He toto ohorere kei roto i te upoko? (Subarachnoid Hemorrhage - SAH) I tēnei rā ka kōrero tātou mō tēnei mea!

Kua pāngia koe e te mamae o te upoko ohorere, tino mamae, me te mea kei te pahū tō upoko, me te mea rānei kua pā mai te uira ki a koe? E kīia ana e ētahi ko "te mamae o te upoko kino rawa atu o tō ao." Ehara tēnei i te kata. He tino morearea tēnei āhua. I roto i te rongoā, ka karangatia tēnei āhua ko `(Subarachnoid Hemorhage)` ko `(SAH)` rānei. He āhuatanga ohorere hauora tēnei. Nō reira, me kōrero tātou mō tēnei mea me ētahi atu kōrero, me ngā kupu māmā noa iho, āe?

He aha rawa tēnei (Subarachnoid Hemorrhage)? Me mārama noa iho, me pēhea?

Ki te kī ngāwari, ko te `(Subarachnoid Hemorrhage)` he toto kei waenganui i te roro me te kiriuhi angiangi e karapoti ana i te roro . Whakaarohia, he rite tō tātou roro ki tētahi taonga utu nui. Nō reira, hei tiaki i a ia, kua homai e te taiao ki a tātou ētahi paparanga angiangi e toru o te kiriuhi angiangi. Ka karangatia ēnei e tātou ko `(Meninges)`. He rite ki te kiri o te riki, he rite rānei ki te kiri o te kokonati ngā paparanga maha.

Ko ēnei taupoki e toru ko:

• Dura mater: Koinei te uhi o waho kaha ake i raro i te angaanga.
• Arachnoid mater: Koinei te uhi o waenganui. He kiriuhi angiangi e rite ana ki te tukutuku pungawerewere.
• Pia mater: Koinei te hipoki tino angiangi, tino o roto e piri ana ki te roro tonu.

Nā, ko te mea e tupu ana i roto i tēnei `(Subarachnoid Hemorrhage)` ko te toto ka puta i raro i te kiriuhi arachnoid i waenganui (arā, i roto i te wāhi "sub-arachnoid"). He tino morearea tēnei, nā te mea ka taea e tēnei toto te pēhi i te roro, ā, ka taea hoki te pakaru i ngā pūtau roro. Koia te take i kiia ai tēnei he āhuatanga ohorere hauora.

He aha te rerekētanga i waenga i te (Subarachnoid Hemorrhage) me te (Subdural Hematoma)?

Kua rongo pea koe i tētahi atu mate e kiia nei ko te "Subdural Hematoma". He toto e rua kei roto i te roro. Ko te rerekētanga ko te wāhi e puta ai te toto .

• I roto i te "Subdural Hematoma", ka rere te toto ki te wāhi i raro i te hipoki o waho rawa, te "dura mater" i kōrerotia i mua ake nei.
• I roto i te totohu subarachnoid, ka rere te toto ki te wāhi i raro i te membrane arachnoid .

He rite tonu ngā tohu o ngā mea e rua i ētahi wā, ka pā kino pea te roro ki ēnei e rua, ā, he āhuatanga e rua e hiahia ana ki te maimoatanga hauora ohorere.

Ko wai te hunga ka nui ake te tūponotanga ki te pāngia e te SAH? He aha ngā āhuatanga mōrearea?

Ka pā tēnei āhuatanga, e kiia nei ko te "Subarachnoid Hemorrhage," ki te tangata katoa. Heoi, he nui ake te kitea i roto i te hunga i waenga i te 40 me te 60 tau te pakeke .

He nui ake te kitea o te whara o te upoko (SAH) i roto i ngā kaumātua nā te mea ka nui ake te tūponotanga o te hinga me te ngaronga o te taurite i te kaumātuatanga o te tangata. I roto i te hunga rangatahi, ko ngā aituā waka te tino take.

Hei tāpiritanga, he maha atu anō ngā āhuatanga mōrearea ka whai wāhi ki te whanaketanga o te SAH. Ko ēnei:

• He aneurysm kāore anō kia pakaru i roto i tō roro, i tētahi atu wāhi rānei o tō tinana (he uaua toto e pupuhi ana te aneurysm pērā i te poihau).
• He hītori o te pakaru o te aneurysm roro o mua.
• Te momi hikareti. (Koinei te pūtake o ngā mate maha, kāore?)
• He toto toto tiketike tō te tangata (hypertension). (Ka kīia e mātou ko te "high pressure").
• Ko ētahi āhuatanga ira, hei tauira, ngā mate hononga hononga pērā i te "Fibromuscular dysplasia (FMD)" me te "Ehlers-Danlos syndrome".
• He mate tākihi tō te tinana e kiia nei ko te "(Polycystic kidney disease)".
• Te whakamahi i ngā raau taero pēnei i te kōkaini me/te methamphetamine rānei.
• Te inu nui rawa o te waipiro.
• Te whakamahi i ngā rongoā whakangawari toto pēnei i te Warfarin (Me whakamahi noa i raro i te tohutohu a te tākuta).
• Mena kua pāngia tētahi o tō whānau e te aneurysm (ko te tikanga he nui te hītori o tōna whānau).

He mea nui: Mena kei a koe tētahi, neke atu rānei o ēnei āhuatanga mōrearea, ehara i te mea ka tino pāngia koe e te SAH. Heoi, he nui ake tō mōrearea. Nō reira, he mea tino nui kia rapu tohutohu hauora.

He aha ngā tohu o tēnei mate kino? Me pēhea te mōhio ki tēnei?

Ko te tohu matua, me te tino mōrearea o te totohu subarachnoid ko te "whatiwhati o te upoko" i kōrerotia i mua ake nei. He tino kino, he ohorere te mamae o te upoko. Ka rite ki te mea kei te pahū tetahi mea i roto i tōu upoko. He tokomaha te hunga e kī ana, "Kāore anō kia pāngia ahau e tēnei mamae o te upoko i roto i tōku ao."

Ki te pāngia koe e te mamae nui, ohorere pēnei i tēnei, inā koa kei a koe tētahi o ngā tohu kua whakarārangihia i raro nei, waea atu ki te 911 (1990 Suwaseriya i Sri Lanka) i runga i te wā poto, haere rānei ki te rūma whawhati tata i te wā e taea ai. Mā tēnei pea ka ora ai koe!

Ko ētahi atu tohu ko:

• Te hekenga o te māramatanga me te uaua ki te noho ara.
• Whakapairuaki me te ruaki.
• Te mārō o te kaki, te uaua ki te piko i te kaki (Stiff neck) .
• Te āhua nei kua ngaro whakarere tōu ora.
• Ngā panonitanga o te wairua me te tuakiri (hei tauira, te ohooho, te riri).
• Pōuriuri .
• Te aro o ngā kanohi ki te māramatanga kanapa (te aro o ngā kanohi ki te māramatanga kanapa) .
• Te mamae o ngā uaua , inā koa ki te kaki me ngā pakihiwi.
• Te ngoikore o tētahi wāhanga o te tinana.
• Te pāngia e te mate hopuhopu `(Ngā mate hopuhopu)` .
• Ngā huringa tirohanga : Te tirohanga takirua, ngā ira pango o te tirohanga, te ngaronga o te tirohanga mō te wā poto o te kanohi kotahi.

Mena ka haere tahi mai tētahi, ētahi rānei o ēnei tohu me te mamae nui o te upoko, he nui te tūponotanga he 'SAH' tēnei.

He aha tēnei (Te Toto i te Ipu o te Runga o te Ipu) ka puta? He aha ngā tino take?

E rua ngā tino take o te totohu i roto i te roro (subarachnoid hemorrhage).

1. Te whara o te upoko: Koinei te tino take. Hei tauira, ka pā kino te mate ki te upoko i te hinganga kino, i te aituā motuka rānei.

2. Pakaru o te aneurysm roro: He tino take noa hoki tēnei. E ai ki tā mātou i kōrero ai i mua ake nei, ko te aneurysm he wāhi ngoikore i roto i te pakitara o te uaua toto i roto i te roro e pupuhi ana pērā i te poihau. Mēnā ka pakaru ohorere, ka rere tika te toto ki roto i te wāhi i raro i te kiriuhi arachnoid. Koinei te take o te 85% o ngā pakaru ohorere o te aneurysm (SAH) kāore he whara o te upoko.

Haunga ēnei take matua e rua, tera atu anō ētahi atu take kāore i te tino kitea:

• Te toto e puta mai ana i tētahi wāhi e raranga ana i ngā uaua toto. Ka kiia tēnei ko te "Arteriovenous malformation (AVM)".
• Ko ētahi mate toto.
• Te whakamahinga o ngā rongoā whakaheke toto (ina whakamahia ana me te kore tohutohu hauora).
• Te whakamahi i ngā raau taero pēnei i te kōkaini me/te methamphetamine rānei.

Me pēhea te tautuhi a ngā tākuta i tēnei mate? He aha ngā whakamātautau ka mahia e rātou?

Ki te whakapae te tākuta kei a koe te "Subarachnoid Hemorrhage" i muri i te arotake i ō tohu me te tirotiro tuatahi, ka tonoa tonutia e ia he "scan CT" (scan Tomography Rorohiko).

Ka taea e te matawai CT te tango pikitia taipitopito o ngā kiko o roto i tō tātou tinana. He huarahi tino whai hua te matawai CT o te roro ki te kite mēnā he SAH. I ētahi wā, ka mahia hoki he matawai e kiia nei ko te CT angiography (CTA) mā te werohanga i tētahi wai motuhake ki roto i tētahi uaua hei tirotiro i te āhua o ngā oko toto.

Heoi, ki te mea he SAH tino iti, ki te mea rānei i puta i roto i ngā wiki e rua kua pahure ake nei, tērā pea kāore e kitea e te matawai CT. Mēnā koinā, me mahi pea e te tākuta ētahi atu whakamātautau.

Ko rātou ēnei:

• Wero i te hope: Ko te werohanga o tētahi ngira angiangi rawa ki roto i tō tuara o raro, ka tangohia he tauira o te wai e karapoti ana i tō roro me tō taurakira (e kiia nei ko te wai cerebrospinal - CSF). Kātahi ka whakamatautauria tēnei wai mō te xanthochromia (he āhua kōwhai). Mena kei reira, tera pea he tohu kei a koe te SAH.
• Whakaahua aukume roro (MRI): Ka taea hoki e tēnei te tirotiro mō te toto o te roro i ngā wā tata nei.

Kia kitea te SAH, ka tīmata te maimoatanga i te hōhipera mā te kimi me te rongoā i te pūtake, me te whakahaere i ngā raruraru ka puta mai. Nā te mea neke atu i te 80% o ngā SAH kāore he whara o te upoko i puta mai i te aneurysm, he maha ngā wā ka whakahaerehia e ngā tākuta he whakamātautau e kiia nei ko te angiogram cerebral, e tango pikitia ana i ngā uaua o te roro, ā, ka rongoā i te aneurysm.

He aha ngā maimoatanga mō tēnei? Kia pēhea te roa o te wā e ora ai?

He āhuatanga ohorere e morearea ana te totohu o raro-ā-roto, ā, i te nuinga o te wā ka rongoatia i roto i te wāhanga tiaki nui (ICU) o te hōhipera , kei reira ngā tohungatanga ki ngā mate pūnaha io. Ko ngā whāinga matua o te maimoatanga ko:

• Te whakaora i tōu ora.
• Tāutuhia te pūtake o te toto me te rongoā.
• Te whakamamae i ngā tohu.
• Te ārai i ngā raruraru (hei tauira, te Vasospasm - te whakawhāititanga o ngā oko toto, te Hydrocephalus - te kohikohinga wai i roto i te roro, te kino pumau o te roro).

Ko ngā maimoatanga whakaora ora me ngā maimoatanga whakahaere tohumate ka uru atu ki:

• Ngā pūnaha tautoko ora.
• Te whakauru i tētahi ngongo hei whakamama i te pēhanga i roto i te roro.
• Ngā tikanga hei tiaki i te ara manawa.
• He rongoā hei whakaiti i te pupuhi i roto i te angaanga.
• Te rongoā e hoatu ana mā roto i te uaua hei whakahaere i te toto totoka.
• Ngā rongoā hei ārai i ngā vasospasms.
• Ngā rongoā mamae mō te ānini me ngā rongoā ārai-manukanuka.
• He rongoā hei ārai, hei rongoā rānei i te mate pāwera.

Tērā pea ka hiahiatia he pokanga hei rongoā i te SAH me tōna take:

• Mena i puta te SAH i tētahi whara, tangohia ngā toto toto nui kua kohia, whakaitihia rānei te pēhanga ki te roro.
• Mena kua pakaru te aneurysm, ā, kua huri hei "SAH", whakatikahia te aneurysm.

Ka rerekē te roa o te noho ki te hōhipera i runga i tō āhua hauora. Ko te nuinga o te hunga whai SAH ka noho ki te hōhipera mō te 10 ki te 20 rā , i runga i tō rātou āhua me te hiahia ki te whakaora.

Me aha tātou hei ārai i te whanaketanga o te SAH?

Ko te nuinga o ngā mate toto i roto i te roro (subarachnoid hemorrhage) ka puta mai i ngā whara o te mahunga, i te pakaru rānei o ngā aneurysm o te roro. Nō reira, ko te mea pai rawa atu hei karo i te toto i roto i te roro (subarachnoid hemorrhage) ko te ngana ki te whakahaere i ngā āhuatanga mōrearea mō ēnei āhuatanga e rua.

Kia tūpato kei whara tō upoko:

• Me mau tonu he potae i te wā e eke pahikara ana, e motopaika ana, e takaro ana rānei i ngā hākinakina morearea.
• Kia haumaru te taraiwa , kia whai hoki i ngā ture huarahi.
• Ki te mea he maha āu hinganga, tirohia he kaiwhakaora tinana, he kaiwhakaora mahi rānei, kia ako ai koe i ngā huarahi hei ārai i ngā hinganga, hei whakapai ake hoki i te haumaru o tō kāinga.

Hei whakaiti i te mōrearea o te whakawhanaketanga o te aneurysm roro, me/ranei te ārai i te pahūtanga o te aneurysm kua oti kē te whakarite:

• Kōrero ki tō tākuta mō ngā mea ka taea e koe te mahi hei pupuri i tō hauora. He maha ngā wā ka tūtohu ia i ēnei e whai ake nei:
• Whakahaerehia te toto toto tiketike (mā te rongoā me ngā huringa āhua noho).
• Kaua e kai hikareti.
• Whakakorikori tinana i ngā wā katoa (engari kaua e hiki i ngā taumaha katoa i te wā kotahi, nā te mea ka pakaru pea te aneurysm).
• Kai i te kai taurite.
• Mena he raruraru tōu ki te waipiro, ki te tarukino rānei, rapua he āwhina. Kaua e whakamahi i ngā mea whakaohooho pērā i te kōkāne.

He aha ngā mea ka taea te tumanako i muri i tēnei āhuatanga? (Te Matapae me ngā Huarahi Whakararuraru)

Ko te āhua o te mate i muri i te totohu subarachnoid ka whakawhirinaki ki te take, te kaha o te mate, me te mea he raruraru, he whara rānei kei reira.

He tino kino tēnei mate . Tata ki te haurua o te hunga e pāngia ana e te SAH ka mate ohorere . Mō te hunga ka taea te haere ki te hōhipera:

• Tata ki te tuatoru o ngā tāngata i mate i te hōhipera.
• Tata ki te kotahi hautoru o te hunga e ora ana me tētahi momo hauātanga.
• Tata ki te hautoru ka hoki ki te āhua noa.

Ko ngā raruraru tata tonu o te SAH ko:

• Te pāngia e te mate haurangi (ngā mate haurangi).
• Te vasospasm (te whaiti o te oko toto i roto i te roro, e aukati ana i te rere o te toto).
• Te toto anō i muri i te maimoatanga tuatahi.
• Te hydrocephalus (te kohikohinga o te wai i roto i te roro).
• Te pikinga o te pēhanga intracranial.
• Te hernia o te roro.
• Ko te infarction cerebral / ischemic stroke ka puta mai i te hekenga o te rere o te toto ki te roro.
• Te mate.

He aha ngā raruraru roa o te SAH?

Nā te mea ka taea e te totohu subarachnoid te kino ki te roro, ka taea e ia te whakararu i te roro mō te wā roa, tae noa ki te wā pumau. Ko ngā raruraru pea mō te wā roa ko:

• Ngā raruraru tinana: Te hiamoe me te ngenge tonu, te ngoikore, te ngoikore rānei o ngā wāhanga o te tinana, te uaua ki te horomi, te ngaro o te taurite.
• Ngā raruraru hinengaro: ngā raruraru mahara, te uaua ki te arotahi, te uaua ki te whakamahere me te mahi i ngā mahi uaua.
• Ngā uauatanga o te kōrero: Te kōrero pōturi, te kōrero puhoi rānei. Te uaua ki te kimi i ngā kupu e hiahiatia ana.
• Ngā take hauora hinengaro: He whara nui te SAH i roto i te ao. Ka taea e ia te arahi ki ngā āhuatanga pēnei i te pouri, te manukanuka whānui, me te mate ahotea muri-traumatic (PTSD).

He maha ngā maimoatanga mō ēnei raruraru roa. Hei tauira:

• Te whakaora tinana.
• Te whakaora mahi.
• Te whakaora kōrero.
• Hinengaro whakaora (kōrero whakaora).

Ka taea hoki e ētahi rongoā te āwhina i tēnei. Mena kei a koe tētahi o ēnei raruraru, kōrero ki tō tīma hauora.

Ki te kore e rongoatia, e 65% te tūponotanga ka mate te SAH i roto i te tau kotahi. Heoi, ki te tika te tātaritanga me te rongoā, ka taea te whakaiti i te tūponotanga ka mate i roto i te tau kotahi ki te 18%.

Mena kua tāpaetia koe kei te pāngia e te SAH, me toro atu koe ki tō tīma hauora i ia wā, i ia wā, hei aroturuki i tō hauora me tō ahunga whakamua. Tērā pea ka hiahia koe ki te whakaora tinana, whakaora mahi, whakaora kōrero rānei mēnā ka puta he raruraru.

Karere Tangohia ki te Kāinga

Āe, ko tāku tumanako kua mārama pai koutou ki tā tātou i kōrero ai i tēnei rā, arā, ko te `(Subarachnoid Hemorrhage).` Anei ētahi o ngā mea nui hei maumahara māu:

• Ko te ānini ohorere, kaha, me te whatitiri he tohu matua pea o te SAH.
• He āhuatanga ohorere hauora te `(SAH)`. Mēnā ka pā mai ngā tohu, me rapu āwhina hauora tonu.
• Ko ngā whara o te mahunga me te pakaru o ngā aneurysms o te roro ngā tino take o tēnei.
• Ka taea te whakaiti i te mōrearea o te whakawhanake i te SAH mā te whakahaere i ngā āhuatanga mōrearea me te whai i tētahi momo noho haumaru.
• Ahakoa he kino rawa tēnei mate, he wāhi anō kei reira hei whakaora i ngā oranga me te noho i te oranga pai mā te maimoatanga tere me te whakaora tika.

Nō reira, kia tūpato hoki ki tēnei. Mēnā ka pāngia koe, tētahi atu rānei e mōhio ana koe e tētahi o ēnei tohu, me mahi tonu. Kia ora tonu!

` Totoronga toto o te roro, SAH, Totonga toto o te roro, Mamae upoko whatitiri, Aneurysm o te roro, Maimoatanga ohorere, Whara o te upoko, Taupoki roro