He raruraru toto kei roto i tō tuaiwi? Me ako atu tātou mō te Spinal Arteriovenous Malformation (AVM)!

Ka mamae tō tuara i ētahi wā? Ka rongo rānei koe i te ngoikore, i te ngoikore rānei o te ringa, o te waewae rānei? Ehara pea ēnei i te mea noa iho. I tēnei rā ka kōrero tātou mō tētahi āhuatanga kāore i te tino rangona, engari he mea nui rawa atu. Koia tēnei he uaua toto i roto i te taurakira, he āhuatanga e kiia nei ko te `(Spinal Arteriovenous Malformation)` ko te `(AVM)` rānei i roto i ngā kupu hauora.

He aha tēnei `(Spinal AVM)`?

He māmā noa iho, ko te Spinal AVM he āhuatanga e raranga ana, e pōrearea ana ngā oko toto (ngā uaua toto) huri noa, i runga rānei i tō taurakira (te taura io i roto i tō tuaiwi). E mōhio ana koe me pēhea tēnei? He uaua kei roto i ō tātou tinana (ngā uaua e kawe ana i te toto whai hāora mai i te ngākau) me ngā uaua (ngā uaua e kawe ana i te toto kua whakamahia ki te ngākau). I te nuinga o te wā, ka honoa ēnei uaua me ngā uaua e tētahi pūnaha o ngā oko toto tino angiangi e kiia nei ko ngā capillaries . Ko ēnei capillaries te mea e tohatoha ana i te hāora ki tō tātou taurakira me ngā kiko e karapoti ana.

Heoi, i roto i tēnei āhuatanga `(AVM)`, ka hono tika mai tētahi uaua ki tētahi uaua. Ka karohia te pūnaha capillary i waenganui. Whakaarohia, he rite ki te waka e tūpono ana te huri ki tētahi huarahi iti, kātahi ka hono anō ki tētahi huarahi nui. He aha te mutunga? Ka whakaitihia te nui o te hāora e hiahiatia ana e ngā pūtau o te taurakira. Waihoki, ka taea e tēnei hononga rerekē te whakanui i ngā oko toto, te huri i te pēhanga, ā, i ētahi wā ka pakū . Ki te tupu tēnā, ka puta te toto nui `(Hemorrhage)` , ka tūpono pea te ora . Engari kaua e manukanuka, he maimoatanga kei reira hei ārai i tēnei āhuatanga. I ētahi wā ka karangahia tēnei e ngā tākuta ko `(Spinal Arteriovenous Shunt)`, e ai ki tāu i rongo ai.

He aha ngā momo matua o te `(Spinal AVM)`?

Nā, kia tirohia tātou he aha ngā momo matua o te `(Spinal AVM)`. E rima ngā momo hapa o ngā oko toto e puta ana i roto i te taurakira. Kei roto i ēnei ko te `(Spinal Arteriovenous Malformations - AVM)` me te `(Spinal Arteriovenous Fistulas - AVF)`. I roto i ēnei e rua, ka puta he hononga rerekē i waenga i te uaua me te uaua. Heoi, ka puta te `(AVM)` i roto i te kiko o te taurakira. Ka puta te `(AVF)` i roto i te `(Dura mater)` , te kiriuhi hipoki e karapoti ana i te taurakira.

Anei ngā momo matua e rima:

• Momo I: Dural AVF: Kei roto tēnei i te uhi o waho rawa o te taurakira (dura mater).
• Momo II: Intramedullary glomus AVM: Kei roto i te taurakira tēnei.
• Momo III: Intramedullary juvenile AVM: Ka horapa pea tēnei ki roto i te taurakira me ngā kiko e karapoti ana. He mea tino noa tēnei i roto i ngā tamariki me ngā taiohi.
• Momo IV: Perimedullary AVF: Kei roto i ngā kiko e karapoti ana i te taurakira tēnei.
• Momo V: AVF i waho o te dural: Kei roto tēnei i te wāhi i waho o te dura mater.

Kotahi te mea hei maumahara, ki te pakaru te AVM, ka kaha ake ngā tohu i ērā o te AVF. Nā te mea ka pakaru tika te AVM ki roto i te kiko, engari ko te AVF kei roto i te dura mater, e whakarato ana i ētahi tiaki.

He pēhea te noa o tēnei āhuatanga?

He pēhea te noa o te ingoa o tēnei mate ko te `(Spinal AVM)`? Inaa, koinei te mate tino noa o ngā oko toto e pā ana ki te taurakira. Heoi, he uaua ki te kī tika e hia ngā tāngata e pāngia ana e tēnei mate. Nā te mea he maha ngā tāngata kāore e mōhio kei a rātou tae noa ki te puta o ngā tohumate. I ētahi wā ka kitea tūponotia i roto i ngā whakamātautau mō tētahi atu mate. Nō reira, he mate onge te nuinga o te wā .

He aha ngā tohu o te `(Spinal AVM)`?

Ka puta ngā tohu o te `(Spinal AVM)` nā te mea ka pēhia e te puranga uaua o ngā oko toto ki ngā pakiaka io o te taurakira me te taurakira tonu. I roto i te rongoā, ka kiia tēnei momo pēhanga ko `(Myelopathy)` . Ko ngā tohu tino kitea ko:

• Mamae tuara .
• Te ngoikore, te pakari rānei o ngā uaua (i roto i te kaki, i ngā ringa, me ngā waewae).
• Te ngenge, te ngaro o te kare ā-roto, ngā kare ā-ahua rerekē rānei o ngā waewae.
• Te mamae o te upoko .
• Te ngaro o te taurite, te uaua ki te hikoi .
• Te uaua ki te whakahaere i te mimi me te paru .

Ka rerekē ēnei tohu i runga i te momo AVM, tōna kaha, me tōna wāhi kei roto i te tuaiwi. Hei tauira, mēnā kei tō tuara o runga, kei tō uma rānei te AVM, ka puta pea ngā tohu ki tō uma, ki tō tinana, ki tō tuara, ki ō ringaringa, me ō waewae. Mēnā kei waenganui o tō tuara, kei tō tuara o raro rānei, ka pā pea ngā tohu ki tō puku o raro, ki tō tuara, ki ō waewae rānei.

Ka puta pea ēnei tohu i te taha kotahi o te tinana, i ngā taha e rua rānei. I ētahi wā ka kite pea koe ka piki haere haere i te roanga o te wā, ka haere mai, ka haere atu rānei. Kia maumahara ka pāngia ētahi tāngata e te AVM tuaiwi, engari kāore he tohu.

Heoi, he mea nui kia toro atu ki te tākuta i te tīmatanga o ngā tohu. Ko te mamae ohorere o te tuara, he tohu pea kua pakaru te AVM. He āhuatanga ohorere hauora tēnei, nō reira rapua tonutia he maimoatanga.

Āhea ka tīmata ngā tohu?

Ka puta pea ēnei tohu `(AVM)` i ngā tau katoa. Heoi, ko te nuinga o te tangata ka pāngia e ngā tohu i waenga i te 15 me te 60 tau te pakeke. Ka rerekē anō hoki i runga i te momo `(AVM)`. I te nuinga o te wā, he whānau mai ēnei mate `(Spinal AVM)`. Ko te tikanga tēnei, tera pea he raruraru kei roto i te pēpi me ēnei oko toto i a ia e noho ana i roto i te kōpū. Heoi, i ētahi wāKa puta anō hoki tēnei āhuatanga i muri i te pakeketanga (kua riro mai).

He aha ngā take o te `(Spinal AVM)`?

Kāore anō kia tino mōhio ngā tākuta he aha te take o tēnei `(Spinal AVM)`.

Mō te whānautanga o te `(Spinal AVM),` kua whakaatuhia e ngā rangahau i te wā e tipu ana te pēpi i roto i te kōpū, ka whanake rerekē ngā oko toto e karapoti ana i te taurakira. Hei tauira, tera pea nā te huringa o te ara rere toto hei karo i te aukati.

I muri i te whānautanga, ka puta pea te "Spinal AVM" i muri i tētahi aituā, pokanga, tētahi atu momo whara rānei ki te taurakira .

He aha ngā raruraru ka pā mai i tēnei?

Ko ngā raruraru ka puta mai i te `(Spinal AVM)` ka mate pea i ētahi wā. Ko ngā mea matua ko:

• Te Toto: Ka pakū te AVM ka tīmata te toto i roto i te tinana.
• Ischemia: Koinei te wā ka motuhia te rere o te toto. Ka whakaitihia te nui o te hāora me ngā matūkai e hiahiatia ana e ngā wāhanga o te tinana. Ka mutu pea te mahi tika a ngā pūtau, ā, i roto i te wā, ka nui haere te kino.
• Pararutiki: Ki te pakaru te taurakira, ka pāngia e te pararutiki, he āhuatanga e kore ai e taea te neke i ētahi wāhanga o te tinana.

Me pēhea te mōhio mēnā kei a koe tētahi `(Spinal AVM)`?

Me pēhea te tātaritanga a te tākuta i te AVM tuaiwi? Ka tirohia tō tinana i te tuatahi , kātahi ka whakahaerehia he whakamātautau io . Hei tāpiri, ka tono pea rātou i ētahi whakamātautau whakaahua motuhake .

Mā ēnei whakamātautau whakaahua ka āwhina i te whakatau i te rahi o te AVM me tōna wāhi kei roto i te taurakira. Tērā pea ka whakamahia e tō tākuta ēnei whakamātautau:

• Matawai Whakaahua Āhua Aukume (MRI).
• Whakamātautau Angiography Resonance Magnetic (MRA) (e tirotiro ana tēnei i ngā oko toto)
• Te matawai Myelogram me te CT (Tomography Rorohiko - CT).

Hei tāpiritanga, ki te ngoikore tō uaua, ki te kore rānei e taea te nekeneke o te io, ka taea pea te whakahaere i te whakamātautau hikohiko me te whakamātautau EMG.

Me pēhea te rongoā i te `(Spinal AVM)`?

He maha ngā tikanga matua mō te rongoā i te `(Spinal AVM)`:

• Te whakapūngao:I tēnei, ka whakamahia e te taote pokanga he ngongo tino angiangi (he catheter) hei toro atu ki te oko toto e pāngia ana, hei whakamutu i te toto, hei kati rānei i te hononga rerekē.
• Pokanga: Ka tangohia katoatia e te taote pokanga te AVM, ā, ka tukuna kia rere tika ngā oko toto.
• Pokanga irahiko stereotactic: I roto i tēnei, ka tukuna tika ngā hihi irahiko kaha-nui ki te wāhi o te AVM, ka whakangaro me te kati i ngā hononga uaua toto rerekē.

Mā tō tākuta koe e whakamārama ko tēhea te maimoatanga pai rawa atu mō tō āhua. Mā te rahi o te AVM me tōna wāhi e whakatau te maimoatanga haumaru me te tino whai hua. Māna anō hoki e kōrero ki a koe ngā pānga taha o te maimoatanga kia taea ai e koe te whakatau whai whakaaro.

I te nuinga o ngā wā o te `(Spinal AVM)`, me pokanga hei ārai i ngā raruraru kua whakahuatia ake nei. Tae noa ki te rā o te pokanga, ka tohua pea e tō tākuta ngā rongoā whakamamae mamae, ētahi atu maimoatanga rānei hei whakahaere i ō tohumate, hei pupuri hoki i a koe kia marino.

Kia pēhea te roa ka pai ake ai taku āhua i muri i te maimoatanga?

I muri i te pokanga, ka tīmata koe ki te rongo i te whakaoranga mai i ngā tohu pēnei i te mamae me te ānini. Heoi, ka rerekē te wā e pau ana ki te tino ora i runga i te momo pokanga kua tohua e tō tākuta. E rua wiki pea te roa. I muri i te pokanga, me whai rongoā tinana , rongoā mahi rānei koe hei whakapakari i ō uaua me te whakapai ake i tō taurite.

He aha te tirohanga mō tēnei āhuatanga?

Ka taea te rongoā i ngā AVM tuaiwi mā te pokanga. Ka tutuki ngā hua pai rawa atu ina kitea wawetia te mate, ā, ka rongoatia i mua i te whanaketanga o ngā raruraru. Heoi, ehara i te mea ngāwari tonu tēnei. I ētahi wā, ahakoa kei te kitea he AVM tuaiwi, kāore pea ngā tohu e puta tonu mai. Ki te kore e rongoātia, ka arahi pea ki ngā raruraru nui, mōrearea hoki pērā i te pararutiki me te toto.

He pēhea te angitu o te pokanga AVM Tuaiwi?

He angitu te pokanga AVM tuaiwi i te nuinga o te wā. I kitea i roto i tētahi rangahau he 74% me te 88% te angitu o ngā maimoatanga embolization me te tango pokanga. I roto i taua rangahau anō, 70% o te hunga i rongoatia i wheako i te whakaoranga o ngā tohu.

Heoi, ko te putanga o te pokanga e whakawhirinaki ana ki ngā āhuatanga maha, pērā i tō hauora whānui, te rahi o te AVM, me tōna wāhi. Ka taea e tō tākuta te tohutohu pai rawa atu ki a koe mō tō āhua.

Te AVM Tuaiwi me te haputanga

Ahakoa e taea ana te haputanga angitu me te `(Spinal AVM)`, he nui te mōrearea o ngā raruraru.He nui te mōrearea o te pakaru o te AVM, ka puta he mamae nui me te pararutiki. Ka taea e tēnei te whakararu i te ora o te whaea me te pēpi kāore anō kia whānau. Nō reira, ma tō tākuta koe e tohutohu mō ngā maimoatanga haumaru mō tō āhua me pēhea te whakarite mō te hāputanga hauora.

Ka taea te ārai i tēnei?

Kāore anō kia mōhiotia he huarahi hei ārai i tēnei mate (Spinal AVM). Kei te whakahaerehia he rangahau anō hei whakatau i te pūtake o ēnei mate.

Āhea koe me toro atu ki te tākuta?

Ki te mea kei a koe ngā tohu o te `(Spinal AVM)`, me toro atu koe ki te tākuta .

I ētahi wā, ka pakaru ohorere te AVM. He āhuatanga ohorere hauora tēnei. Ki te pāngia koe e tētahi o ngā tohu e whai ake nei, haere tonu ki te rūma ohorere o te hōhipera:

• Mamae tuara ohorere, kāore e taea te manawanui.
• Kiri mā, makariri, werawera.
• Te uaua ki te manawa.
• Ka piki ake te tere o te manawa.
• Whakapairuaki, ruaki rānei.
• Te ngaronga o te taurite o te tinana.
• Te pōhēhē, te ngaronga o te mahara.
• Te uaua ki te neke, ki te huri rānei i te kaki.
• Te mamae nui o te upoko.
• Te ngaronga o te māramatanga.

Ngā pātai me pātai atu koe ki tō tākuta

Ko ētahi pātai me pātai atu koe ki tō tākuta:

• Kei hea taku `(Spinal AVM)`?
• He aha te maimoatanga e taunaki ana koe?
• He aha ngā pānga taha o te maimoatanga?
• Kia pēhea te roa o te wā e ora ai i muri i te pokanga?
• Ka taea e te AVM te tupu anō i muri i te tango?
• Mena he mate AVM tuaiwi tō tētahi o ōku whanaunga tata, me whakamātautau ira anō hoki ahau?

Ko te mea nui rawa atu kia maumahara koe!

Ina puta ohorere mai ngā tohu, tae atu ki ngā panonitanga o te nekehanga o te tinana me te kaha o te uaua, ka tino whakamataku pea. Mēnā ka rongo koe i tētahi mea rerekē, me toro atu ki te tākuta . Ko te mamae nui o te tuara he tohu nui kei te hē rawa tetahi mea. Ka taea e tēnei āhuatanga, e kiia nei ko te spinal arteriovenous malformation (AVM), te whakararu i te ora . Nō reira, ko te wawe o te tautuhi me te rongoā i te mate, ko te pai ake o te putanga . Ka taea e te pokanga te whakatika i te āhua rerekē o ēnei uaua toto.

` AVM tuaiwi, taurakira, uaua toto, mamae tuara, AVM, toto, pokanga