Mob taub hau phem tshaj plaws hauv koj lub neej? Puas yog nws yog RCVS? (Reversible Cerebral Vasoconstriction Syndrome)

Xav txog koj tsuas yog poob siab, thiab tam sim ntawd, tsis txog ib pliag, koj mob taub hau hnyav tshaj plaws uas koj tau muaj hauv koj lub neej ... zoo li xob laim ntaus koj lub taub hau. Hauv kev kho mob, peb hu qhov no ua "Thunderclap Headache." Qhov no yog cov tsos mob feem ntau thiab hnyav tshaj plaws ntawm tus mob uas peb tab tom tham txog niaj hnub no, RCVS. Mob taub hau zoo li no yog xwm txheej ceev hauv kev kho mob uas xav tau kev kho mob tam sim ntawd.

RCVS yog dab tsi yooj yim?

Hais yooj yim xwb, Reversible Cerebral Vasoconstriction Syndrome (RCVS) yog ib qho mob uas cov hlab ntsha hauv koj lub hlwb tam sim ntawd nruj thiab raug thaiv. Nws zoo li ib lub yeeb nkab dej raug nias tam sim ntawd. Thaum cov hlab ntsha raug thaiv li no, lub hlwb tsis tau txais cov ntshav ntau npaum li nws xav tau. Qhov no yog vim li cas koj thiaj mob taub hau zoo li xob laim uas kuv tau hais ua ntej.

Lo lus "rov qab kho tau" hauv lub npe ntawm tus mob no txhais tau tias nws tuaj yeem rov qab kho tau nrog kev kho mob kom zoo . Txawm li cas los xij, yog tias tsis kho, nws tuaj yeem ua rau muaj mob hnyav xws li mob stroke lossis ntshav hauv hlwb. Qee zaum, cov tsos mob zoo ib yam li cov tsos mob ntawm mob taub hau lossis mob stroke, ua rau nws nyuaj rau paub qhov txawv ntawm ob qho tib si.

Cov tsos mob ntawm tus mob no yog dab tsi?

Tag nrho cov tsos mob ntawm RCVS yog tshwm sim los ntawm kev cuam tshuam ntawm cov ntshav mus rau lub hlwb. Cia peb saib seb cov tsos mob no yog dab tsi.

Dab tsi ua rau muaj RCVS?

Peb cov hlab ntsha muaj ib txheej ntawm cov leeg nqaij du sab hauv. Cov leeg no tswj cov ntshav ntws los ntawm kev sib zog thiab so. Tab sis qee zaum cov leeg no cia li ntswj thiab sib zog nruj dhau. Peb hu qhov no tias "vasospasm". Qhov no yog qhov ua rau RCVS.

Muaj ntau yam ua rau qhov mob no (vasospasm) tshwm sim.

Cev xeeb tub thiab lub sijhawm tom qab yug menyuam

Qhov ua rau muaj RCVS feem ntau yog cev xeeb tub. Qhov kev pheej hmoo ntawm tus mob no yog siab tshaj plaws thaum rau lub lis piam thawj zaug tom qab yug menyuam. Qhov no ntseeg tau tias yog vim muaj kev hloov pauv sai sai ntawm cov tshuaj hormones. Qhov kev pheej hmoo no tuaj yeem tshwm sim txawm tias koj tsis muaj mob xws li preeclampsia thaum cev xeeb tub.

Qee cov tshuaj thiab kev siv tshuaj

RCVS tuaj yeem tshwm sim los ntawm qee cov tshuaj thiab cov tshuaj uas cuam tshuam rau koj lub cev ntshav.

• Qee cov tshuaj kho kev nyuaj siab, tshwj xeeb tshaj yog cov uas nyob hauv pawg SSRIs.
• Cov tshuaj kho mob migraine (triptans thiab cov tshuaj ergot).
• Cov tshuaj uas tiv thaiv kab mob.
• Qee cov tshuaj kho mob rau tus kab mob Parkinson.
• Cov tshuaj stimulants (amphetamines, cocaine, pseudoephedrine).
• Tshuaj yeeb.
• Kev haus dej cawv thiab caffeine ntau dhau.
• Cov tshuaj nicotine.
• Cov tshuaj yeeb zoo li 'LSD' lossis 'MDMA' (ecstasy).

Lwm yam mob nkeeg

Qee yam mob uas cuam tshuam rau lub hlwb lossis cov ntshav ncig kuj tseem tuaj yeem ua rau muaj kev pheej hmoo ntawm RCVS.

• Mob taub hau migraine: Cov neeg uas muaj mob taub hau migraine feem ntau yuav muaj RCVS.
• Cov calcium hauv cov ntshav ntau (Hypercalcemia): Cov calcium uas ntau ntxiv tuaj yeem cuam tshuam rau kev ua haujlwm ntawm cov leeg hauv cov hlab ntsha.
• Cov teeb meem Hormonal: Cov tshuaj hormones estrogen tshwj xeeb yog xav tias muaj feem cuam tshuam, yog vim li cas tus kab mob no thiaj li tshwm sim ntau dua rau cov poj niam.
• Qee yam mob uas los ntawm noob caj ces, xws li "Pheochromocytoma" (ib qho qog uas tsim cov tshuaj adrenaline ntau dhau) thiab "Porphyria", yuav ua rau muaj kev pheej hmoo ntau ntxiv.

Tej yam teeb meem uas yuav tshwm sim los ntawm RCVS yog dab tsi?

Yav dhau los, cov kws kho mob xav tias RCVS tsis yog ib qho mob hnyav. Tab sis kev tshawb fawb tshiab qhia tau tias qee zaum nws tuaj yeem ua rau muaj teeb meem. Kwv yees li 30% ntawm cov neeg uas muaj RCVS yuav muaj qee qhov kev tsis taus me me mus tas li (xws li cov leeg tsis muaj zog). Kwv yees li 8% yuav muaj teeb meem loj dua mus sij hawm ntev.

Ntxiv rau, cov teeb meem loj xws li cov no tuaj yeem tshwm sim hauv ob peb hnub ntawm thawj cov tsos mob:

• Ischemic stroke: Kev thaiv ntawm cov hlab ntsha uas muab ntshav mus rau lub hlwb.
• Kev los ntshav hauv lub hlwb (SAH lossis lwm hom kev los ntshav hauv lub hlwb): Los ntshav ntawm lub hlwb thiab lub taub hau.
• Qaug dab peg.

Cov kws kho mob nrhiav tau qhov no li cas?

Tus kws kho mob siv ntau txoj kev los kuaj mob no.

• Kev kuaj lub cev thiab lub paj hlwb: Koj cov reflexes, lub zog, thiab kev xav raug kuaj xyuas.
• Kev kuaj ntshav: Xyuas seb puas muaj teeb meem ntshav txhaws, kab mob, thiab tsis sib npaug ntawm cov ntsev.
• Kev luam theej duab: Qhov no yog txoj hauv kev tseem ceeb tshaj plaws los kuaj mob RCVS.

Kev luam theej duab

Cov kev ntsuas no tuaj yeem "pom" sab hauv ntawm lub taub hau thiab lub hlwb. Lawv tuaj yeem kuaj xyuas seb puas muaj cov hlab ntsha raug thaiv lossis cov ntshav ntws tsawg dua.

• Kev ntsuas Computed Tomography (CT): Tshwj xeeb, CT angiograms tuaj yeem pab soj ntsuam qhov xwm txheej ntawm cov hlab ntsha zoo dua.
• Kev ntsuas Magnetic Resonance Imaging (MRI): Kev ntsuas MRI tshwj xeeb hu ua Magnetic Resonance Angiogram (MRA) kuj tseem tuaj yeem ntes tau vasospasm hauv cov hlab ntsha.
• Transcranial Doppler ultrasound: Qhov no tuaj yeem ntsuas qhov ceev ntawm cov ntshav ntws los ntawm lub hlwb.

Feem ntau, kev kuaj CT yuav tsum ua ua ntej. Vim tias nws ua haujlwm sai. Nws tuaj yeem txiav txim siab sai sai seb puas muaj xwm txheej ceev xws li mob stroke lossis los ntshav. Thaum muaj mob stroke, txhua ob feeb suav tias yog qhov tseem ceeb, yog li qhov ceev ntawd tseem ceeb heev. Tom qab ntawd, yog tias tsim nyog, kev kuaj MRI yuav tsum ua kom paub meej ntxiv txog qhov txhaws hauv cov hlab ntsha.

Cov kev kho mob rau RCVS yog dab tsi?

Raws li lub npe qhia, RCVS yog ib yam mob uas kho tau yooj yim heev . Kev kho mob muaj ob lub hom phiaj tseem ceeb.

1. Yog tias nrhiav tau ib qho ua rau mob (piv txwv li, ib yam tshuaj), tshem tawm qhov ua rau mob ntawd.

2. Txhawm rau txo qhov vasospasm (nruab) ntawm cov hlab ntsha thiab rov qab kho lawv kom zoo li qub.

Cov tshuaj uas siv ntau tshaj plaws los kho qhov mob no (vasospasm) yog cov tshuaj calcium channel blockers (CCBs) . Cov tshuaj no ua haujlwm los ntawm kev thaiv calcium kom tsis txhob nkag mus rau hauv cov leeg nqaij hauv cov hlab ntsha. Tom qab ntawd cov leeg nqaij so, cov hlab ntsha dav dua, thiab cov ntshav ntws rov qab mus rau qhov qub.

Muaj tsawg tsawg zaus, qee zaum, kev kho mob yuav ua tau los ntawm kev siv txoj kev kho mob hu ua "endovascular". Qhov no suav nrog kev xa ib lub raj nyias nyias (catheter) hla cov hlab ntsha hauv caj npab lossis ceg mus rau cov hlab ntsha hauv lub hlwb uas raug thaiv, thiab tom qab ntawd txhaj tshuaj lossis siv ib yam dab tsi zoo li lub npas kom nthuav cov hlab ntsha (angioplasty).

Peb yuav cia siab li cas rau qhov xwm txheej no?

Feem ntau cov neeg uas muaj RCVS (kwv yees li 80% - 85%) rov zoo tag nrho yam tsis muaj teeb meem mus sij hawm ntev. Yog li ntawd, muaj kev cia siab zoo rau qhov no. Tab sis qhov tseem ceeb tshaj plaws hauv qhov no yog kuaj mob thaum ntxov thiab pib kho kom zoo.

Tej yam koj ua tau kom tiv thaiv RCVS kom tsis txhob rov tshwm sim dua

Vim tias nws tsis meej meej tias yog vim li cas RCVS thiaj tshwm sim, nws tsis tuaj yeem tiv thaiv tau tas li. Txawm li cas los xij, muaj qee yam koj tuaj yeem ua tau los txo koj qhov kev pheej hmoo. Koj tus kws kho mob yuav muab lus qhia ntxiv rau koj txog qhov no.

• Yog tias muaj cov tshuaj uas xav tias ua rau muaj RCVS, tsum tsis txhob noj thiab tsis txhob noj ntxiv lawm yav tom ntej.
• Noj cov tshuaj uas tus kws kho mob tau sau tseg raws li tau sau tseg thiab kom raug.
• Tsis txhob siv tshuaj lossis tshuaj yeeb (tshwj xeeb yog cov tshuaj stimulants thiab marijuana) yam tsis tau kev qhia los ntawm kws kho mob.
• Txo lossis tsum tsis txhob haus caffeine thiab dej haus muaj zog kiag li.

Thaum twg koj yuav tsum mus ntsib kws kho mob thiab mus rau ETU?

Yog koj muaj RCVS, koj tus kws kho mob yuav qhia koj kom tuaj rau lub tsev kho mob tas li. Nws yog ib qho tseem ceeb heev uas yuav tsum tuaj koom cov kev teem sijhawm no tsis tu ncua. Ua li no, koj tus mob yuav raug saib xyuas thiab koj txoj kev kho mob yuav raug hloov kho raws li qhov xav tau.

Thaum twg yuav tsum mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) tam sim ntawd:

Yog tias koj mob taub hau nrov nrov lossis muaj cov tsos mob zoo li mob stroke (piv txwv li, ib sab ntawm lub cev tsis muaj zog, hais lus tsis tau zoo, pom kev hloov pauv) dua, nws yeej ib txwm yog xwm txheej ceev hauv kev kho mob. Tsis txhob tos kom txog thaum nws lig dhau lawm. Mus rau tsev kho mob sai li sai tau.

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