Ua lohe anei ʻoe i kahi maʻi e hoʻopilikia ana i nā ʻāpana keʻokeʻo o kou lolo (White Matter Disease)? E kamaʻilio kākou e pili ana!

Ke manaʻo nei ʻoe i kekahi manawa e emi iki ana kou hoʻomanaʻo i kou wā ʻelemakule? A i ʻole ke manaʻo nei ʻoe ua emi iki kou kaulike ke hele ʻoe a hana paha i nā mea? He mau mea maʻamau paha kēia e hele mai me ka ʻelemakule. Eia nō naʻe, i kekahi manawa aia paha ke kumu ma hope o kēia mau hōʻailona e pono ai ʻoe e makaʻala iki. ʻĀ, i kēia lā e kamaʻilio mākou e pili ana i kahi maʻi e hoʻopilikia ai i ka mea keʻokeʻo o ko mākou lolo.

He aha kēia maʻi e hoʻopilikia ai i nā ʻāpana keʻokeʻo o ka lolo (White Matter Disease)?

I ka ʻōlelo maʻalahi, he huaʻōlelo maʻamau ia no ka hōʻino a me nā loli i ka mea keʻokeʻo i loko o ko kākou lolo. E noʻonoʻo i kēia mea keʻokeʻo he pūnaewele o nā "alanui" e hoʻopili ana i nā ʻāpana like ʻole o ko kākou lolo kekahi i kekahi, a me ka lolo a me ke kaulahao kuamoʻo. Hoʻomaka nā pilikia ke hōʻino ʻia kēia mau "alanui".

Ua kapa ʻia kēia ʻano maʻi ʻaʻai liʻiliʻi o ka lolo i kekahi manawa he maʻi aʻa koko liʻiliʻi o ka lolo a i ʻole ka maʻi microvascular . Hiki ke hana me ka ʻelemakule a me nā loli i loko o nā aʻa koko i loko o ka mea keʻokeʻo o ka lolo. Hiki ke akahai, kaulike, a koʻikoʻi paha .

Ke hōʻino ʻia kou mea keʻokeʻo, lilo ia i ʻeha mea keʻokeʻo . Hiki i nā kauka ke ʻike i kēia mau mea ma ke ʻano he mau kiko ʻālohilohi ma kahi scan magnetic resonance imaging (MRI) o ka lolo. I kekahi manawa ʻaʻole paha e hana kēia mau ʻeha i nā hōʻailona nui, a he "maʻamau" ke loaʻa kekahi o lākou i ko kākou wā ʻelemakule. Eia nō naʻe, hiki i kekahi mau ʻeha ke hōʻino i nā "alanui nui" koʻikoʻi i loko o ka lolo, e hoʻoulu ai i nā pilikia me ka hoʻomanaʻo, ke kaulike, a me ka hele wāwae .

ʻO ka maʻamau, ʻo ka poʻe me nā ʻeha keʻokeʻo he nui aʻe (ʻo ia hoʻi, ʻoi aku ka nui o ka maʻi keʻokeʻo) e loaʻa pinepine iā lākou nā hōʻailona hou aʻe .

Ua pili pono kēia maʻi keʻokeʻo me nā mea pilikia o ka maʻi cardiovascular . Manaʻo nā kānaka noiʻi he biomarker ia e hōʻike ana i ka pilikia o ka hahau ʻana, ka dementia, a me ke kīnā i ke ola holoʻokoʻa.

He aha maoli kēia mea keʻokeʻo?

He pūnaewele nui o nā olonā nerve (axons) ka mea keʻokeʻo i loko o ko kākou lolo. Maanei e hoʻololi ʻia ai ka ʻike a hana ʻia ke kamaʻilio ʻana ma waena o nā ʻāpana like ʻole o ka lolo. Ua kapa ʻia ʻo "mea keʻokeʻo" no ka mea ua hoʻopuni ʻia kēia mau olonā nerve e kahi ʻūpā pale i kapa ʻia ʻo myelin . Ma muli o kēlā myelin i loaʻa ai i kēia ʻiʻo kona waihoʻoluʻu keʻokeʻo.

He mea hina ko kou lolo ma ka ʻili a me nā ʻāpana hohonu. Loaʻa iā ia kona kala hina mai nā kino cell o nā cell nerve (neurons).

I mea e olakino ai ko kākou mea keʻokeʻo, pono ia i ka lako koko maikaʻi a me nā meaʻai .

E like me ka pono o ka mauʻu i loko o kā mākou māla i ka wai, ka lā, a me kahi ʻūlū e hoʻomau i kona nani, hiki ke hōʻino ʻia ka mea keʻokeʻo i loko o ka lolo inā nele i ka lako koko maikaʻi a me ka meaʻai.

ʻO ka emi ʻana o ke koko (i ʻike ʻia ma ke ʻano lapaʻau he ischemia ) a me ka emi ʻana o nā meaolaola e hōʻino i kēia mau olonā aʻalolo. Hiki iā lākou ke pehu, haki, a make loa paha.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi keʻokeʻo?

ʻOiai hiki ke ulu i loko o kekahi kanaka, ʻoi aku ka maʻamau i nā poʻe ma luna o 60 mau makahiki a me ka poʻe me nā maʻi cardiovascular .

ʻO kekahi poʻe ʻōpio, no ka laʻana, ka poʻe me nā maʻi e like me ka migraines , loaʻa paha kekahi mau ʻeha keʻokeʻo ma kahi scan MRI o ka lolo. Eia nō naʻe, me ka makahiki a me ka piʻi ʻana o nā mea pilikia i kāohi ʻole ʻia no ka maʻi cardiovascular, e piʻi paha ka nui o kēia mau ʻeha.

Hiki paha i kekahi poʻe ke loaʻa i kēia maʻi ma muli o nā kumu pilikia genetic .

Pehea ka maʻamau o kēia ʻano?

He maʻi maʻamau loa ka maʻi keʻokeʻo, e hoʻopilikia ana ma mua o ka hapalua o nā kānaka ma luna o 60 mau makahiki.

He aha nā hōʻailona o kēia maʻi keʻokeʻo?

Eia kekahi mau hōʻailona e hiki ke ʻike ʻia ma kēia kūlana:

• Nā pilikia hoʻomanaʻo .
• Hele mālie .
• Nā pilikia kaulike a me nā hāʻule pinepine .
• Paʻakikī ke hana i ʻelua a ʻoi aku paha mau mea i ka manawa hoʻokahi , no ka laʻana, e hele wāwae ana me ke kamaʻilio ʻana.
• Nā loli o ka naʻau , nā kūlana e like me ke kaumaha .
• Ka paʻakikī ke kāohi ʻana i ka mimi (urinary incontinence) .

ʻOi aku ka maʻamau o kēia mau hōʻailona i nā poʻe me ka maʻi ʻoi aku ka koʻikoʻi .

Akā e hoʻomanaʻo, hiki ke hana ʻia ka nui o kēia mau hōʻailona e nā loli maʻamau e hele mai me ka ʻelemakule, a i ʻole e nā kūlana olakino ʻē aʻe e like me ka arthritis, ka neuropathy e pili ana i ka maʻi diabetes, ka dementia Alzheimer, a i ʻole ka insomnia . Eia nō naʻe, inā ʻike ʻia kēia mau hōʻailona a ʻoi aku ka wikiwiki, he mea hopohopo ia.

I kekahi manawa, ʻike ʻia ka maʻi keʻokeʻo ma ka ulia pōpilikia i ka wā o ka MRI o ka lolo no kekahi kumu ʻē aʻe. Loaʻa paha i kekahi poʻe akā ʻaʻole hōʻike i kekahi mau hōʻailona (asymptomatic). ʻOi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e hoʻoholo ai inā ma muli o ka maʻi keʻokeʻo a i ʻole kekahi kumu ʻē aʻe kāu mau hōʻailona.

He aha ke kumu o kēia maʻi keʻokeʻo?

Ke noiʻi nei nā kānaka noiʻi i ka maʻi a me kona mau kumu. I kēia manawa, manaʻoʻiʻo lākou ʻo ka emi mau ʻana o ke kahe koko i nā olonā aʻalolo i loko o ka mea keʻokeʻo ke kumu.ʻO kēia no ka mea ua hōʻino ʻia kēia mau olonā.

I ko kākou ʻelemakule ʻana, lilo ko kākou mau aʻa i ʻoi aku ka paʻakikī a me ka emi ʻana o ka elasticity . Hiki i kēia ke hōʻemi i ke kahe koko i nā aʻalolo i loko o ka lolo a hōʻino i ka mea keʻokeʻo.

Hiki nō hoʻi ke hana ʻia e kahi maʻi i kapa ʻia ʻo atherosclerosis . ʻO kēia ka wā e hōʻiliʻili ai ka plaque i loko o ko kākou mau aʻa i ka hala ʻana o ka manawa, e hoʻomānoanoa a paʻakikī ai nā paia o ke aʻa. Hiki i kēia ke hoʻopilikia i kekahi aʻa i loko o ke kino, me nā aʻa i loko o ka lolo.

ʻO ka loaʻa ʻana o nā mea pilikia o ka maʻi cardiovascular, e like me ke koko kiʻekiʻe, ke kiʻekiʻe o ke kō koko ma muli o ka maʻi diabetes, ka cholesterol kiʻekiʻe i ka meaʻai, a me ka puhipaka , hiki ke hoʻonui i ka nui o nā ʻeha o ka mea keʻokeʻo i loko o kou lolo.

Nā kumu ʻē aʻe o nā ʻeha keʻokeʻo

ʻO kēlā me kēia kaʻina hana e hoʻololi ai i ke ʻano kemika o nā olonā nerve i uhi ʻia i ka myelin, ka hōʻino ʻia, a i ʻole ka emi ʻana o ke koko (ischemia), hiki ke ʻike ʻia he mau ʻeha mea keʻokeʻo ma kahi MRI scan.

ʻOiai ʻo ka maʻi keʻokeʻo he hōʻiliʻili o nā ʻeha keʻokeʻo i hoʻokumu ʻia e nā pilikia vascular, hiki iā ʻoe ke hoʻomohala i nā ʻeha keʻokeʻo liʻiliʻi no nā kumu ʻē aʻe. No ka laʻana, hiki ke ʻike ʻia kēia mau ʻeha i nā maʻi mumū demyelinating e like me ka multiple sclerosis (MS) a me nā kūlana genetic e like me ka leukodystrophy .

Hiki i nā kauka e like me nā neurologists a me nā neuroradiologists ke hoʻokaʻawale pinepine ma waena o ka maʻi keʻokeʻo a me nā kumu ʻē aʻe o nā ʻeha ma muli o ko lākou wahi i loko o ka lolo ma kahi scan MRI. I kekahi manawa pono nā hoʻokolohua hou aʻe e hoʻoholo ai i ke kumu pololei o nā ʻeha keʻokeʻo i ʻike ʻia ma kahi scan MRI.

Pehea e ʻike ʻia ai kēia maʻi keʻokeʻo?

ʻO ke ala nui e ʻike ai i kēia maʻi me ka nānā ʻana i ka magnetic resonance imaging (MRI) o ka lolo . He hoʻāʻo ʻeha ʻole ka MRI scan e hoʻopuka ana i nā kiʻi maopopo loa o nā ʻāpana like ʻole o ke kino. Hoʻohana ka mīkini MRI i kahi magnet nui, nā nalu lekiō, a me kahi kamepiula e hana i kēia mau kiʻi kikoʻī, me ka hoʻohana ʻole ʻana i kekahi radiation (ʻaʻohe X-ray).

Hiki i nā scan MRI lolo ke kōkua i nā kauka e ʻike i ka nui o ka hōʻino ʻia i ka mea keʻokeʻo o kou lolo a hoʻomaopopo i ka maʻi mea keʻokeʻo.

ʻIke ʻia nā loli o ke keʻokeʻo ma ke ʻano he mau ʻeha ma ka MRI. Hiki ke kapa ʻia kēia mau loli o ke keʻokeʻo ma nā ʻano like ʻole ma kahi hōʻike MRI:

• Ka maʻi a i ʻole nā ​​​​​​ʻeha o ka mea keʻokeʻo o ka lolo a i ʻole subcortical.
• Ka maʻi microvascular.
• Nā loli keʻokeʻo kikoʻī ʻole.
• Nā hyperintensities T2 (nā ʻeha).

I kekahi manawa, ʻike paha kāu kauka i nā hōʻailona o ka maʻi keʻokeʻo ma muli o nā hopena o kahi scan MRI i loaʻa iā ʻoe no kekahi maʻi ʻē aʻe. I kekahi manawa, kauoha paha kāu kauka i kahi MRI inā ʻaʻole hiki iā lākou ke loaʻa kahi kumu maopopo ʻē aʻe no kāu mau hōʻailona, ​​​​e like me nā pilikia me ke kaulike a me ka hoʻomanaʻo.

ʻOiai aia nā hoʻokolohua kiʻi ʻē aʻe, e like me CT scans (Computed Tomography scans) , ʻo ka magnetic resonance imaging (MRI) ka mea ʻoi aku ka maikaʻi o ke kiʻi a me ka ʻike no ka ʻike ʻana i ka maʻi keʻokeʻo.

I ka wā e hōʻoia ai i kēia maʻi, hiki i kāu kauka ke hana i kahi hoʻokolohua neurological e loiloi i kāu mau hōʻailona.

Ma muli o ka pili ʻana o ka maʻi keʻokeʻo me nā mea pilikia o ka maʻi cardiovascular, hiki i kāu kauka ke kauoha i nā hoʻāʻo koko e like me kēia e loiloi i kāu pilikia:

• Papa metabolic piha .
• Panel lipid (e nānā i nā pae cholesterol).
• Hoʻāʻo hemoglobin glycosylated (HbA1c) (e nānā i ke kūlana maʻi diabetes).

Pehea e mālama ʻia ai kēia maʻi keʻokeʻo?

I ka mālama ʻana i kēia maʻi, kau nui nā kauka i ka hoʻokele ʻana i nā hōʻailona a me ka kaohi ʻana i nā mea pilikia e pili ana i nā maʻi cardiovascular.

ʻO ka mālama ʻana i nā pilikia olakino ma lalo, e like me ke koko kiʻekiʻe, ka maʻi diabetes, a me ka cholesterol kiʻekiʻe, a me ka haʻalele ʻana i ka puhipaka, hiki ke kōkua i ka pale ʻana i nā ʻeha keʻokeʻo hou aʻe .

ʻOiai ʻaʻohe lāʻau lapaʻau e hoʻoponopono ai i ka mea keʻokeʻo i hōʻino mua ʻia, ʻo ka poʻe me nā pilikia olakino i ʻoi aku ka kaohi ʻole ʻia, ʻoi aku ka nui o ka hōʻino ʻia o ka mea keʻokeʻo a me ke kīnā.

Lapaʻau no nā hōʻailona o ke keʻokeʻo

• Hoʻōla kino : Hiki i kēia ke kōkua i ke kaulike a me nā pilikia hele wāwae i hoʻokumu ʻia e ka maʻi keʻokeʻo. Hoʻokomo pū ia i ka hoʻonaʻauao a me ka mālama ʻana e pale aku i ka hāʻule ʻana.
• ʻŌlelo aʻoaʻo noʻonoʻo a me ka mālama ʻana i ka noʻonoʻo : No nā pilikia olakino noʻonoʻo e like me ke kaumaha, hiki ke hoʻomalu ʻia nā hōʻailona ma ke kamaʻilio ʻana me kahi psychologist a, inā pono, ma ka loaʻa ʻana o nā antidepressants mai kahi psychiatrist .
• ʻO ka incontinence mimi : Aia kekahi mau lāʻau lapaʻau no kēia, me nā lāʻau lapaʻau, nā loli o ke ʻano o ka nohona, a me kekahi mau kaʻina hana lapaʻau.

Ka hoʻokele ʻana i nā kumu pilikia o ka maʻi cardiovascular

ʻO ka mālama ʻana i nā kumu pilikia e pili ana i nā maʻi cardiovascular hiki ke kōkua i ka kaohi ʻana i ka holomua hou ʻana o ka maʻi o ka mea keʻokeʻo a pale i nā hanana cardiovascular e hoʻoweliweli i ke ola e like me ka hahau ʻana.

ʻO nā lāʻau lapaʻau e kōkua i ka mālama ʻana i nā pilikia pilikia o ka maʻi cardiovascular:

• Nā lāʻau lapaʻau a me nā hoʻololi ʻana i ke ʻano o ka nohona e mālama ai i ke koko koko maikaʻi.
• Ka mālama ʻana i ka maʻi diabetes (inā loaʻa iā ʻoe ka maʻi diabetes).
• Ke kāohi ʻana i nā pae cholesterol ma o nā lāʻau lapaʻau a me nā hoʻololi ʻana i ke ʻano o ka nohona .
• Hoʻoikaika kino mau .
• E pale i ka puhipaka .
• Ke pale ʻana i ka hoʻohana ʻana i ka waiʻona .
• Nā lāʻau lapaʻau antiplatelet (he hui kēia o nā lāʻau lapaʻau e pale ai i nā hunaola koko mai ka pipili pū ʻana a me ke kūkulu ʻana i nā ʻūpā koko).
• ʻO Statins (ʻoiai inā maʻamau kāu mau pae cholesterol, hiki i kēia mau mea ke kōkua i ka hōʻemi ʻana i ka mumū i loko o nā kīʻaha koko).

He aha ke ʻano o nā kauka e mālama nei i kēia maʻi keʻokeʻo?

Ma muli o kāu mau hōʻailona a me ke kūlana, hiki iā ʻoe ke ʻike i hoʻokahi a ʻoi aku paha o kēia mau kauka e mālama i nā hōʻailona o ka maʻi keʻokeʻo a nānā i kona holomua:

• Kauka lapaʻau noʻonoʻo
• Kou kauka ʻohana (mea lawelawe mālama mua)
• Luna hoʻōla kino
• Luna lapaʻau hana
• Kauka Lapaʻau Kino
• Kauka Puʻuwai
• Kauka Urology
• Kauka Noʻonoʻo a me/a i ʻole Kauka Noʻonoʻo

Hiki ke pale ʻia kēia maʻi keʻokeʻo?

Ua hōʻike ʻia nā noiʻi he ʻoi aku ka nui o ka pilikia o ka poʻe me nā kumu pilikia no ka maʻi cardiovascular i ka hoʻomohala ʻana i ka maʻi mea keʻokeʻo.

ʻO nā kumu pilikia no nā maʻi cardiovascular:

• Ke koko kiʻekiʻe (Hypertension)
• ʻO ke kolesterol kiʻekiʻe (Hyperlipidemia, Dyslipidemia)
• Puhipaka
• ʻO ka maʻi diabetes i kāohi pono ʻole ʻia

Aia kekahi mau mea hiki iā ʻoe ke hana e kāohi i ka holomua o kēia maʻi. Ua hōʻike ʻia nā haʻawina e hiki i ka mālama ʻana i kēia mau mea pilikia, e like me ka lawe ʻana i nā lāʻau lapaʻau, ka hoʻololi ʻana i ke ʻano o ka nohona, a/a i ʻole ka haʻalele ʻana i ka puhipaka, ke kōkua i ka pale ʻana i ka hoʻokumu ʻia ʻana o nā ʻeha keʻokeʻo hou.

He aha ka wānana o ka maʻi keʻokeʻo?

He ʻano ākea ka maʻi keʻokeʻo o nā kūlana e hiki ke ʻano mai ka maʻalahi a i ka koʻikoʻi ma ka MRI. Hiki ke ʻano o nā hōʻailona e pili ana me ia mai ka ʻole a i ka koʻikoʻi. No laila, ʻokoʻa ka nānā ʻana no ka maʻi keʻokeʻo mai kēlā kanaka a kēia kanaka.

Inā ua ʻike ʻia ʻoe me ka maʻi keʻokeʻo, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me kāu neurologist e pili ana i ka mea hiki iā ʻoe ke manaʻo.

Āhea ʻoe e ʻike ai i ke kauka e pili ana i ka maʻi keʻokeʻo?

Inā ua ʻike ʻia ʻoe me ka maʻi keʻokeʻo, he mea nui e ʻike pinepine i kāu kauka mālama mua e kūkākūkā i ka hoʻokele ʻana i kāu mau kumu pilikia. Ma muli o ke ʻano a me ke koʻikoʻi o kāu maʻi keʻokeʻo, a me kāu mau hōʻailona, ​​​​pono paha ʻoe e ʻike i nā loea hou aʻe.

Inā loaʻa iā ʻoe ka maʻi keʻokeʻo, he mea nui e hoʻoikaika i kou olakino cardiovascular. No ka laʻana, ʻo ka lawe ʻana i nā lāʻau lapaʻau e kāohi i kāu cholesterol a me ke koko a me ka hoʻololi ʻana i ke ʻano o ka nohona e hiki ke kōkua i ka pale ʻana i nā ʻeha keʻokeʻo hou a hōʻemi i kou pilikia o ka hahau ʻana a me ka dementia. Inā he mau nīnau kāu e pili ana i kēia kūlana a i ʻole nā ​​​​mea pilikia o ka maʻi cardiovascular, e nīnau i kāu kauka. Eia lākou e kōkua.

Leka Lawe-Home

ʻAe, e nānā kākou i kekahi mau mea maʻalahi e hoʻomanaʻo e pili ana i ka White Matter Disease a mākou i kamaʻilio ai:

• He hōʻino kēia i ka mea keʻokeʻo o ka lolo , e like me ka hōʻino ʻana i nā "alanui" e lawe ana i ka ʻike i loko o ka lolo.
• Hoʻopili pinepine ʻia me ka ʻelemakule a me nā mea pilikia o ka maʻi puʻuwai (ke koko kiʻekiʻe, ka maʻi diabetes, ka cholesterol, ka puhipaka).
• Hiki i nā hōʻailona ke komo pū me ka nalowale o ka hoʻomanaʻo, ka paʻakikī i ka hele wāwae, a me ka nalowale o ke kaulike .
• Hoʻomaopopo nui ʻia ia ma o kahi scan MRI .
• ʻOiai ʻaʻole hiki ke hoʻihoʻi loa ʻia ka pōʻino i hana ʻia, hiki ke hoʻokele ʻia ke kūlana ma o ka kaohi ʻana i nā kumu pilikia a me ka mālama ʻana i nā hōʻailona .
• He mea nui loa ka mālama ʻana i ke olakino o ka puʻuwai e pale aku ai i ka holomua hou ʻana o kēia maʻi.

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​a inā makemake ʻoe e ʻike hou aʻe e pili ana i kēia, e ʻimi pono i ke aʻo lapaʻau . Mai makaʻu, ʻo ka mea nui loa i kēia mau mea a pau, ʻo ia ka ʻike i ka ʻike kūpono a hana i nā hana e pono ai.

ʻO ka maʻi keʻokeʻo, nā maʻi lolo, ka maʻi keʻokeʻo, ka hemahema o ka hoʻomanaʻo, ka nalowale o ke kaulike, ka ʻelemakule, ka pilikia o ka maʻi puʻuwai, MRI