Tangoganizirani ngati mukuchita ntchito yanu yachizolowezi ndipo mwadzidzidzi, popanda chenjezo lililonse, mutu wanu unayamba kupweteka kwambiri kuposa kale lonse. Unali ululu wopweteka kwambiri m'moyo wanu. Ululuwo unkafika pachimake pakangopita masekondi ochepa. Mu zamankhwala, mutu wopweteka mwadzidzidzi komanso woopsawu timautcha "Thunderclap Headache." Uwu si mutu wamba. Nthawi zambiri uwu ndi chenjezo lalikulu lomwe thupi lathu likutipatsa. RCVS ndi vuto limodzi lotere lomwe limapereka chenjezo lotere.
Mwachidule, kodi RCVS ndi chiyani?
Dzina lonse la RCVS ndi Reversible Cerebral Vasoconstriction Syndrome . Dzinali lingawoneke lalitali komanso lovuta, koma tiyeni tipitirizebe kulimvetsa.
- Kusinthika: kutanthauza "kungathe kubwezeretsedwa." Izi zikutanthauza kuti vutoli silikhala lokhalitsa ndipo lingachiritsidwe ndi chithandizo choyenera .
- Cerebral: amatanthauza "zokhudzana ndi ubongo."
- Vasoconstriction: amatanthauza "kuchepa kapena kufupika kwa mitsempha yamagazi."
Mwachidule, RCVS ndi vuto lomwe mitsempha yamagazi muubongo imatsekeka mwadzidzidzi, imatsekeka, komanso imatsekeka . Komabe, izi zitha kuthetsedwa ndi chithandizo choyenera.
Tangoganizirani chitoliro cha madzi. Kodi chimachitika n’chiyani ngati titafinya gawo limodzi la chitolirocho? Chimaletsa madzi kuyenda, sichoncho? Chinthu chomwecho chimachitika ndi mitsempha ya magazi muubongo mwathu. Pamene mitsempha ya magazi iyi imalimba mwadzidzidzi (timaitcha kuti "vasospasm"), ubongo sulandira kuchuluka kwa magazi kofunikira. Ichi ndichifukwa chake timamva mutu waukulu womwe umamveka ngati mphezi ikugunda. Vutoli nthawi zina likhoza kusonyeza zizindikiro monga mutu waching’alang’ala, sitiroko, kapena kutuluka magazi muubongo .
Chofunika Kwambiri: "Mutu Wopweteka Kwambiri", womwe ndi mutu wopweteka kwambiri womwe umamveka ngati mutu woopsa kwambiri womwe mudakumana nawo, ndi vuto lachipatala . Izi zitha kukhala chizindikiro cha kutuluka magazi muubongo. Ngati inu kapena munthu amene mumamudziwa ali ndi mutu woterewu, pitani ku chipatala chapafupi cha Emergency Department (ETU) mwachangu.
Kodi zizindikiro za RCVS ndi ziti?
Mu RCVS, kuyenda kwa magazi kupita ku ubongo kumasokonekera, zomwe zimapangitsa kuti pakhale zizindikiro zosiyanasiyana. Chizindikiro chachikulu ndi mutu waukulu, koma palinso zizindikiro zina.
| Chizindikiro | Kufotokozera |
|---|---|
| Mutu wa "Thunderclap" | Mutu waukulu womwe umayamba mwadzidzidzi, umafika pachimake pa masekondi ochepa, ndipo ukhoza kubwereranso mkati mwa sabata imodzi kapena inayi. |
| Kuwonjezeka kwa chidwi | Kusalolera kuwala kowala (`(Photophobia)`) ndi phokoso lalikulu (`(Phonophobia)`). |
| Zina mwazinthu | Kusanza ndi kusanza, kusintha kwa masomphenya (kuona zinthu molakwika, kuona zinthu ziwiri), kufooka kwa minofu m'thupi, kusokonezeka maganizo. |
| Zizindikiro zazikulu | Kugwidwa ndi khunyu, kuvutika kulankhula kapena kumvetsetsa zomwe ena akunena (`(Aphasia)`). |
Nthawi zina, RCVS ingayambitse kutuluka magazi pakati pa ubongo ndi chigaza. Izi zimatchedwa `(Subarachnoid Hemorrhage - SAH)`. Izi ndi zadzidzidzi zoopsa kwambiri zachipatala. Kuwonjezera pa zizindikiro zomwe zili pamwambapa, SAH ingasonyezenso zizindikiro zotsatirazi:
- Kuuma kwa khosi, kupweteka kwa minofu m'khosi ndi m'mapewa.
- Kusintha kwa khalidwe ndi momwe munthu akumvera (kukwiya popanda chifukwa).
- Kusanza m'thupi.
Kodi ndi zinthu ziti zomwe zimathandiza pakukula kwa RCVS?
Ngakhale kuti chomwe chimayambitsa RCVS sichinadziwikebe, zinthu zingapo zoopsa zapezeka zomwe zingathandize kuti vutoli lipitirire.
Mimba ndi kubereka
Choopsa chachikulu komanso chofala kwambiri cha RCVS ndi mimba. Chiwopsezochi chimakhala chachikulu kwambiri m'masabata asanu ndi limodzi oyambirira mutabereka (pambuyo pa kubereka). Madokotala amakhulupirira kuti kusintha kwa mahomoni panthawi ya mimba kungathandize. RCVS imatha kuchitika ngakhale palibe mavuto monga preeclampsia, yomwe ndi vuto la kuthamanga kwa magazi lomwe limachitika panthawi ya mimba.
Kugwiritsa ntchito mankhwala ndi mankhwala enaake
Mankhwala ndi mankhwala ena omwe amakhudza kayendedwe ka magazi m'thupi lathu amawonjezera chiopsezo cha RCVS.
| Mtundu wa mankhwala/mankhwala | Zitsanzo |
|---|---|
| Mankhwala ochizira kuvutika maganizo | Makamaka mankhwala amtundu wa SSRI (`(Selective Serotonin Reuptake Inhibitors)`). |
| Mankhwala a mutu waching'alang'ala | Triptans ndi mankhwala okhala ndi ergot. |
| Mankhwala oletsa chitetezo chamthupi | Mankhwala ochepetsa chitetezo chamthupi omwe amaperekedwa pa matenda ena. |
| Zolimbikitsa ndi mankhwala osokoneza bongo | Mankhwala osokoneza bongo monga amphetamines, cocaine, chamba, nicotine patches, energy drinks, LSD, ndi MDMA. |
Matenda ena
Matenda ena amawonjezeranso chiopsezo chotenga kachilombo ka RCVS.
- Mutu Wopweteka: Anthu omwe ali ndi mutu wopweteka kwambiri amakhala ndi vuto la RCVS.
- Kuchuluka kwa calcium m'magazi (Hypercalcemia): Pamene kuchuluka kwa calcium m'magazi kukukwera, kungasokoneze ntchito ya mitsempha yamagazi.
- Mavuto a mahomoni: Homoni ya estrogen ikuganiziridwa kuti imayambitsa izi. Ichi ndichifukwa chake matendawa amapezeka kwambiri pakati pa akazi.
- Matenda obadwa nawo: Matenda omwe amayambitsa zotupa zomwe zimapanga mahomoni ochulukirapo a adrenaline, monga ``Pheochromocytoma``.
Kodi mavuto omwe angakhalepo chifukwa cha RCVS ndi ati?
Kale, madokotala ankaganiza kuti RCVS ndi vuto lopanda vuto lililonse, koma kafukufuku watsopano wasonyeza kuti sizili choncho nthawi zonse.
Pafupifupi 30% ya odwala a RCVS akhoza kukhala ndi chilema chokhazikika (monga kufooka kwa minofu, mavuto oyenda bwino). Pafupifupi 8% akhoza kukhala ndi mavuto aakulu komanso a nthawi yayitali.
Kuphatikiza apo, mavuto aakulu kwambiri angabuke mkati mwa masiku ochepa zizindikiro zoyamba kuwonekera.
- Ischemic Stroke: Kuvulala kwa mitsempha yamagazi komwe kumachitika chifukwa cha kutsekeka kwa mitsempha yamagazi yomwe imapereka magazi ku ubongo.
- Kutuluka magazi muubongo: Matenda ofanana ndi a SAH.
- Khunyu (`(Kugwidwa)`).
Ichi ndichifukwa chake timanena mobwerezabwereza kuti ndikofunikira kwambiri kupeza chithandizo chamankhwala mwachangu ngati mutu wanu wadzidzidzi komanso woopsa. Kulandira chithandizo mwachangu kungapewe mavuto ambiri owopsa awa.
Kodi RCVS imapezedwa bwanji?
Mukapita ku Dipatimenti Yoona za Zadzidzidzi (ETU), madokotala amatsatira njira zingapo kuti adziwe vutoli.
1. Kuwunika thupi ndi mitsempha: Kuwonjezera pa kufunsa za zizindikiro zanu, ntchito ya mitsempha yanu (monga kulankhula, kuona, ndi kukhazikika kwa thupi) idzayesedwa.
2. Kuyezetsa magazi: Kuyezetsa magazi kumachitika pofuna kuona zinthu monga mavuto okhudza magazi kuundana, matenda opatsirana, komanso kusalinganika kwa mchere m'thupi.
3. Kujambula Zithunzi: Kujambula kumeneku ndi kofunika kwambiri pozindikira ma RCVS. Kumatha "kuyang'ana" mkati mwa ubongo ndikupeza madera omwe ali ndi vuto.
Ndi mitundu iti ya ma scan yomwe imachitika?
- Kujambula kwa CT (`(Computed Tomography - CT scan)`): Kujambula kotchedwa `(CT angiogram)` kungagwiritsidwe ntchito kuona momwe mitsempha yamagazi ilili muubongo. Kujambula kwa CT ndikofunikira kwambiri pozindikira msanga sitiroko, chifukwa sekondi iliyonse imawerengedwa pochiza sitiroko.
- Kujambula kwa MRI (Magnetic Resonance Imaging - MRI scan): Kujambula kotchedwa Magnetic Resonance Angiogram - MRA kungawonetse bwino momwe mitsempha yamagazi imatsekekera (vasospasm) imagwirira ntchito komanso momwe ubongo umakhudzira.
- Kujambula kwa Transcranial Doppler ultrasound: Izi zimayesa liwiro la kuyenda kwa magazi kudzera muubongo ndipo zingapereke lingaliro la ngati mitsempha yamagazi yatsekedwa.
Kawirikawiri, pambuyo poti palibe sitiroko, MRI/MRA scan imafunika kuti itsimikizire RCVS.
Kodi RCVS imachiritsidwa bwanji?
Monga momwe dzinalo likusonyezera ("Kusinthika"), uwu ndi matenda ochiritsika . Pali zolinga ziwiri zazikulu za chithandizo.
1. Kuchotsa chomwe chimayambitsa matenda a RCVS: Ngati chomwe chimayambitsa matenda a RCVS chingadziwike bwino (monga mankhwala enaake), choyamba ndi kuchotsa chomwe chimayambitsa matendawa.
2. Kulamulira kutsekeka kwa mitsempha yamagazi: Mankhwala amaperekedwa kuti athetse kutsekeka kwa mitsempha yamagazi (`(vasospasm)`).
Mankhwala omwe amagwiritsidwa ntchito kwambiri pa izi ndi calcium channel blockers (`(Calcium Channel Blockers - CCBs)`).Mankhwalawa amagwira ntchito poletsa calcium kulowa m'maselo osalala a minofu m'makoma a mitsempha yamagazi. Kenako minofu imamasuka, mitsempha yamagazi imakulanso, ndipo magazi amapita ku ubongo.
Nthawi zina, pamene matendawa sakuyankha mankhwala, njira yotchedwa ``endovascular'' ingagwiritsidwe ntchito. Pankhaniyi, chubu choonda kwambiri (``catheter'') chimadutsa mtsempha wamagazi womwe uli m'dzanja kapena mwendo kupita ku mtsempha wamagazi womwe uli muubongo, ndipo baluni imadzazidwa kudzera mu mtsemphawo (``angioplasty'') kuti ikule mtsempha wotsekeka kapena kupereka mankhwala mwachindunji.
Kodi mungayembekezere chiyani ngati RCVS ipangidwa?
Ngati muli ndi RCVS, chinthu choyamba chomwe mungakumane nacho ndi mutu waukulu komanso wadzidzidzi. Izi ndi zadzidzidzi zachipatala ndipo zimafuna chithandizo chadzidzidzi. Chithandizo chikayamba, anthu ambiri amachira patatha masiku kapena milungu ingapo .
Anthu ambiri (pafupifupi 80% - 85%) amachira kwathunthu popanda mavuto a nthawi yayitali . Ndicho chinthu chabwino kwambiri pa matendawa. Pafupifupi 10% akhoza kukhala ndi kusapeza bwino pang'ono. Komabe, pali chiopsezo chochepa cha mavuto aakulu, monga sitiroko yomwe takambirana kale, kotero kuzindikira msanga ndi chithandizo ndikofunikira kwambiri.
Kodi tiyenera kuchita chiyani kuti tipewe kubwereranso kwa ma RCVS?
Ngati mwakhalapo ndi RCVS, dokotala wanu angakulangizeni kuti musinthe moyo wanu kuti musadzabwerenso.
- Kuletsa mankhwala omwe amayambitsa RCVS: Ngati mankhwala ayambitsa vutoli, siyani monga momwe dokotala wanu wanenera ndipo pewani kumwa mankhwalawo mtsogolo.
- Imwani mankhwala omwe dokotala wakupatsani nthawi zonse: Imwani mankhwala omwe mwapatsidwa pa nthawi yake kuti zizindikiro zisabwererenso.
- Pewani kugwiritsa ntchito mankhwala osokoneza bongo mosayenera: Pewani kugwiritsa ntchito mankhwala opatsa mphamvu, makamaka omwe amakhudza kayendedwe ka magazi, monga chamba.
- Chepetsani kumwa caffeine ndi zakumwa zopatsa mphamvu: Ndi bwino kuchepetsa kumwa zakumwazi kapena kusiya kuzimwa kwathunthu.
Dokotala wanu adzakupemphani kuti mubwerere ku chipatala kuti mukayang'anire vuto lanu. Onetsetsani kuti mwafika pa nthawi yokumana ndi dokotala.
Uthenga Wopita Nawo Kunyumba
- Kuyamba mwadzidzidzi mutu waukulu ("Thunderclap Headache") ndi vuto lachipatala. Pitani ku chipatala chapafupi cha Emergency Department (ETU) mwamsanga.
- RCVS ndi matenda omwe amayamba chifukwa cha kutsekeka kwadzidzidzi kwa mitsempha yamagazi muubongo. Koma monga momwe dzinalo likusonyezera, ndi matenda omwe amatha kuchiritsidwa bwino .
- Izi zimachitika kwambiri munthu akabereka, chifukwa chogwiritsa ntchito mankhwala enaake, kapena zimatha kuchitika ndi matenda ena.
- Kuzindikira matenda msanga ndi chithandizo kungalepheretse mavuto aakulu monga sitiroko, ndipo anthu ambiri amachira mokwanira.
- Kambiranani momasuka ndi dokotala wanu za matenda anu, chithandizo chanu, ndi nkhawa zanu zamtsogolo.
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