolo, ka hahau ʻana, ke apo o ke aʻa lolo, nā kīʻaha koko i loko o ka lolo, ke olakino o ka lolo, aneurysm