Ese hari amazi asa n'amazi ava mu mutwe wawe cyangwa mu mugongo? Ese ni amazi ava mu bwonko (CSF leak)?

Ese hari igihe uba ufite amazi asukuye nk'amazi ava mu mazuru yawe? Cyangwa urwara umutwe ukaza iyo uhagaze, uhengamye umutwe, cyangwa uryamye? Ushobora gutekereza ko ibi ari ibicurane gusa cyangwa ikindi kintu. Ariko, hari igihe ibi bishobora kuba ikintu cyo guhangayikishwa. Uyu munsi turimo kuvuga ku ndwara ishobora gutera ibimenyetso bisa, ariko ntabwo ari ikintu gikunze kugaragara cyane, ariko ni ingenzi cyane kubimenya. Ibyo ni ukuva kw'amazi yo mu bwonko , cyangwa nk'uko abaganga babyita (Cerbrospinal Fluid Leak) , cyangwa (CSF Leak) mu magambo ahinnye.

Amazi yo mu bwonko (CSF) ni iki? Kuki ava?

Mu magambo make, amazi yo mu bwonko, cyangwa CSF, ni amazi yihariye akikije kandi akarinda ubwonko bwacu n'umugongo wacu. Afite isuku nk'amazi. CSF ifite imirimo myinshi y'ingenzi:

1. Ibiryo bitanga intungamubiri: Aya mazi arimo intungamubiri ubwonko bwacu bukeneye.

2. Gutanga uburinzi: Kimwe n'ibikoresho bigabanya impanuka mu modoka, aya mazi arinda ubwonko bwacu n'umugongo kwangirika guterwa no kunyeganyega no guhungabana. Anatanga uburyo ubwonko bushobora kurerembamo.

Tekereza kuri ubu buryo. Bigenda bite iyo dushyize umuzabibu mu icupa ry'ikirahure tukawunyeganyeza cyane? Umuzabibu ushobora gushenjagurwa, ugashenjagurwa, sibyo? Ibyo ni ko biba ku bwonko bwacu tudafite CSF. Ariko, iyo twujuje iryo cupa amazi, tugashyiramo umuzabibu, tukawunyeganyeza, amazi azatuma umuzabibu unyeganyeza cyane, bityo ntibizagire ingaruka mbi cyane. Uko ni ko CSF ​​irinda ubwonko bwacu.

Rero, uku kuva (CSF) kuva aho bigomba kuba byitwa (CSF Leak) . Iyo uku kuva kw'amazi ari kunini, bishobora kugutera ibimenyetso bikomeye. Bishobora no gutuma gukora imirimo ya buri munsi bigorana.

Ni nde wibasirwa cyane n'iki kibazo (CSF Leak)?

Nubwo ibi bishobora guterwa n'umuntu uwo ari we wese, hari abantu bakunze kubigiraho ingaruka.

• Abantu barengeje imyaka 30, cyane cyane hafi y'imyaka 42, bafite amahirwe menshi yo guhura n'ibibyimba bya CSF mu buryo butunguranye nta mpamvu igaragara ihari.
• Abagore nabo bafite amahirwe menshi yo kurwara iyi ndwara kurusha abagabo.

Ese CSF Leak ni indwara isanzwe?

Mu by’ukuri, kuva kwa CSF bituma umuvuduko w’amazi mu mutwe ugabanuka. Ibi byitwa Intracranial Hypotension . "Intracranial" bivuga "imbere mu gahanga," naho "Hypotension" bivuga "umuvuduko uri hasi ugereranije n’usanzwe." Iyi ndwara, izwi nka Intracranial Hypotension, ni indwara ikunze kugaragara. Ibaho ku bantu bagera kuri 5 ku 100.000.

Ariko, abahanga bemeza ko amazi ya CSF akunze kugaragara cyane . Impamvu ni uko bigoye kuyasuzuma. Hari n'igihe abaganga babyitiranya n'izindi ndwara, nko kurwara umutwe .Indwara za sinus zishobora kwitiranywa na allergie .

Iyi ndwara igira ingaruka zite ku mubiri wanjye?

Iyo CSF ​​iva, ingano y'amazi akikije ubwonko iragabanuka. Ibi bigabanya uburinzi n'ubushobozi bwo kuzenguruka ubwonko.

• Iyo amazi yavuyemo ari make , ushobora kutabona itandukaniro rinini. Cyangwa, ushobora kuba ufite ibimenyetso ariko ukumva ko ari ikindi kintu.
• Ariko, iyo amazi avanze neza bihagije , bigatera hypotension mu bwonko, ubwonko bwawe buzatangira kumanuka mu mutwe. Ibi bishyira igitutu kidakenewe ku bice byo hasi by'ubwonko bwawe. Ibi bishobora kubangamira imikorere y'ibyo bice, bigatera ibimenyetso bishobora kuva ku bimenyetso bito, bitagaragara cyane kugeza ku bimenyetso bikomeye, bitavugwa.

Ni ibihe bimenyetso by'uko CSF ​​iva?

Iyo amazi yavuyemo ari make, ushobora kutagira ibimenyetso. Bitabaye ibyo, ushobora gutekereza ko ari ikindi kintu. Ariko niba amazi yavuyemo ari menshi kandi agatera umuvuduko muke mu bwonko (intracranial hypotension), uzatangira kugira ibimenyetso.

Ikimenyetso nyamukuru kandi gikunze kugaragara ni umutwe ugaragara mu mwanya wawo.

Ibi ni byo bibaho:

• Umutwe urushaho kwiyongera iyo uhagaze cyangwa wicaye .
• Iyo wunamye cyangwa uryamye, umutwe uragabanuka cyangwa urashira burundu.

Ibimenyetso biratandukanye bitewe n'aho amazi yavuye.

Ibimenyetso bimwe na bimwe bishobora gutandukana bitewe n'aho amazi yavuye. Ahantu habiri h'ingenzi amazi yo mu bwonko (CSF) ashobora kuva ni mu mazuru yawe no mu mazuru yawe . Uko byagenda kose, ushobora kugira amazi asohoka mu mazuru yawe (rhinorrhea) . Iyi si ibicurane bisanzwe. Hari ubwoko bubiri bwayo:

1. Iyo uhanaguye izuru ryawe n'agatambaro, iyo ururenda rusanzwe rwumye, agatambaro kaba gakomeye gato. Ariko iyo rwumye (CSF), agatambaro ntikamera gutyo .

2. Uku kuva mu mazuru rimwe na rimwe bishobora kubaho mu bihe runaka. Urugero, iyo wunamye imbere, utora ikintu hasi, cyangwa uhambiriye imigozi y'inkweto zawe .

Ahandi hantu CSF ishobora gutera ibimenyetso ni mu matwi . Gusohoka kw'amazi mu gutwi (Otorrhea) na byo ni ikimenyetso cy'uko CSF ​​yavuye. Ariko, ibi ntibikunze kubaho cyane. Kugira ngo ibi bishoboke, ugomba no kugira umwobo mu gituza cy'amatwi (Tympanic Membrane) .

Ibindi bimenyetso bishobora kubaho iyo CSF ​​ivujitse

• Kubura impumuro (Anosmia): Ibi bikunze kubaho iyo hari amazi yo mu bwonko (CSF) ava mu gisebe cyo mu maso bitewe n'igikomere cyo mu maso.
• Kureba nabi cyangwa kureba kabiri (Diplopia): Ibi bishobora guterwa n'igitutu ku mitsi y'amaso iyo ubwonko bumanuka.
• Impinduka mu kumva cyangwa kubura amatwi: Nkuko byavuzwe haruguru, ibi bishobora guterwa n'igitutu ku mitsi ifitanye isano n'amatwi iyo uhindura imiterere.
• Gucuranga cyane: Kumva ijwi ry'umutima wawe nta gikoresho na kimwe ukoresheje.
• Indwara zo mu mutwe: Izi ndwara zishobora guterwa cyane n’indwara yo kuva amaraso menshi (CSF) cyangwa indwara ikomeye yo mu mutwe (Intracranial Hypotension).
• Kubabara ijosi no kunanuka.
• Ibiryo nta buryohe bwabyo.
• Kuribwa umutwe: Hari igihe ibi bishobora kuba bikomeye cyane kandi ntibihanganirwe.
• Kuzungera cyangwa kumva uzunguruka hirya no hino (Vertigo).
• Isesemi no kuruka.
• Gutinya foto (Photophobia) (kudashobora kureba urumuri).
• Ibibazo byo kuringaniza no kugenda mu nzira iyo ugenda n'amaguru.

Ni izihe mpamvu zitera kuvuja kwa CSF?

Impuguke zivuga ko hafi 90% by'amazi ya CSF aturuka ku bikomere . 10% bisigaye bibaho ku buryo butunguranye cyangwa ku mpamvu zitazwi.

Gutemba kwa CSF guterwa n'imvune

Gutemba kwa CSF bishobora guterwa n'imvune zitandukanye. Ingero:

• Ibikomere ku maso, ku mutwe, ku ijosi, cyangwa ku mugongo: Ingero zikunze kugaragara zirimo impanuka z'imodoka. Ibikomere ku mazuru, ku mazuru, ku matwi, inyuma y'amatwi, cyangwa munsi y'agahanga ni byo bishobora gutera ibi. Whiplash ishobora kandi gutuma amazi yo mu bwonko (CSF) ava mu ruti rw'umugongo.
• Ibikomere byinjira mu mubiri: nko guterwa icyuma, kuraswa.
• Ibikomere byatewe no kubagwa ubwonko.
• Ibikomere biterwa n'ubuvuzi bujyanye n'umuhogo, ugutwi, n'izuru (uburyo bwo kuvura indwara zo mu muhogo, izuru n'izuru).
• Uburyo bwo kuvura bujyanye n'umugongo: Urugero, iyo utanga ikinya cyo mu mugongo , ukoresha uburyo bwo gutobora uruhu rwo mu ruti rw'umugongo , cyangwa ufata amazi mu mugongo (umugongo) .

Izindi mpamvu zitari imvune

Mu bantu bagera kuri 10%, impamvu nyayo itera kuva kwa CSF ntabwo izwi. Ariko, impuguke zasanze iki kibazo gifitanye isano n'izindi ndwara zimwe na zimwe. Ntibiramenyekana neza niba izi ndwara zitera kuva kwa CSF, ariko ubushakashatsi burimo gukorwa kuri iki kibazo.

• Indwara z'imitsi ihuza imiterere y'umubiri zigabanya imbaraga z'ingingo zifata CSF: Urugero, indwara nka Marfan Syndrome na Ehlers-Danlos Syndrome .
• Ubwiyongere bw'umuvuduko mu gahanga (Intracranial Hypertension): Ibi bishobora gutuma ingingo zikikije zicika maze amazi akava.
• Igisebe cy'ubwonko (Pseudotumor Cerebri).
• Umubyibuho ukabije: Cyane cyane umubyibuho ukabije.
• Ubusembwa bw'imiterere y'izuru, sinuses, cyangwa ibindi bice by'agahanga bibaho mu gihe umuntu avukana cyangwa yavutse.

Ese iyi ni indwara yandura?

Oya. (CSF Leak) si indwara yandura.Ntabwo ushobora kubikwirakwiza ku wundi muntu uwo ari we wese, cyangwa ngo ubigeze ku wundi muntu uwo ari we wese.

Abaganga bapima iki kibazo gute?

Muganga ashobora gusuzuma amazi ya CSF binyuze mu gusuzuma umubiri, kubaza ibimenyetso byawe, no kubaza amateka y'ubuzima bwawe n'indwara zawe muri iki gihe. Bashobora kandi gukoresha ibizamini bitandukanye byo muri laboratwari no gupima amashusho kugira ngo bemeze cyangwa bakureho amazi ya CSF.

Ubwoko bw'ibizamini uzakora bizaterwa n'aho ukeka ko hari aho amazi yavuye ndetse niba hari ibikomere wagize mbere (bya kera cyangwa bishya).

Ni ibihe bipimo bikorwa kugira ngo hamenyekane iyi ndwara?

Hari ibizamini byinshi bishobora gukoreshwa mu gusuzuma aho CSF ​​yavuye. Ibyinshi muri byo ni ibizamini byo gufata amashusho. Ibi bituma abaganga bareba mu mutwe no mu mugongo wawe kugira ngo barebe aho hari aho amazi yavuye n'ibyangiritse bishobora kuba byayateye.

• Ikizamini cy'amazi: Niba ufite ibimenyetso by'izuru riva mu mazuru (cyane cyane mu mazuru), muganga wawe ashobora gushaka gupima amazi. Ikizamini nyamukuru kuri ibi ni ikizamini cya beta-2 transferrin . Iki kizamini gishakisha poroteyine yitwa tau , iboneka muri CSF ariko itari mu mvubura z'amazuru. Ikindi kizamini gishobora gukorwa ni ikizamini cya glucose . Ibi biterwa nuko ingano ya glucose muri CSF isa n'ingano iri mu maraso. Ariko, ingano ya glucose mu mvubura z'amazuru ni nke cyane, cyangwa ntayo ihari.

• Ibipimo byo gupima no gusuzuma indwara:
• Gupima CT (Ifotokopi ya mudasobwa)
• Gupima MRI (Ishusho ya Magnetic Resonance)
• Angiografiya yo Gukuramo hakoreshejwe ikoranabuhanga
• Mielography ( X-ray ikoresha irangi mu gutera urutirigongo)
• Cisternography ( isuzuma ryo kureba inzira za CSF)
• Gutera Indwara yo mu Kigongo / Gutera Umwobo mu Mugongo: Ariko, ubusanzwe iki si cyo kizamini cya mbere gikorwa iyo hakekwa ko hari ikibazo cyo kuvoma kwa CSF.

Ese CSF Leaks ivurwa ite? Ese ishobora gukira?

Akenshi, abaganga ntibavura amazi ya CSF mu buryo butaziguye. Ibi biterwa nuko amazi ya CSF aterwa n'imvune nyinshi akira ubwazo uko igihe kigenda gihita iyo umuntu aruhutse gusa .

Ariko, iyo amazi ya CSF adakunze gukira ubwayo, cyangwa iyo bizwi ko atazakira, hari uburyo butandukanye bwo kuvura bushobora gufasha. Akenshi, amazi yavuyemo ashobora gusanwa cyangwa agafungwa . Ibi bizahagarika ibimenyetso kurushaho cyangwa bikabuza ko bibaho.

Zimwe mu ndwara zidakira, cyane cyane (Marfan Syndrome) cyangwa (Ehlers-Danlos Syndrome)Indwara z'imitsi nk'iyi ntizishobora gukira. Iyo CSF ​​iva bitewe n'indwara nk'iyi kandi idashobora kuvurwa mu buryo butaziguye, abaganga bazagerageza kuvura ibimenyetso byawe.

Ni ubuhe bwoko bw'imiti cyangwa uburyo bwo kuvura bukoreshwa?

Uburyo bwo kuvura buzaterwa n'ibintu nk'icyateye CSF kuva amazi n'aho iherereye.

• Uburyo bwo kuvura burambye: Ubu si uburyo bwo kuvura CSF Leaks. Ibi bisaba kuruhuka mu buriri igihe gito. Nanone, kuguma ufite amazi menshi . Imiti ivura ububabare no kubyimba nayo irakunze kugaragara. Niba kuvamo kwatumye CSF igabanuka, ushobora kugirwa inama yo gufata inyunganiramirire ya kafeyine n'umunyu . Niba ubu buryo rusange budafashije nyuma y'icyumweru kimwe cyangwa bibiri, muganga wawe ashobora kukugira inama yo kuvura mu buryo butaziguye.

• Kubaga n'uburyo bifitanye isano: Kubaga ni uburyo busanzwe bwo gusana imyanda ya CSF. Iyo imyanda yatewe n'igikomere kinini, kubaga bishobora gufunga imyanda cyangwa gusana aho byangiritse. Hari uburyo bwo kubaga bushobora gukorwa binyuze mu gahanga. Hari ubundi bushobora gukorwa binyuze mu mazuru cyangwa mu kanwa. Ubwoko bw'uburyo bwo kubaga buterwa n'aho imyanda yavuye, impamvu, n'uburemere bw'iyo myanda.

• Inshinge zo guterwa amaraso: Imwe mu nzira z'ingenzi zo kuvura amazi ya CSF atari ukubaga ni Blood Patch . Muri ibi, muganga ashyira urushinge mu gice cyo hasi cy'umugongo wawe (igice cyo mu kibuno). Iyo rugeze ahantu heza, amaraso yawe make afatwa agashyirwa muri CSF ikikije uruti rw'umugongo wawe. Hanyuma amaraso "arakuraho" amazi yavuyemo, cyangwa akayafunga. Hari igihe hashobora gukenerwa Blood Patch zirenze imwe. Ariko, abantu benshi bumva baruhutse nyuma yo guterwa bwa mbere.

• Imiti: Hari ubwoko butandukanye bw'imiti ishobora gufasha mu gihe CSF iva. Imwe igabanya umuvuduko mu gahanga. Indi itangwa ku bimenyetso bikomeye nk'ububabare. Antibiyotike zishobora no gutangwa. Iyo bagiteri zinjiye mu bwonko zinyuze muri CSF, indwara zikomeye nka meningitis na encephalitis zishobora kubaho.

Ni izihe ngorane cyangwa ingaruka mbi z'ubuvuzi?

Ingorane n'ingaruka mbi zo kuvurwa biterwa n'aho amazi yavuye (CSF), uburemere bwayo, icyayiteye, n'ubuvuzi uhabwa. Muganga wawe ashobora gusobanura ingorane zishobora kubaho n'ingaruka mbi ku buzima bwawe n'icyo wakora kugira ngo ubigabanyirize cyangwa ubyirinde.

Ni gute nakwiyitaho/nshobora guhangana n'ibimenyetso?

Kumena kwa CSF si ikintu ushobora gusuzuma cyangwa kuvura wenyine. Niba ukeka ko ufite iyi ndwara, ugomba kujya kwa muganga vuba bishoboka.Ibi biterwa nuko ibimenyetso by'iyi ndwara bishobora gusa n'iby'indwara zikomeye zisaba ubuvuzi bwihuse.

Nzumva meze neza nyuma y'igihe kingana iki?

Igihe bifata kugira ngo umuntu akire kandi agire ubuzima bwiza gitandukana bitewe n'uburyo avurwa. Abantu benshi bumva baruhutse iyo baryamye bakaruhuka. Ariko ku bandi, bishobora gufata iminsi, ndetse n'ibyumweru, kugira ngo bakire.

Nigute nagabanya cyangwa ngakwirinda ibyago byo kuba iki kibazo cyabaho?

(CSF Leak) ni ikintu kibaho mu buryo butunguranye. Kubwibyo, ntabwo gishobora kwirindwa burundu. Ariko, ushobora kugerageza kwirinda ibintu cyangwa ibintu bishobora gutera amazi. Ariko ushobora kubikora gusa ku mpamvu ziterwa n'imvune.

Ikintu cy'ingenzi ushobora gukora kugira ngo wirinde ko CSF ​​yava mu gikomere ni ukwambara ibikoresho byo kwirinda . Gukomereka mu maso, mu mutwe, mu ijosi no mu mugongo bishobora gutera imvune zishobora kuva mu gikomere. Waba uri ku kazi cyangwa mu buzima bwawe bwite, ushobora kugabanya iyi ngaruka ukoresheje ibikoresho byo kwirinda n'ibikoresho byo kwirinda.

Ni iki nakwitega mu gihe mfite iyi ndwara?

Gutemba kwa CSF rimwe na rimwe bishobora kugorana kubisuzuma. Ariko, ingaruka muri rusange kuri iyi ndwara ni nziza . Nubwo ibimenyetso bishobora kubangamira, gukomeretsa, cyangwa kubangamira imirimo ya buri munsi, iyi ndwara ikunze kuvurwa. Abantu benshi bafite CSF bakize iyo batembaga, haba mu kuvurwa cyangwa kubagwa.

Gutemba kwa CSF bimara igihe kingana iki?

Gutemba kwa CSF bishobora kumara iminsi, ibyumweru, cyangwa amezi. Biterwa n'ingano y'igitemba n'icyabiteye. Kuvura bishobora kugabanya cyane igihe wumva ingaruka z'igitemba cya CSF. Muganga wawe ni we muntu mwiza wo kumenya igihe iki kibazo kizakugiraho ingaruka n'icyakorwa kugira ngo kigufashe.

Ni iki giteganyijwe kuri iki kibazo?

Muri rusange, icyizere cy'uko CSF ​​ishobora kuva amazi ni cyiza cyane . Abantu bagera kuri 98% bafite CSF bakira, uko icyabiteye cyaba kiri kose.

Nitwara nte?

Niba ufite ikibazo cya CSF, ugomba gukurikiza amabwiriza ya muganga wawe y'uko wakwitaho. Ni bo isoko nziza y'amakuru ku byo ushobora gukora n'ibyo ukwiye gukora. Bazakubwira kandi ibimenyetso cyangwa ibimenyetso byo kwitondera, n'ibyo kwirinda.

Ni ryari ngomba kubonana na muganga cyangwa gushaka inama kwa muganga?

Niba utekereza ko ufite ikibazo cya CSF, ugomba kuvugana na muganga cyangwa ukabonana na we. Nubwo ubusanzwe iki kibazo kidatera ingorane zikomeye cyangwa zishobora gushyira ubuzima mu kaga, ibimenyetso byacyo bisa n'iby'impanuka kandi biteye akaga.

Niba usanzwe ufite ikibazo cya CSF, muganga wawe azaguteganyiriza gahunda yo kugukurikirana uko ugenda ukira. Niba wumva ibimenyetso byawe birimo kwiyongera cyangwa bitera ibindi bibazo mu buzima bwawe bwa buri munsi, ugomba kubonana na muganga wawe.

Ni ryari nkwiye kujya mu ishami rishinzwe ubutabazi bwihutirwa (ETU) ?

Niba ufite ikibazo cya CSF, ugomba kujya mu cyumba cy’ubutabazi bw’ibanze niba ufite umutwe utunguranye kandi ukomeye, intege nke z’imitsi, cyangwa guhagarara bigoye . Ugomba kandi kubibona niba ugize ikibazo cyangwa intege nke ahantu hose mu mubiri wawe, cyane cyane mu maboko yawe, amaguru, ibirenge, n’amaguru . Ibi bishobora kuba ibimenyetso by’imvune ku mugongo wawe, bishobora no gutuma urwara ubumuga buhoraho.

Nanone, ugomba gushaka ubuvuzi bwihutirwa mu gihe ugize ibimenyetso bisa n'iby'indwara yo gucika intege mu bwonko . Ibi birimo:

• Intege nke, ibinya cyangwa ubumuga ku ruhande rumwe rw'umubiri.
• Imvugo idasobanutse neza cyangwa imvugo idasobanutse neza.
• Kugwa k'uruhande rumwe rw'isura cyangwa guta ubwenge mu jisho rimwe.
• Kugorwa no kumira.
• Urujijo, kurakara, cyangwa guhungabana.
• Kugorwa no gutekereza, gutekereza, cyangwa kwibuka.
• Kubabara umutwe cyane, cyane cyane iyo bibangamira imirimo yawe isanzwe.

Amaherezo, ibintu byo kwibuka (Ubutumwa bwo kujyana mu rugo)

Kuva kw'amazi yo mu bwonko, cyangwa CSF, ni indwara idakunze kuvugwaho cyane, ariko rimwe na rimwe ishobora gutera ibimenyetso bitoroshye kandi bikomeye. Ariko, ntugatinye. Bitewe n'iterambere ry'ubuvuzi n'ikoranabuhanga bigezweho, abaganga bashoboye gusuzuma iki kibazo vuba kandi byoroshye. Nanone, abaganga ubu bashoboye kuvura iki kibazo neza kurusha mbere. Kubwibyo, icyizere cy'iki kibazo ni cyiza cyane .

Igikuru ni ukujya kwa muganga vuba niba ufite ibi bimenyetso, aho kubitekerezaho . Hari igihe kuruhuka byoroshye bishobora gufasha. Bitabaye ibyo, ushobora gukira vuba uvuwe neza. Muganga wawe azaguha ubuyobozi bwiza. Komeza ubuzima bwiza!

Amazi yo mu bwonko , CSF iva, kuribwa umutwe, izuru riva, ububabare bw'umugongo, indwara z'imitsi, umuvuduko w'ubwonko ku bwonko