Ese uruhande rumwe rw'umubiri wawe rufite ibinure n'urundi ruhande rufite ibinure? Ese byaba ari indwara ya Brown-Séquard?

Ese wigeze wumva indwara idasanzwe aho udashobora kwimura uruhande rumwe rw'umubiri wawe ntugire icyo wumva ku rundi ruhande? Ishobora kubaho nyuma y'impanuka. Nubwo ishobora gutera ubwoba gato, uyu munsi tugiye kuvuga ku ndwara ishobora kubaho mu gihe gikwiye, ariko idakunze kugaragara cyane, yitwa Brown-Séquard Syndrome . Ntugahangayike, reka tubiganireho mu buryo bworoshye.

Iyi ndwara yitwa Brown-Séquard Syndrome ni iki?

Mu magambo make, indwara ya Brown-Séquard (BSS) ni indwara idakunze kugaragara mu mitsi. Ibaho iyo uruti rw'umugongo rwangiritse, ariko ingaruka zayo zigarukira ku ruhande rumwe gusa rw'umugongo. Tekereza nk'umugongo wawe, umeze nk'insinga itwara ubutumwa buva mu bwonko bwawe mu mubiri wawe wose hanyuma ikajyana amakuru ava mu mubiri wawe mu bwonko. Iki kibazo rero kibaho gusa iyo uruhande rumwe gusa rw'iyi nsinga rwangiritse.

Icyabaye ni uko ku ruhande rumwe rw'umugongo wangiritse, hari intege nke cyangwa ubumuga bw'imitsi iri munsi y'urugero rw'ibyangiritse. Ibi bivuze ko udashobora kwimura urwo ruhande. Ariko, igitangaje ni uko kumva ububabare n'ubushyuhe bigabanuka ku rundi ruhande , ariko biri munsi y'urugero rw'ibyangiritse. Bisa nkaho bigoye gato, sibyo? Reka dusobanure byinshi.

Uruti rw'umugongo rwawe ni imiterere y'uruziga ihera ku mutwe w'ubwonko ikagera ku gice cyo hasi cy'umugongo wawe. Ni yoroshye cyane. Igizwe n'imitsi myinshi. Ni igice kinini cy'imitsi yacu.

Indwara ya Brown-Séquard ifatwa nk'indwara y'umugongo idahagije (SCI) . Ibi bivuze ko hari ugutakaza ibyiyumvo, imikorere y'imitsi, cyangwa byombi munsi y'aho byakomeretse. Muri SCI yuzuye, nta kumva cyangwa kugenda munsi y'aho byakomeretse.

Yitiriwe umuhanga mu bya siyansi Charles-Edouard Brown-Sequard, wasobanuye bwa mbere iyo ndwara mu 1849.

Ibi bitandukanye bite na Syndrome yo mu Mutwe?

Ushobora kuba warigeze kumva ibyerekeye indwara yo mu mugongo (CCS) . Nubwo byombi ari imvune zidahagije, ni indwara ebyiri zitandukanye.

CCS ni igikomere kidahagije hagati mu ruti rw'umugongo, akenshi mu ijosi. Ibi bitera intege nke mu maboko kurusha amaguru.

Ariko, muri BSS , kwangirika kw'igice icyo ari cyo cyose cy'umugongo ku ruhande rumwe bitera ubumuga ku ruhande rwafashwe, mu gihe urundi ruhande rutakaza ibyiyumvo. Urabyumva itandukaniro?

Ni nde ushobora kugira iyi ndwara? Ni ku rugero rungana iki?

Indwara ya Brown-Séquard ishobora gufata umuntu uwo ari we wese. Ariko, ni indwara ikunze kugaragara gake cyane.Ibi bishobora kubaho hatitawe ku gitsina.

Muri Leta Zunze Ubumwe za Amerika honyine, buri mwaka hagaragara abantu bagera ku 12.000 barwaye indwara z’umugongo. Muri abo, BSS ingana na 2% kugeza kuri 4% gusa. Ibi bivuze ko muri Sri Lanka, igipimo gishobora kuba kiri hasi kurushaho.

Ni ibihe bimenyetso by'indwara ya Brown-Séquard (BSS)?

Ibimenyetso bya BSS bikunze gutangira nyuma yo kwangirika k'uruhande rumwe rw'umugongo.

Ibimenyetso bya mbere bigaragara ni ibi bikurikira:

• Kudashobora kwimura amaguru munsi y'imvune (kubura imitsi igenda) ku ruhande rumwe rw'imvune y'umugongo. Ibi bishobora gutangira nk'intege nke bikagera ku gucika intege.
• Ku rundi ruhande, hari ukubura ububabare n'ubushyuhe biri munsi y'urugero rw'imvune.

Tekereza muri ubu buryo. Iyo umuntu afite BSS, ari yo mvune y'umugongo ku ruhande rw'iburyo rw'umugongo we, ntabwo azashobora kwimura uruhande rwe rw'iburyo, ni ukuvuga kuva hagati mu mugongo we umanuka - ikibuno cye cy'iburyo, ukuguru, n'ikirenge. Ariko, ku ruhande rw'ibumoso, kuva hagati mu mugongo we umanuka, azatakaza ububabare kandi akumva ubushyuhe/ubukonje, ariko azabasha kwimura uruhande rwe rw'ibumoso. Umutwe, ijosi, ibitugu, n'amaboko bizakora neza, nta ngaruka z'iyi mvune.

Byongeye kandi, BSS ishobora gutera ibimenyetso nk'ibi:

• Kudashobora kugenzura inkari n'umwanda (kunanirwa kwifata mu nkari no mu mwanda).
• Intege nke z'imitsi no gutakaza imbaraga (gucika intege kw'imitsi) mu gace kagize ikibazo.

Ibimenyetso bya BSS bishobora kuba byoroshye cyane kuri bamwe, ndetse bikaba bikomeye cyane ku bandi. Ariko, iyo bivuwe neza, ibi bimenyetso bigenda birushaho kwiyongera .

Ibi birababaza?

Niba icyateye BSS ari ikintu giteye ihungabana nko gukomereka kw'isasu cyangwa impanuka y'imodoka, impanuka izatera ububabare nta kabuza. Ariko, bitewe n'indwara ubwayo, ni ukuvuga kwangirika k'umugongo, nta bubabare bushobora kubaho.

Ariko, bamwe mu bantu barwaye BSS bashobora kugira ibyiyumvo bidasanzwe (dysesthesia) bitewe n'ibyangiritse by'umugongo, bishobora kuba ubushye, gushotora, cyangwa gushinyagurika.

Ni izihe mpamvu nyamukuru zitera indwara ya Brown-Séquard (BSS)?

Impamvu zikunze gutera BSS ni ibikomere ku mugongo:

• Amasasu.
• Gutera icyuma.
• Impanuka z'imodoka.
• Ihungabana rikabije.
• Kuvunika uruti rw'umugongo bitewe n'impanuka nko kugwa.

Niba ugize impanuka nk'iyi, ni ngombwa cyane kujya ku bitaro bikwegereye vuba bishoboka no gushaka ubuvuzi bwihuse.

Uretse ibi, BSS ishobora no guterwa n'impamvu zitari iz'impanuka, ariko ntabwo zikunze kugaragara cyane:

• Indwara y'umura.
• Indwara yo kugabanya umuvuduko ni indwara ibaho iyo umuntu ahuye n'umuvuduko ukabije munsi y'amazi.
• Disiki yacitse mu mugongo (disiki ya herniated).
• Indwara nka meningite.
• Sclerosis nyinshi (MS).
• Guhura n'imirasire.
• Kuziba k'imitsi ijyana amaraso mu ruti rw'umugongo (ischemia yo mu ruti rw'umugongo).
• Ibibyimba by'umugongo.
• Myelite ihinduranya.
• Igituntu.

Abaganga bapima iki kibazo gute? (Isuzuma)

Niba umuganga wawe akeka ko ufite BSS, azakora ibi bikurikira:

• Akora isuzuma ryuzuye ry’umubiri .
• Hakorwa isuzuma ry’imitsi risuzuma uburyo umubiri ugenda n’uko wumva ibintu mu buryo burambuye.
• Bazakubaza amateka yawe y'uburwayi, ibibazo byo mu bwonko, n'impanuka zose wagize.

Hanyuma, bazategeka ibizamini byinshi, nko gupima MRI , kugira ngo bemeze ko indwara yanduye ndetse banarebe izindi mpamvu.

Ni ibihe bizamini biri gukorwa kuri ibi?

Niba ukeka ko BSS ihari, muganga wawe ashobora gutumiza ibizamini nka:

• Gupima MRI (Magnetic Resonance Imaging): Iki ni ikizamini kidasaba ububabare. Gikoresha rukuruzi nini, imiraba ya radiyo, na mudasobwa kugira ngo gikore amashusho asobanutse neza y’ingingo n’imiterere y’umubiri. MRI ni ingirakamaro cyane kuri BSS kuko ishobora gufasha kumenya ibyangiritse ku ruti rw’umugongo no gufasha kumenya icyateye BSS kuba nta mpanuka ibaye.
• Myelogram na CT scan (Computed Tomography): Niba udashobora gupimwa na MRI, muganga wawe ashobora gutumiza myelogram hanyuma agakorerwa CT scan y'umugongo wawe. Ibi bizamini bishobora kureba niba imitsi y'amaraso iri ku ruhande rumwe rw'umugongo wawe yangiritse. Myelogram ni ikizamini cyo gupima gisuzuma isano iri hagati y'umugongo wawe, disiki, umugongo, imitsi n'imitsi. CT scan ikoresha X-ray na mudasobwa kugira ngo ikore amashusho arambuye y'imbere mu mubiri wawe.
• Gupima amaraso: Niba impamvu ya BSS idasobanutse neza, muganga wawe ashobora gutegeka ko hakorwa ibizamini byinshi by'amaraso kugira ngo arebe niba hari ubwandu bushobora gutera iyo ndwara.
• Gutobora mu gituza / Gutobora mu mugongo: Niba bikekwa ko indwara ya sclerosis nyinshi (MS) , myelitis ihindagurika, cyangwa igituntu ari byo bitera BSS, muganga wawe ashobora kugutobora mu gituza kugira ngo afate urugero rw'amazi yo mu bwonko (CSF) . CSF ni amazi asobanutse neza akikije uruti rw'umugongo n'ubwonko.

Ni ubuhe buryo bwo kuvura indwara ya Brown-Séquard (BSS)?

Uburyo bwo kuvura BSS buterwa n'impamvu nyamukuru yangiza uruti rw'umugongo.

Muri rusange, intego z'ubuvuzi bwa BSS ni izi zikurikira:

• Kubungabunga cyangwa kunoza imikorere y'imitsi n'ibyumviro.
• Kurinda kwangirika kw'inyongera.
• Kugabanya ingorane.

Umuntu ufite BSS yakomeretse ku ntwaro ityaye, nk'igikomere yatewe n'icyuma, azakenera kuvurwa kubera kuva amaraso no kwangirika kw'ingingo. Byongeye kandi, abantu bafite izindi mvune zatewe n'impanuka yateye BSS bazakenera ubundi buvuzi kuri izo mvune.

Hari ibyiciro bibiri by'ingenzi byo kuvura BSS: ubuvuzi bw'ibanze n'ubuvuzi bwo kuvura indwara .

Ubuvuzi bw'ibanze

Uburyo bwa mbere bwo kuvura BSS bushobora kuba bukubiyemo:

• Kubagwa: Mu gihe BSS ibaye nta mpanuka, akenshi biterwa no gukandamizwa cyangwa gucika kw'umugongo. Kubagwa birakenewe kugira ngo bikoroherwe gukandamizwa.
• Imiti ibuza amaraso kuzura: Abantu bafite imvune mu mugongo bafite ibyago byinshi byo kurwara amaraso kuzura mu mitsi (VTE) . Ibi birimo ibintu nka deep vein thrombosis (DVT) na pulmonary embolism . Muganga wawe ashobora kuguha imiti yitwa anticoagulants , nka heparin cyangwa warfarin, kugira ngo hirindwe kuzura amaraso.
• Kurinda uruhu (kugira ngo wirinde ibisebe byo mu buriri): Kugira ngo wirinde imvune zo mu buriri/ibisebe byo mu buriri, itsinda ry’abaganga rizagufasha guhindukira no guhindura imiterere nibura buri masaha abiri. Bazagufasha kugumisha uruhu rwawe rusukuye kandi rwumye, kandi bashyireho amavuta yo kwisiga ku ruhu rwumye.
• Umuyoboro wa Gastrostomy (G-tube): Kugira ngo ugabanye ibyago byo kubyimba igifu bitewe na paralytic ileus, muganga wawe ashobora gushyira G-tube mu gifu cyawe. G-tube ni umuyoboro utanga intungamubiri uva mu gifu ujya mu gifu. Paralytic ileus ni ukubura by'agateganyo imitsi ijyana ibiryo mu mara. Ibi bikunze kugaragara mu mvune zo mu ruti rw'umugongo.
• Inkunga yo guhumeka: Niba ufite ikibazo cyo guhumeka bitewe n'imvune yo mu mugongo wawe, ushobora gukenera guhumekwa n'icyuma gihumeka . Iyi ni imashini igufasha guhumeka, cyangwa igufasha guhumeka.
• Uburyo bwo kuvura uruhago rw'inkari: Abantu bafite imvune zo mu mugongo, harimo na BSS, bashobora kubura uburyo bwo kuvura uruhago rw'inkari. Ibi bibaye, hashobora kuba ngombwa gukoresha catheter y'inkari n'ubundi buryo bwo kuvura bujyanye n'uruhago rw'inkari.
• Uburyo bwo kuvura indwara yo mu bwonko itera indwara mu buryo bwikora: Abantu bafite imvune mu mugongo bashobora kugira impinduka zikomeye mu muvuduko w'amaraso n'ibindi bimenyetso. Ibi bigomba kuvurwa neza hakoreshejwe imiti igenzura umuvuduko w'amaraso n'umuvuduko w'umutima.
• Amashuka agenzura ubushyuhe: Abantu barwaye BSS bakunze kugorwa no kugenzura ubushyuhe bw'umubiri wabo. Itsinda ry'abaganga rishobora gutanga amashuka agenzura ubushyuhe kugira ngo ribifashe muri iki kibazo.

Gusana

Nyuma yo kuvurwa bwa mbere na BSS, gusubiranamo, nko kuvura umubiri no kuvura indwara z’akazi , bigomba gutangira vuba bishoboka kugira ngo birusheho kunoza no kongera kugenda neza.

Intego za physiotherapy:

• Gukomeza imbaraga z'imitsi hamwe n'imikorere myiza y'imitsi.
• Gukomeza gukora neza mu ngingo.
• Irinde kwangirika k'uruhu binyuze mu kwifata neza no guhindura ibiro.
• Kunoza uburyo bwo kugenda .

Ubuvuzi bw'umubiri bukubiyemo imyitozo ngororamubiri n'ubuvuzi bigufasha kugabanya ububabare no kugarura imikorere isanzwe no kugenda neza. Umuvuzi wawe w'umubiri azakorana nawe kugira ngo anonosore kugenda neza. Bashobora kuguha ibikoresho bigufasha gukora imirimo ya buri munsi, nko gupfuka amaguru, imigozi y'intoki, imitsi y'amaguru, cyangwa intebe y'abamugaye.

Ubuvuzi bw'akazi bukubiyemo uburyo bwo kuvura no gukora imyitozo ngororamubiri igufasha kugarura ubwigenge mu bice byose by'ubuzima bwawe nyuma y'ikibazo cy'umubiri cyangwa ubwonko. Iyo uhawe ubuvuzi bw'akazi bwa BSS, uziga uburyo bushya bwo gukora imirimo ya buri munsi, nko kwisukura, kurya, no kwambara, ukoresheje cyangwa udafite ibikoresho bigufasha.

Ese ibi bishobora kwirindwa ko bitabaho?

Uburyo bwonyine bwo kwirinda indwara ya Brown-Séquard ni ugukurikiza ingamba zisanzwe zo kwirinda kugira ngo wirinde kwangiza uruti rw'umugongo. Urugero, witondere igihe utwaye imodoka cyangwa ugenda n'amaguru mu muhanda.

Ni ayahe mahirwe yo gukira iyi ndwara? (Ibisobanuro)

Icyizere cyo gukira nyuma yo kuva muri BSS giterwa n'ibintu byinshi, birimo icyateye kwangirika k'umugongo n'ingano y'ibyangiritse.

Ariko muri rusange, igipimo cyo gukira nyuma ya BSS muri rusange ni cyiza . Abantu barwaye BSS bafite amahirwe menshi yo kugarura zimwe mu nshingano zabo, harimo no kugenda n'amaguru. Ariko, gukira ni inzira igenda buhoro . Gukira bigenda buhoro, bimara amezi atatu kugeza kuri atandatu kuva indwara itangiye, kandi bishobora gufata imyaka ibiri kugira ngo imitsi ikire neza.

Ni izihe ngorane zishobora kubaho iyo zitavuwe?

Iyo indwara ya Brown-Séquard itavuwe, ibibazo nk'ibi bikurikira:

• Kubyimba inda.
• Kwiheba.
• Umuvuduko w'amaraso uri hasi (Hypotension).
• Kuziba kw'imitsi y'ibihaha.
• Indwara zandurira mu bihaha no mu nzira y'inkari.
• Gupfa kw'ubumuga buhoraho.

Ni ibihe bihe byiza byo kujya kwa muganga?

Niba ugize intege nke z'imitsi cyangwa ubumuga bw'ingingo cyangwa ukumva udafite icyo wumva ku ruhande rumwe rw'umubiri wawe, jya mu cyumba cy'ubutabazi bw'ibanze kiri hafi yawe vuba bishoboka .

Niba warasanzwe urwaye indwara ya Brown-Séquard, ugomba kujya kwa muganga buri gihe kugira ngo urebe neza ko imvune yawe y'umugongo ikira neza. Menya neza ko ukurikiza gahunda zawe zo kuvura no kuvura indwara z'umubiri kugira ngo bigufashe gukira vuba bishoboka.

Ikintu cy'ingenzi cyo kwibuka (Ubutumwa bwo kujyana mu rugo)

Indwara ya Brown-Séquard ishobora gutera ubwoba kuyumva. Ariko inkuru nziza ni uko abantu benshi bafite iyi ndwara bongera kugarura cyangwa kunoza ubushobozi bwabo bwo gukora no kumva nyuma y'amezi make bamaze gukira. Wibuke ko itsinda ry'abaganga rizaba rihari kugira ngo rigufashe kugaruka mu nzira nziza. Komeza ukomere kandi ukurikize inama wahawe.

Indwara ya Brown -Séquard, umugongo, uruti rw'umugongo, imitsi, ubumuga, kubura ibyiyumvo, kwangirika k'umugongo