Kubabara umutwe cyane mu buryo butunguranye nk'inkuba? Ese byaba ari RCVS? (Reversible Cerebral Vasoconstriction Syndrome)

Tekereza uramutse ukora akazi kawe gasanzwe, hanyuma ukumva urwaye umutwe mubi cyane kurusha iyindi yose wigeze uhura nayo. Ubwo bubabare bwari bukabije cyane mu buzima bwawe. Ubwo bubabare bwagera ku rwego rwo hejuru mu masegonda make. Mu buvuzi, ubu bubabare bw'umutwe butunguranye kandi bukomeye twita "Umutwe wo mu mutwe ushyushye." Uyu si umutwe uwo ari wo wose gusa. Akenshi uyu ni umuburo ukomeye umubiri wacu uduha. RCVS ni imwe muri izo ndwara itanga umuburo nk'uwo.

Mu magambo make, RCVS ni iki?

Izina ryuzuye rya RCVS ni Reversible Cerebral Vasoconstriction Syndrome . Izina rishobora gusa nkaho ari rirerure kandi rigoye, ariko reka tubikomeze byoroshye.

• Gusubira inyuma: bivuze "gushobora gusubizwa inyuma." Ibi bivuze ko iyo ndwara idakira burundu kandi ishobora gukira iyo umuntu avuwe neza .
• Ubwonko: bivuze "ijyanye n'ubwonko."
• Vasoconstriction: bivuze "kugabanuka cyangwa kugabanuka kw'imitsi y'amaraso."

Mu magambo make, RCVS ni indwara aho imiyoboro y'amaraso mu bwonko ihita ifungana, igafungana, kandi igafungana . Ariko, ibi bishobora gusubizwa inyuma iyo umuntu avuwe neza.

Tekereza umuyoboro w'amazi. Bigenda bite iyo dukanda igice kimwe cy'umuyoboro? Bihagarika amazi gutemba, si byo se? Ibyo ni nako biba ku miyoboro y'amaraso yo mu bwonko bwacu. Iyo iyi miyoboro y'amaraso ifashe umugongo mu buryo butunguranye (tubyita "vasospasm"), ubwonko ntibubona amaraso akenewe. Niyo mpamvu tugira umutwe ukomeye wumva nk'inkuba ikubita. Iyi ndwara ishobora kandi kugaragaza ibimenyetso nko kurwara umutwe mu nda, gucika imitsi, cyangwa kuva amaraso mu bwonko .

Ni ibihe bimenyetso bya RCVS?

Muri RCVS, amaraso atembera mu bwonko arahungabana, bigatera ibimenyetso bitandukanye. Ikimenyetso nyamukuru ni ukurwara umutwe cyane, ariko hari n'ibindi bimenyetso.

Mu bihe bimwe na bimwe, RCVS ishobora gutera kuva amaraso hagati y'ubwonko n'agahanga. Ibi byitwa `(Subarachnoid Hemorrhage - SAH)`. Iki kandi ni ikibazo gikomeye cyane cy’ubuvuzi. Uretse ibimenyetso byavuzwe haruguru, SAH ishobora no kugaragaza ibimenyetso bikurikira:

• Kubabara ijosi, kubabara imitsi mu ijosi no mu bitugu.
• Impinduka mu myitwarire no mu byiyumvo (kurakarira nta mpamvu).
• Gucika intege mu gice cy'umubiri.

Ni ibihe bintu bigira uruhare mu iterambere rya RCVS?

Nubwo impamvu nyayo ya RCVS itaramenyekana, hari ibintu byinshi bishobora gutera iyi ndwara.

Gutwita no kubyara

Impamvu ikunze kugaragara kandi ikunze kugaragara cyane yo kurwara RCVS ni ugutwita. Ingaruka ziba nyinshi cyane mu byumweru bitandatu bya mbere nyuma yo kubyara (nyuma yo kubyara). Abaganga bemeza ko impinduka mu misemburo mu gihe cyo gutwita zishobora kugira uruhare. RCVS ishobora kubaho nubwo nta ngorane zibaho nka preeclampsia, ikaba ari indwara y'umuvuduko ukabije w'amaraso ibaho mu gihe cyo gutwita.

Gukoresha imiti imwe n'imwe n'imwe

Imiti imwe n'imwe igira ingaruka ku mikorere y'amaraso mu mubiri wacu yongera ibyago byo kurwara RCVS.

Izindi ndwara

Hari indwara zimwe na zimwe na zimwe zongera ibyago byo kurwara RCVS.

• Migraine: Abantu barwaye migraine bafite amahirwe menshi yo kurwara RCVS.
• Urugero rwinshi rwa kalisiyumu mu maraso (Hypercalcemia): Iyo urugero rwa kalisiyumu mu maraso rwiyongereye, rushobora kubangamira imikorere y'imitsi y'amaraso.
• Ibibazo by'imisemburo: Hakekwa ko imisemburo ya estrogen igira uruhare muri ibi. Niyo mpamvu iyi ndwara ikunze kugaragara cyane mu bagore.
• Indwara z'uruhererekane: Indwara zitera ibibyimba bitanga imisemburo myinshi ya adrenaline, nka ``Pheochromocytoma``.

Ni izihe ngorane zishobora guterwa na RCVS?

Mu bihe byashize, abaganga batekerezaga ko RCVS ari indwara idakira kandi idakira, ariko ubushakashatsi bushya bwagaragaje ko atari ko bimeze buri gihe.

Abagera kuri 30% by'abarwayi ba RCVS bashobora gusigarana ubumuga budakira (urugero, intege nke z'imitsi, ibibazo byo kuringaniza imikorere y'umubiri mu gihe cyo kugenda). Abagera kuri 8% bashobora kugira ibibazo bikomeye kandi by'igihe kirekire.

Byongeye kandi, ingorane zikomeye zishobora kugaragara mu minsi mike nyuma y’uko ibimenyetso bya mbere bigaragaye.

• Ischemic Stroke: Istroke iterwa no kuziba kw'imitsi y'amaraso itanga amaraso mu bwonko.
• Kuva amaraso mu bwonko: Indwara isa na SAH.
• Indwara y'igicuri (`(Indwara zo mu mutwe)`).

Ni gute isuzuma rya RCVS?

Iyo ugiye mu Ishami ry’Ubutabazi bw’Imbere (ETU), abaganga bakurikiza intambwe nyinshi kugira ngo bamenye iyi ndwara.

1. Isuzuma ry'umubiri n'imitsi: Uretse kubaza ibimenyetso byawe, imikorere y'imitsi yawe (urugero: imvugo, kureba, kuringaniza umubiri) izageragezwa.

2. Gupima amaraso: Gupima amaraso bikorwa kugira ngo harebwe ibintu nk'ibibazo byo kuvura amaraso, indwara zandura, n'ubusumbane mu myunyu y'umubiri.

3. Gupima amashusho: Izi scan ni zo zingenzi cyane mu gusuzuma RCVS. Zishobora "kureba" imbere mu bwonko no kumenya ahantu hafite ikibazo.

Ni ubuhe bwoko bwa scan bukorwa?

• CT Scan (`(Computed Tomography - CT scan)`): Isuzuma ryitwa `(CT angiogram)` rishobora gukoreshwa mu kureba imiterere y'imitsi y'amaraso mu bwonko. Isuzuma rya CT scan ni ingenzi cyane mu gusuzuma vuba indwara yo mu bwonko, kuko buri segonda riba rigira agaciro mu kuvura indwara yo mu bwonko.
• Isuzuma rya MRI (Ishusho ya Magnetic Resonance - Isuzuma rya MRI): Isuzuma ryitwa Magnetic Resonance Angiogram - MRA rishobora kwerekana neza uburyo imiyoboro y'amaraso ifungana (vasospasm) n'ingaruka bigira ku bwonko.
• Ultrasound ya Transcranial Doppler: Iyi ultrasound ipima umuvuduko w'amaraso mu bwonko kandi ishobora gutanga igitekerezo cy'uko imiyoboro y'amaraso yafunzwe.

Akenshi, nyuma yo kwemeza ko nta ndwara yo mu bwonko yatewe n'imitsi yo mu bwonko, hakenewe isuzuma rya MRI/MRA kugira ngo hemezwe RCVS.

Indwara ya RCVS ivurwa ite?

Nk'uko izina ribigaragaza ("Ishobora guhindurwa"), iyi ni indwara ishobora kuvurwa . Hariho intego ebyiri z'ingenzi zo kuvura.

1. Gukuraho impamvu: Niba impamvu ya RCVS ishobora kumenyekana neza (urugero: umuti runaka), intambwe ya mbere ni ukurandura iyo mpamvu.

2. Kugenzura uburyo imitsi ifungana: Imiti itangwa kugira ngo igenzure uburyo imitsi ifungana (`(vasospasm)`).

Ubwoko bw'imiti ikoreshwa cyane kuri ibi ni imiti ifunga imiyoboro ya kalisiyumu (`(Calcium Channel Blockers - CCBs)`).Iyi miti ikora mu kubuza kalisiyumu kwinjira mu turemangingo tw’imitsi yoroshye mu nkuta z’imitsi. Hanyuma imitsi iraruhuka, imitsi y’amaraso ikongera kwaguka, maze amaraso agasubira gutembera mu bwonko.

Mu bihe bike cyane, iyo indwara idakira imiti, hashobora gukoreshwa uburyo bwitwa "endovascular". Muri iki gihe, umuyoboro muto cyane (``catheter'') unyuzwa mu miyoboro y'amaraso iri mu kuboko cyangwa ku kuguru ukagera ku miyoboro y'amaraso iri mu bwonko, hanyuma agapira k'amaraso kakanyuzwamo (``angioplasty'') kugira ngo kagure umuyoboro w'amaraso uzibye cyangwa ngo gatange imiti mu buryo butaziguye.

Ni iki cyakwitegwa niba RCVS ikozwe?

Niba ufite RCVS, ikintu cya mbere ushobora kugira ni ukurwara umutwe ukabije kandi utunguranye. Iki ni ikibazo cyihutirwa cy’ubuvuzi kandi gisaba kuvurwa vuba. Iyo ubuvuzi butangiye, abantu benshi bakira mu minsi mike cyangwa ibyumweru bike .

Abantu benshi (hafi 80% - 85%) bakira burundu nta kibazo cy'igihe kirekire bafite . Icyo ni cyo kintu cyiza kuri iyi ndwara. Hafi 10% bashobora kugira ububabare buke. Ariko, hari ibyago bike byo kugira ingorane zikomeye, nk'indwara yo mu bwonko twavuze mbere, bityo gusuzuma no kuvura hakiri kare ni ingenzi cyane.

Ni iki twakora kugira ngo wirinde ko RCVS igaruka?

Niba warigeze kugira RCVS, muganga wawe ashobora kukugira inama yo guhindura imibereho yawe kugira ngo wirinde ko isubira.

• Guhagarika imiti yateye RCVS: Niba hari umuti wateye iyo ndwara, hagarika nk'uko muganga yabigutegetse kandi wirinde gufata uwo muti mu gihe kizaza.
• Fata imiti wanditswe na muganga buri gihe: Fata imiti wanditswe ku gihe kugira ngo wirinde ko ibimenyetso bigaruka.
• Irinde burundu gukoresha ibiyobyabwenge bitari ngombwa: Irinde ibintu bitera imbaraga, cyane cyane bigira ingaruka ku mikorere y'amaraso, nka marijuana.
• Genzura kafeyine n'ibinyobwa bitera imbaraga: Ni byiza kugabanya ingano y'ibi unywa cyangwa kubireka burundu.

Muganga wawe azagusaba kugaruka kwa muganga gukurikirana uburwayi bwawe. Menya neza ko witabiriye gahunda zo kwa muganga.