Xav txog seb yog koj ua koj txoj haujlwm ib txwm thiab tam sim ntawd, tsis muaj lus ceeb toom dab tsi, koj muaj mob taub hau phem tshaj plaws uas koj tau ntsib dua. Nws yog qhov mob hnyav tshaj plaws hauv koj lub neej. Qhov mob yuav nce mus txog nws qhov siab tshaj plaws hauv ob peb feeb xwb. Hauv kev kho mob, peb hu qhov mob taub hau tam sim ntawd no ua "Thunderclap Headache." Qhov no tsis yog mob taub hau xwb. Qhov no feem ntau yog qhov ceeb toom loj uas peb lub cev tab tom muab rau peb. RCVS yog ib qho mob uas muab lus ceeb toom zoo li no.
Hais yooj yim xwb, RCVS yog dab tsi?
Lub npe tag nrho rau RCVS yog Reversible Cerebral Vasoconstriction Syndrome . Lub npe yuav zoo li ntev thiab nyuaj me ntsis, tab sis cia peb ua kom yooj yim xwb.
- Rov Qab Tau: txhais tau tias "tuaj yeem rov qab tau." Qhov no txhais tau tias tus mob no tsis yog mus tas li thiab tuaj yeem kho tau nrog kev kho mob kom zoo .
- Cerebral: txhais tau tias "hais txog lub hlwb."
- Vasoconstriction: txhais tau tias "kev nqaim lossis kev nqaim ntawm cov hlab ntsha."
Hais yooj yim xwb, RCVS yog ib qho mob uas cov hlab ntsha hauv lub hlwb cia li nruj, nqaim, thiab thaiv . Txawm li cas los xij, qhov no tuaj yeem kho tau yog tias kho kom zoo.
Xav txog ib lub yeeb nkab dej. Yog tias peb nias ib feem ntawm lub yeeb nkab, yuav ua li cas? Nws ua rau dej tsis ntws, puas yog? Tib yam li ntawd tshwm sim rau cov hlab ntsha hauv peb lub hlwb. Thaum cov hlab ntsha no nruj zuj zus (peb hu qhov no "vasospasm"), lub hlwb tsis tau txais cov ntshav txaus. Qhov no yog vim li cas peb thiaj li mob taub hau hnyav uas zoo li xob laim. Qhov mob no kuj qee zaum qhia txog cov tsos mob xws li mob taub hau loj heev, mob hlwb, lossis ntshav hauv lub hlwb .
Tseem ceeb heev: Mob taub hau "Thunderclap Headache", uas yog mob taub hau sai sai, mob taub hau hnyav uas zoo li mob taub hau phem tshaj plaws uas koj tau muaj, yog xwm txheej ceev kho mob . Qhov no yuav yog ib qho cim qhia tias muaj ntshav hauv lub hlwb. Yog tias koj lossis ib tus neeg koj paub muaj hom mob taub hau no, mus rau chav kho mob ceev (ETU) ze tshaj plaws yam tsis muaj kev ncua.
Cov tsos mob ntawm RCVS yog dab tsi?
RCVS muaj peev xwm ua rau muaj ntau yam tsos mob vim yog cov ntshav ntws mus rau lub hlwb tsis zoo. Cov tsos mob tseem ceeb yog mob taub hau hnyav, tab sis kuj muaj lwm yam tsos mob thiab.
| Cov tsos mob | Kev piav qhia |
|---|---|
| Mob taub hau "Thunderclap" | Mob taub hau loj heev uas pib tam sim ntawd, nce mus txog qhov siab tshaj plaws hauv ob peb feeb xwb, thiab tej zaum yuav rov tshwm sim dua hauv ib lossis plaub lub lis piam. |
| Kev rhiab heev ntxiv | Tsis kam rau lub teeb ci ntsa iab ('(Photophobia)') thiab suab nrov ('(Phonophobia)'). |
| Lwm yam nta | Xeev siab thiab ntuav, pom kev hloov pauv (pom kev tsis meej pem, pom ob sab), cov leeg nqaij tsis muaj zog hauv ib feem ntawm lub cev, tsis meej pem. |
| Cov tsos mob hnyav | Qaug dab peg, nyuaj hais lus lossis nkag siab txog yam uas lwm tus hais (`(Aphasia)`). |
Muaj tej lub sij hawm, RCVS tuaj yeem ua rau los ntshav ntawm lub hlwb thiab lub taub hau. Qhov no hu ua '(Subarachnoid Hemorrhage - SAH)'. Qhov no kuj yog ib qho xwm txheej ceev heev. Ntxiv rau cov tsos mob saum toj no, SAH kuj tseem yuav muaj cov tsos mob hauv qab no:
- Mob caj dab, mob cov leeg hauv caj dab thiab xub pwg.
- Kev hloov pauv ntawm tus cwj pwm thiab lub siab (npau taws yam tsis muaj laj thawj).
- Kev tsis muaj zog ntawm ib feem ntawm lub cev.
Dab tsi yog cov yam uas ua rau muaj kev loj hlob ntawm RCVS?
Txawm hais tias tseem tsis tau pom qhov ua rau muaj RCVS tseeb los xij, muaj ntau yam ua rau muaj kev pheej hmoo uas yuav ua rau muaj tus mob no.
Cev xeeb tub thiab yug menyuam
Qhov feem ntau thiab feem ntau ua rau muaj RCVS yog cev xeeb tub. Qhov kev pheej hmoo siab tshaj plaws yog thaum rau lub lis piam tom qab yug me nyuam (tom qab yug me nyuam). Cov kws kho mob ntseeg tias kev hloov pauv hormonal thaum cev xeeb tub yuav ua lub luag haujlwm. RCVS tuaj yeem tshwm sim txawm tias tsis muaj teeb meem xws li preeclampsia, uas yog ib qho mob ntshav siab uas tshwm sim thaum cev xeeb tub.
Kev siv qee yam tshuaj thiab tshuaj yeeb
Qee cov tshuaj thiab cov tshuaj uas cuam tshuam rau peb lub cev cov ntshav ncig ua rau muaj kev pheej hmoo ntawm RCVS ntau ntxiv.
| Hom tshuaj/tshuaj | Piv txwv |
|---|---|
| Cov tshuaj kho mob kev nyuaj siab | Tshwj xeeb tshaj yog cov tshuaj SSRI (`(Selective Serotonin Reuptake Inhibitors)`). |
| Cov tshuaj rau mob migraines | Cov tshuaj triptans thiab cov tshuaj uas muaj ergot. |
| Cov tshuaj uas tiv thaiv kab mob | Cov tshuaj uas txo qhov kev tiv thaiv kab mob uas tau muab rau qee yam kab mob. |
| Cov tshuaj txhawb zog thiab cov tshuaj | Cov tshuaj xws li amphetamines, cocaine, marijuana, nicotine patches, energy drinks, LSD, thiab MDMA. |
Lwm yam mob nkeeg
Qee yam mob kuj ua rau muaj kev pheej hmoo ntawm kev mob RCVS.
- Mob taub hau migraine: Cov neeg uas muaj mob taub hau migraine feem ntau yuav muaj RCVS.
- Cov calcium hauv cov ntshav nce ntxiv (Hypercalcemia): Thaum cov calcium hauv cov ntshav nce ntxiv, kev ua haujlwm ntawm cov hlab ntsha tuaj yeem raug cuam tshuam.
- Teeb meem Hormonal: Cov tshuaj hormones estrogen raug xav tias muaj feem cuam tshuam rau qhov no. Qhov no yog vim li cas tus kab mob no thiaj li tshwm sim ntau dua ntawm cov poj niam.
- Cov kab mob uas los ntawm noob caj: Cov kab mob uas ua rau muaj qog nqaij hlav uas tsim cov tshuaj adrenaline ntau dhau, xws li "Pheochromocytoma"
Tej yam teeb meem uas yuav tshwm sim los ntawm RCVS yog dab tsi?
Yav dhau los, cov kws kho mob xav tias RCVS yog ib qho mob uas tsis muaj teeb meem dab tsi, tab sis kev tshawb fawb tshiab tau qhia tias qhov no tsis yog li ntawd tas li.
Kwv yees li 30% ntawm cov neeg mob RCVS yuav muaj qee qhov kev tsis taus me me mus tas li (piv txwv li, qee qhov leeg tsis muaj zog, teeb meem nrog kev sib npaug thaum taug kev). Kwv yees li 8% yuav muaj teeb meem loj dua, mus sij hawm ntev.
Ntxiv rau, tej zaum yuav muaj teeb meem loj dua hauv ob peb hnub tom qab cov tsos mob thawj zaug tshwm sim.
- Ischemic Stroke: Mob stroke uas tshwm sim los ntawm kev thaiv ntawm cov hlab ntsha uas xa cov ntshav mus rau lub hlwb.
- Kev ntshav hauv lub hlwb: Ib qho mob zoo ib yam li SAH.
- Kab mob qaug dab peg ('(Qaug dab peg)').
Qhov no yog vim li cas peb thiaj hais ntau zaus tias nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev kho mob tam sim ntawd yog tias koj mob taub hau sai sai thiab hnyav. Kev kho mob sai sai tuaj yeem tiv thaiv tau ntau yam teeb meem loj no.
Yuav kuaj mob RCVS li cas?
Thaum koj mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU), cov kws kho mob ua raws li ob peb kauj ruam los kuaj mob no.
1. Kev kuaj lub cev thiab lub paj hlwb: Ntxiv rau kev nug txog koj cov tsos mob, yuav kuaj koj lub paj hlwb ua haujlwm (piv txwv li, kev hais lus, kev pom kev, kev sib npaug ntawm lub cev).
2. Kev kuaj ntshav: Kev kuaj ntshav yog ua los nrhiav tej yam xws li teeb meem ntshav txhaws, kev kis kab mob, thiab kev tsis sib npaug ntawm cov ntsev hauv lub cev.
3. Kev Thaij Duab: Cov kev thaij duab no yog qhov tseem ceeb tshaj plaws hauv kev kuaj mob RCVS. Lawv tuaj yeem "saib" sab hauv lub hlwb thiab txheeb xyuas cov teeb meem.
Cov kev luam theej no ua hom twg?
- Kev Ntsuas CT (`(Computed Tomography - CT scan)`): Ib qho kev ntsuas hu ua `(CT angiogram)` siv tau los saib cov hlab ntsha hauv lub hlwb. Kev ntsuas CT yog ib qho tseem ceeb heev rau kev kuaj mob stroke sai sai, vim tias txhua ob feeb suav thaum kho mob stroke.
- Kev thaij duab MRI (Magnetic Resonance Imaging - MRI scan): Ib qho kev thaij duab hu ua Magnetic Resonance Angiogram - MRA tuaj yeem qhia meej txog qhov kev nqaim ntawm cov hlab ntsha (vasospasm) thiab cov teebmeem uas tshwm sim rau lub hlwb.
- Transcranial Doppler ultrasound: Qhov no ntsuas qhov ceev ntawm cov ntshav ntws los ntawm lub hlwb thiab tuaj yeem muab lub tswv yim seb cov hlab ntsha puas raug thaiv.
Feem ntau, tom qab txiav txim siab tias puas muaj mob stroke, yuav tsum tau kuaj MRI/MRA kom paub meej tias muaj RCVS.
Yuav kho tus kab mob RCVS li cas?
Raws li lub npe qhia ("Kho Rov Qab Tau"), qhov no yog ib qho mob uas kho tau . Muaj ob lub hom phiaj tseem ceeb ntawm kev kho mob.
1. Tshem tawm qhov ua rau muaj mob: Yog tias qhov ua rau muaj mob RCVS pom tseeb (piv txwv li, ib yam tshuaj), thawj kauj ruam yog tshem tawm qhov ua rau mob ntawd.
2. Tswj cov hlab ntsha kom nruj: Cov tshuaj no muab rau kom tswj tau cov hlab ntsha kom nruj (`(vasospasm)`).
Cov tshuaj siv ntau tshaj plaws rau qhov no yog cov tshuaj calcium channel blockers ('(Calcium Channel Blockers - CCBs)').Cov tshuaj no ua haujlwm los ntawm kev thaiv cov calcium kom tsis txhob nkag mus rau hauv cov leeg nqaij du hauv cov phab ntsa ntawm cov hlab ntsha. Cov leeg nqaij ces so, cov hlab ntsha dav dua, thiab cov ntshav ntws mus rau lub hlwb rov qab zoo li qub.
Muaj tej yam tsawg tsawg uas tus kab mob tsis teb rau tshuaj, yuav siv tau ib txoj kev kho mob hu ua "endovascular". Hauv qhov no, yuav muab ib lub raj nyias nyias ("catheter") tso rau hauv ib txoj hlab ntshav hauv caj npab lossis ceg mus rau ib txoj hlab ntshav hauv lub hlwb, thiab muab ib lub npas cua los ntawm nws ("angioplasty") kom nthuav cov hlab ntshav uas raug thaiv lossis muab tshuaj ncaj qha rau.
Yog tias RCVS raug tsim los, yuav muaj dab tsi tshwm sim?
Yog koj muaj RCVS, thawj qhov koj yuav ntsib yog mob taub hau loj heev tam sim ntawd. Qhov no yog xwm txheej ceev thiab yuav tsum tau kho tam sim ntawd. Thaum pib kho, feem ntau cov neeg yuav zoo li qub hauv ob peb hnub lossis ob peb lub lis piam .
Feem ntau cov neeg (kwv yees li 80% - 85%) rov zoo tag nrho yam tsis muaj teeb meem mus sij hawm ntev . Qhov ntawd yog qhov zoo tshaj plaws txog tus kab mob no. Kwv yees li 10% tej zaum yuav muaj teeb meem me me. Txawm li cas los xij, muaj kev pheej hmoo me me ntawm cov teeb meem loj, xws li mob stroke uas peb tau tham txog ua ntej, yog li kev kuaj mob thiab kev kho mob thaum ntxov yog qhov tseem ceeb heev.
Peb yuav tsum ua li cas thiaj li tiv thaiv tau RCVS kom tsis txhob rov qab los?
Yog tias koj tau muaj RCVS, koj tus kws kho mob yuav qhia koj kom hloov qee yam kev ua neej kom tiv thaiv nws kom tsis txhob rov tshwm sim dua.
- Tsum tsis txhob noj tshuaj uas ua rau muaj RCVS: Yog tias muaj tshuaj ua rau muaj mob, tsum tsis txhob noj raws li koj tus kws kho mob hais thiab tsis txhob noj tshuaj ntawd yav tom ntej.
- Noj cov tshuaj uas tus kws kho mob tau sau tseg tsis tu ncua: Noj cov tshuaj raws sijhawm kom tiv thaiv cov tsos mob kom tsis txhob rov qab los.
- Tsis txhob siv tshuaj yeeb yam tsis tsim nyog kiag li: Tsis txhob siv cov tshuaj uas ua rau lub cev muaj zog, tshwj xeeb tshaj yog cov uas cuam tshuam rau lub cev ntshav ncig, xws li tshuaj marijuana.
- Tswj cov dej haus uas muaj caffeine thiab cov dej haus muaj zog: Nws yog ib qho zoo uas yuav tsum txo qhov koj haus lossis tsum tsis txhob haus cov no kiag li.
Koj tus kws kho mob yuav hais kom koj rov qab los rau lub tsev kho mob kom saib xyuas koj tus mob. Nco ntsoov mus koom cov sijhawm teem tseg ntawd.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Mob taub hau loj heev uas pib tshwm sim sai sai ("Thunderclap Headache") yog ib qho xwm txheej ceev. Mus rau chav kho mob ceev (ETU) ze tshaj plaws yam tsis muaj kev ncua.
- RCVS yog ib qho mob uas tshwm sim los ntawm kev nqaim thiab nqaim ntawm cov hlab ntsha hauv lub hlwb. Tab sis raws li lub npe qhia, nws yog ib qho mob uas kho tau tag nrho nrog kev kho mob kom zoo .
- Qhov no feem ntau tshwm sim tom qab yug menyuam, vim yog siv qee yam tshuaj, lossis tuaj yeem tshwm sim nrog lwm yam mob.
- Kev kuaj mob thiab kev kho mob thaum ntxov tuaj yeem tiv thaiv tau cov teeb meem loj xws li mob hlwb, thiab ntau tus neeg rov zoo tag nrho.
- Tham nrog koj tus kws kho mob txog koj tus mob, kev kho mob, thiab tej yam uas koj txhawj xeeb txog yav tom ntej.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus