Lu na tak tak, rang takin i lu a rawn nuai ang maia i lo nei tawh em? Mi tam tak chuan "i lu na ber" tiin an sawi. Hetiang lu na rang tak, na tak hi kan ngaihthah ngai lo tur a ni. Thluak chhunga thisen chhuak nasa tak chhinchhiahna a ni thei. Vawiin hian chutiang medical emergency pakhat, subarachnoid hemorrhage (SAH) chungchang kan sawi dawn a ni.
A awlsam zawngin Subarachnoid Hemorrhage (SAH) hi eng nge ni?
Okay, he hming hi a buaithlak deuhin a lang thei a, mahse a awlsam zawngin han sawi ila. I thluak hi i lu hnung lamah a thu mai mai lo. Tissue layer thum khuh hmanga venhim a ni. Damdawi lam hawi chuan hei hi meninges kan ti a.
Onion ang maiin ngaihtuah rawh. Onion chhungril lam hian a chhehvelah vun te tak te a nei a, chutiang chuan heng membrane te hi thluak vel ah hian an awm a ni.
1. Dura mater: Hei hi a pawn lam ber, membrane chak tak, luruh hnuai chiaha awm a ni.
2. Arachnoid: Hei hi a laiah a hring, spider-web ang maia awm a ni.
3. Pia mater: Hei hi a chhungril ber a ni a, thluak tissue ngeiah hian a inzawm tlat a ni.
Tunah chuan a laiah arachnoid membrane leh a chhung lam layer-a pia mater inkar hmun chu `Subarachnoid space` an ti ta a ni. `Sub` tih awmzia chu "hnuaiah" tihna a ni. Chuvangin hei hian arachnoid membrane hnuaia space awm chu a kawk a ni. Eng emaw chhan vanga he hmunah hian thisen a chhuak a nih chuan chu chu Subarachnoid Hemorrhage (SAH) kan tih chu a ni.
Hei hi medical emergency pawi tak, nunna atana hlauhawm tak a ni. Heng symptoms te hi i neih chuan damdawi in pakhata Emergency Department (ETU) ah tihkhawtlai lohvin i pan tur a ni.
SAH leh Subdural Hematoma hi eng nge an danglamna?
`Subdural Hematoma` tih natna pawh i hre tawh mai thei. An pahnih hian thluak area-ah thisen an chhuak vek a ni. Mahse a danglamna chu thisen chhuahna hmun a ni. Hei hi chiang takin han then ila.
| Nihphung | Subarachnoid Hemorrhage (SAH) atanga chhuak a ni. | Subdural Hematoma a awm a ni |
|---|---|---|
| Thisen chhuahna hmun | Arachnoid membrane hnuaiah (subarachnoid space-ah) . | Dura mater hnuaiah (subdural space-ah) . |
| A symptom ber a ni | Thunderclap lu na | Lu na a pung zauh zauh thei a, buaina a awm thei a, chak lohna a awm thei bawk. |
| Vawi tam tak chu a chhan | Brain aneurysm ruptured emaw lu hliam emaw. | Vein a ruptured, a tam zawk chu lu hliam vang a ni. |
Heng natna pahniha symptoms hi a chang chuan a inang thei bawk. Tin, an pahnih hian thluak tichhe thei emergency an ni. Chuvangin symptoms a lan veleh doctor advice lak a pawimawh.
He natna hi tuin nge vei tam ber? Risk factors te chu engte nge ni?
Tu pawhin subarachnoid hemorrhage (SAH) an vei thei a, mahse kum 40 leh 60 inkar mite zingah a tam ber .
SAH hi kum upa zawkte lu hliam vang a ni ber. An tlu a, an lu an vuak hian a thleng thei. Tleirawl zawkah chuan a chhan ber chu motor chetsualna a ni.
Tin, SAH vei theihna tipungtu thil dang engemaw zat a awm bawk. Eng nge an nih i en ang u.
- Thluak emaw taksa hmun dangah emaw thisen kalna kawng (unruptured aneurysm) neih: Aneurysm chu thisen kalna kawng (blood vessel) balloon ang maia bung chhuak, a bang chak lohna a ni. Hei hi engtik lai pawhin a puak thei.
- Tun hmaa thluak (brain aneurysm) ruptured tawh tawhna history nei.
- Meizial zuk: Meizial hian thisen kalna kawng a tichhe nasa hle.
- Thisen sang (Hypertension): Thisen sang thunun loh chuan thisen kalna kawng a tichhe thei a, thisen kalna kawng (aneurysm) siam leh puak theihna a tipung a ni.
- Genetic conditions thenkhat: Connective tissue tichhe thei natna, Fibromuscular Dysplasia (FMD) leh Ehlers-Danlos syndrome te.
- Polycystic Kidney Disease nei a ni.
- Ruihhlo hman: A bik takin ruihhlo tichaktu cocaine leh methamphetamine te.
- Zu in tam lutuk.
- Thisen tithianghlimtu damdawi hman dan: Entirnan, Warfarin.
- Chhungkaw history nghet tak neia aneurysm nei.
SAH natna lanchhuahna chu engte nge ni?
Kan sawi tawh ang khan, a lan chhuahna ber leh a lan chhuah nghal ber chu lu na tak, na tak, "Thunderclap Headache" an tih hi a ni. Hei hian second tlemte chhungin a natna sang ber a thleng thin.
Ngaihtuah teh, i hna pangngai i thawk mek a ni. Engmah vaukhânna awm lovin, rang takin i lu-ah natna nasa tak i nei a, i chhûngah bomb a puak ang maiin, emaw, mi pakhatin hammer-in a rawn kap che ang maiin i hre ta a ni. Chu chu hei hi a ni.
Hetiang lu na nen hian a hnuaia symptoms pakhat emaw a aia tam emaw i neih chuan damdawi in Emergency Department (ETU) ah kal nghal rawh. Hei hi in lama i nghah theih tur thil a ni lo.
| Symptom category hrang hrang a awm | Hrilhfiahna |
|---|---|
| Consciousness nena inzawm harsatna | Thil hriatna tlahniam, mutthilh, a chhehvela thil thleng ngaihven loh, hriatna hloh. |
| Taksa mizia | Nausea leh luak chhuak, kawr khauh (kawng ben harsa), chak lo thut, taksa peng thenkhata bengchheng. |
| Rilru leh nungchang inthlak danglamna | Mood leh personality inthlak danglam te, thinrim thut leh hriatrengna hloh te. |
| Mit hmuhna lama harsatna a awm | Eng êng laka sensitivity (Photophobia), mit pahnih, mit hmuhna hmun dum, mit pakhata hun eng emaw chen hmuh theih lohna. |
| Thil dang pawh a awm | Luak chhuak, taksa ruh na (a bik takin kawr leh kekawrte), seizures. |
SAH awm chhan berte chu engte nge ni?
Tunah hian he dinhmun hlauhawm tak awm chhan berte hi han thlir ila.
- Lu hliam na tak: SAH thlentu ber chu lu-a vuakna na tak, tlu nasat emaw, car accident emaw a ni.
- Aneurysm rupture: Hei hi SAH 85% vel accident awm lo thlentu a ni. Thluak thisen kalna kawng chak lo tak chu balloon ang maiin a hring a, a puak darh nghal a. Chumi hnuah thisen chu pressure sang tak hnuaiah subarachnoid space-ah a luang lut leh thin.
- Thisen kalna kawng dik lo: Thisen kalna kawng hrang hrang inzawmkhawmna, arteriovenous malformation (AVM) ang chi avang pawh hian thisen a chhuak thei bawk.
- Thisen chhuahna (Bleeding disorders): Thisen hi awlsam taka a inzawm lohna dinhmun.
- Thisen tihthianghlimna damdawi hman.
- Ruihhlo hman: Cocaine ang ruihhlo hian thisen sang a tisang nghal thei a, thisen kalna kawng a tipuak thei bawk.
He natna hi Doctor ten engtin nge an hriat chian?
Hetiang symptom neia damdawi ina i kal hian doctor-te chuan emergency angin an en a, rang takin test an ti thin.
1. CT Scan (Computerized Tomography Scan): Hei hi test hmasa ber leh pawimawh ber a ni. Hei hian lu chhung lam thlalak a la a, thluak velah thisen a awm leh awm loh chiang takin a hmu thei a ni. A chang chuan special scan CT Angiography (CTA) an tih pawh an ti thin. Chutah chuan thisen kalna kawngte dinhmun enfiah nan vein pakhatah dye an inject a ni.
2. Lumbar Puncture: A chang chuan CT scan hian thisen chhuah tlem lutuk a hmu lo thei. Chutiang hunah chuan doctor ten he test hi an ti thin. Hetah hian hnungzang hnuai lam ah needle te tak te tak te dahin thluak leh ruhro vel atang hian cerebrospinal fluid (CSF) tlem te te chu lakchhuah a ni. Fluid hi thisen sen emaw xanthochromia (yellowing) emaw a awm leh awm loh enfiah thin a ni. He tui hi hun rei vak lo thisen chhuah hnuah a sen a ni.
3. MRI Scan (Magnetic Resonance Imaging): Tun hnaia thisen chhuak nia rinhlelhna a awm chuan he test hian a hmuchhuak thei a ni.
Diagnosis a nih hnuah test dang, cerebral angiogram ang chi te chu thisen chhuah chhan dik tak hriat theih nan tih theih a ni.
Engtin nge enkawl a nih?
SAH hi nunna atana hlauhawm tak a nih avangin damlo hi damdawi in intensive care unit (ICU) -ah dah a ni tlangpui a, doctor team, neurological diseases lama tui tak takte enkawl a ni. Enkawlna tum berte chu:
- Damlo nunna chhanhim.
- Thisen chhuah chhan siamthat.
- Symptoms control dan tur.
- Harsatna (e.g. vasospasm, hydrocephalus) lo awm thei tur venna.
Nunna chhanhimna tur leh natna lanchhuahna control dan tur:
- Nunna puihna pek.
- Thluaka pressure tihhniam nan draining tube dah.
- Thluak lam venhimna atana hmalak.
- Thisen sang control nan IV (intravenous) damdawi pek.
- Thisen kalna kawng (vasospasm) venna atana damdawi pek.
- Lu natna nasa tak tan painkiller leh anti-anxiety damdawi pek.
- Seizures venna emaw control nan damdawi pek.
Thisen chhuah chhan enkawl dan: 1.1.
- Aneurysm a rupture chuan: A siamthat nan operation an ti thin. Hei hi `Surgical Clipping` (clip hmanga aneurysm kawng khar) emaw `Endovascular Coiling` (thisen kaltlanga wire coil hmanga aneurysm khar) ang chi technique hmangin tih theih a ni.
- Accident avanga thisen a pungkhawm a nih chuan: Thluak pressure tihziaawmna tur leh thisen awmkhawm chu paih chhuah nan operation neih a ngai mai thei.
A tlangpuiin SAH vei chu a dinhmun leh rehabilitation mamawh dan azirin ni 10 atanga ni 20 emaw a aia rei emaw damdawi inah a awm a ngai thei a ni.
He natna hian hun rei tak chhunga nghawng leh harsatna a neihte chu engte nge ni?
Hei hi dinhmun pawi tak a ni. Statistics atanga a lan dan chuan SAH vei zinga a chanve vel chu an thi thut a ni. Damdawi ina lo kalte zingah hian:
- hmun thuma ṭhena hmun khat chu damdawi inah an thi.
- Pathum zinga pakhat chu rualbanlohna chi khat neiin a nung a ni.
- hmun thuma ṭhena hmun khat chu nun pangngaiah a kir leh a ni.
SAH hian thluak a tichhe thei a, chu chuan hun rei tak chhung emaw, chatuan atan emaw harsatna a thlen thei a ni.
- Taksa lama harsatna: Chauh leh mutthilh reng, taksa peng hrang hranga rilru hah emaw, chak lo emaw, ei harsat, balance hloh.
- Cognitive issues: hriatrengna lama harsatna, ngaihtuahna seng harsa, ruahmanna siam leh hna harsa tak tak thawh harsat.
- Thusawi harsatna: tawngkam thiam lo, thusawi slow, thumal dik hmuh harsat.
- Mental health issues: Hei hi nunah harsatna lian tak a nih avangin depression, generalized anxiety, leh post-traumatic stress disorder (PTSD) te ang chi dinhmun a awm thei a ni.
Hêng hun rei tak chhûnga harsatna awmte hi enkawl tûrin, taksa lam enkawlna, hnathawhna lama enkawlna, thusawi enkawlna, leh rilru lam enkawlna te hian hahdamna nasa tak a pe thei a ni.
A hlauhawmna tihziaawmna turin eng nge kan tih theih ang?
SAH thlentu ber chu lu hliam leh aneurysm rupture a nih avangin heng thil pahnih hi venna atana hmalak a tha ber.
Lu hliam laka inven nan:
- Bicycle emaw motor emaw khalh emaw, infiamna hlauhawm tak tak khelh emaw hian helmet vuah fo ang che.
- Hrisel takin lirthei khalh la, traffic dan zawm rawh.
- I tlu fo chuan physical therapist hnen atangin thurawn la la, tlu loh dan tur leh i in him zawka siam dan tur zir rawh.
Aneurysm hlauhawmna tihtlem nan:
- Thisen sang control. I damdawi ei tur chu i doctor-in a tih ang chiah khan ei rawh. Nunphung thlak danglam (salt ei tlem, exercise).
- Meizial zuk kha bansan vek rawh.
- Exercise tih fo la, mahse vawi khatah thil rit phurh loh tur a ni, thawhrim lutuk hian aneurysm a tipuak thei a ni.
- Ei leh in inthlau tak ei rawh.
- Zu leh ruihhlo hman hi pumpelh vek tur a ni a, a bik takin cocaine ang chi stimulant te hi pumpelh vek tur a ni.
I doctor-in unruptured aneurysm i neih thu a hrilh che a nih chuan, enkawl dan tur leh enkawl dan tur awmte chu sawipui rawh.
Take-Home Thuchah a ni
- Subarachnoid hemorrhage (SAH) chu thluak leh a chhehvel membrane inkara thisen chhuak a ni. Hei hi a pawi hle a, emergency medical condition a ni.
- A symptom ber chu rang taka, "thunderclap headache" a ni a, chu chu ka dam chhunga lu na ber nia sawi a ni.
- Hetiang lu na nen hian natna lan chhuah dan, luak chhuak, kawng na, leh hriatna hloh ang chi i neih chuan damdawi in Emergency Department (ETU)-ah kal nghal rawh.
- A chhan ber chu lu hliam leh thluak (brain aneurysm) ruptured vang a ni.
- Thisen sang control te, meizuk pumpelh te, ruihhlo hman loh te hian a hlauhawmna a tiziaawm thei a ni.
- A hmaa hriatchhuah leh enkawl dan dik chuan nunna chhanhim theihna a tipung a, harsatna a tihziaawm bawk.
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