Thisen kalna kawng pangngai lo taka inzawm khawmna hi eng natna nge ni? (Arteriovenous Malformation - AVM) Kan sawi dawn nia!

Kan taksa chhunga thisen kalna kawngte hi a chang chuan kawng mak takin, thread ball ang maiin a inzawm khawm thei tih i hre tawh em? Hei hi a mak deuh mai thei, a dik em? Mahse, a thleng tak tak thei a, a chang chuan a hlauhawm deuh thei bawk. Vawiin hian Arteriovenous Malformation , or AVM tih hming pu condition kan sawi dawn a ni . A awlsam zawngin, hei hi kan taksaa thisen phurtu vein system-a chhiatna a ni.

Arteriovenous malformation (AVM) tih hi eng nge ni? A awlsam zawngin i hrethiam ang u.

Kan taksa pum puiah thisen kalna kawng (network of blood vessels) kan nei ang tih han ngaihtuah teh. Heng thisen kalna kawng hi chi hnih a awm a, chungte chu Arteries leh Veins te an ni. Arteries te hi highway ang a ni a, thinlung atanga thisen thianghlim, oxygen awmna chu taksa peng zawng zawng, a bik takin thluak thlengin a phur a ni. Vein hi thisen hman tawh, deoxygenated chu thinlungah phur kir lehtu thisen kalna kawng tenau zawk ang a ni.

A tlangpuiin heng highway (arteries) te hi vein te tak te, te tak te tak tak network-ah an tawp thin. Hengte hi capillaries kan ti a . Kawngpui lian tak, khaw pakhat a thlen chuan side road tenauah a branch chhuak ang mai a ni. Heng capillaries hmang hian thisen chhunga oxygen leh nutrients te hian kan cell te chu a thleng a, chu cell atanga bawlhhlawh te chu thisenah a lut thin. Tichuan he thisen hi vein an tih vein hmangin thinlungah a kal leh thin.

Tunah chuan AVM nei mi pakhata thil thleng chu artery leh vein inkara awm tur capillary bridge chu a awm lo tihna a ni. Tichuan, thisen kalna thisen, thisen sang atanga lo chhuak chu a inzawm nghal a, chu chu thisen zam (veins) nen a inzawm a, chu chu pressure hniam nan an hmang thin. Tui pipe lian tak chu pipe te tak te, bang chak lo tak nena inzawm nghal mai chu han mitthla teh. Hei hian veins te hian tuar theih loh pressure a siam thin. Hei hi thisen kalna ball inzawmkhawm, sava awmna ang maia ngaih a ni. Hetiang inzawmna pangngai lo avang hian thisen kalna kawng a puak (Rupture) a, thluaka thisen a chhuak (Bleeding into the brain) a awm thei a ni.

AVM chi hrang hrang a awm em? Khawiah nge an insiam?

Ni e, AVM chi hnih kan sawi thei ber a ni:

1. Brain AVMs: Hengte hi a tam ber. Thluak chhung hmun apiangah, thluak chung lamah, thluak bul , a nih loh leh ruhro (spinal cord) bulah te an lo thang lian thei a ni. Hengte hi a hlauhawm deuh a, a chhan chu thluak hi hmun sensitive tak a nih vang a ni.

2. Peripheral AVMs: Hengte hi taksa thisen kalna kawng mel 100,000 vela thui khawi hmunah pawh a awm thei. Entirnan, hmai, kut, ke-ah te, chubakah chhungril peng hrang hrang, thinlung, thin, leh lungah te pawh an lo thang lian thei a ni.

Hetiang dinhmun hi engtiang chiahin nge AVM tia koh a nih?

AVM hi a takah chuan a awm lo hle.Mi sang za zinga pakhat chauhin an nei thei niin an sawi. Tupawh pianpui theih a ni. Mahse, doctor-te chuan kum 20 leh 40 inkar mi an hmu tam ber a, kum 30 leh 50 inkarah a lan chhuah tam ber.

AVM natna lan chhuah dan chu engte nge ni?

Hetah hian a pawimawh ber. Mi thenkhat chuan AVM an nei a, symptom an nei lo thei bawk. AVM nei zinga 15% vel chuan symptom an nei lo ang. A tam zawkah chuan AVM i neih chu a rupture hnuah chauh i hrechhuak a, chu chu thisen a chhuak tihna a ni.

Mahse, symptoms a awm tak tak chuan hetiang hi a ni thei:

• Seizures, hriat loh emaw, hriat loh emaw pawh nise. Hei hi a thleng thut thei a ni.
• Lu na fo thin. A châng chuan hei hi a na thei hle.
• Muscle chak lohna emaw, paralysis vek emaw.
• Nausea leh luak chhuak.
• Taksa hmun thenkhatah numbness emaw tingling sensation emaw a awm.
• Luak chhuak thei.
• Kea kal harsatna, tawng harsa, hriatrengna hloh, ngaihtuah harsa, balance hloh emaw, mit hmuhna lama harsatna emaw.
• Rilru buai, hallucinations, emaw dementia ang chi dinhmun.
• Hnung lam natna. Hei hi a lo thleng nghal thei a, a na hle thei bawk. Tin, hip atanga ke leh ke ruh thlengin rilru hahna a thlen thei bawk.
• Thawhrimna laiin thawk hah (chu chu lungah AVM a awm chuan a thleng thei) .
• Thisen khuh (hei hi lung AVMs chhinchhiahna a ni bawk) .
• Pum natna.
• Kut, ke emaw, ke ruh emaw-ah hnah (lumps) a lo lang thin.
• Natna leh hliam.

Pawimawh: Brain AVM nei zinga 50% vel chuan an symptom hmasa ber atan thluaka thisen chhuak an nei ang. Hei hian stroke leh thluak chhiatna a thlen thei a ni.

Engvangin nge heng AVM te hi an lo awm? A chhan chu eng nge ni?

Dik tak chuan scientist te hian AVM lo awm chhan chiang tak chu an la hre lo . Mi tam tak chuan pianpui an ni tih an ring . Chumi awmzia chu heng thisen kalna kawng (blood vessel tangles) te hi nausen pian chhuah laiin, nu pum chhungah a lo awm tihna a ni. A tlem hle a, thlah khat atanga thlah dangah an inthlak danglam thei a, chu chu rochun an ni thei tihna a ni .

AVM hian kan taksaah eng nghawng nge a neih?

AVM hian chhiatna a thlen theih dan tlangpui pathum a awm a, chungte chu:

1. Thisen chhuak: .Ka sawi tawh ang khan thisen sang atanga thisen sang chu AVM kaltlangin a kal chuan vein bang te chu a chak lo thei a, pressure chu a tuar thei lo thei bawk. Tichuan veins te chu a puak a, thisen a chhuak tan ta a ni. He thisen hi a chhehvêla tissue-a a luh chuan, a chhe vek thei a ni . Thisen chhuak tam tak a awm chuan , thihna pawh a thlen thei.

2. Taksa peng hrang hrang press: He inzawmna pangngai lo hian thisen kalna kawng (veins) ah thisen tam zawk a khawlkhawm thin. Chumi hnuah chuan vein te chu a lian a, a chhehvel tissue te, thluak ang chi te chu a press thei ta a ni. Hei hian chutiang hmuna oxygen thleng chu a tihtlem bakah lymphatic system-in bawlhhlawh a paih chhuah theihna a ti tlem bawk.

3. Tissue-a oxygen mamawh tihtlem: Arteries leh vein inkarah capillary bridge a awm loh avangin AVM awmna hmuna tissue te hian oxygen leh nutrients an dawng tlem hle. Tichuan chu lai hmuna tissue leh nerve cell te chu an thi tan thei a ni.

AVM avanga harsatna awm thei te chu engte nge ni?

AVMs, a bik takin thluaka awm hian harsatna lian tak tak a thlen thei a, chungte chu:

• Brain bleed / Stroke : Hei hi AVM hlauhawmna lian ber a ni. AVM chu thluak chhungah a puak chuan paralysis, thluak tichhe thei, seizures a thlen thei. AVM hian thluak emaw, ruhro emaw hmun thenkhat chu a nawr lut thei a, a tichhia thei bawk.
• Seizures: Thluaka electric hnathawh nghal vanga hriatna hloh leh kut leh ke ruh tliak thunun theih loha awm thin.
• Aneurysm: Thisen kalna kawng chak lo tak, AVM nena inzawm emaw, a chhehvel emaw, balloon ang maia bulge chhuak. Chungte chu thisen kalna kawng bang chak lo vang a ni. Hetiang dinhmun hi thluak leh ruhroa AVM 50% vel ah hmuh a ni. Chungte chuan AVM rupture theihna a tipung a ni.
• Thluak chhiatna: Hei hian ngaihtuahna thiamna, hriatrengna leh thusawi hriatthiamna ang chi thilte a nghawng thei a ni.
• Coma leh thihna: A bik takin thluak chhungah thisen chhuak lian tak a awm chuan.

Engtin nge AVM i neih leh neih loh i hriat theih ang?

Symptoms i neih chuan i doctor chuan a chanchin a zawt hmasa ang che a, taksa enfiahna a nei ang. A châng chuan AVM chungah stethoscope dah a nih chuan bruit (thisen kal tlanga thisen chhuak ri) a hriat theih.

Tin, imaging test te pawh a awm bawk a, chungte chu:

• MRI (Magnetic Resonance Imaging) Scan: Magnetic field leh radio wave hmanga test a ni.
• CT (Computed Tomography) Scan: X-ray hmangin taksa cross-sectional image a la thin.
• Catheter hmanga Angiography siam dan:Hetah hian doctor chuan i kut emaw, i ke ruh emawa thisen kal tlangin tube te tak te (catheter) a dah lut a, AVM awm nia ngaihna hmunah a kaihruai thin. Tichuan, dye bik an inject a, X-ray hmangin thisen kalna kawng chipchiar takin an la a ni.

Thluak-ah AVM rinhlelh a nih chuan test bik, hetiang hi:

• Cerebral MRI Angiography (Cerebral MRA): MRI technology hmangin thluak chhung leh a chhehvela thisen kalna kawng chipchiar tak tak a la chhuak thin.
• CT angiography (CTA): CT technology hmang hian thisen kalna kawng chipchiar takin a siam chhuak thin.
• Transcranial Doppler ultrasound: Sound wave hmangin thluaka thisen kal chak dan tehna a ni.

AVM tam tak hian symptoms an neih loh avangin, chhan dang (hliam, mit lama harsatna, emaw lu na ang chi) scan an tih laiin emaw, thisen chhuah avanga symptoms a lo awm hnuah emaw hmuhchhuah a ni fo thin.

AVM hi engtin nge enkawl a nih?

AVM enkawl dan hi thil engemaw zatah a innghat a, chung zingah chuan:

• AVM chi hrang hrang, a lian zia, a awmna hmun, leh a kaihhnawih arteries leh veins awm dan te.
• AVM a rupture theihna tur risk.
• I symptoms te chu.
• i kum zat.
• I hriselna zawng zawng.

Enkawlna tum ber chu AVM atanga thisen chhuah theihna tihtlem emaw, tihdam vek emaw a ni. Enkawlna kawng hrang hrang a awm. Chung zingah chuan open surgery , catheter-based artery blocking (Embolization) , leh/ emaw AVM-a focused radiation (Radiosurgery) te a tel a ni. Treatment option tin hian hlawkna leh hlauhawmna a nei vek a. Hengte hi i hriselna leh AVM chi hrang hrang a zirin a inang lo.

A tlangpuiin AVM hi a rang thei ang bera enkawl hi harsatna lian tham lo thleng tur venna kawng tha ber a ni.

Mi tin AVM hi a danglam vek. I tih tur dik tak hrilh thei tur treatment plan set a awm lo. I medical team chuan nang leh i chhungte nen inbiakna neiin i dinhmun enkawlna tha ber tur an rel ang.

A châng chuan AVM hi engmah tih loh aiin operation emaw, enkawlna dang emaw tih hlauhawmna hmunah a awm ṭhin. Chutiang a nih chuan i medical team chuan i AVM chu periodic scan hmangin uluk takin an enfiah ang. AVM-ah hian danglamna eng emaw, thisen chhuah tamna chhinchhiahna te a lan chuan chutih hunah chuan enkawl dan tur ngaihtuah theih a ni.

Damdawi chi hrang hrang

Damdawi hi a lan chhuah dan thenkhat control nan pek theih a ni:

• Anti-seizure damdawi hman tur.
• Lu na leh hnungzang na tan natna tidamtu.
• Thisen sang damdawi.

Enkawl dan (Procedures) 1.1.

Doctor-te chuan heng zinga pakhat emaw, a aia tam emaw hi an lo enchhin thei a ni:

1. AVM lakchhuahna tur surgery: Hemiah hian AVM bulah incision te tak te siam a ni a, a chhehvel arteries leh veins te chu thisen chhuah loh nan sealed a ni a, AVM chu lakchhuah a ni. Tichuan, thisen kal dan chu thisen kalna kawng pangngaiah a divert leh ta a ni. Hei chauh hi AVM tihdam kim theihna kawng awmchhun a ni. Surgery zawhah thluak scan-in AVM chu a chhuak kim tawh em tih an en a. Damdawi inah ni engemaw zat awm a ngai mai thei a, rehabilitation hun rei lote pawh i nei thei bawk.

2. Embolization: Hetiang tih danah hian doctor chuan i groin emaw arm emaw chhunga artery pakhatah catheter a thun a, AVM lam pan chuan a kaihruai thin. Chutah chuan an thlen chuan glue ang chi thil, coil emaw thil dang emaw chu AVM-ah a chhuak ta a ni. Hei hian AVM kaltlangin thisen chhuah chu a tihtlem emaw, a titawp vek emaw a ni. Hetiang tih dan hi AVM lian tak leh thisen chhuak nasa tak a nih chuan hman a ni ber. Tichuan, a hnua surgery tih a nih chuan awlsam takin AVM chu lakchhuah theih a ni a, thisen chhuah theihna a ti tlem a ni. Surgery hi tih nghal ni lo mah se, he procedure hian thisen chhuah theihna a ti tlem thei a ni.

3. Gamma Knife® radiosurgery: Hetah hian radiation beam focus sang tak tak te chu AVM lam hawiin an kal thin. Kum engemaw zat chhungin AVM chu zawi zawiin a tlahniam a, a hliam a, a hmin emaw, a te lutuk a, operation hmanga awlsam taka lakchhuah theih a ni. AVM hi a tlahniam em tih enfiah nan a hun hunah scan a ngai thin.

Enkawlna avanga harsatna awm thei

AVM enkawlna hian harsatna emaw, side effect emaw a thlen thei a, chungte chu:

• Thisen chhuak.
• Lu na.
• Vung.
• A chhehvel tissue te tihchhiat.
• Taksa sir khatah natna hrik awm.
• Thusawi, hriatna emaw, mit hmuhna emaw a nghawng dan.
• Results chu a kim lo thei a, rei a daih lo thei a, a kim vek theih nan thla tam tak a la ngai thei bawk.
• Harsatna na tak tak, chak lohna emaw, thihna thlen thei emaw.

AVM siam hi a veng thei ang em?

No. AVM hi pianpui a nih rin a nih avangin a lo pian chhuah loh nan a veng thei lo. Amaherawhchu, he thuziaka kan sawi tak symptoms eng emaw tal i neih chuan doctor pan nghal rawh. Symptoms a lan veleh chhan let nghal a tha ber.

AVM i neih chuan eng nge i beisei theih ang?

Mi tin AVM hi a danglam vek. Surgery i neih a, AVM hlawhtling taka lakchhuah a nih chuan he natna hi i dam vek ang.

Enkawlna dang rah pawh a tha hle a, mahse thil engemaw zatah a innghat a ni:

• AVM awmna hmun.
• AVM lian tham tak a ni.
• AVM chi hrang hrang.
• I kum leh i hriselna tlangpui.

I medical team chuan i AVM chungchang leh a rah chhuah theih dan tur an hrilhfiah thei ber ang che.

Pawimawh:AVM i neih a, enkawl i hmuh loh chuan kum khatah thisen chhuah theihna risk 2-4% a awm. AVM a rupture tawh chuan kum khatah 17% chance a nei a, a rupture leh thei a ni.

Engtikah nge ka doctor ka hmuh ang?

Mi thenkhat chuan vawi khat aia tam AVM an nei thei (recur). Symptom thar i neih chuan doctor rawn rawh. Enkawl zawhah kum khatna atan thla thum danah doctor i pan tur a ni. Kum khatna hnuah kum khatah vawi khat Doctor i pan tur a ni.

Engtikah nge Emergency Department (ETU) ah ka kal ang ?

Heng symptoms te hi i neih chuan doctor tanpuina zawng nghal rawh:

• Lu na tak, na tak ("ka dam chhunga ka tawn tawh zawng zawng zingah chuan a na ber").
• Convulsions a awm thin.
• Kut emaw ke emaw a natna (numbness) a awm.
• Mit hmuhna, balance, hriatrengna, ngaihvenna lama harsatna.

Hengte hi nunna atana hlauhawm emergency chhinchhiahna a ni. Hei hi thluaka thisen chhuak a ni thei.

Doctor hnenah eng zawhna nge ka zawh ang?

Doctor i zawh theih tur zawhna thenkhat chu:

• Ka taksaah hian ka AVM hi khawiah nge a awm?
• Eng enkawl dan nge ka tan a tha ber?
• Surgery ka neih nghal loh chuan eng chen nge ka enkawl a ngai ang?

AVM hi a hlauhawm em?

Ni e, a ni thei. A hlauhawm ber chu thisen chhuah (hemorrhage) a ni. Lu na tak ("i nunah i tawn tawh zawng zawng zingah a pawi ber") i neih thut chuan 119 call nghal rawh. Thluak chhunga AVM ruptured a ni thei. AVM rupture loh chuan kum khatah thisen chhuah theihna chance 2-4% a nei a ni. A hmaa AVM rupture tawh chu kum khatah 17% zetin a rupture leh thei a ni.

AVM zawng zawng hi a tawpah thisen chhuak vek em?

No. AVM thenkhat chu thisen a chhuak ngai lo va, dam chhungin symptom emaw hriselna lama harsatna emaw a thlen lo thei bawk. AVM thenkhat chu chhan dang avanga scan an tih lai emaw, autopsy an neih lai emaw hian hmuhchhuah a ni.

AVM hian thisen chhuah bakah hriselna lama harsatna dang a thlen thei bawk. AVM thenkhat lian tham tak takte chuan tissue hmun thenkhat chu an compress thei a, chu tissue, nerve cells leh cell dangte chu a tichhe thei a ni. An lian a, hmun pawimawh takah an awm a nih chuan, thisen kalna kawng leh thisen kalna inkara capillary awm loh avangin chu hmuna tissue chuan oxygen, ei tur tha, leh bawlhhlawh a dawng thei lo. Hei hian tissue thihna a thlen thei a ni.

AVM hian thihna a thlen thei em?

Ni e, a ni thei. AVM hi engtiang chiahin nge a hlauhawm leh nasat zia chu a lian leh te, a awmna hmunah a innghat a ni. AVM a rupture a, thluak chhungah thisen tam tak a chhuah chuan thihna a thlen thei a ni. Mahse, AVM vei thenkhat chuan symptom leh hriselna lama harsatna an nei ngai lo.

Ka lu natna ka hriatna hmun atang hian AVM awmna chu i hre thei em?

A ni lo tak zet.Chutiang chu a ni mai thei, mahse a tam zawkah chuan lu na awmna hmun hi AVM awmna hmun nen a chiang lo.

Hmeichhe naupai hian AVM a neih chuan a hlauhawmna a sang zawk em?

Mi thenkhat tan chuan naupai laiin a danglamna avang hian AVM symptoms hi a lo lang nghal thei a, a na zual thei bawk . Naupai laiin thisen volume leh thisen sang a san chuan AVM atanga thisen chhuah theihna a tipung thei a ni.

AVM hian naupang tê tête a nghawng em?

AVM hian naupangte nungchang tihdanglamna tenau emaw, zirlai harsatna emaw a thlen thei a ni. Heng inthlak danglamna te hi naupang a lo upa deuh (symptoms a lo awm chuan) hmaa symptoms langsar zawk a lan hmain a thleng thei a ni.

AVM atanga thluaka thisen chhuak hian thluak a tichhe fo em?

No. Thluak thisen te tak te thenkhat, microbleeds , an tih hian chhiatna a thlen tlem a, a lan chhuah dan pawh a tlem hle. Mahse, hun kal zelah microbleed tam tak a awm chuan dementia vei theihna a tipung thei a, ngaihtuahna kalphung a tibuai thei bawk.

AVM, Aneurysm, Hemangioma, Cavernous malformation, leh Fistula te hi eng nge an danglamna?

• Aneurysm chu thisen kalna kawng (artery) chhunga balloon ang maia bulge chak lo tak a ni. A tam ber chu artery pahnih inthenna hmunah a lo awm thin. Aneurysm hi AVM avanga harsatna angin a lo awm thei bawk.
• Hemangiomas hi vascular malformations a ni a, vunah hmuh theih a ni. An hlauhawm lo va, enkawl ngai an awm lo.
• Cavernous malformation pawh hi vascular lesion chi khat a ni bawk. AVM ang lo takin hengte hi thisen kalna kawng, a luang chhuak a, a tam zawkah chuan thisen zam (clots) a awm thin. Thisen chhuak thei mahse AVM angin thisen a chhuak nasa lo va, symptoms an siam lo fo bawk.
• Fistula hi thisen kalna kawng inzawmna dik lo sawina thumal tlangpui a ni. Arteriovenous fistulas hi thluak leh ruhro khuh tu tissue-ah a lo awm thei a. AVM te hi thluak tissue chhungah a lo awm thin. Fistulas hi AVM aiin head trauma emaw infection emaw nen a inzawm tam zawk.

Arteriovenous malformation (AVM) hi damdawi lama natna khirh tak ni mahse, tuna enkawlna hman mekte hi a hlawhtling hle. I medical team chuan i AVM chungchang chipchiar tak – a lian leh te, a awmna hmun – leh thil dangte chu an sawiho ang a, i tana enkawlna tha ber berte chu an ruat ang. Thil chiang lo a awm chuan zawhna zawh pawh hlau suh. I duhthlannate hriatthiamna chuan thu tlûkna dik siam tûrin a ṭanpui thei che a ni.

Kan hriat reng tur pawimawh ber berte (Take-Home Message) .

Okay, chuvangin kan sawi tawh AVM chungchanga hriat reng tur thenkhat chu khaikhawm ila:

• AVM chu thisen kalna kawng hrang hrang inzawmkhawm (abnormal tangle of blood vessels) a ni a, chu chuan arteries leh veins te chu direct-in a thlunzawm a, capillary nei lovin, sava awmna ang mai a ni.
• Hengte hi a pianphung atanga lo chhuak a ni.A ni mai thei, a chhan dik tak chu ka hre lo.
• Symptoms hi mi zawng zawngah a lang lo va, mahse symptoms lu na, seizure, leh hriatna hloh te hi a awm thei.
• A hlauhawm ber chu thisen chhuah a ni a, a bik takin thluak chhunga a awm chuan. Hei hian stroke a thlen thei a ni.
• MRI, CT scan, leh angiography ang chi test hmangin a hriat theih a ni.
• Enkawlna kawng hrang hrangte chu operation, embolization, leh radiosurgery te a ni . I doctor chuan i tana tha ber tur chu a rel ang.
• Lu na, na tak, seizure emaw, hriatna hloh emaw i neih chuan damdawi in pan nghal rawh.
• Hei hi thil awm lo tak ni mahse, fimkhur a pawimawh hle.

Nangmah emaw, i hriat emaw hian heng symptoms te hi i neih chuan doctor rawn la. A pawimawh ber chu hlauthawng lova, thu dik tak hriat a, a tul anga hmalak hi a ni.

` Arteriovenous Malformation, AVM, thluaka thisen kalna kawng, thisen chhuak, paralysis, seizures, lu na