Ua paʻakikī koke anei kou makuahine, makuakāne, a kupuna wahine paha i ka hele wāwae? Ke hele mālie nei ʻo ia? A i ʻole ke manaʻo nei ʻoe e emi mālie ana kou hoʻomanaʻo? Manaʻo pinepine mākou he mau mea maʻamau kēia e hana ʻia i ko mākou wā ʻelemakule. Akā i kekahi manawa, hiki i kēia ke lilo i mau hōʻailona o kahi maʻi hiki ke mālama ʻia. Pēlā nō, ʻo NPH kahi maʻi i kuhihewa ʻia e ka poʻe he nui no ka dementia, akā he maʻi hiki ke mālama ʻia. E ʻike kākou i nā mea hou aʻe e pili ana i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka NPH?
ʻO ke ʻano piha o NPH ʻo ia ka Normal Pressure Hydrocephalus. Ma ka ʻōlelo Sinhala, ʻo ia hoʻi "normal pressure hydrocephalus". Akā, ʻoi aku ka maʻalahi o ka hoʻomaopopo ʻana ma mua o kēlā huaʻōlelo ke ʻike ʻoe he mea kēia e hana nei i ka lolo.
I ka ʻōlelo maʻalahi, ʻo NPH kahi kūlana kahi e hōʻiliʻili ai ke wai i loko a puni o ko kākou lolo (kapa mākou ma ke ʻano lapaʻau he Cerebrospinal Fluid - CSF) a hoʻopilikia i ka hana o ka lolo. ʻO kēia wai, i kapa ʻia ʻo CSF, hānai i ko kākou lolo a kōkua i ka wehe ʻana i nā huahana ʻōpala mai ka lolo. ʻO kēia wai hoʻi e pale ai i ka lolo mai ka hoʻokuke ʻia ʻana a puni i loko o ke poʻo a me ke kumu ʻana i nā ʻeha.
Aia i loko o ka lolo o ka pākeke maʻamau ma kahi o 150 mililita o kēia wai. Ke hana mau nei ko mākou kino i kēia wai, e hoʻopuni ana iā ia, a e omo hou ana i ka wai kahiko. Inā e hana pono ana kēia pōʻaiapuni, ʻaʻohe pilikia.
Akā i ke ʻano o NPH, no kekahi kumu, ua pilikia ka reabsorption a i ʻole ke kahe ʻana o kēia wai. A laila, hoʻomaka mālie kēia wai e hōʻiliʻili i loko o nā ventricles i loko o ka lolo. No ka mea, hana pinepine kēia, ʻaʻole e piʻi koke ke kaomi i loko o ka iwi poʻo. ʻO ia ke kumu i kapa ʻia ai ʻo "Normal Pressure". Akā i ka hala ʻana o ka manawa, hoʻomaka kēia wai i hōʻiliʻili ʻia e ʻomi i ka ʻiʻo o ka lolo a hōʻino iā ia. ʻO ia ka manawa e ʻike ʻia ai nā hōʻailona o NPH.
ʻO wai ka mea kūpono loa e loaʻa i kēia kūlana NPH?
He maʻi ka NPH e hoʻopilikia pinepine ʻia ai ka poʻe ma luna o 65 mau makahiki. Piʻi ka pilikia o ka loaʻa ʻana o kēia maʻi me ka makahiki. ʻO ka awelika o ka makahiki o ka hoʻomaka ʻana ma kahi o 70 mau makahiki.
ʻAʻole kēia e hilinaʻi i nā mea e like me ka lāhui, ka hoʻomana, a i ʻole ke kāne. ʻO ka ʻelemakule ke kumu nui o ka pilikia. Wahi a nā helu helu, 0.2% o ka poʻe ma waena o 70 a me 80 mau makahiki a me 5.9% o ka poʻe ma luna o 80 mau makahiki i loaʻa i kēia maʻi. ʻO ia hoʻi, ʻoi aku ma mua o 8 miliona mau kānaka ma ka honua holoʻokoʻa e ʻeha nei i kēia maʻi.
He aha nā hōʻailona nui o ka NPH? "Hakim's Triad"
ʻEkolu mau hōʻailona nui o ka NPH. ʻIke mālie ʻia kēia mau mea ma kahi o 3 a 6 mau mahina. Kāhea nā kauka i kēia mau hōʻailona nui ʻekolu ʻo "Hakim's Triad." Ma waena o 50% a me 75% o nā maʻi NPH e ʻike pū i nā hōʻailona ʻekolu.
E nānā kākou i kēia mau ʻano ʻekolu.
| Hōʻailona | Wehewehena |
|---|---|
| 1. Nā pilikia hele wāwae | ʻO kēia ka hōʻailona maʻamau o ka NPH. Loaʻa i ka 80% - 95% o nā maʻi kēia. Manaʻo ia ua paʻa ko lākou mau wāwae i ka honua. He mea paʻakikī loa ke hāpai i kahi ʻanuʻu. He liʻiliʻi loa nā ʻanuʻu, me he mea lā e kauō ana nā wāwae ma ka honua. No laila, ke hāʻule mau nei lākou. I kekahi manawa kū koke lākou i ka wā e hele ana, me he mea lā ʻaʻole hiki iā lākou ke noʻonoʻo pehea e lawe ai i ka ʻanuʻu aʻe. Hiki ke ʻike ʻia lākou e hele ana me ko lākou kaumaha ma nā ʻaoʻao ʻelua, e like me ka penguin. |
| 2. Hiki ʻole ke kāohi i ka mimi (Urinary Incontinence) | Hoʻomaka ia me ka pono e mimi pinepine. A i ka wā e pono ai ʻoe e mimi, manaʻo ʻoe i kahi makemake nui e mimi. I ka hala ʻana o ka manawa, hoʻomaka ʻoe e hoʻokahe i ka mimi me ka ʻike ʻole. Hilahila kekahi poʻe i kēia, akā ma muli o ka hana o ka lolo i hōʻino ʻia, ʻaʻole paha e ʻike kekahi poʻe maʻi ua hoʻokahe lākou i ka mimi. |
| 3. Nā pilikia noʻonoʻo | Ua like loa kēia me ka dementia. Hoʻemi ʻia ka wikiwiki o ka noʻonoʻo a me ka hana. Hana lohi loa nā mea āpau. Hoʻemi ʻia ka hoʻomanaʻo, a poina pinepine ʻia nā mea. Lilo ia i mea paʻakikī ke hoʻoholo a me ka kaohi ʻana i nā manaʻo. Nalo ʻoe i nā mea āpau āu i hauʻoli ai. |
ʻO ka mea nui loa, ʻo ia ke ʻimi i ka ʻōlelo aʻo lapaʻau, ma mua o ka hoʻokuke ʻana i kēia mau hōʻailona ma ke ʻano he ʻāpana maʻamau o ka ʻelemakule, no ka mea, he maʻi hiki ke mālama ʻia ka NPH.
No ke aha i ulu ai kēia NPH? He aha nā kumu?
ʻElua ʻano nui o NPH, ma muli o nā kumu.
1. NPH Mua (Idiopathic)
ʻO kēia ke ʻano maʻamau. Ma kahi o ka hapalua o nā maʻi i loaʻa i kēia ʻano. ʻO ke ʻano "Idiopathic" ʻaʻole ʻike ʻia ke kumu pololei.I kēia manawa, ua manaʻoʻiʻo ʻia ua hana ʻia kēia ma muli o kekahi mau loli i ke kahe ʻana o ke koko a me ka omo ʻana o ka wai CSF i loko o ka lolo i ko kākou wā ʻelemakule.
2. NPH Lua
Hana ʻia kēia ma muli o kekahi maʻi a i ʻole ulia paha. ʻO ia hoʻi, aia kekahi kumu e hoʻopilikia nei i ke kahe ʻana o ka wai CSF i loko o ka lolo. ʻO kekahi o kēia mau kumu:
- Nā ʻeha lolo traumatic
- Nā puʻupuʻu lolo
- Hahau
- Ke kahe koko ʻana o loko o ke poʻo
- ʻAneurysm o ka lolo
- Nā maʻi lolo e like me ka meningitis
- ʻO ke ʻoki lolo
Pehea e ʻike pololei ai ke kauka i ka NPH?
Hiki ke paʻakikī ka ʻike ʻana i ka NPH no ka mea ua like loa kona mau hōʻailona me nā maʻi dementia e like me ka maʻi Alzheimer. I kekahi manawa, hiki ke hele pū ʻia ka NPH me ka maʻi Alzheimer.
Hoʻohana ke kauka i kekahi mau hoʻokolohua e ʻike ai i kēia maʻi.
- Hoʻokolohua kino a me ka neurological: E nānā ke kauka i kou hele ʻana, ke kaulike, nā reflexes, a me ka ikaika o nā ʻiʻo.
- Ke nīnau ʻana e pili ana i nā hōʻailona a me ka mōʻaukala olakino: E nīnau i kou ʻohana e pili ana i ke ʻano o ka hoʻomaka ʻana o kēia mau hōʻailona a me ka lōʻihi o ko lākou noho ʻana.
- ʻO ke scan lolo: ʻO kēia ka hoʻāʻo koʻikoʻi loa. Hiki i kahi scan MRI (Magnetic Resonance Imaging) ke ʻike maopopo inā ua hoʻonui ʻia nā ventricles, kahi e hōʻiliʻili ai ka wai CSF. I kekahi manawa hana ʻia kahi scan CT (Computed Tomography) e kāpae i nā kūlana ʻē aʻe.
- ʻO Spinal Tap / Lumbar Puncture: He hoʻāʻo koʻikoʻi loa kēia. Maanei, hoʻokomo ʻia kahi nila liʻiliʻi i loko o ke kaula spinal a lawe ʻia kahi hāpana o ka wai CSF. Hiki ke hoʻohana ʻia kēia e nānā i nā maʻi ʻē aʻe. Eia kekahi, ʻo ka mea nui loa, he mea nui e ʻike inā e hoʻomaikaʻi iki nā hōʻailona o ka mea maʻi, e like me ka paʻakikī i ka hele wāwae, ma hope o ka wehe ʻana i kekahi o nā wai CSF keu. Inā hana ia, he hōʻailona ikaika ia e loaʻa ana ka NPH.
Aia kekahi lāʻau lapaʻau no kēia? Hiki ke ho'ōla ʻia?
ʻAe! ʻO kēia ka nūhou maikaʻi e pili ana iā NPH. ʻOiai ke ʻano like me ka dementia, he maʻi hiki ke mālama ʻia ka NPH. ʻAʻole maikaʻi loa nā lāʻau lapaʻau. ʻO ke ʻoki kino ka lāʻau lapaʻau nui a maikaʻi loa.
ʻO kēia ʻoki kino e pili ana i ka hoʻopili ʻana i kahi mea liʻiliʻi e like me ka paipu i kapa ʻia he shunt i ka lolo.
- E noʻonoʻo i kēia me he paipu lā e hoʻokuʻu ana i ka wai keu.
- Hoʻopili ʻia kekahi ʻaoʻao o kēia shunt i kahi keʻena i loko o ka lolo kahi i hōʻiliʻili ʻia ai ka wai CSF.
- Hoʻokomo ʻia kekahi ʻaoʻao ma lalo o ka ʻili i loko o ka lua ʻōpū (ʻōpū) a i ʻole ka umauma.
- ʻO ke kahe CSF keu e hōʻiliʻili ana i loko o ka lolo a laila hele i lalo o kēia ʻōmole a ninini i loko o kahi e like me ka lua ʻōpū, kahi e hiki ai i ke kino ke omo hou i ka wai.
Ma hope o kēia ʻoki kino, hoʻomaka nā hōʻailona o nā maʻi e hoʻomaikaʻi nui i loko o kekahi mau hola a i ʻole mau lā. ʻO kēia ka hopena i nā hopena maikaʻi loa, ʻoiai no ka paʻakikī o ka hele wāwae.
I ke ʻano o ka NPH lua, ʻo ka maʻi i hoʻokumu i ka NPH (e.g., he puʻupuʻu lolo) e mālama mua ʻia.
He aha nā pilikia e hiki ke kū mai ma hope o ka mālama ʻana?
ʻOiai ʻo ke ʻoki shunt he palekana ia, e like me nā ʻoki kino āpau, aia kekahi mau pilikia.
- Ka maʻi ʻana.
- Ua ālai ʻia a hana hewa paha ka shunt.
- Aia ka shunt ma ka verr.
- Ka nui o ka wai CSF e kahe ana mai ka lolo (hiki i kēia ke hana i nā hōʻailona e like me ke poʻo ʻeha).
Inā hana ʻia kekahi mea e like me kēia, hiki ke ʻike koke ʻia a mālama ʻia. No laila, he mea nui loa ka hahai ʻana i nā ʻōlelo a ke kauka ma hope pono o ke ʻoki ʻana a e hele i nā keʻena lapaʻau i nā lā i hoʻonohonoho ʻia.
He aha kāu e manaʻo ai i kou noho ʻana me NPH?
ʻO ka hopena o ka NPH e hilinaʻi pinepine ʻia i ka wikiwiki o ka ʻike ʻia ʻana a me ka mālama ʻia ʻana o ka maʻi . ʻO ka hāʻawi ʻia ʻana o ka lāʻau lapaʻau ma hope, ʻo ka nui aʻe o ka hiki ke mau loa ka pōʻino o ka lolo.
ʻOiai ʻaʻole paha i ʻike ka mea maʻi i kā lākou mau hōʻailona, he kuleana nui ko ka ʻohana a me nā mea aloha i kēia. Inā ʻike ʻoe i kēia mau hōʻailona i kāu mea aloha, he mea nui loa ia e lawe iā lākou e ʻike i ke kauka, ma mua o ka manaʻo he ʻāpana maʻamau ia o ka ʻelemakule.
Eia nā manawa kūpono e hoʻopau ai nā hōʻailona ma hope o ka mālama ʻana:
- Paʻakikī i ka hele wāwae: Ma kahi o 85% o nā maʻi e ho'ōla ana.
- ʻO ka hoʻōki ʻana o ka mimi: Ma kahi o 80% o nā maʻi e ho'ōla ʻia.
- Ka hemahema o ka noʻonoʻo a me ka hoʻomanaʻo: Ma kahi o 80% o nā maʻi e ho'ōla ana.
E nānā kākou i nā kumu e hoʻopilikia ai i ka hopena o ka maʻi NPH ma ka papa ma lalo nei.
| Nā mea e hoʻonui ai i ka likelika o kahi hopena maikaʻi | Nā mea e hōʻemi ai i ka likelika o kahi hopena maikaʻi |
|---|---|
| Ka ʻike mua ʻana a me ka mālama ʻana i ka maʻi. | Ka lohi o ka ʻike ʻana a me ka mālama ʻana i ka maʻi. |
| ʻO ka mua, ua paʻakikī ka hele ʻana, a laila nā pilikia hoʻomanaʻo. | ʻO ka mea mua, hoʻomaka nā pilikia hoʻomanaʻo. |
| Hoʻomaikaʻi iki nā hōʻailona ma hope o ka lawe ʻana i ka wai mai ke kua. | Ka hōʻino nui o ka hoʻomanaʻo a me ka noʻonoʻo ʻana. |
| Hoʻokumu ʻia ka NPH lua e kahi maʻi hiki ke ho'ōla ʻia. | ʻO ke alo o nā maʻi lolo ʻē aʻe e like me Alzheimer's. |
Āhea wau e ʻike ai i ke kauka? He aha nā manawa e hele ai i ka ETU?
Inā loaʻa i kekahi o kou ʻohana kahi shunt, pono ʻoe e makaʻala pono i kekahi mau hōʻailona. He mau hōʻailona paha kēia o kahi pilikia me ka shunt a i ʻole kahi maʻi.
Inā loaʻa kekahi o kēia mau hōʻailona, e kāhea koke aku i kāu kauka a i ʻole e lawe iā ʻoe iho i ka Emergency Treatment Unit (ETU) o ka haukapila .
- ʻEha poʻo nui: Inā e ʻoi aku ka ʻino o ke poʻo, ʻoiai ke noho ʻana a kū paha, he hōʻailona paha kēia ua emi a hoʻonui ʻia paha ka kahe ʻana mai ka shunt.
- Kuni a ʻūlū paha: He hōʻailona paha kēia o kahi maʻi ma hope o ke ʻoki ʻana. Mai hoʻowahāwahā i kēia ʻano maʻi no ka mea hiki iā lākou ke laha koke.
- ʻĀʻī paʻakikī.
- ʻEha ma ka umauma a i ʻole ka ʻōpū kahi e hele ai ke paipu shunt.
- Ka ʻike hou ʻia ʻana o nā hōʻailona NPH kahiko (ka paʻakikī i ka hele wāwae, nā pilikia mimi).
Leka Lawe-Home
- Mai hoʻowahāwahā i nā pilikia hele wāwae, ka paʻa ʻole o ka mimi, a me ka nalowale o ka hoʻomanaʻo ma ke ʻano he "ʻelemakule maʻamau." He mau hōʻailona paha kēia o kahi maʻi i kapa ʻia ʻo NPH.
- ʻO ka NPH kahi kūlana i hana ʻia e ka hōʻiliʻili ʻana o ka wai cerebrospinal (CSF) i loko o ka lolo.
- ʻOiai hiki ke hōʻike ʻia me nā hōʻailona like me ka dementia, ʻo ka NPH he maʻi hiki ke ho'ōla ʻia me ke ʻoki ʻana.
- ʻO ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi, ʻoi aku ka maikaʻi o ka hopena. No laila, he mea nui loa ka nānā ʻana o ka ʻohana a me nā mea aloha ma ʻaneʻi.
- Inā loaʻa i kāu mea aloha kēia mau hōʻailona, e ʻoluʻolu e ʻike koke i ke kauka kūpono.
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