I lu chhunga pressure a sang lutuk em? (Increased Intracranial Pressure - ICP) Hei hi i hre chiang ang u!

Lu na tak tak nen hian a chang chuan luak chhuak duhna i nei thin em? A nih loh leh i mit hmuh chu a hlim lo deuh niin i hria em? Hengte hi a chang chuan kan ngaihven vak loh symptom ni mahse, kan lu chhunga pressure, chu chu cranial cavity chhunga pressure a sang tih a tilang thei a ni (Increased Intracranial Pressure - ICP) Hei hi thawnthu serious deuh a nih avangin vawiin hian chipchiar takin i sawi dawn nia.

He intracranial pressure tihpun hi eng nge ni?

A awlsam zawngin, Increased Intracranial Pressure (ICP) chu i luruh chhunga pressure, a nih loh leh cranial vault chhunga pressure chu a tlangpui aia sang a nih chuan a ni. Kan luruh hi bawm tight ang maiin han ngaihtuah teh. He bawm chhungah hian thil pawimawh pathum a awm a:

• Kan thluak
• Cerebrospinal fluid (CSF) : Hei hi kan thluak leh ruhro vel hualtu leh venhimtu tui a ni. Cushion ang mai a ni.
• Thisen : Thluak mamawh chaw tha leh oxygen phurtu thisen.

Tunah chuan he box chhunga hmun hi a tlem tawh hle. Chuvângin, chûng thil pathum—thluak, thluak tui, leh thisen—te chu inthlauhna engemaw chen a awm vek a ngai a ni. Mahse eng emaw chhan vanga heng pathum zinga pakhat tal volume a san chuan a dangte tan hmun awm chu a tlahniam a, lu chhunga pressure pum pui chu a sang chho ta a ni. Hetianga pressure sang hi a rang (acute) a ni thei a, a nih loh leh hun kal zelah a lo thang zauh zauh thei (chronic).

Hetianga lu chhunga pressure a san chuan thluaka thisen kal zat a tlahniam thei a ni. A nih loh leh, thluak hmun thenkhat chu a hmun atanga nawr chhuah theih a ni. Hei hi thluak herniation kan ti a . Heng pahnih hi thil hlauhawm tak, nunna atana hlauhawm tak an ni. Hrethiam e?

Lu chhunga pressure sang lutuk hian eng symptoms nge a neih?

Tunah chuan he ICP condition-ah hian eng symptoms nge a lan tih kan en ang. Heng symptoms te hi puitling, naupang te leh nausen ah te hian a danglam deuh thei.

Puitling leh naupang tête inkara mizia hmuh chhuah:

• Lu na: Hei hi a lan chhuah dan ber a ni. Zing lamah a na zawk fo a, mut lai pawhin a na zawk thei bawk. Mi thenkhat chuan "lu chu chhung lam atang chuan a puak dawn" tih ang maiin a awm an ti.
• Nausea leh vomiting: Hetiang dinhmun hi zing lamah a tam hle. A châng chuan luak chhuak chu a chhan hriat lohvin a thleng thut ṭhin.
• Rilru dinhmun inthlak danglamna: Hei hi mutthilh mai mai atanga hriat lohna (coma) thlengin a awm thei . Chu mi chu a buai thei a, a buai thei a, a thusawi pawh a danglam thei bawk.
• Vision changes: Blurred vision, double vision , light laka sensitivity tihpun, chu chu light en theih lohna (photophobia) a awm thei tihna a ni.
• Mit chet harsatna: I mit i thunun thei lo mai thei a, a sir khata hawitir pawh a harsa thei bawk.
• Muscle chak lohna: I ke ruhte chu a hring emaw, nunna nei lo emaw a ni thei.
• Numbness a awm.
• Seizures: Sudden convulsions a awm thei.

Nausen natna lan chhuah dan: 1.1.

Nausen te te chunga hetiang thil a thlen hian an rilru put hmang sawi chhuah dan an hre lo. Chuvang chuan an symptoms an lantir te hi a danglam deuh hlek a ni. Hemi kawngah hian nu leh pate fimkhur hle tur a ni.

• Mutthilh: Naute chu a muhil reng a, inkhelh duhna a neih loh chuan, harh harsa a nih chuan.
• Swollen fontanelle: Naute lu chunglama hmun nem tak, bulh emaw, hring emaw anga lang chu chhinchhiahna dang a ni. I khawih pawhin a harsa hle thei bawk.
• Luak chhuak: Luak chhuak fo, a chang chuan luak nawn fo thin. Nausen thenkhat chuan bawnghnute an in zawh veleh an luak nghal mai thei.

A pawimawh ber chu he lu chhunga pressure sang hi medical emergency a ni. Nangmah emaw, i fa emaw hian heng symptoms te hi i neih chuan damdawi in hnai ber pan nghal tur a ni. Hun khawhral suh.

Late Signs te chu:

A chang chuan he ICP hi a nasat em em a, chu chu thluak herniation a lo thleng dawn tihna a ni a, symptom thenkhat a lo lang thin. Hei hi ‘Cushing’s reflex’ kan ti a ni. Hemiah hian symptom lian pathum hmuh tur a awm a, chungte chu:

• Thisen sang (hypertension).
• Heart rate slow: minute khatah 60 aia tlem lo (bradycardia) .
• Thâwk lak dan mumal lo: Thâwk harsa, a bik takin thawk hah lutuk, boruak zawnga gasping (agonal breathing) ang chi .

Heng symptom pathumte hi a awm vek a nih chuan thil awmdan chu a hlauhawm hle tihna a ni a, thluak tihchhiat a hnai tawh tihna a ni. Chuvangin emergency room-ah i kal nghal tur a ni.

Engvangin nge lu chhunga pressure hi hetiang hian a pung? A chhante chu engte nge ni?

Tûnah chuan, ‘Engvângin nge leiah hian hetiang hi a lo awm?’ tiin i ngaihtuah mai thei. A nihna takah chuan chhan hrang hrang a awm. Kan sawi tawh ang khan luruh chhunga hmun hi a tlem hle. A tlangpuiin mi hrisel luruh chhunga pressure chu mercury millimeter 20 (20 mm Hg) aia tlem a ni .

Thil pathum zinga pakhat—thluak tissue, cerebrospinal fluid (CSF), leh thluaka thisen—a volume a san chuan, a dang pahnih tan hmun awm chu a tlahniam a, pressure pum pui chu a sang chho ta a ni. He balance hi tihbuai a nih hian harsatna a awm thin. Doctor-te chuan heng chhante hi eng component nge pressure tipungtu tih a zirin an thliar hrang thin.

Brain Volume tihsan chhan: 1.1.

Thluak a hring (cerebral edema) hian lu chhungah pressure a tisang thei a ni. Hei hi a chhan chu:

• Thluak hliam na tak: 1.1.Tlu, intlansiak, car accident ang chi thilin thluak a tihchhiat chuan.
• Thluaka thisen kal tlem (ischemia): Thluak hian thisen a dawn tlem chuan entirnan heart attack hnuah.
• Thisen a ammonia level sang (hyperammonemia): Hei hi thin natna nei te tan a thleng thei.
• Kidney hnathawh tlahniam hian thisenah toxins a tipung a, chu chuan thluak hnathawh a tlahniam (uremic encephalopathy) a thlen thin.
• Thisen a sodium level hniam (hyponatremia): Hei hi thluak a ti na bawk.

Tin, thluak hmun bik takah chuan a hring (swelling) a awm thei bawk. Entir nan:

• Intracerebral emaw subdural hematomas: Hei hi thluak chhunga thisen zam emaw, thluak khuhna inkar emawa lo awm a ni . Thisen sang nei leh thisen tihthianghlimna damdawi ei thinte chu an hlauhawm zawk.
• Thluak natna (brain tumor) a awm.
• Thluaka bacteria infection avanga thluaka abscess awm.
• Thai.

Cerebrospinal Fluid (CSF) tihpun chhan: 1.1.

ICP hi thluaka cerebrospinal fluid a pun avangin a pung thei bawk. Hei hi a chhan hrang hrang:

• Hydrocephalus: Hei hi thluak chamber-a CSF fluid awmkhawmna a ni. Hei hi CSF flow tihkhawtlai a nih chuan, CSF siam chhuah a pun chuan, absorption a tlahniam chuan a thleng thei a ni.
• Choroid plexus tumor: Hei hi tumor hmuh tur awm lo, CSF siamna hmuna lo awm thin a ni.
• Meningitis: Thluak khuh tu membrane-a natna hrik awm. Hei hian CSF kal dan a tikhawlo thei bawk.
• I meninges ah granulomas a awm.

Brain Blood Volume tihpun chhan: 1.1.

Thluaka thisen volume sang hian pressure a tisang thei bawk. Entirnan:

• Brain aneurysm ruptured emaw thisena carbon dioxide level sang (hypercapnia) emaw a ni.
• Thluak thisen zam (Cerebral venous sinus thrombosis) ah thisen a chhuak thin.
• Lung lam chak lohna.

A chhan dangte:

Hei bakah hian chhan dang pawh a awm thei:

• Lu chhunga pressure tihpun chhan hriat loh (Benign or idiopathic intracranial hypertension): Hei hi hmeichhe naupang, thau lutuk zingah hmuh tur a tam ber.
• Skull deformities, entirnan, craniosynostosis (skull ruh inzawm hmasak) an tih.
• Taksaah Vitamin A a tam lutuk.
• Antibiotic tetracycline hman dan.

Engtin nge he natna hi hriat chhuah a nih? (Diagnosis) tih a ni.

ICP i vei nia i rinhlelh chuan doctor in uluk takin i symptoms a ngaithla ang a, medical history a la ang. Tichuan physical exam leh neurological exam an nei ang.

He natna hi nemnghet thei tur leh a chhan bulpui zawng chhuak thei tur test engemaw zat a awm a:

• Brain CT scan emaw MRI scan: Heng imaging test te hian thluak hring, ventricles lian, leh thluak herniation te ang chi thil a zawng thei a ni. ICP thlen chhan hriatchhuahna kawngah pawh an pui thei bawk. Ngaihtuah teh, kan Kamal chuan rang takin lu na a nei a, a luak chhuak a, a mit a chhing nghal bawk. Damdawi in a thlen chuan Doctor-te chuan rang takin CT scan an ti a, eng nge dik lo tih an en a.
• Funduscopic exam: Hei hi mit endikna bik a ni. I mit chhunga optic disc-ah a hring (papilledema) a awm leh awm loh a enfiah thei. Hei hi ICP chhinchhiahna tha tak a ni.
• Lumbar puncture (spinal tap): Hei hian i ruh leh ruhro atanga cerebrospinal fluid (CSF) tlemte lak a, a pressure tehna a ni. ICP thlentu dinhmun thenkhat hriatchhuahna kawngah pawh a pui thei bawk. Mahse, he test hi ICP vei zawng zawng tan tih a ni lo a, a chang chuan a natna a tizual thei a ni. Hei hi i tih leh tih loh tur chu i doctor-in a rel ang.

A châng chuan, doctor chuan i lu ruh-ah khur te tak te siamin, i lu-ah hmanraw bik, a nih loh leh tube (catheter) , dahin CSF pressure chu direct-in a teh thei a ni. Hei hi intensive care unit (ICU) ah tih a ni fo thin .

Hei hi eng enkawl dan nge ni ang?

ICP i neih nghal chuan damdawi in Intensive Care Unit (ICU) ah enkawl i ni ang . Chutah chuan medical team chuan i nervous system leh vital signs te chu uluk takin an enfiah ang.

Enkawlna chu a natna nasat dan leh a chhan bulpuiah a innghat a ni. Hei hian a huam thei ang:

• Khum lu chawi sang: Khum lu hi degree 30 vel a sang a ni. Hei hian thluak atanga thisen leh CSF awlsam zawka a chhuah theih nan a pui a, pressure a tihniam bawk.
• Cerebrospinal fluid (CSF) lakchhuah: A chang chuan thluak ventricle-ah tube (ventricular drain) dahin CSF tam lutuk thenkhat chu paih chhuakin pressure tihhniam a ni.
• Thâwk chhuahna lama ṭanpuina: Mi ṭhenkhat chuan thawk chhuah theih nân tube dah (intubation) leh mechanical ventilator- a connect a ngai mai thei. Hei hian thluak hian oxygen a hmu tling thei a, thisena carbon dioxide level control nan leh ICP tihhniam nan a pui bawk.
• Thluak natna tihziaawmna damdawi: entirnan , barbituratesDamdawi mannitol emaw hypertonic saline emaw hmang hian thluak natna tihziaawm theih a ni.
• Antiseizure damdawi: Epileptic seizure a awm chuan ICP a na zual thei a, chuvangin a venna atan damdawi pek thin a ni.
• Decompressive craniectomy: Hei hi a hnuhnung ber a ni. Treatment dang zawng zawngin pressure a control theih loh chuan thluak a hring chhuah theih nan luruh hmun thenkhat chu rei lo te chhung lakchhuah a ni. Hei hian thluak a compress thei lo. A hnuah chuan a hring a reh chuan luruh atanga lak chhuah chu a inzawm leh ta a ni.

He enkawlna an tih lai hian medical team te hian ICP awm chhan bulpui ber pawh an zawng ang a, an enkawl ang. Entîr nân, thluaka natna hrik a nih chuan, a paih chhuah nân zai a ngai mai thei a, a nih loh leh infection a nih chuan antibiotics pek a ni thei bawk.

Hetiang dinhmun atanga dam leh theihna chance engzat nge awm? (Prognosis) tih a ni.

ICP vei tan chuan thil engemaw zat a innghat a:

• A natna a nasat dan.
• A bulpui ber leh a enkawl theih zat.
• Engtiang chiahin nge enkawlna i dawng thuai.
• ICP chu a lo thleng nghal (acute) emaw, a lo thang zauh zauh (chronic) emaw pawh nise.

Sudden ICP hi nunna atana hlauhawm tak a ni fo thin. Enkawlna i hmuh hma chuan i dam theihna chance a sang zawk. Mahse, pressure a san a, thluak leh thisen kalna hmun pawimawh tak takte a nawr chuan thluak a tichhe vek thei a, thihna pawh a thlen thei a ni.

Idiopathic intracranial hypertension (ICP) ang chi natna rei tak hi a na lo tlangpui a, mahse enkawl loh chuan mitdelna a thlen thei a ni. Chuvangin, ICP chi hrang hrang thliar lovin, enkawl vat a pawimawh hle.

Lu chhunga pressure sang zawk chhinchhiahna hmasa ber chu eng nge ni?

Vawi tam tak chu lu chhunga pressure sang zawk chhinchhiahna hmasa ber chu lu na, zing emaw, mut lai emawa na zual a ni. Hei hi ICP symptom langsar ber a ni. Mahse, lu na zawng zawng hi ICP vang a ni lo tih hre reng ang che. Mahse, hei hi symptom dang (luak, mit inthlak danglamna ang chi) nen i neih chuan doctor thurawn i dil ngei ang.

A tawp berah chuan a pawimawh ber (Take-Home Message) .

Kan thluak hi kan taksa peng pawimawh leh buaithlak tak a ni. Thil tam tak a ti thin! Chuvangin he thluaka thil a chhiat chuan harsatna lian tak a thlen thei a ni. Chuvangin Increased Intracranial Pressure (ICP) ang chi case-ah chuan a rang thei ang bera damdawi lam tanpuina lak a pawimawh hle.

Nangmah emaw, i fa emaw hian lu na, luak chhuak, mit hmuh dan danglam ang chi symptoms i neih chuan ngaihthah ngai suh. Ngaihtuah nawn ngai lovin damdawi inah kal rawh. ICP enkawl hmasak hian result tha zawk a thlen thei a ni. I hriselna hi a pawimawh ber tih hre reng ang che!

` ICP, Increased Intracranial Pressure, lu a pressure, thluaka pressure, luruh ah pressure, CSF, thluak a hring, lu na, luak chhuak, mit hmuh fiah lo