Ka tuyige buli kimu ekikwata ku bulwadde bwa NPH (Normal Pressure Hydrocephalus) mu ngeri ennyangu.

Maama wo, taata wo, oba jjajja wo omukadde asanga obuzibu okutambula mu bwangu? Atambula mpola nnyo? Oba owulira ng’okujjukira kwo kugenda kukendeera mpolampola? Bino tutera okubirowoozaako ng’ebintu ebya bulijjo ebibaawo nga tukaddiwa. Naye oluusi, bino biyinza okuba obubonero bw’embeera esobola okujjanjabibwa. Mu ngeri y’emu, NPH mbeera abantu bangi gye bakyamusa nti obulwadde bw’okubulwa amagezi, naye mu butuufu mbeera esobola okujjanjabibwa. Katumanye ebisingawo ku nsonga eno leero.

Mu ngeri ennyangu, NPH kye ki?

Amakulu mu bujjuvu aga NPH ge Normal Pressure Hydrocephalus. Mu lulimi Olusinhala, kitegeeza "normal pressure hydrocephalus". Naye kyangu okutegeera okusinga ekigambo ekyo ng’okimanyi nti kino kintu ekituuka ku bwongo.

Mu ngeri ennyangu, NPH mbeera amazzi agali mu bwongo bwaffe n’okwetooloola (mu by’obusawo tugayita Cerebrospinal Fluid - CSF) mwe gazimba ne gataataaganya enkola y’obwongo. Amazzi gano agayitibwa CSF galiisa obwongo bwaffe era gayamba okuggya kasasiro mu bwongo. Era amazzi gano ge gakuuma obwongo obutasindikibwa munda mu kiwanga ne buleeta obuvune.

Obwongo bw’omuntu omukulu obwa bulijjo bubaamu mililita nga 150 ez’amazzi gano. Emibiri gyaffe buli kiseera gikola amazzi gano, ne gagitambuza, era ne giddamu okunyiga amazzi amakadde. Kasita enzirukanya eno eba egenda mu maaso bulungi, tewali buzibu.

Naye mu mbeera ya NPH, olw’ensonga ezimu, okuddamu okunyiga oba okutambula kw’amazzi gano kukosebwa. Olwo, amazzi gano gatandika mpolampola okukuŋŋaanyizibwa mu bitundu by’omubiri ebiyitibwa ventricles munda mu bwongo. Olw’okuba kino kitera nnyo okubaawo, puleesa eri munda mu kiwanga teyongera nnyo mangu. Eno y'ensonga lwaki kiyitibwa "Normal Pressure". Naye ekiseera bwe kigenda kiyitawo, amazzi gano agakung’aanyiziddwa gatandika okusika ebitundu by’obwongo ne byonoona. Wano obubonero bwa NPH we bulabika.

Ani asinga okulwala embeera eno eya NPH?

NPH bulwadde obusinga okukwata abantu abasukka mu myaka 65. Obulabe bw’okukwatibwa obulwadde buno bweyongera n’emyaka. Emyaka gya wakati egy’okutandika giri nga 70.

Kino tekisinziira ku bintu ng’amawanga, eddiini, oba ekikula ky’omuntu. Okukaddiwa kye kisinga okuleeta akabi. Okusinziira ku bibalo, abantu 0.2% abali wakati w’emyaka 70 ne 80 ate 5.9% ku bantu abasukka mu myaka 80 balina obulwadde buno. Ekyo kitegeeza nti abantu abasoba mu bukadde 8 mu nsi yonna be batawaanyizibwa obulwadde buno.

Bubonero ki obukulu obulaga nti omuntu alina obulwadde bwa NPH? "Obusatu bwa Hakim".

Waliwo obubonero 3 obukulu obwa NPH. Bino birabika mpolampola mu bbanga lya myezi 3 okutuuka ku 6. Obubonero buno obukulu obusatu abasawo babuyita "Hakim's Triad." Wakati wa 50% ne 75% ku balwadde ba NPH bafuna obubonero bwonna obusatu wamu.

Ka tulabe engeri zino essatu kye ziri.

Lwaki NPH eno ekulaakulana? Biki ebivaako?

Waliwo ebika bibiri ebikulu ebya NPH, okusinziira ku bivaako.

1. NPH esookerwako (Idiopathic).

Kino kye kika ekisinga okubeerawo. Abalwadde nga kitundu ku balwadde balina ekika kino. "Idiopathic" kitegeeza nti ekivaako ekituufu tekimanyiddwa.Mu kiseera kino kirowoozebwa nti kino kibaawo olw’enkyukakyuka ezimu mu ntambula y’omusaayi n’okunyiga amazzi ga CSF mu bwongo nga bwe tukaddiwa.

2. NPH ya siniya

Kino kibaawo olw’embeera endala ey’obujjanjabi oba akabenje. Kwe kugamba nti waliwo ensonga endala etaataaganya okutambula kw’amazzi ga CSF mu bwongo. Ezimu ku nsonga zino mulimu:

• Obuvune ku Bwongo Obulumwa
• Ebizimba ku Bwongo
• Storoko
• Okuvaamu omusaayi mu mutwe
• Obulwadde bw’emisuwa mu bwongo
• Yinfekisoni z’obwongo nga meningitis
• Okulongoosa obwongo

Omusawo azuula atya mu butuufu obulwadde bwa NPH?

Okuzuula NPH kiyinza okuba ekizibu kubanga obubonero bwayo bufaanagana nnyo n’embeera z’okubulwa amagezi ng’obulwadde bwa Alzheimer. Oluusi, NPH era esobola okuwerekerwako obulwadde bwa Alzheimer.

Omusawo akozesa ebigezo ebiwerako okuzuula obulwadde buno.

• Okukeberebwa omubiri n’obusimu: Omusawo ajja kukebera entambula yo, bbalansi, engeri gy’okwatamu ebirowoozo n’amaanyi g’ebinywa.
• Okubuuza ku bubonero n‟ebyafaayo by‟obujjanjabi: Buuza ab‟omu maka go ku ngeri obubonero buno gye bwatandika n‟ebbanga lye bumaze nga buliwo.
• Okukebera obwongo: Kino kye kigezo ekisinga obukulu. MRI scan (Magnetic Resonance Imaging) esobola okulaba obulungi oba ventricles, amazzi ga CSF mwe gakuŋŋaanyizibwa, zigaziwa. Oluusi nakyo kikolebwa CT scan (Computed Tomography) okusobola okugaana embeera endala.
• Spinal Tap / Lumbar Puncture: Kino nakyo kigezo kikulu nnyo. Wano, empiso entono eyingizibwa mu mugongo ne batwalibwa sampuli y’amazzi ga CSF. Kino osobola okukikozesa okukebera oba waliwo yinfekisoni endala. Ate era ekisinga obukulu, kikulu okulaba oba obubonero bw’omulwadde, gamba ng’okukaluubirirwa okutambula, butereera okumala akaseera oluvannyuma lw’okuggyamu agamu ku mazzi aga CSF ag’enjawulo. Bwe kiba bwe kityo, kiba kiraga nnyo nti NPH eriwo.

Waliwo obujjanjabi ku kino? Kisobola okuwona?

Yee! Gano ge mawulire amalungi agakwata ku NPH. Wadde nga kiyinza okulabika ng’obulwadde bw’okusannyalala, NPH etera okuba obulwadde obujjanjabibwa . Eddagala terikola nnyo. Obujjanjabi obukulu era obusinga okukola obulungi kwe kulongoosa.

Okulongoosa kuno kuzingiramu okuyunga ekyuma ekitono ekiringa ttanka ekiyitibwa shunt ku bwongo.

• Kino kirowoozeeko nga payipu efulumya amazzi ag’enjawulo.
• Enkomerero emu eya shunt eno eyungibwa ku kisenge mu bwongo amazzi ga CSF mwe gakuŋŋaanyizibwa.
• Enkomerero endala eyingizibwa wansi w’olususu mu kisenge ky’olubuto (olubuto) oba mu kifuba.
• Amazzi ga CSF ag’enjawulo agakuŋŋaanyizibwa mu bwongo olwo gatambula wansi mu ttanka eno ne gafuluma mu kifo ng’ekisenge ky’olubuto, omubiri we gusobola okuddamu okunyiga amazzi ago.

Oluvannyuma lw’okulongoosebwa kuno, obubonero bw’abalwadde butandika okutereera ennyo mu ssaawa oba ennaku ntono. Kino kivaamu ebirungi ennyo naddala ku buzibu okutambula.

Mu mbeera ya NPH ey’okubiri, obulwadde obwaleeta NPH (e.g., ekizimba ku bwongo) busooka kujjanjabwa.

Bizibu ki ebiyinza okubaawo oluvannyuma lw’okujjanjabwa?

Wadde ng’okutwalira awamu okulongoosa shunt tekulina bulabe, okufaananako n’okulongoosa kwonna, waliwo akabi akayinza okuvaamu.

• Ekirwadde.
• Shunt ezibiddwa oba tekola bulungi.
• Shunt esangibwa ku verr.
• Amazzi ga CSF agayitiridde okukulukuta okuva mu bwongo (kino kiyinza okuleeta obubonero ng’okulumwa omutwe).

Singa ekintu nga kino kibaawo, kisobola okuzuulibwa n’okujjanjabibwa amangu. N’olwekyo kikulu nnyo okugoberera ebiragiro by’omusawo ddala ng’omaze okulongoosebwa n’okugenda mu malwaliro ku nnaku eziteekeddwawo.

Kiki ky’oyinza okusuubira ng’obeera ne NPH?

Ebiva mu NPH bitera okusinziira ku ngeri obulwadde gye buzuulibwamu amangu n'okujjanjabwa . Obujjanjabi gye bukoma okuweebwa oluvannyuma, gye kikoma okuba nti okwonooneka kw’obwongo kujja kuba kwa lubeerera.

Okuva omulwadde bw’ayinza obutamanya bubonero bwe, ab’omu maka n’abaagalwa be balina obuvunaanyizibwa bunene mu kino. Bw’olaba obubonero buno mu muntu wo, kikulu nnyo okumutwala ew’omusawo, okusinga okukitwala nti kitundu kya bulijjo mu kukaddiwa.

Wano waliwo emikisa gy’obubonero okuwona oluvannyuma lw’okujjanjabibwa:

• Okukaluubirirwa okutambula: Abalwadde nga 85% bawona.
• Obutakwata musulo: Abalwadde nga 80% bawona.
• Obuzibu mu kulowooza n‟okujjukira: Abalwadde nga 80% bawona.

Katutunuulire ensonga ezikosa ebiva mu bulwadde bwa NPH mu kipande wansi.

Ddi lwe nnina okulaba omusawo? Biseera ki eby’okugenda mu ETU?

Singa omuntu mu maka go alina shunt, naddala olina okumanya obubonero obumu. Bino biyinza okuba obubonero bw’obuzibu ku shunt oba yinfekisoni.

• Omutwe ogw’amaanyi: Singa omutwe gweyongera naddala ng’otudde oba ng’oyimiridde, kano kayinza okuba akabonero akalaga nti amazzi agafuluma mu shunt gakendedde oba geeyongedde.
• Omusujja oba okuwunya: Kino kiyinza okuba akabonero akalaga nti omuntu alina yinfekisoni oluvannyuma lw’okulongoosebwa. Tobuusa maaso yinfekisoni ez’ekika kino kuba zisobola okusaasaana amangu.
• Obulago obukaluba.
• Obulumi mu kifuba oba ekitundu ky’olubuto awayita shunt tube.
• Okuddamu okulabika kw’obubonero bwa NPH obukadde (okukaluubirirwa okutambula, obuzibu mu kufulumya omusulo).