Lu na lutuk, tuar theih loh khawpa na i nei tawh em? I lu a rawn deng ang maiin, bomb puak ang maiin i hria em? A chang chuan heng thilte hi lu na pangngai ang maiin kan ngai thin a, mahse hriselna lama harsatna lian tham tak chhinchhiahna a ni thei. Chutiang dinhmun pakhat, ngaihven vat ngai chu tûn laia kan sawi tum hi a ni a, chu chu "Brain Aneurysm ." He hming hriat hi a hlauhawm thei hle a, mahse hriat chian a pawimawh hle.
A awlsam zawngin, aneurysm tih hi eng nge ni?
Tui phur thei pipe a awm angin han ngaihtuah teh. He pipe hmun khat hi a chak lo deuh a, a hlui tawh bawk. Tichuan, tui a luang chak deuh deuh chuan chu a chak lo lam chu tlem a lo chhuak tan a, balloon te tak te ang maiin. Kan thluak chhunga thisen kalna kawng, a nih loh leh thisen kalna kawng ( artery)-ah thil a thleng a nih pawhin chutiang bawk chu a ni .
Brain aneurysm, emaw doctor-te’n an tih angin cerebral aneurysm tih hi thluak chhehvel emaw, a chhunga emaw artery-a bang chak lo tak, thisen pressure hnuaia bulge chhuak, bulge siam a ni.
Kan thinlung a nat apiangin thisen chu pressure hnuaiah thluak thisen kal tlangin a luang chhuak thin. He pressure hian chu hmun chak lo tak chu a rawn deng chhunzawm zel a, zawi zawiin a lian chho zel a ni. Balloon-a boruak kan vawrh luh ang bawkin a thim zual sauh sauh a ni. A lian poh leh a puak darh mai thei.
Heng aneurysm te hi thluak khawi hmunah pawh lo awm thei mahse, kan luruh bul hnaia thisen kalna kawng lian ber ber (major arteries)-ah an lo awm tam ber. Mi thenkhat (10% - 30%) vel hian aneurysm vawi khat aia tam an nei thei. Mahse thu lawmawm tak chu heng aneurysm tam zawk hi chu a te hle a ni. Symptom engmah an siam lo.
Symptoms hi aneurysm chu a lian tawk a, a chhehvel thluak tissue emaw nerve emaw press thei tur khawpa lian a nih chauhvin a lang tan thin. Thil awmdan hlauhawm ber chu aneurysm-in thisen a leak emaw, a rupture vek emaw hi a ni. Hei hian thluak chhungah thisen a chhuah tir thei a ni.
Hei hi nunna atana hlauhawm medical emergency a ni. Aneurysm a chhe hnua a rei poh leh thihna emaw, chak lohna nasa tak emaw a thlen theihna a sang zawk.
Aneurysm a puak chuan eng nge thleng?
Aneurysm a puak chuan a chhehvel thluak tissue-ah thisen a luang lut thin. Hei hi thisen chhuak (hemorrhage) an ti.He thisen hian thluak tissue-ah pressure a siam belh a, thluak a ti hring chhuak thin. Chumi avanga lo lang tlangpui chu "thunderclap headache ," kan tih hi a ni a, chu chu lu na tak, ngaihtuah phak loh khawpa na tak a ni.
Aneurysm ruptured hian hriselna lama harsatna lian tak a thlen thei a, chungte chu:
- Subarachnoid Hemorrhage (SAH): Hei hi thluak leh thluak khuh tu membrane te tak te (arachnoid layer) inkar hmuna thisen chhuak a ni. Heng thisen chhuah zinga 90% hi aneurysm ruptured vang a ni.
- Hemorrhagic Stroke : Luruh leh thluak inkar hmuna thisen chhuak avanga stroke awm.
Heng dinhmunte hian thluak a tichhe reng thei a , harsatna lian tham dang a thlen thei bawk .
| Complication awm thei | A awlsam zawngin sawifiah a ni |
|---|---|
| Vasospasm a ni | Thluaka thisen kalna kawngte chu a inkhar emaw, a zim emaw a, chu chuan thluaka oxygen a thlen tlem phah a ni. |
| Hydrocephalus natna a ni | Cerebrospinal fluid (CSF) emaw thluak chhehvela thisen awmkhawm avanga thluaka pressure sang. Hei hi "hydrocephalus" kan ti bawk. |
| Seizures a awm thin | Thluak chhunga electrical activity thunun theih loh. Hei hian aneurysm a rupture chuan thluak a tichhe zual thei a ni. |
| Coma ah a awm | Mut thuk ang maia hriat lohna dinhmun, kar tam tak chhunga awm thei. |
| Thihna | Lungchhiatthlak takin aneurysm rupture 50% vel chu thihnaah a tawp thin. |
Tute nge aneurysm vei? Engtiang chiahin nge a hluar?
He natna hi kum eng pawhah a lo awm thei a, tu pawhin an nei thei bawk. Mahse, kum 30 leh 60 inkar mite chu an hlauhawmna a sang zawk. Tin, zirchianna atanga a lan dan chuan he natna hi mipa aiin hmeichhiaah a tam zawk deuh hlek a ni.
Sri Lanka-ah hian he thil chungchangah hian data chiang tak awm lo mah se, United States ang ram mipui zinga 6% vel chuan unruptured aneurysm an nei nia chhut a ni. Hei hi mi pakhatin a ngaihtuah angin a tlem lo tihna a ni. Mahse, aneurysm rupture hi chutiang chuan a awm lo.
Aneurysm natna lan chhuah dan chu engte nge ni?
Hei hi a lan chhuah dan chu aneurysm a rupture leh rupture loh a zirin a inang lo. He danglamna hi hriatthiamna hian i nunna a chhanhim thei a ni.
| Aneurysm ruptured (emergency!) a lan chhuah dan . | Aneurysm chhe lo (lian) chhinchhiahna |
|---|---|
| Heng symptoms te hi i neih chuan damdawi in ETU ( Emergency Treatment Unit ) ah kal nghal rawh! | |
| - Ka dam chhunga lu na ber, rang tak (Thunderclap Headache) . - Nausea leh luak chhuak - Kawngkhar khauh, ben theih loh - Mit hmuh fiah lo emaw, mit pahnih emaw - Eng en thiam lohna (Photophobia) . - Fit (Seizure) neih a ni. - Mitmeng tla leh mit dum lian zawk - Mit chung leh hnunglam natna - Beidawnna, rilru hahdam lohna - Taksa peng pakhata rilru hahna emaw, chak lohna emaw - Thil hriatna hloh | - Lu na (a tam emaw, a chang chuan emaw) . - Mit hmuh dan a inthlak danglam - Mit mitmeng (pupil) tihzauh - Lu emaw hmai emaw a natna - Mit chung leh hnunglam natna - A chang chuan fit a lo thleng thin. |
A chang chuan aneurysm a rupture hmain thisen tlem a leak thei bawk. Hei hi sentinel bleed an ti a . Hemi hun chhung hian warning headache (sentinel headache) hi a lian hma ni engemaw zat emaw, kar engemaw zat emaw a awm thei. Lu na danglam tak, na tak i neih chuan ngaihthah ngai suh. Doctor hmu nghal rawh.
Engvangin nge heng aneurysm te hi an lo awm? Risk factors te chu engte nge ni?
Aneurysm hi thluaka thisen kalna kawngte chu a hring a, a chak lo a nih chuan a lo awm thin. A tlangpuiin arteries branching point-ah an awm thin. A chang chuan mi chu a pian tirh lamah thisen kalna kawng (artery wall) chak lohna neiin a awm thin. Chu bâkah, thil dang engemaw zât chuan hei hi a nghawng thei bawk.
Hereditary factors atanga lo chhuak a ni
Hengte hi kan thunun theih loh leh genetically inherited thilte an ni.
- Hriselna lama natna thenkhat: Entirnan, `Vascular Ehlers-Danlos syndrome`, `Autosomal dominant polycystic kidney disease`, `Marfan syndrome`, `Fibromuscular dysplasia` te hi a ni.
- Arteriovenous malformation hi thluaka thisen kalna kawng (arteries) leh thisen kalna kawng (veins) inzawmna dik lo tak a ni.
- Chhungkaw hnai tak (nu, pa, unaupa) in aneurysm a neih chuan nang pawh i hlauhawm zawk.
Kan nunphung leh hriselna dinhmun dangte
Hengte hi kan thlak danglam theih leh kan thunun theih thilte an ni.
- Meizial zuk: Hei hi hmêlma lian tak a ni a, arterial wall tichhetu a ni.
- Thisen sang: Thisen sang thunun loh chuan thisen kalna kawng (artery walls) ah pressure a siam reng thin.
- Ruihhlo hman: A bik takin ruihhlo cocaine ang chi.
- Zu in tam lutuk.
Aneurysm puak chhante chu engte nge ni?
Aneurysm siamna atana puitu thilte tho hian a rupture pawh a pui bawk. Zirchiangtute chuan thisen sang hi thisen sang hi thisen sang (aneurysm rupture) thlentu ber niin an ngai. Thisen sang a san chuan thisen hian thisen kalna kawng bangte chu a nawr nasa zawk a ni.
Thisen sang a san thut a, aneurysm a puak thei a nih chuan:
- Thil hriatna chak tak, stress chhunzawm zel emaw, thinrimna chhuak nghal emaw ang chi.
- Thil rit tak (rit phurh lai, furniture sawn lai) chawi tur chuan thawhrimna a ngai.
- Thisen sang i nei tih hria mahse a damdawi dik tak ei loh.
Chu bâkah, aneurysm lian leh te, a pianzia leh a awmna hmun ang chi thilte pawhin a chhe dawn leh tliak loh pawh a nghawng bawk.
Engtin nge he dinhmun hi kan hriat theih ang?
Unruptured aneurysm nei tam tak chuan an nei tih pawh an hre lo. A chhan dang vangin thluak MRI emaw CT scan emaw an tih laiin accident-in an hmuchhuak fo thin.
Mahse, aneurysm ruptured symptoms (a bik takin chutiang lu na nasa tak) i neih chuan damdawi in emergency room- ah i kal nghal tur a ni. Chutah chuan doctor-te chuan thisen chhuah a awm leh awm loh enfiah turin test hrang hrang an kalpui ang.
- CT (Computed Tomography) Scan: Hei hian rang takin thluaka thisen a chhuah leh awm loh a enfiah thei a. A châng chuan special scan `CT Angiogram (CTA)` tih an ti a, chu chuan thisen kalna kawngte chu chiang zawkin a hmu thei a ni.
- MRI (Magnetic Resonance Imaging) scan: Hei hian thluak leh thisen kalna kawng chipchiar tak tak a siam thei a.
- Cerebral Angiography: Hetah hian neurosurgeon chuan groin emaw wrist emaw kaltlangin tube te tak te (catheter) a dah a, thluak thisen kalna kawngah a kaihruai a, aneurysm awmna hmun, a lian leh te, a pianzia te chu chiang takin a enfiah thin.
- Cerebrospinal fluid (CSF) test: Lumbar puncture hian thluak vel thisen chhuak a hriat theih.
Enkawlnate chu engte nge ni?
Enkawlna tum ber chu aneurysm atanga thisen chhuak tihtawp a ni. Ruptured aneurysm hi medical emergency a ni a, emergency surgery a ngai a ni. Unruptured aneurysm enkawl leh enkawl loh chu i dinhmun a zirin a ni.
Enkawl dan tlangpui
1. Microvascular Clipping: Hei hi open surgery a ni. Neurosurgeon chuan luruh chhungah khur te tak te a siam a, aneurysm awmna hmunah a kal a. Tichuan, thawmhnaw hrual ang maiin, aneurysm kawr chhungah hian thir clip te tak te an dah a, chu chuan a thisen kal chu a titawp vek a ni.
2. Endovascular Coiling: Hei hian incision te tak te siam a ni. Groin emaw wrist emaw atanga tube te tak te (catheter) dah hmangin aneurysm chhungah wire coil nalh tak tak dah a ni. Heng coil te hian aneurysm chhungah thisen zam (blood clot) a siam a, chu chuan thisen kalna chu a titawp a ni.
3. Flow Diversion Stents: Hei pawh hi incision tel lova tih a ni. Aneurysm awmna thisen kalna kawngah hian mesh ang chi tube (stent) dah a ni. Hei hian thisen kalna chu vessel kaltlangin direct-in a kaihruai a, aneurysm chu a bypass a ni.
Unruptured aneurysm tan eng nge i tih?
Aneurysm te tak te, asymptomatic aneurysm i neih a, risk factor dang i neih loh chuan i doctor chuan enkawl loh a rel mai thei.
Mahse chu chu i theihnghilh tur a ni lo. Thil danglam a awm leh awm loh hriat nan regular scan i neih a ngai ang. Tin, meizuk i nih chuan bansan tur leh i thisen sang thunun turin an fuih bawk ang .
Surgery neih leh neih loh chungchanga thutlukna siam hi thil tam tak atanga siam a ni a, chung zingah chuan i kum, i hriselna zawng zawng, aneurysm lian tham leh awmna hmun, leh i chhungkaw chanchin te pawh a tel. Hemi chungchang hi i doctor nen zalen takin sawipui rawh.
Nakin hun chungchâng eng nge i sawi theih ang?
Aneurysm ruptured a nih chuan a rah chhuah chu i kum, hriselna, thisen hloh zat leh enkawlna i dawn thuai danah a innghat a ni. Lungchhiatthlak takin, mi 25% vel chu aneurysm ruptured atanga darkar 24 chhungin an thi thin. Thla thum chhungin thi zat hi 50% vel a ni.
Damchhuak zinga 66% vel chuan thluak chhiatna eng emaw zat an tuar a ni. Mahse, enkawl hmasak leh rehabilitation tha tak neih a nih chuan, ṭhenkhat chu rualbanlo tlemte emaw, chak lohna nei lo emaw neiin an dam leh ṭhin.
Mahse, thisen zam (aneurysm) te tak te, chhe lo nei tam tak chu dam rei tak an ni a, chuta tang chuan natna lanchhuahna leh nghawng engmah a nei lo.
Take-Home Thuchah a ni
- Brain aneurysm hi thluaka thisen kalna kawng chak lo tak, balloon ang maia bulge a ni.
- Lu na rang tak, na tak (‘thunderclap’ lu na) hi aneurysm ruptured chhinchhiahna lian tak a ni. Hei hi medical emergency a ni. Damdawi in pakhat Emergency Department (ETU) ah kal nghal rawh.
- Unruptured aneurysm tam zawk hian symptom a nei lo va, enkawl a ngai lo thei bawk.
- Thisen sang control te, meizuk pumpelh te, ruihhlo hman loh te hi he hlauhawmna tihziaawmna atana i tih theih tha ber a ni.
- Aneurysm i vei tih hmuhchhuah a nih chuan, thutlukna dik siam turin i hlauhawmna te, enkawl dan tur te, leh enkawl dan tur te doctor nen sawiho rawh.
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