Imajin se yu jɔs de lɔs, ɛn wantɛm wantɛm, insay lɛs wan sɛkɔn, yu gɛt di wɔs ed we yu dɔn ɛva gɛt na yu layf... lɛk laytin we de nak yu ed. Insay mɛrɛsin, wi kin kɔl dis "Thunderclap Headache." Dis na di mɔs kɔmɔn ɛn siriɔs sayn fɔ de sik wae wi de tɔk bɔt tide, RCVS. Ed we de at lɛk dis na mɛdikal imejensi we nid fɔ gɛt tritmɛnt kwik kwik wan.
Wetin na RCVS simpul wan?
Fɔ tɔk am simpul wan, Rivasibul Sɛribra Vasokɔnstrikshɔn Sindrom (RCVS) na wan sik we di blɔd vesel dɛn na yu bren kin tayt wantɛm wantɛm ɛn blok. I tan lɛk se dɛn de swɛt wata paip wantɛm wantɛm. We di blɔd vesel dɛn blok dis we, di bren nɔ kin gɛt di blɔd we i nid. Dis na di rizin we mek yu kin gɛt da ed we tan lɛk laytin we a bin dɔn tɔk bɔt.
di wɔd "rivεrsibl" na di nem fכ dis kכndyushכn min se dεn kin rivεs am wit di rayt tritmεnt . Bɔt if dɛn nɔ trit am, i kin mek i gɛt siriɔs sik lɛk strok ɔ blɔd na in bren. Sɔmtɛm, de sayn dɛm kin rili fiba di wan dɛm wae gɛt maygren ɔr strok, dat kin mek i nɔr izi fɔ no difrɛns bitwin dɛn tu.
I rili impɔtant: If yu ɔ pɔsin we yu sabi gɛt ed we kin at wantɛm wantɛm ɛn we kin fil lɛk se na di wɔs ed pen na dɛn layf, na mɛdikal imejensi. Go na di ɔspitul imejensi rum (ETU) we de nia yu wantɛm wantɛm. Nɔ west tɛm.
Wetin na di sayn dɛm fɔ dis sik?
Ɔl di simptom dɛm fɔ RCVS na bikɔs di blɔd saplai to di bren nɔ de wok fayn. Lɛ wi tek wan luk pan wetin na dɛn sayn ya.
| Di sayn we de sho se di sik de | Wan simpul ɛksplen |
|---|---|
| Tɛndklap Ɛd we de at | Di wɔs ed pen we a dɔn ɛva gɛt na mi layf, we kin bigin wantɛm wantɛm. |
| Fɔ fil fayn to layt ɛn sawnd | Fɔ fil se yu nɔ ebul fɔ luk layt ɔ yɛri sawnd (Photophobia and Phonophobia) . |
| Nɔs ɛn vɔmit | Ɛd pen we kin kam wit vɔmit. |
| Vishɔn kin chenj | Yu nɔ de si fayn, yu nɔ de si tu tɛm, ɔ yu nɔ de si fayn. |
| Di mɔsul dɛn we wik | Fɔ fil se yu nɔ gɛt bɛtɛ trɛnk na wan say na yu bɔdi. |
| Kɔnfyus | Fɔgɛt bɔt ples ɛn tɛm, fɔ lɔs kɔnshɛns. |
| Di sik dɛn we kin mek pɔsin sik | Wan kɔndishɔn we tan lɛk fit. |
| I nɔ izi fɔ tɔk (Aphasia) . | I nɔ izi fɔ tɔk ɔ ɔndastand wetin ɔda pipul dɛn de tɔk. |
| Ɔda sayn dɛm we kin apin wit blɔd we de kɔmɔt na di bren (Subarachnoid Hemorrhage - SAH) . | |
| Nek stiffness | di mכsul dεm stiff εn pen na di nεk εn sholda dεm. |
| Di we aw pipul dɛn de biev kin chenj | Fɔ vɛks wantɛm wantɛm, fɔ vɛks kwik. |
| Di bɔdi we de swɛla | Fɔ fil se yu de fil lɛk yu de swɛt na sɔm pat na yu bɔdi. |
Wetin kin mek pɔsin gɛt RCVS?
Wi blɔd vesel dɛn gɛt wan layt we gɛt smɔl smɔl mɔsul dɛn insay. Dɛn mɔsul dɛn ya kin kɔntrol aw blɔd de flɔ bay we dɛn kin kɔntrakt ɛn rilaks. Bɔt sɔntɛnde, dɛn mɔsul dɛn ya kin spasm wantɛm wantɛm ɛn kɔntrakt tu tayt. Wi kin kɔl dis ``vasospasm''. Dis na di men tin we kin mek pɔsin gɛt RCVS.
Bɔrku rizin de wae mek dis sik (vasospasm) kin apun.
di bεlε εn di tεm we i bכn
Di tin we kin mek pɔsin gɛt RCVS na we uman gɛt bɛlɛ. di risk fכ dis kכndyushכn kin bכku insay di fכs siks wik afta di pikin bכn. Dɛn biliv se dis kin bi bikɔs di ɔmon lɛvɛl kin chenj wantɛm wantɛm. Dis risk kin apin ivin if yu nɔ gɛt kɔndishɔn lɛk prɛeklampsia we yu gɛt bɛlɛ.
Sɔm mɛrɛsin ɛn yuz drɔgs
RCVS kin kam bikɔs ɔf sɔm mɛrɛsin ɛn drɔgs wae kin afɛkt yu blɔd sistɛm.
- Sɔm mɛrɛsin fɔ pwɛl hat, mɔ di wan dɛn we de na di SSRI grup.
- Maygren mɛrɛsin (triptan ɛn ergot-tayp drɔgs).
- Drug dɛn we de mek di bɔdi nɔ ebul fɔ fɛt di sik.
- Sɔm mɛrɛsin fɔ di sik we dɛn kɔl Parkinson.
- Stimulants (amphetamin, kɔkɛyn, pseudoɛfɛdrin).
- Marijuana we dɛn kin yuz.
- Fɔ it pasmak kafinɛ ɛn ɛnaji drink dɛn.
- Nikotin pat dɛn.
- Drugs lɛk `LSD` ɔ `MDMA` (ɛkstasy).
Ɔda tin dɛn we kin apin to pɔsin we sik
Sɔm mɛrɛsin wae kin afɛkt di bren ɔr blɔd sakulayshɔn kin mek bak di risk fɔ gɛt RCVS.
- Maygren: Pipul wae gɛt maygren kin gɛt RCVS.
- di hεy blכd kalsiכm lεvεl (Hypercalcemia): We di kכlsyכm lεvεl bכku i kin ambɔg di wok we di mכsul dεm na di bכdi vεsul dεm de du.
- כmon ishu dεm: dεn sכspεkt se di כmon εstrojen spεshal wan de involv, na dat mek dis sik de mכr pan uman dεm.
- sכm kכndyushכn dεm we dεn kin gεt fכ bכn, lεk ``Pheochromocytoma'' (wan tכmכro we de mek εksyכs adrenaline כmon) εn ``Porphyria'', kin mek di risk bכku.
Wetin na di prɔblɛm dɛn we kin apin we pɔsin gɛt RCVS?
Trade, dɔktɔ dɛn bin de tink se RCVS nɔto siriɔs sik. Bɔt nyu risach dɔn sho se sɔntɛnde i kin mek prɔblɛm dɛn. Na lɛk 30% pan di pipul dɛm wae gɛt RCVS kin lɛf wit sɔm smɔl smɔl pɔrmɛnt disabiliti (lɛk di mɔsul dɛm we wik). Na lɛk 8% kin gɛt mɔ siriɔs prɔblɛm dɛn we kin te fɔ lɔng tɛm.
Apat frɔm dat, siriɔs prɔblɛm dɛn lɛk dis kin apin insay sɔm dez frɔm di fɔs sayn dɛm:
- Ischemic stroke: I de blok wan blɔd vesel we de gi blɔd to di bren.
- Intracerebral hemorrhage (SAH ɔ ɔda kayn blɔd we de kɔmɔt na di bren): Blɔd de kɔmɔt bitwin di bren ɛn di skel.
- Di sik dɛn we kin mek pɔsin sik.
Aw dɔktɔ dɛn kin fɛn dis?
Dɔktɔ kin yuz bɔku we dɛn fɔ no bɔt dis sik.
- Wan ɛgzamin fɔ yu bɔdi ɛn nyurolɔjik: Dɛn kin chɛk yu riflɛs, trɛnk, ɛn aw yu de fil.
- Blɔd tɛst: Chɛk fɔ si if blɔd de klɔt prɔblɛm, infɛkshɔn, ɛn if di sɔl nɔ balans.
- Imej skan: Dis na di impɔtant we fɔ no RCVS.
Imej skan dɛn
dis kayn skan dεm kin "si" insay di ed εn di bren. Dɛn kin chɛk fɔ si if di blɔd vesel dɛn dɔn blok ɔ if di blɔd nɔ de flɔ bɛtɛ.
- Kɔmpyuta Tomografi (CT) skan: Mɔtalman, CT angiogram kin ɛp fɔ no di kɔndishɔn na di blɔd vesel dɛn fayn fayn wan.
- Magnetic Resonance Imaging (MRI) skan: Wan spɛshal MRI skan we dɛn kɔl Magnetic Resonance Angiogram (MRA) kin no bak di vasospasm na di blɔd vesel dɛn.
- Transkranial Doppler ultrasound: dis kin mכsu di spid we di bכdi de fכlכ tru di bren.
Bɔku tɛm, dɛn kin du CT skan fɔs. Na bikɔs i kin apin kwik kwik wan. I kin no kwik kwik wan if imejensi de lɛk fɔ gɛt strok ɔ fɔ blɔd. Insay strok, ɛvri sɛkɔn kin kɔnt, so da spid de rili impɔtant. Dɔn, if nid de, dɛn kin du MRI skan fɔ mek dɛn no mɔ se di blɔd vesel dɛn dɔn blok.
Wetin na di tritmɛnt dɛm fɔ RCVS?
As di nem sho, RCVS na wan sik we dɛn kin trit bad bad wan . Di tritmɛnt gɛt tu men gol dɛn.
1. If dɛn kin fɛn wan kɔz (e.g. wan patikyula mɛrɛsin), pul da kɔz de.
2. fכ mek di vasospasm (tightening) fכ di bכdi vεsul dεm εn mek dεn kam bak to nכmal.
Di kayn mɛrɛsin we dɛn kin yuz fɔ trit dis sik (vasospasm) na di kalsiɔm chanɛl blɔk (CCB) . Dɛn mɛrɛsin ya kin wok bay we dɛn kin mek di kalsiɔm nɔ go insay di mɔsul sɛl dɛn na di blɔd vesel dɛn. Dɔn di mɔsul dɛn kin rilaks, di blɔd vesel dɛn kin big bak, ɛn di blɔd kin go bak lɛk aw i bin de.
na sכm tεm, insay sכm kes dεm, dεn kin du tritmεnt we dεn de yuz wan prosidכs we dεn kכl ``endovaskul''. Dis min se yu fɔ pas wan tiub we rili tan (kateta) tru wan blɔd vesel na di an ɔ leg to di blɔd vesel we dɔn blok na di bren, dɔn yu injekt mɛrɛsin ɔ yuz sɔntin lɛk balyɔn fɔ mek di vessel big (angioplasty).
Aw wi go op fɔ dis tin we go apin?
Bɔrku pipul dɛm wae gɛt RCVS (lɛk 80% - 85%) kin wɛl ɔlsay ɛn nɔr gɛt ɛni prɔblɛm fɔ lɔng tɛm. So gud op de fɔ dis. Bɔt di tin we impɔtant pas ɔl pan dis na fɔ no di sik kwik kwik wan ɛn bigin fɔ gɛt di rayt tritmɛnt.
Mɛmba se fɔ no di sik kwik kwik wan ɛn fɔ trit am na di bɛst we fɔ gɛt di bɛst rizɔlt. If yu delay, dat kin mek yu gɛt prɔblɛm dɛn we denja.
Tin dɛm wae yu kin du fɔ mek RCVS nɔr kam bak
Bikɔs i nɔ klia ɔl wetin mek RCVS de divɛlɔp, nɔto ɔltɛm dɛn kin ebul fɔ stɔp am. Bɔt sɔm tin dɛn de we yu kin du fɔ mek yu nɔ gɛt bɔku prɔblɛm. Yu dɔktɔ go gi yu mɔ advays bɔt dis.
- If mɛrɛsin dɛn de we dɛn tink se dɔn mek yu gɛt RCVS, stɔp dɛn ɛn avɔyd dɛn tumara bambay.
- Fɔ tek di mɛrɛsin dɛn we di dɔktɔ tɛl yu fɔ tek lɛk aw dɛn tɛl yu fɔ tek am ɛn di rayt we.
- Nɔ yuz ɛni mɛrɛsin ɔ drɔgs (especially stimulant ɛn marijuana) if yu nɔ gɛt dɔktɔ advays.
- Ridyus ɔ stɔp fɔ drink kafin ɛn ɛnaji drink dɛn ɔltogɛda.
Ustɛm yu fɔ si dɔktɔ ɛn go na di ETU?
If yu gɛt RCVS, yu dɔktɔ go tɛl yu fɔ kɔntinyu fɔ kam na di klinik. I rili impɔtant fɔ atɛnd dɛn apɔntinmɛnt dɛn ya ɔltɛm. Dis we ya, dɛn kin wach yu kɔndishɔn ɛn ajɔst yu tritmɛnt as nid de.
Ustɛm fɔ go na di Imejɛnsi Tritmɛnt Yunit (ETU) wantɛm wantɛm:
If yu gɛt ed we de at we yu gɛt tɛnda ɔ yu gɛt sɔm kayn sik dɛn we tan lɛk strok (e.g., yu wik na wan say na yu bɔdi, i nɔ izi fɔ tɔk, yu de si chenj) bak, na mɛdikal imejensi ɔltɛm. Nɔ wet te i tu let. Go na ɔspitul kwik kwik wan.
Mɛsej we dɛn kin kɛr go na os
- Wan ed we kin at wantɛm wantɛm, we kin at bad bad wan ("Thunderclap Headache") na mɛdikal imejensi. Go na di ɔspitul we de nia yu Imejɛnsi Dipatmɛnt (ETU) wantɛm wantɛm.
- RCVS na wan sik we kin kam bikɔs di blɔd vesel dɛn na di bren kin blok wantɛm wantɛm. Bɔt lɛk aw di nem sho, na sik we pɔsin kin chenj ɔltogɛda if dɛn trit am di rayt we.
- di risk fכ dis kכndyushכn kin bכku we uman bεlε εn spεshal wan insay di fכs siks wik afta dεn bכn pikin.
- Bɔrku pipul dɛn kin wɛl bak ɛn nɔr kin gɛt ɛni prɔblɛm fɔ lɔng tɛm, bɔt fɔ no di sik kwik kwik wan ɛn fɔ trit am impɔtant.
- Du wetin yu dɔktɔ tɛl yu fɔ du. Tek di mɛrɛsin dɛn we dɛn tɛl yu fɔ tek ɛn nɔ tek drɔgs ɛn rɔm we gɛt prɔblɛm.
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