Ke ʻike nei ʻoe i ka nalowale o ka hoʻomanaʻo a me ka paʻakikī i ka hele ʻana i kou wā ʻelemakule? Hiki paha iā ia ke Normal Pressure Hydrocephalus (NPH)

Ke lilo nei kekahi ʻelemakule i loko o kou hale, ʻo kou makuahine paha, kou makuakāne, a kupuna wahine paha, i mea hoʻopoina nui? Me he mea lā e kauō ana ko lākou mau wāwae ma ka honua ke hele lākou? Ke lilo nei hoʻi i mea paʻakikī ke kāohi i ko lākou mimi ? Manaʻo pinepine mākou i kēia mau mea he "mau mea maʻamau e hana ʻia i ko mākou wā ʻelemakule." Akā hiki iā lākou ke lilo i mau hōʻailona o kahi maʻi hiki ke mālama ʻia a ho'ōla ʻia. I kēia lā, ke kamaʻilio nei mākou e pili ana i kekahi o ia ʻano maʻi, ʻo Normal Pressure Hydrocephalus, a i ʻole NPH.

He aha ka Normal Pressure Hydrocephalus (NPH)?

I ka ʻōlelo maʻalahi, ʻo NPH ka manawa e hōʻiliʻili ai ka wai i loko o ko mākou lolo ma mua o ka mea e pono ai.

E noʻonoʻo i ko kākou lolo a me ke kaula iwi kuamoʻo, e holo ana i lalo o ko kākou iwi kuamoʻo, ua hoʻopuni ʻia e kahi wai moakaka e like me ka uluna. Ma nā ʻōlelo lapaʻau, ua kapa ʻia kēia he wai cerebrospinal (CSF) . Hana ʻia kēia CSF i loko o nā ventricles o ko kākou lolo a kaʻapuni ma loko ona, e hānai ana i ka lolo a me ke kaula iwi kuamoʻo, e wehe ana i nā huahana ʻōpala, a e pale ana i ka lolo mai ke kuʻi ʻana i ke poʻo. ʻO ka maʻamau, hoʻihoʻi ʻia ka CSF keu i loko o ke kino ma o nā aʻa koko ma luna o ka lolo.

Eia nō naʻe, inā he mea keʻakeʻa i loko o ka ʻōnaehana e hoʻokahe ana i kēia wai CSF, hoʻomaka kēia wai e hōʻiliʻili i loko o nā lua o ka lolo. ʻO kēia ka mea a mākou e kapa nei he Hydrocephalus ( ka hoʻopiha wai o ka lolo ). ʻO NPH kahi ʻano kūikawā o kēia maʻi Hydrocephalus. ʻIke pinepine ʻia i nā poʻe ma luna o 60 mau makahiki.

ʻAʻole e like me nā ʻano hydrocephalus ʻē aʻe, lohi loa ka ulu ʻana o ka NPH. Hōʻiliʻili ka wai CSF i ka hala ʻana o ka manawa. ʻO ka hopena, hoʻonui mālie nā lua i loko o ka lolo, e paʻi ana i nā ʻāpana o ka lolo. ʻO ia ke kumu ʻaʻole e hoʻonui koke ʻia ke kaomi i loko o ka lolo, ʻo ia ke kumu i kapa ʻia ai ʻo "Normal Pressure." Akā he mea kuhihewa iki kēlā inoa, no ka mea, ʻike wale ʻia nā hōʻailona ke hoʻonui ʻia nā lua a paʻi i ka lolo.

ʻO ka mea nui, ua like loa nā hōʻailona o ka NPH me nā maʻi o Alzheimer a me Parkinson . ʻO ka hopena, ua kuhi hewa pinepine ʻia nā maʻi NPH me kekahi o nā maʻi ʻelua ʻē aʻe. Eia naʻe, ʻaʻole e like me Alzheimer a me Parkinson, inā ʻike pololei ʻia, hiki ke ho'ōla nui ʻia ka NPH me ke ʻoki ʻana.

ʻO nā ʻano nui ʻekolu o ke kūlana NPH

ʻEkolu mau hōʻailona nui o ka NPH. ʻAʻole paha e ʻike maopopo ʻia kēia i ka wā mua, akā e piʻi mālie lākou i ka hala ʻana o ka manawa. Inā loaʻa kēia mau hōʻailona ʻekolu, pono e kānalua ʻia ka NPH.

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He aha nā kumu o ka NPH?

ʻO kaʻoiaʻiʻo, i ka hapa nui o nā maʻi NPH, ʻaʻohe kumu kikoʻī e hiki ke loaʻa. Eia nō naʻe, i kekahi mau hihia, hiki i nā kumu aʻe ke kōkua i ke kūlana:

• ʻEha poʻo
• Ke kahe koko a puni ka lolo ma muli o ka hahau ʻana i ke poʻo
• Hahau
• Nā maʻi e like me ka meningitis
• ʻŌpū lolo
• ʻO ke ʻoki lolo

ʻAʻohe maopopo maopopo i ke ʻano o kēia mau kūlana e hoʻoulu ai i ka NPH.

Pehea e ʻike pololei ʻia ai ka NPH?

I kēia manawa ke noʻonoʻo nei paha ʻoe, "ʻAe, eia nā hōʻailona, ​​​​pehea wau e ʻike ai i kēia?" He mea paʻakikī iki kēia. No ka mea ua like kēia mau hōʻailona me nā maʻi Alzheimer a me Parkinson, he mea nui e ʻike i kahi neurologist a neurosurgeon paha .

ʻO ke kaʻina hana diagnostic maʻamau penei:

1. Ke kamaʻilio ʻana me ke kauka: E nīnau ke kauka iā ʻoe e pili ana i nā mea āpau mai kāu mau hōʻailona, ​​​​i ka wā i hoʻomaka ai, ka mōʻaukala olakino ʻohana, a me nā lāʻau lapaʻau āu e lawe ai.

2. Hoʻokolokolo kino: E nānā ʻia kou kūlana noʻonoʻo (ke nīnau ʻana i nā nīnau a me ke noi ʻana iā ʻoe e hahai i nā kuhikuhi maʻalahi), ka hele ʻana, a me ke kaulike.

3. Nā hoʻokolohua kūikawā:

• CT Scan a i ʻole MRI Scan: Hiki i kēia mau scan ke hana i nā kiʻi 3D kikoʻī o ka lolo. Hiki iā lākou ke kōkua i ka hoʻoholo ʻana inā ua hoʻonui ʻia nā ventricles i loko o ka lolo ma NPH. Eia nō naʻe, ʻaʻole hiki i kahi scan wale nō ke hōʻoia i ka NPH.
• ʻO ka Lumbar Puncture / Spinal Tap: ʻO kēia kekahi o nā ʻanuʻu koʻikoʻi loa i ka ʻike ʻana. I kekahi manawa kapa mākou i kēia he 'spinal tap'. Mai hopohopo, e hana ke kauka i kēia. Hoʻohana ʻia kahi nila liʻiliʻi e wehe i kekahi o ke kahe CSF e hoʻopuni ana i ke kaula spinal mai ke kua haʻahaʻa.

Hiki ke hoʻohana ʻia kēia lumbar puncture e nānā i ʻelua mau mea. ʻO kekahi, ʻo ke ana ʻana i ke kaomi o kēlā wai. ʻO kekahi mea nui, ʻo ia ka ʻike ʻana inā, ma hope o ka wehe ʻana i kahi 30-50 milliliters o ka wai ma kēia ʻano, e hoʻomaikaʻi iki ka hele ʻana a me ka hoʻomanaʻo o ka mea maʻi i nā hola e hiki mai ana. Inā ʻike ʻia kēlā ʻano hoʻomaikaʻi koʻikoʻi, he hōʻailona maikaʻi ia e hiki ke hoʻokō ʻia kahi hoʻōla nui me ke ʻoki ʻana.

He aha nā lāʻau lapaʻau no ka NPH?

ʻO ke ʻoki ʻana ka lāʻau lapaʻau kūpono loa no ka NPH. ʻAʻohe lāʻau lapaʻau a i ʻole kekahi lāʻau lapaʻau ʻē aʻe e hiki ke ho'ōla i ke kūlana.

ʻO ke ʻano hana nui ka hoʻokomo ʻana i kahi shunt.

E noʻonoʻo i kahi ʻōmole liʻiliʻi e hoʻokomo ʻia ana e hoʻokahe i ka wai CSF keu mai ko mākou lolo a hoʻouna iā ia i kahi ʻāpana ʻē aʻe o ke kino. Ua kapa ʻia kēia he shunt. He ʻōmole lahilahi loa kēia. Hoʻokomo kahi neurosurgeon i kēia ʻōmole i loko o kahi lua i loko o ka lolo a kuhikuhi iā ia ma lalo o ka ʻili i kahi i kapa ʻia ʻo peritoneum. Aia kahi valve i loko o kēia ʻōmole e hoʻomalu i ke kaomi. Ke piʻi aʻe ke kaomi i loko o ka lolo, wehe ʻia kēia valve a kahe ka wai keu i loko o ka lua peritoneal. Ma laila, ua omo ʻia ka wai me ka ʻole o ka hōʻeha ʻana i ke kino.

ʻAʻole like ka holomua o kēia ʻoki shunt no nā kānaka a pau. Eia nō naʻe, no nā kānaka he nui, ua emi nui nā hōʻailona ma hope o kēia ʻoki a ua hoʻomaikaʻi nui ʻia ko lākou ola. ʻO ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi a me ka hana ʻana o ke ʻoki, ʻoi aku ka holomua o nā hopena.

I kekahi mau hihia, ma kahi o ka shunt, hana ʻia kekahi ʻoki kino i kapa ʻia ʻo Endoscopic Third Ventriculostomy , kahi e hoʻohana ʻia ai kahi endoscope (kahi ʻōmole lahilahi me kahi kāmela) e hana i kahi lua liʻiliʻi ma lalo o kahi lua o ka lolo e hana i kahi ala ʻē aʻe no ke kahe ʻana o ka wai CSF.