Loaʻa iā ʻoe kahi pilikia e like me kēia me kahi aʻa i loko o kou ʻāʻī? (Vertebral Artery Dissection) E aʻo kākou e pili ana i ia mea.

Ua ʻike anei ʻoe i ka ʻūmiʻi ma kou ʻāʻī, ka ʻeha poʻo, a i ʻole ka ʻike koke ʻana i ʻelua mau mea i ka maka hoʻokahi? ʻOiai ke ʻano maʻalahi kēia mau mea, i kekahi manawa aia kekahi mea koʻikoʻi ma hope o lākou. ʻO kekahi o ia mau kūlana a mākou e kamaʻilio ai i kēia lā ʻo ia ka "Vertebral Artery Dissection".

He aha ka Vertebral Artery Dissection?

I ka ʻōlelo maʻalahi, ʻo ia ka wā e haehae ai kahi aʻa nui ma ke kua o kou ʻāʻī, ma kou iwi kuamoʻo, e lawe ana i ke koko i kou lolo - i kapa ʻia ʻo ke aʻa vertebral - mai loko mai. E like me ka haehae ʻana o kahi ʻāpana lole, hiki i hoʻokahi a ʻoi aku paha nā papa o ka paia o ke aʻa ke haehae. He kumu kakaikahi kēia o ka hahau ʻana i ka poʻe ʻōpio , ma lalo o 45 mau makahiki, ma mua o ka poʻe ʻelemakule.

No laila he aha kēia aʻa vertebral?

E noʻonoʻo, ma ke kua o kou ʻāʻī, aia ʻelua mau kīʻaha koko e holo ana i luna o kou iwi kuamoʻo. Kāhea mākou iā lākou ʻo nā aʻa vertebral. ʻO kā lākou hana nui ka hoʻolako ʻana i ke koko maʻemaʻe a me ka oxygen i kou lolo a me ke kaula spinal . Ua like ia me ka paipu wai, akā ʻoi aku ka paʻakikī ma mua o kēlā.

ʻEkolu papa nui o kēia aʻa:

• ʻO ka Intima : ʻO kēia ka papa o loko loa, kokoke loa i ke kahe o ke koko.
• Media : ʻO kēia ka papa waena. Kōkua ia i ke kahe ʻana o ke koko i hoʻokahi ʻaoʻao.
• ʻAvetenitia : ʻO kēia ka papa waho loa. ʻO ia ka mea e hāʻawi ai i ke kīʻaha koko i kona ʻano a me kona ikaika.

Pehea ka hopena o kēia ʻoki ʻana i kou olakino?

I kēia manawa, e noʻonoʻo, e like me kaʻu i ʻōlelo ai, i ka wā e haehae ai ka papa o loko o ke aʻa, hoʻomaka ke koko e kahe ma waena o nā papa ʻelua i kapa ʻia ʻo intima a me ka media. A laila hiki i ke koko ke hōʻiliʻili ma laila a pehu e like me kahi pōpō liʻiliʻi. Hiki i kēia koko i hōʻiliʻili ʻia ke paʻa ma laila a hana i kahi ʻūpā koko . Hiki i kēia ʻūpā koko ke ālai i ke kahe koko i loko o ke aʻa, a hiki iā ia ke ālai loa iā ia. Hiki i ke aʻa ke pehu (dilate).

ʻO ka hopena weliweli loa o kēia ka hahau ʻana :

• ʻO ka hahau ischemic : Hana ʻia kēia ke nui ka nui o ke koko e ālai piha a hapa paha i ke kahe koko i ka lolo. I kekahi manawa, hiki i kahi ʻāpana o ke koko ke haki a hele i lalo i ke kahe koko i ka lolo a paʻa i loko o kahi aʻa liʻiliʻi.
• ʻO ka hahau koko : Hana ʻia kēia ke haehae nā papa ʻekolu o ka paia o ke aʻa. A laila hoʻomaka ke koko e kahe mai loko mai o ke aʻa, ma kahi o loko o ka lolo. Inā komo hohonu kēia haehae i loko o ka lolo, hiki i ke koko ke kahe i loko o ka hakahaka a puni ka lolo - kapa mākou ia he hemorrhage subarachnoid - a i ʻole hiki ke kahe ke koko i loko o ka ʻiʻo o ka lolo.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka hoʻomohala ʻana i ka dissection o ke aʻa vertebral?

Hiki i kekahi poʻe ke loaʻa i kēia maʻi me ke kumu ʻole. Eia nō naʻe, inā loaʻa iā ʻoe kekahi mau maʻi olakino, aia paha ʻoe i kahi pilikia kiʻekiʻe iki o ka loaʻa ʻana. E nānā inā pili kēia mau mea iā ʻoe pū kekahi:

• Ka puhipaka : He mea kēia e wehe ai i ka puka i nā maʻi he nui.
• ʻO kekahi mau kūlana hoʻoilina : No ka laʻana , ʻo ka cystic medial necrosis , ʻo Ehlers-Danlos syndrome , ʻo Marfan syndrome , a me ka osteogenesis imperfecta hiki ke hoʻonāwaliwali i nā paia o nā kīʻaha koko.
• ʻO ka dysplasia fibromuscular : He ʻano kēia e ulu ai nā pūnaewele ʻano ʻē i loko o nā aʻa.
• Ke koko kiʻekiʻe : Ke koko kiʻekiʻe, ʻoi aku hoʻi i loko o nā aʻa e hoʻopili ana i nā māmā a me ka puʻuwai (arterial hypertension).
• ʻO ka maʻi puʻupaʻa polycystic : He maʻi kahi e hana ʻia ai nā cysts i loko o nā puʻupaʻa.
• Vasculitis : Ka mumū ʻana o nā kīʻaha koko.

Aia kekahi mau kumu pilikia ʻē aʻe?

ʻAe, ʻoiaʻiʻo nō. Hiki nō hoʻi kēia ʻoki ʻana ma muli o kekahi mau ʻeha i ka ʻāʻī. Hiki ke hana ʻia kēia ke kū ka ʻāʻī i kahi kūlana hyperextended a i ʻole ke neʻe koke ʻia ka ʻāʻī . E noʻonoʻo i nā mea e like me kēia:

• Nā ulia kaʻa.
• Hiki ke kōkua kekahi mau lāʻau lapaʻau ʻāʻī, e like me nā hoʻoponopono chiropractic a me ka lomilomi ʻāʻī ʻiʻo hohonu. Eia nō naʻe, ʻaʻole paha e hana kēia mau mea no nā mea āpau, a aia kekahi mau pilikia.
• E wehe i ka huʻa ma ke ʻū ʻana i kou mau ʻā me ka leo nui.
• I ka hana ʻana i ka yoga, ua paʻa ka ʻāʻī i luna a hoʻohuli ʻia no ka manawa lōʻihi.
• He like ia me ke pena ʻana i kahi kaupaku, e hana mau ana me kou ʻāʻī e kūlou ana.
• ʻO ka Cardiopulmonary resuscitation (CPR) ka lāʻau lapaʻau i hāʻawi ʻia inā loaʻa ka hopu koke ʻana o ka puʻuwai.
• Ke kihe nui nei.
• Ka luaʻi ʻana.
• Nā haʻuki piliwaiwai (Wrestling).
• Ka hāpai kaumaha.
• ʻO nā mea ʻē aʻe e hiki ai ke hōʻeha i ka ʻāʻī.

Hiki ke loaʻa ka hahau ma muli o ka dissection arterial ʻē aʻe?

ʻAe, ke haehae ʻia kahi aʻa i loko o kou ʻāʻī, kapa pinepine mākou ia he dissection aʻa cervical . Hoʻokomo pū kēia me nā aʻa vertebral a mākou i kamaʻilio ai, a me nā aʻa carotid ʻelua e holo ana ma ke alo o kou ʻāʻī. Inā hemo kekahi o kēia mau aʻa, hiki iā ia ke ʻoki i ke kahe koko i ka lolo, e hana ana i ka hahau .

He aha ka pilikia maoli o ka hahau ʻana?

ʻO kaʻoiaʻiʻo, ʻo kēia ma muli o ka dissection o ke aʻa vertebral a i ʻole carotid.Haʻahaʻa ka pilikia holoʻokoʻa o ka hahau ʻana. ʻO ka hapa nui o nā hahau ischemic ma muli o kahi maʻi i kapa ʻia ʻo atherosclerosis . ʻO kēia ka wā e mānoanoa ai a ʻili nā paia o nā aʻa ma muli o nā kumu pilikia ʻē aʻe, e like me ka puhipaka, ke koko kiʻekiʻe, ka cholesterol kiʻekiʻe, a me ka maʻi diabetes.

Akā eia ka mea nui: ʻO ka ʻoki ʻana o nā aʻa vertebral kekahi kumu nui o ka hahau ʻana i nā poʻe ʻōpio a me nā poʻe waena. Hiki iā ia ke hana a hiki i ka 25%, a i ʻole hoʻokahi i loko o ʻehā, o nā hahau ʻana i kēia hui makahiki.

He aha nā hōʻailona o ka dissection o ke aʻa vertebral?

ʻAʻole paha ʻoe e ʻike i kekahi mau hōʻailona i ka wā mua. Akā inā pahū kahi aʻa koko a ālai paha kahi ʻūpā koko i ke kahe koko i ka lolo, hiki iā ʻoe ke ʻike i nā hōʻailona o ka hahau ʻana .

E makaʻala i kēia mau ʻano:

• Ataxia : Ka nalowale o ke kaulike i ka wā e hele ana a kū paha, hiki ʻole ke hana pono i nā hana.
• Pōʻaiʻī.
• Ka nalowale o ka lohe.
• ʻIke pālua.
• ʻEha ʻāʻī (pinepine ma kekahi ʻaoʻao).
• ʻEha poʻo nui.
• ʻŌlelo pahee (Dysarthria).
• Vertigo - He manaʻo o ka wili ʻana.

Pehea ʻoe e ʻike ai inā he dissection vertebral artery kāu?

ʻO ka hoʻāʻo maikaʻi loa e ʻike pono ai i ka mea e hana nei, ʻo ia ka magnetic resonance angiography (MRA) . Hoʻohui kēia i kahi scan MRI me kahi ʻano hana i kapa ʻia ʻo angiography e lawe i nā kiʻi maopopo loa o kou mau aʻa vertebral. Hiki i kēia i nā kauka ke hoʻoholo koke i kahi o ka dissection, pehea kona koʻikoʻi, a pehea ka lōʻihi o kona noho ʻana ma laila.

Eia nō naʻe, ʻaʻole loaʻa kēia hoʻāʻo MRA ma nā wahi āpau a ʻaʻole maʻalahi ke hana. No laila, ʻike pinepine nā kauka i kēia kūlana me kahi CT scan (Computed Tomography - CT scan) a i ʻole kahi CT angiography (CT angiography) . ʻO kēia mau mea maʻamau kekahi o nā hoʻāʻo mua e hana ʻia ke hele mai ke kanaka.

I kekahi manawa, hiki i kāu kauka ke ʻōlelo aku i kahi angiography maʻamau . Pili kēia i ke komo ʻana i kahi ʻōmole lahilahi a lōʻihi (catheter) ma kou pulima a i ʻole ka ʻūhā, e hoʻokomo ana i kahi dye kūikawā (contrast dye), a me ka lawe ʻana i nā kiʻi X-ray e ʻike ai pehea e kahe ana ke koko i loko o ke aʻa, ka nui o ka dissection, a me kahi o ka lesion.

Pehea e mālama ʻia ai kēia?

I ka hapanui o ka manawa, e ho'ōla pono'ī kēia mau kūlana dissection i ka hala ʻana o ka manawa. Eia nō naʻe, no ka hōʻemi ʻana i ka pilikia o nā ʻūpā koko, hiki ke hāʻawi ʻia iā ʻoe nā lāʻau hoʻomāmā koko.ʻO kēia nā lāʻau lapaʻau mua. No ka laʻana, hiki ke hāʻawi ʻia ka aspirin , nā lāʻau lapaʻau ʻē aʻe (e like me Plavix®) , heparin i ke ʻano wai, a i ʻole nā ​​papa warfarin .

Eia nō naʻe, inā ua pālahalaha ka ʻoki ʻana i loko o ka lolo, a inā paha ua loaʻa iā ʻoe kahi hahau hemorrhagic , ʻaʻole paha e palekana ke hāʻawi i kēia mau lāʻau hoʻokahe koko. E paipai kāu kauka i nā lāʻau lapaʻau ʻē aʻe.

He aha ka mea e hana ai inā ʻaʻole holomua ka lāʻau lapaʻau maʻamau?

Inā hana ʻia kēlā, pono paha ʻoe e hana i kahi kaʻina hana. Hoʻohana ʻia kēia mau ʻano hana no ka poʻe i loaʻa i ka hahau hemorrhagic .

ʻO nā kaʻina hana no ka dissection artery vertebral penei:

• ʻO ka embolization Endovascular : E like me ka mea i ʻōlelo ʻia ma mua, ua hoʻokomo ʻia nā ʻōmole lahilahi (catheters) ma o ka pulima a i ʻole ka ʻūhā, i loko o ka wahi o ka dissection, a ua hoʻokomo ʻia kahi mea embolic a i ʻole ua hoʻokomo ʻia nā wili metala liʻiliʻi. Ua sila ʻia ka ʻāpana ʻē o ke aʻa me kēia mea a i ʻole nā ​​wili. Hoʻōki kēia i ke koko mai ke kahe ʻana ma o ia mea.
• Angioplasty : Pili pū kēia i ka hoʻohana ʻana i nā ʻōmole lahilahi (catheters) e hele i kahi o ka dissection a me ka hoʻopiha ʻana i kahi pōpō kūikawā e hoʻoponopono i ka ʻāpana i haehae ʻia o ke aʻa.
• ʻO ka stenting intracranial : Pili pū kēia i ke kau ʻana i kahi ʻōmole lahilahi (catheter) i loko o ka wahi o ka dissection a me ke kau ʻana i kahi mea hao e like me ka mesh (i kapa ʻia he stent) i loko o ke aʻa. Hoʻoikaika kēia i ka paia o ke aʻa. ʻAʻole hana ʻia kēia no nā mea āpau, no nā poʻe maʻi i koho ʻia wale nō. I ka manawa pinepine, hana pū nā kauka i ka angioplasty a me ka stenting .
• ʻOki kino : No ka poʻe hiki ʻole ke hana i nā kaʻina hana endovascular i ʻōlelo ʻia ma luna, pono paha ke ʻoki kino. I ka wā o ke ʻoki kino, hoʻohana nā kauka i nā ʻūmiʻi metala liʻiliʻi e pani i ka ʻāpana ʻē o ke aʻa.

He aha ka nui o ka ho'ōla ʻana no ka poʻe me kēia maʻi?

Hoʻōla piha ka hapa nui o nā kānaka . Eia nō naʻe, hiki nō iā ʻoe ke loaʻa i kahi pilikia o ka hoʻomohala ʻana i kahi ʻoki like i ka wā e hiki mai ana. Akā e emi ana kēlā pilikia i ka hala ʻana o ka manawa.

He aha ke ʻano o ke ola ʻana me ka ʻoki ʻia ʻana o ke aʻa vertebral?

E nānā mau nā kauka iā ʻoe a hiki i kou maopopo ʻana ua ho'ōla loa ʻia kēia. ʻO ka maʻamau, e loaʻa iā ʻoe kahi magnetic resonance angiography (MRA) i kēlā me kēia ʻekolu a ʻeono mahina.E noi ʻia ʻoe e hana i kekahi mau hoʻokolohua. Pono nō hoʻi ʻoe e hoʻomau i ka lawe ʻana i nā lāʻau hoʻokahe koko i kēia manawa. Pono ka poʻe i loaʻa i ka pilikia kiʻekiʻe o ka loaʻa ʻana o kahi dissection i ka wā e hiki mai ana e ʻike i kā lākou mau kauka no nā makahiki e loaʻa ai ka ʻōlelo aʻoaʻo ('mālama hahai').

He aha ka mea pono ʻole iaʻu e hana ma hope o ka dissection vertebral artery?

Hiki iā ʻoe ke hoʻoikaika kino, akā pono ʻoe e noho mamao mai nā mea e like me:

• Nā hoʻoikaika kino e hana ʻia ma ke kau ʻana i ke kaumaha o kou kino ma kou mau lima, e like me nā push-up a me nā pull-up.
• Ke hāpai ʻana i nā mea kaumaha ma luna o 25-30 paona (ma kahi o 11-13.5 kg).
• Ke hāpai ʻana i nā mea kaumaha ma luna o ke poʻo.
• Nā haʻuki pili.
• Ke holo nei ma nā holo wikiwiki e like me nā kaʻa wili.
• Ke hoʻopā aku nei kekahi chiropractor i kou poʻo/ʻāʻī.
• Ke lomilomi ikaika nei i ka ʻāʻī.
• Nā mea e like me ka luʻu lani.
• Nā hana ʻē aʻe e hoʻonui/hoʻēmi koke i ka wikiwiki.
• Kūlana "Plank" (Plank position). (Akā ma waho aʻe o kēlā, ʻaʻohe pilikia i ka hana ʻana i ka yoga a i ʻole Pilates, inā ʻaʻole ia e kau i ke kaomi ma ka ʻāʻī).
• E hōʻalo i kekahi hana e hoʻoulu ai i ka ʻāʻī e haki koke i hope (ʻeha whiplash), a i ʻole kekahi hana e hoʻonui mau ai i ka ʻāʻī i luna (hyperextension).

Leka Lawe-Home

ʻO ka Vertebral Artery Dissection kahi haehae i ka paia o kahi kīʻaha koko ma ke kua o kou ʻāʻī. ʻAʻole pinepine ia e alakaʻi i ka hahau . Akā inā hana ia, hiki i ka mālama koke (pinepine nā mea hoʻoheheʻe koko a i ʻole ke kaʻina hana) ke hoʻopakele i kou ola. Hiki i ka mālama lapaʻau a me ka nānā mau ʻana i ke kauka ke kōkua i ka poʻe me kēia maʻi e pale i nā pilikia. No laila, inā loaʻa iā ʻoe kekahi o nā hōʻailona i ʻōlelo ʻia ma kēia ʻatikala, e ʻoluʻolu e ʻimi koke i ke aʻo lapaʻau. ʻO ia ka mea nui loa.

ʻO ka ʻoki ʻana i ke aʻa Vertebral, ka hahau ʻana, ka maʻi lolo, ka ʻeha ʻāʻī, ka ʻeha poʻo, ka poniuniu, ka haki ʻana o ke aʻa koko