He ngoikore tetahi taha o tō tinana, he ngoikore tetahi taha? He mate Brown-Séquard pea tēnei?

Kua rongo kē koe i tētahi āhuatanga rerekē e kore e taea te neke i tētahi taha o tō tinana, ā, kāore he mea e pā ki tētahi taha? Tērā pea ka puta i muri i tētahi aituā. He āhua whakamataku, engari i tēnei rā ka kōrero tātou mō tētahi āhuatanga ka puta i te wā tika, engari kāore i te tino noa, e kiia nei ko te Brown-Séquard Syndrome . Kaua e manukanuka, me kōrero noa iho tātou.

He aha te Brown-Séquard Syndrome, tēnei mate kāore i te mōhiotia whānuitia tōna ingoa?

He whakarāpopototanga noa iho, he mate pūnaha io tino onge te mate Brown-Séquard (BSS) . Ka puta mai ina pakaru tō taura tuaiwi , engari ka mutu te pakaru ki te taha kotahi o te taura tuaiwi. Whakaarohia he rite ki tō taura tuaiwi, he rite ki te taura e kawe ana i ngā karere mai i tō roro puta noa i tō tinana, kātahi ka tukuna ngā mōhiohio mai i tō tinana ki tō roro. Nō reira, ka puta noa tēnei raruraru ina pakaru te taha kotahi o tēnei taura.

Ko te mea ka tupu, i te taha kotahi o te taurakira i pakaru, ka ngoikore, ka pararutiki rānei ngā uaua i raro iho i te taumata o te pakaru. Ko te tikanga tēnei kāore e taea te neke i taua taha. Engari, he mea miharo, ka ngaro te kare o te mamae me te pāmahana i tērā taha , engari i raro iho i te taumata o te pakaru. He ahua uaua te tangi, tika? Me whakamārama atu anō.

He hanganga porotaka tō taurakira e rere ana mai i te take roro tae noa ki raro ki te pūtake o tō tuaiwi. He tino ātaahua. He maha ngā muka io e hangaia ana. He wāhanga nui ia o tō tātou pūnaha io.

Ko te mate Brown-Séquard e kiia ana he whara tuaiwi kāore i oti (SCI) . Ko te tikanga tēnei he ngaronga o te kare ā-roto, te mahi nekeneke, ngā mea e rua rānei i raro i te wāhi whara. I roto i te SCI katoa, kāore he kare ā-roto, he nekehanga rānei i raro i te wāhi whara.

I tapaina tēnei mate i muri i te kaipūtaiao a Charles-Edouard Brown-Sequard, nāna i whakaahua tuatahi te mate i te tau 1849.

He aha te rerekētanga o tēnei i te Mate Puku o te Taura Matua?

Kua rongo pea koe i te Central Cord Syndrome (CCS) . Ahakoa he whara tuarā kāore i oti, he rerekē ngā āhuatanga e rua.

Ko te CCS he whara kāore i tino oti ki waenganui o te taurakira, i te nuinga o te wā i te kaki. Ka nui ake te ngoikore o ngā ringa i ngā waewae.

Heoi, i roto i te BSS , ka pāngia tetahi wāhanga o te taurakira i tetahi taha ka pāngia e te pararutiki, engari ka ngaro te rongo o tetahi taha. E mārama ana koe ki te rerekētanga?

Ko wai ka pāngia e tēnei mate? He pēhea te noa o tōna pānga?

Ka pāngia te tangata e te mate Brown-Séquard. Heoi, he tino onge te mate.Ka taea tēnei te tupu ahakoa te ira tangata.

I te Hononga o Amerika anake, e 12,000 ngā kēhi hou o te whara tuaiwi e pūrongohia ana i ia tau. O ēnei, e 2% ki te 4% anake te BSS. Ko te tikanga tēnei, i Sri Lanka, tera pea he iti ake te reiti.

He aha ngā tohu o te mate Brown-Séquard (BSS)?

Ko ngā tohu o te BSS ka tīmata i muri i te pakaru o tetahi taha o te taurakira.

Ko ngā tohu tuatahi ka puta ko:

• Te kore e taea te neke i te peka i raro i te whara (te ngaronga o te nekehanga uaua) i te taha kotahi o te whara o te tuaiwi. Ka tīmata pea tēnei hei ngoikore, ā, ka haere ki te pararutiki.
• I tētahi atu taha, ka ngaro te mamae me te kare ā-roto i te pāmahana i raro iho i te taumata o te whara.

Whakaarohia pēnei. Mēnā he BSS te mate o te tangata, arā, he whara tuaiwi ki te taha matau o tōna tuaiwi, e kore e taea e ia te neke i tōna taha matau, arā, mai i waenganui o tōna tuaiwi ki raro – ko tōna hope matau, ko tōna waewae, me tōna waewae. Heoi, i te taha maui, mai i waenganui o tōna tuaiwi ki raro, ka ngaro te mamae, ka rongo hoki i te wera/mātao, engari ka taea e ia te neke i tōna taha maui. Ka mahi noa te mahunga, te kaki, ngā pakihiwi, me ngā ringa, kāore e pāngia e tēnei whara.

Hei tāpiri, ka taea e te BSS te whakaputa tohu pēnei i:

• Te kore e taea te whakahaere i te mimi me te paru (te kore e taea te pupuri i te mimi me te paru).
• Te ngoikore me te ngenge o te uaua (te memeha haere o te uaua) i te wāhi e pāngia ana.

He tino ngawari ngā tohu o te BSS mō ētahi tāngata, ā, he tino kino mō ētahi atu. Heoi, mā te maimoatanga tika, ka pai haere haere ēnei tohu .

He mamae tēnei?

Mena he aituā whara pēnei i te patunga pū, i te aituā motuka rānei te pūtake o te BSS, ka tino mamae te tinana. Heoi, nā te mate tonu, arā, te pakaru o te taurakira, kāore pea he mamae.

Heoi, ko ētahi tāngata whai BSS ka pāngia pea e ngā kare ā-roto rerekē (dysesthesia) nā te kino o te taurakira, arā, he kare wera, he werowero, he wiri rānei.

He aha ngā tino take o te mate Brown-Séquard (BSS)?

Ko ngā tino take o te BSS ko ngā whara ki te taurakira:

• Ngā pupuhi pū.
• Te wero.
• Ngā aituā motuka.
• Te whara tūpato.
• Ngā whati o te tuaiwi i puta mai i tētahi aituā pēnei i te hinganga.

Ki te pāngia koe e tētahi aituā pēnei, he mea tino nui kia haere wawe tonu koe ki te hōhipera tata, ka rapu awhina hauora tonu atu.

Haunga tēnei, ka puta anō hoki te BSS nā ngā take kāore i te tūpono noa, engari he iti ake te kitea:

• Te spondylosis o te kaki.
• Ko te mate decompression he mate e puta ana i muri i te pānga ki te pēhanga nui rawa i raro i te wai.
• Te kōpae paheke i te tuaiwi (te kōpae herniated).
• Ngā mate urutā pērā i te meningitis.
• Te Mate Pukupuku Maha (MS).
• Te pānga o te irahiko.
• Te aukati i te uaua toto e tuku ana i te taurakira ki te tuaiwi (ischemia tuaiwi).
• Ngā pukupuku tuaiwi.
• Te myelitis whakawhiti.
• Te mate kohi.

Me pēhea te tautuhi a ngā tākuta i tēnei mate? (Tautuhinga)

Mena kei te whakapae tō tākuta kei a koe te BSS, ka mahi ia i ēnei e whai ake nei:

• Ka oti te whakamātautau tinana katoa.
• Ka whakahaerehia he whakamātautau io hei tirotiro taipitopito i te nekehanga me te kare ā-roto.
• Ka pātai atu rātou mō tō hītori hauora, ō raruraru pūnaha io, me ngā aituā kua pā ki a koe.

Kātahi ka tonoa e rātou ētahi whakamātautau, pērā i te matawai MRI , hei whakaū i te mate me te tirotiro mō ētahi atu take.

He aha ngā whakamātautau e mahia ana mō tēnei?

Mena kei te whakapaehia he BSS, ka tono pea tō tākuta i ngā whakamātautau pēnei i:

• Matawai MRI (Whakaahua Āhua-Mate): He whakamātautau kore mamae tēnei. Ka whakamahia he aukume nui, he ngaru reo irirangi, me te rorohiko hei hanga pikitia mārama o ngā whekau me ngā hanganga i roto i te tinana. He tino whai hua te MRI mō te BSS nā te mea ka taea te āwhina ki te tautuhi i ngā pakaru hanganga o te tuaiwi, me te āwhina ki te kimi i te pūtake o te BSS e puta ana me te kore he aituā.
• Te Myelogram me te matawai CT (Tomography Rorohiko): Ki te kore e taea te whai MRI, ka tono pea tō tākuta i tētahi myelogram, kātahi ka whai matawai CT o tō tuaiwi. Ka taea e ēnei whakamātautau te rapu i te kino o te kiko io i te taha kotahi o tō taurakira. He whakamātautau whakaahua te myelogram e tirotiro ana i ngā hononga i waenga i tō tuaiwi, i ngā kōpae, i te taurakira, i ngā io, me ngā pakiaka io. Ka whakamahia e te matawai CT ngā hihi-X me ngā rorohiko hei hanga pikitia taipitopito o roto o tō tinana.
• Ngā whakamātautau toto: Mena kāore i te mārama te take o te BSS, ka tono pea tō tākuta i ētahi whakamātautau toto hei tirotiro i ngā mate e puta ai te mate.
• Werohanga o te hope / Werohanga o te tuaiwi: Mena kei te whakapaetia ko te multiple sclerosis (MS) , te transverse myelitis, te mate kohi rānei te take o te BSS, ka whakahaerehia pea e tō tākuta he werohanga o te hope hei tango tauira o te wai cerebrospinal (CSF) . Ko te CSF te wai mārama e karapoti ana i tō tuaiwi me tō roro.

He aha ngā maimoatanga mō te mate Brown-Séquard (BSS)?

Ko te maimoatanga mō te BSS ka whakawhirinaki ki te tino take o te kino o te taurakira.

Ko ngā whāinga whānui o te maimoatanga BSS ko:

• Te tiaki, te whakapai ake rānei i te mahi a te tinana me te tinana.
• Te ārai i ngā kino tuarua.
• Te whakaiti i ngā raruraru.

Ko te tangata kua pāngia e te BSS i te whara o te patu koi, pērā i te patunga i te maripi, me rongoā mō te toto me te pakaru o te kiko. Hei tāpiri, ko te hunga kua pāngia e ētahi atu whara i te aituā i puta ai te BSS me rongoā anō mō ​​aua whara.

E rua ngā wāhanga matua o te maimoatanga BSS: te maimoatanga tuatahi me te whakaora .

Te Maimoatanga Tuatahi

Ko ngā maimoatanga tuatahi mō te BSS ka uru atu ki:

• Pokanga: Mēnā ka puta te BSS me te kore he aituā, ko te tikanga he pēhanga ā-ringa, he hernia rānei o te taurakira. Me pokanga hei whakamama i tēnei pēhanga.
• Ngā rongoā ārai toto totoka: Ko te hunga kua whara te taurakira, he nui ake te mōrearea ki te whakawhanake i ngā toto totoka i roto i ngā uaua (Venous Thromboembolism - VTE) . Kei roto i tēnei ko ngā mea pēnei i te deep vein thrombosis (DVT) me te pulmonary embolism . Ka hoatu pea e tō tākuta ki a koe ngā rongoā e kiia nei ko ngā anticoagulants , pēnei i te heparin, te warfarin rānei, hei ārai i ngā toto totoka.
• Te tiaki i te kiri (hei ārai i ngā mate moenga): Hei ārai i ngā whara pēhanga/mate moenga, ka āwhina tō rōpū hauora i a koe ki te tahuri me te whakarerekē i ō tūranga i te iti rawa i ia rua hāora. Ka āwhina rātou ki te pupuri i tō kiri kia ma, kia maroke hoki, ā, ka pania he hinu whakamakuku ki te kiri maroke.
• Ngongo Gastrostomy (ngongo-G): Hei whakaiti i te mōrearea o te pupuhi o te puku nā te ileus paralytic, ka whakanohoia pea e tō tākuta he ngongo-G ki roto i tō puku. Ko te ngongo-G he ngongo e tuku tika ana i te kai mai i te puku ki te puku. Ko te ileus paralytic he ngaronga wā poto o ngā uaua e neke ana i te kai mā roto i ngā whekau. He mea noa tēnei i roto i ngā whara o te taurakira.
• Tautoko manawa: Mena he uaua ki a koe te manawa nā te whara o tō taurakira, me hono atu pea koe ki tētahi mīhini manawa . He mīhini tēnei hei āwhina i a koe ki te manawa, hei manawa rānei māu.
• Te whakahaere i te pūkahukahu neurogenic: Ko te hunga e whara ana i te taurakira, tae atu ki te BSS, ka ngaro pea te mana whakahaere o te pūkahukahu. Mēnā ka puta tēnei, me whakamahi pea he catheter mimi me ētahi atu maimoatanga e pā ana ki te pūnaha mimi.
• Te rongoā mō te dysreflexia autonomic: Tērā pea ka pāngia te hunga whai whara tuaiwi e ngā huringa nui o te toto toto me ētahi atu tohu. Me ata rongoatia tēnei mā te whakamahi i ngā rongoā hei whakahaere i te toto toto me te tere o te manawa.
• Paraikete whakahaere pāmahana: He maha ngā wā ka uaua ki te hunga whai BSS te whakahaere i te pāmahana o ō rātou tinana. Tērā pea ka whakaratohia e te tīma hauora he paraikete whakahaere pāmahana hei āwhina i tēnei.

Whakaoraora

I muri i te maimoatanga tuatahi mō te BSS, me tīmata wawe tonu te whakaora, pērā i te whakaora tinana me te whakaora mahi , hei whakapai ake, hei whakahoki mai rānei i te nekenekehanga.

Ngā whāinga o te whakaora tinana:

• Te pupuri i te kaha o ngā uaua me te mahi pai o ngā io.
• Te pupuri i te whānuitanga o te nekehanga i roto i ngā hononga.
• Āraihia te pakaru o te kiri mā te tū tika me te neke taumaha.
• Te whakapai ake i te nekenekehanga .

Ko te whakaora tinana he mahi whakakori tinana me ngā maimoatanga hei āwhina i a koe ki te whakaiti i te mamae, hei whakahoki anō hoki i a koe ki te mahi me te nekeneke noa. Ka mahi tahi tō kaiwhakaora tinana me koe ki te whakapai ake i tō nekenekehanga. Tērā pea ka whakaratohia e rātou he taputapu hei āwhina i a koe ki te mahi i ngā mahi o ia rā, pērā i ngā whītiki, ngā whitiki ringa, ngā tautoko waewae, te tūru wīra rānei.

Ko te whakaora mahi he maimoatanga me ngā mahi whakakori tinana hei āwhina i a koe kia hoki mai anō te mana motuhake i ngā āhuatanga katoa o tō ao i muri i tētahi raruraru tinana, raruraru roro rānei. Ina whiwhi koe i te whakaora mahi mō te BSS, ka ako koe i ngā huarahi hou hei mahi i ngā mahi o ia rā, pērā i te horoi i a koe anō, te kai, me te whakakakahu, me ngā taputapu āwhina, me te kore rānei.

Ka taea te ārai i tēnei mea kei tupu?

Ko te huarahi anake hei ārai i te mate Brown-Séquard ko te whai i ngā mahi ārai haumaru paerewa kia kore ai e pakaru tō taurakira. Hei tauira, kia tūpato i te wā e taraiwa ana, e hikoi ana rānei i te rori.

He aha ngā tūponotanga ka ora mai i tēnei mate? (Te matapae)

Ko te tirohanga mō te whakaoranga mai i te BSS e whakawhirinaki ana ki ētahi āhuatanga, tae atu ki te pūtake o te kino o te taurakira me te whānuitanga o te kino.

Heoi, i te nuinga o te wā, he pai te tere o te whakaoranga mai i te BSS . He pai te tūponotanga o te hunga whai BSS ki te whakahoki mai i ētahi o ā rātou mahi, tae atu ki te hikoi. Heoi, he puhoi te tukanga whakaoranga . He puhoi ake te whakaoranga, e toru ki te ono marama te roa mai i te tīmatanga o te mate, ā, ka roa pea ki te rua tau kia tino ora ai ngā io.

He aha ngā raruraru ka puta mai mēnā kāore e rongoatia?

Mena ka kore e rongoatia te mate Brown-Séquard, ka puta ngā raruraru pēnei i:

• Te pupuhi o te puku.
• Te pouri.
• Te toto toto iti (hypotension).
• Te embolism pūkahukahu.
• Ngā mate urutā – te nuinga i roto i ngā pukahukahu me te ara mimi.
• Pararutiki tuturu.

He aha ngā wā pai rawa atu hei toro atu ki te tākuta?

Ki te pāngia koe e te ngoikore o te uaua, te pararutiki rānei, me te ngaro rānei o te rongo i tetahi taha o tō tinana, haere ki te rūma whawhati tata i te wā e taea ai .

Mena kua tāpaetia koe kei te pāngia koe e te mate Brown-Séquard, me toro atu koe ki tō tīma hauora i ia wā, i ia wā, kia mōhio ai koe kei te ora pai tō whara tuaiwi. Kia mau ki ō wā whakarite mō te whakaora tinana me te whakaora mahi hei āwhina i a koe kia ora wawe tonu.

Ko te mea nui hei maumahara (Karere hei tango ki te kāinga)

He ahua whakamataku te rongo i te mate Brown-Séquard. Engari ko te rongo pai ko te tokomaha o te hunga whai mate nei ka hoki mai, ka whakapai ake rānei i ō rātou pūkenga nekeneke me ō rātou pūkenga rongo i muri i ētahi marama o te whakaoranga. Kia mahara, kei reira tonu tō rōpū hauora hei āwhina i a koe kia hoki ki te huarahi tika. Nō reira kia kaha, kia whai i ngā tohutohu kua hoatu.

Te Mate Brown -Séquard, te taurakira, te taurakira, ngā io, te pararutiki, te ngaronga o te rongo, te kino o te taurakira