He pilikia kīʻaha koko kūpono ʻole paha kou i loko o kou poʻo? (Dural Arteriovenous Fistula - dAVF) E kamaʻilio kākou e pili ana i kēia!

Ke lohe nei ʻoe i kekahi manawa i kahi walaʻau i loko o kou poʻo? A i ʻole he pinepine kou poʻo ʻeha? Manaʻo paha ʻoe he mea maʻamau kēia mau mea, akā i kekahi manawa aia kekahi mea ma hope o kēia e pono ai ka nānā ʻana. ʻO ia ka mea i kapa ʻia he dural arteriovenous fistula (dAVF) . E kamaʻilio maʻalahi kākou e pili ana i ia mea.

He aha ka dural arteriovenous fistula (dAVF)?

I ka ʻōlelo maʻalahi, aia kahi membrane pale lahilahi a puni ko mākou lolo a me ke kaula iwi kuamoʻo. ʻO kēia ka mea a mākou e kapa nei ʻo dura mater . Ua like ia me ka uhi hope o kahi puke.

I kēia manawa, e nānā, loaʻa iā kākou kahi pūnaewele o nā kīʻaha koko e lawe i ke koko i nā ʻāpana a pau o ko kākou kino. Lawe nā aʻa i ke koko maʻemaʻe a waiwai i ka oxygen mai ka puʻuwai a i nā ʻōpū ʻē aʻe a pau, me ka lolo. Lawe nā aʻa koko i ke koko i hoʻohana ʻia a nele i ka oxygen i ka puʻuwai. Ma waena o kēia mau aʻa koko a me nā aʻa koko, aia kahi pūnaewele maikaʻi loa o nā kīʻaha koko, a mākou e kapa nei he capillaries . Hoʻomalu kēia mau capillaries i ke kahe o ke koko a hāʻawi pono i ke koko i nā ʻōpū.

I kēia manawa, ma kēia kūlana i kapa ʻia ʻo fistula , pili pololei kahi aʻa i kahi vein, me ka ʻole o ka ʻōnaehana waena o nā capillaries. E noʻonoʻo me he mea lā ua hoʻopili koke ʻia kahi paipu wai nui i kahi paipu liʻiliʻi. A laila, holo wikiwiki ke koko i loko o kēlā aʻa me ka wikiwiki a ma lalo o ke kaomi kiʻekiʻe. ʻAʻole maʻa kahi aʻa i kēlā nui o ke koko a me kēlā nui o ke kaomi.

No laila, ʻo kēia mea i kapa ʻia ʻo dural arteriovenous fistula (dAVF) he pilina maʻamau ʻole ia ma waena o kahi aʻa a me kahi vein i loko o ka dura mater, ka membrane e hoʻopuni ana i ka lolo. I kekahi manawa hiki i kāu kauka ke kapa i kēia he dural arteriovenous malformation .

Hiki i kēia pilina kūpono ʻole ke hoʻolilo i ke koko i loko o nā kīʻaha koko i mea paʻa ʻole, hiki ke loli ke ʻano o nā kīʻaha koko, a ʻaʻole paha e kahe ke koko i ke ala e pono ai. I kekahi manawa, hiki ke pohā kahi kīʻaha koko no ka mea ʻaʻole hiki iā ia ke hoʻomanawanui i ke kaomi kiʻekiʻe. Inā hana ʻia kēlā, hiki ke hoʻoulu i ke kahe koko e hoʻoweliweli i ke ola.

Pehea ka maʻamau o kēia ʻano?

ʻOiaʻiʻo, ʻaʻole maʻamau kēia kūlana (dAVF) . No ka laʻana, ma ʻAmelika Hui Pū ʻIa, ua ʻōlelo ʻia e kū mai ana ma ka helu ma waena o 0.15 a me 0.19 no 100,000 poʻe i kēlā me kēia makahiki. ʻO ia hoʻi, he mea kākaʻikahi loa ia.

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He kūlana koʻikoʻi anei kēia (dAVF)?

Eia ke ʻano o ka hana ʻana. He ʻoluʻolu loa kekahi (dAVF) a ʻaʻole ia e hoʻoulu i nā pilikia olakino nui. Eia nō naʻe, he koʻikoʻi loa kekahi a hiki ke hoʻoweliweli i ke ola. ʻOi loa inā pohā a kahe ke koko o kahi kīʻaha koko, e like me ka mea i ʻōlelo ʻia ma luna, hiki iā ia ke hōʻino i nā ʻiʻo lolo a hana i ka hahau .

ʻO ka mea nui loa, ʻo ia ke ʻike koke i ke kauka inā loaʻa iā ʻoe kekahi mau hōʻailona. Inā ʻike ʻoe a i ʻole kekahi mea kokoke iā ʻoe i nā hōʻailona o ka hahau ʻana (e.g., nāwaliwali ma kekahi ʻaoʻao, ʻōlelo palahalaha, nalowale o ka ʻike), pono ʻoe e kāhea koke i ka 911 a i ʻole ke keʻena pilikia kokoke loa.

He aha nā hōʻailona o (dAVF)?

I kekahi manawa ʻaʻole paha ʻoe e loaʻa i kekahi mau hōʻailona ʻoiai inā loaʻa iā ʻoe kahi (dAVF) . Akā inā loaʻa iā ʻoe nā hōʻailona, ​​​​hiki iā lākou ke ʻano mai ka liʻiliʻi a i ka koʻikoʻi. ʻOkoʻa nō hoʻi nā hōʻailona ma muli o kahi o ka lolo i loaʻa ai ka fistula. E nānā i kēia mau mea:

• ʻEha poʻo: ʻAʻole paha he ʻeha poʻo maʻamau wale nō, akā he ʻano ʻeha poʻo hou i kekahi manawa ʻoi aku ka koʻikoʻi.
• Ka luaʻi a me ka luaʻi: ​​Hiki ke hana i kēia mau mea, ʻoiai me nā poʻo ʻeha.
• Pulsatile tinnitus: He hōʻailona kikoʻī loa kēia. Ua like ia me ke kani "kani" a i ʻole "buzzing" i loko o kou pepeiao, e like me kou puʻuwai. Ua wehewehe pū kekahi poʻe iā ia he "kani kani i loko o kou pepeiao."
• Nā loli o ka ʻike: Ka pohihihi koke o ka ʻike, ka ʻike pālua, a i ʻole ka manaʻo o ka maopopo ʻole o ka ʻike.
• Nā pilikia ma ka ʻōlelo a i ʻole ka ʻōlelo: Ke hūpō o nā huaʻōlelo, me he mea lā ʻaʻole hiki ke ʻōlelo.
• Ka nalowale ʻana o ke kaulike i ka wā e hele ana, ka pilikia o ka kaohi ʻana i nā lālā i ka wā e hana ana.
• Ka nāwaliwali o nā ʻiʻo a i ʻole ka mae ʻana o ka ʻiʻo: He manaʻo o ka mae ʻana a i ʻole ka nāwaliwali ma kekahi ʻaoʻao o ka lima, ka wāwae, a i ʻole ka maka.
• ʻEha ma ka maka, nā lima, a i ʻole nā ​​wāwae.
• Poho ka hoʻomanaʻo.
• Nā manaʻo a i ʻole nā ​​​​​​mea i kū ʻole i ke ʻano.

ʻO ka maʻamau, hoʻokumu ʻia kēia mau hōʻailona e ke kahe ʻana o ke koko i loko o kou lolo . No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​e ʻike koke i ke kauka.

He aha nā kumu o kēia (dAVF)?

ʻAʻole maopopo loa i nā kauka ke kumu o ka dAVF . Eia nō naʻe, manaʻo ka nui o nā kānaka ʻepekema hiki ke hana ʻia e ka trauma poʻo . Hiki ke ʻike ʻia i nā makahiki ma hope o ka ʻeha. Manaʻo kekahi mau noiʻi e pili ana ia i kahi paʻa ʻana o nā kīʻaha koko e lawe ana i ke koko i ka lolo. Hiki ke hana ʻia kēia paʻa ʻana e kahi maʻi, kahi ulia, a i ʻole kekahi hanana ʻē aʻe. Eia kekahi laʻana:

• ʻO ke koko paʻa (Thrombosis).
• ʻEha lolo traumatic.
• ʻO ke ʻoki lolo, e like me ke craniotomy.

I kekahi manawa, hiki ke hānau ʻia kekahi me kēia (dAVF) , akā, ʻaʻole ia he mea hoʻoilina. Ke noiʻi ʻia nei kēia maʻi.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i kēia (dAVF)?

Hiki ke loaʻa kēia maʻi (dAVF) i kēlā me kēia makahiki, akā ʻoi aku ka maʻamau i nā pākeke ma waena o 40 a me 60 mau makahiki .

He aha nā pilikia e hiki mai ana o (dAVF)?

ʻO nā pilikia i hoʻokumu ʻia e kēia (dAVF) hiki ke hoʻoweliweli i ke ola i kekahi manawa. ʻO nā mea nui:

• Ke kahe ʻana o ke koko i loko o ka ʻiʻo o ka lolo (hemorrhage).
• Ke kahe ʻana o ke koko i loko o ke poʻo, akā ma waho o ka lolo (Subdural hematoma).
• Ke kahe ʻana o ke koko ma waena o ka lolo a me ka membrane pale e hoʻopuni ana iā ia (Subarachnoid hemorrhage).
• Hoʻonui ʻia ke kaomi i loko o ke poʻo (kaomi intracranial).
• Nā ʻōʻili.
• Hahau.

E noʻonoʻo, he aha ka mea e hana ʻia inā hemo koke kahi piula wai liʻiliʻi i pili i ka paipu nui e lawe mai ana i ka wai i ka pahu wai o ko mākou hale? E piha ana ka wai ma ka hale a pau. ʻO ia ka mea e hana ʻia inā pohā kahi kīʻaha koko i loko o ka lolo. ʻO ia ke kumu he mea weliweli loa kēia.

Pehea e ʻike ʻia ai kēia maʻi (dAVF)?

Hoʻoponopono ke kauka i kēia kūlana (dAVF) ma hope o kēia mau hana:

• Hoʻokolokolo kino.
• He hoʻokolohua e pili ana i ka ʻōnaehana nerve.
• Nā hoʻokolohua kiʻi kūikawā.

I ka wā e hana ai i kēia mau hoʻokolohua, e nīnau kāu kauka iā ʻoe e pili ana i kāu mau hōʻailona a me nā kikoʻī e pili ana i kāu mau maʻi ma mua.

I kekahi manawa, ʻaʻohe ou hōʻailona a hiki ke ʻike ʻia ma kahi ulia ke loaʻa iā ʻoe kahi hoʻāʻo kiʻi o kou lolo a i ʻole ka iwi kuamoʻo no kekahi kumu ʻē aʻe.

Nā hoʻokolohua kūikawā e kōkua i ka ʻike ʻana (dAVF)

Hiki i ke kauka ke kiʻi i kahi kiʻi maikaʻi o kou mau kīʻaha koko a hoʻohana i nā hoʻokolohua e like me kēia e ʻike ai inā loaʻa iā ʻoe kēia (dAVF) :

• ʻO kahi scan MRI (Magnetic Resonance Imaging) a i ʻole kahi scan MRA (Magnetic Resonance Angiography).
• Hoʻāʻo CT Angiography (CTA - Computed Tomography Angiography).

ʻAʻohe ʻeha o kēia mau hoʻāʻo ʻelua a ʻaʻole hoʻi e hoʻoluhi nui. Hiki iā lākou i kāu kauka ke kiʻi i kahi kiʻi maopopo o nā kīʻaha koko i loko o kāu ʻōnaehana nerve, ka mea paha ke kumu o kāu mau hōʻailona.

Inā hāpai kahi hoʻokolohua kiʻi e like me kēia (dAVF) i nā hopohopo, e kamaʻilio kāu mau kauka me ʻoe e pili ana i kahi hoʻokolohua kūikawā ʻē aʻe i kapa ʻia he angiogram cerebral .

He hoʻāʻo ʻole invasive ka angiogram cerebral e hiki ke hana i nā kiʻi maikaʻi loa a maopopo loa o nā kīʻaha koko i loko o kou lolo. Ma kēia hoʻāʻo, hoʻokomo nā kauka i kahi ʻōmole liʻiliʻi loa - kapa mākou iā ia he catheter - i loko o kahi kīʻaha koko ma kou pulima a i ʻole ka wāwae luna, a hoʻokomo iā ia ma o kahi aʻa koko ma kou ʻāʻī i nā kīʻaha koko i loko o kou lolo. A laila, ma o kēlā catheter , hoʻokomo ʻia kahi wai kūikawā.Hoʻokomo ʻia kahi mea hoʻohālikelike i loko o ke kino. Ke hui pū ʻia me kou koko, hiki ke ʻike ʻia ma nā wikiō X-ray i ke kahe ʻana o ke koko ma o nā aʻa i loko o ka lolo a hoʻi mai nā aʻa. ʻO kēia ka mea e hiki ai i nā kauka ke hoʻoholo pono i ke ʻano o ka dAVF a me ke ʻano o ka lāʻau lapaʻau maikaʻi loa no ia.

Aia kekahi lāʻau lapaʻau no kēia maʻi (dAVF)?

ʻAe, hiki i ka lāʻau lapaʻau ke wehe i kēia fistula a hoʻihoʻi i ke kahe koko maʻamau i loko o nā aʻa. Hiki i kēia ke hōʻemi a pale paha i nā hōʻailona hou a me nā pilikia.

Pehea e mālama ʻia ai (dAVF)?

ʻO ka pahuhopu nui o kēia lāʻau lapaʻau (dAVF) ʻo ia ka hoʻopau ʻana i ka pilina maʻamau ʻole (fistula) ma waena o ke aʻa a me ke aʻa. Aia paha kekahi mau koho lapaʻau e like me:

• ʻOki kino: Hiki ke hana ʻia ke ʻoki kino hāmama e wehe i ka pilina maʻamau ʻole (fistula) i loko o ke kīʻaha koko i hoʻopilikia ʻia.
• ʻO ka embolization endovascular: Ma kēia, e like me ka mea i ʻōlelo ʻia ma mua, ua hoʻokomo ʻia kahi ʻōmole liʻiliʻi loa (catheter) ma kekahi o kou mau aʻa, i kahi o ka fistula, a ua pani ʻia. Ua like ia me ke kau ʻana i kahi sila ma kahi leaka.
• ʻO ke ʻoki kino radiotactic: He ʻano radiation therapy kēia. Ma kēia, ua kuhikuhi pono ʻia nā kukuna radiation i ke kīʻaha koko i hoʻopilikia ʻia kahi e pili ai ka fistula, e ālai ana iā ia.

Na kāu kauka e hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa nāu. E hilinaʻi kēia i nā kumu he nui, me ke ʻano o ka (dAVF) , kou olakino laulā, nā hōʻailona, ​​a me kou pilikia o ke kahe ʻana o ke koko a i ʻole nā ​​​​pilikia.

Inā ʻaʻohe ou hōʻailona, ​​ʻaʻole paha e mālama koke kāu kauka iā ʻoe, akā e nānā mau paha iā ʻoe e pale i nā pilikia.

He aha ka wānana o (dAVF)?

Aia kou wānana ma nā kumu he nui, e like me kahi o ka fistula a inā he kahe koko. Inā ʻike ʻia a mālama ʻia i ka wā mua, maikaʻi ka wānana. ʻO ka mea pōʻino, hiki i kekahi (dAVF) ke hana i nā pilikia mau loa a i ʻole e hoʻoweliweli i ke ola. Inā loaʻa kēlā mau pilikia, aia nā lawelawe mālama ma hope a me ke kākoʻo e kōkua, e like me ka hoʻōla kino , ka hoʻōla hana , a me ka hoʻōla ʻōlelo .

ʻO kāu kauka ke kanaka hiki ke hāʻawi iā ʻoe i ka nānā pololei loa e pili ana i kou kūlana.

Ka helu ola mai (dAVF)

No ka mea, ʻaʻole maʻamau loa kēia kūlana (dAVF) , ke hoʻomau nei ka noiʻi ʻana i nā helu ola. Hōʻike nā haʻawina o kēia manawa ua emi ka nui o ka make makahiki mai kēia kūlana.Ua manaʻo ʻia ma waena o 11% a me 19%. ʻO ke ʻano kēia, i kekahi mau hihia, hiki ke manaʻo ʻia ka nui o ke ola makahiki ma mua o 80%.

Hiki ke pale ʻia kēia kūlana (dAVF)?

ʻAʻohe ala i ʻike ʻia e pale aku ai i kēia maʻi (dAVF) . Eia nō naʻe, hiki iā ʻoe ke hōʻemi i kou pilikia ma ka kaohi ʻana i nā kūlana olakino ma lalo (e like me nā maʻi ʻaʻa koko) e hiki ai ke alakaʻi i kēia maʻi. Hiki iā ʻoe ke pale iā ʻoe iho mai nā ʻeha poʻo ma ke kau ʻana i nā lako pale kūpono i ka wā e pāʻani ana i nā haʻuki a me nā hana ʻē aʻe.

I ka manawa hea e pono ai iaʻu ke ʻike i ke kauka?

E ʻike i ke kauka inā ʻike ʻoe i kekahi o kēia mau hōʻailona:

• He ʻeha poʻo nui a koke.
• Ka nāwaliwali o nā ʻiʻo a i ʻole ka mae ʻana o ka ʻiʻo.
• Nā loli i kāu ʻōlelo, hele wāwae, kaulike, a i ʻole ʻike.
• Hoʻomaka hou, kani ʻana i nā pepeiao (Pulsatile tinnitus).

Inā ʻike ʻoe a i ʻole kekahi mea kokoke iā ʻoe i nā hōʻailona o ka hahau ʻana (e laʻa, nāwaliwali ma kekahi ʻaoʻao, ʻōlelo palahalaha, nalowale o ka ʻike), pono ʻoe e kāhea koke i ka 911 a i ʻole ke keʻena pilikia kokoke loa. He mea nui ka manawa!

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Ke ʻike ʻoe i ke kauka, he mea maikaʻi ke nīnau i nā nīnau e like me kēia:

• Aia i hea kēia fistula?
• He aha ke koho lapaʻau āu e paipai nei?
• Pono maoli anei au i ke ʻoki kino?
• He aha nā hopena ʻaoʻao o kēia lāʻau lapaʻau?
• Hiki ke ulu hou kēia fistula ma hope o ka mālama ʻia?
• ʻEhia ka lōʻihi ma mua o koʻu hoʻi ʻana mai no nā hoʻokolohua?

ʻO ka mea hope loa, leka lawe i ka home

ʻO kēia kūlana, i kapa ʻia ʻo dural arteriovenous fistula (dAVF), hiki ke loaʻa kahi hopena nui a liʻiliʻi paha i kou ola. I kekahi mau hihia, hiki ke lilo i pilikia liʻiliʻi e hiki ke mālama maʻalahi ʻia ma lalo o ka nānā ʻana a ke kauka. Eia nō naʻe, inā ʻaʻole i ʻike ʻia a mālama koke ʻia, hiki iā ia ke alakaʻi i nā pilikia mau loa a i ʻole nā ​​​​pilikia e hoʻoweliweli i ke ola.

Inā loaʻa iā ʻoe kekahi mau hōʻailona a i ʻole hopohopo paha no kekahi mea, e kāhea koke i ke kauka a i ʻole ke keʻena pilikia. Aia nā lāʻau lapaʻau e hiki ke kōkua i ka wehe ʻana i ka fistula a hoʻihoʻi i ke kahe koko i nā ʻāpana āpau o kou kino. Aia kekahi mau koho lapaʻau like ʻole, ʻaʻole pono nā mea āpau i ke ʻoki kino wehe. E loiloi kāu hui lapaʻau i kāu mau hōʻailona a hoʻoholo i ka hoʻolālā lapaʻau maikaʻi loa no ʻoe e pale aku i nā pilikia.

ʻO ʻoe ka mea ʻike maikaʻi loa i kou olakino. No laila, inā ʻike ʻoe i kekahi mau loli i kou kino, mai hoʻowahāwahā iā ia. ʻO ka hana wikiwiki ʻana hiki ke pale i nā maʻi koʻikoʻi he nui.

ʻO ka fistula arteriovenous dural, dAVF, nā kīʻaha koko lolo, ʻeha poʻo, pulsatile tinnitus, kahe koko lolo, hahau