Musoro wakanyanya kurwadza muhupenyu hwako here? Ingava RCVS here? (Reversible Cerebral Vasoconstriction Syndrome)

Fungidzira kuti wangopererwa, uye kamwe kamwe, munguva isingasviki sekondi imwe chete, unonzwa musoro wakanyanya kurwadza wawati wambova nawo muhupenyu hwako... sekunge mheni inorova musoro wako. Mukurapa, tinoti izvi "Musoro weKutinhira." Ichi ndicho chiratidzo chakajairika uye chakakomba chechirwere chatiri kutaura nezvacho nhasi, RCVS. Musoro wakadai idambudziko rekurapa rinoda kurapwa nekukurumidza.

Chii chinonzi RCVS zviri nyore?

Zvichitaurwa zviri nyore, Reversible Cerebral Vasoconstriction Syndrome (RCVS) chirwere chekuti tsinga dzeropa dziri muuropi dzinongoerekana dzaoma dzovharika. Zvakafanana nepombi yemvura inongoerekana yadzvanywa. Kana tsinga dzeropa dzavharika nenzira iyi, uropi hauwani huwandu hweropa hwaunoda. Ndokusaka uchirwadziwa nemusoro wakaita semheni wandambotaura kare.

Izwi rekuti "reversible" muzita rechirwere ichi rinoreva kuti chinogona kugadziriswa nekurapwa kwakakodzera . Zvisinei, kana chikasarapwa, chinogona kutungamira kuzvirwere zvakakomba zvakaita sestroke kana kubuda ropa muuropi. Dzimwe nguva, zviratidzo zvakafanana zvikuru nemigraine kana stroke, zvichiita kuti zviome kusiyanisa pakati pezviviri izvi.

Ndezvipi zviratidzo zvechirwere ichi?

Zviratidzo zvese zveRCVS zvinokonzerwa nekukanganiswa kweropa rinoenda kuuropi. Ngationei kuti zviratidzo izvi chii.

Chii chinokonzera RCVS?

Mitsipa yedu yeropa ine tsandanyama dzakatsetseka mukati. Tsandanyama idzi dzinodzora kuyerera kweropa nekudzikama uye kuzorora. Asi dzimwe nguva tsandanyama idzi dzinongoerekana dzaoma uye dzaoma zvakanyanya. Tinodaidza izvi kuti "vasospasm". Ichi ndicho chikonzero chikuru cheRCVS.

Pane zvikonzero zvakawanda zvinoita kuti chirwere ichi (vasospasm) chiitike.

Pamuviri uye mushure mekusununguka

Chikonzero chinowanzo kukonzera RCVS pamuviri. Njodzi yechirwere ichi yakanyanya kuwanda mukati memavhiki matanhatu ekutanga mushure mekusununguka. Izvi zvinofungidzirwa kuti zvinokonzerwa nekuchinja kamwe kamwe kwemazinga emahormone. Njodzi iyi inogona kuitika kunyangwe usina zvirwere zvakaita se preeclampsia panguva yekuzvitakura.

Mimwe mishonga uye kushandiswa kwemishonga

RCVS inogona kukonzerwa nemimwe mishonga nemishonga inokanganisa mashandiro eropa mumuviri wako.

• Mimwe mishonga yekurapa kushungurudzika, kunyanya iyo iri muboka reSSRIs.
• Mishonga yemigraine (triptans nemishonga yerudzi rweergot).
• Mishonga inodzvinyirira masoja emuviri.
• Mimwe mishonga yekurapa chirwere cheParkinson.
• Zvinokurudzira (amphetamines, cocaine, pseudoephedrine).
• Mbanje.
• Kunwa caffeine zvakanyanya uye zvinwiwa zvinopa simba.
• Zvidimbu zveNicotine.
• Mishonga yakaita se `LSD` kana `MDMA` (ecstasy).

Zvimwe zvirwere

Mamwe matambudziko anokanganisa uropi kana kufamba kweropa anogonawo kuwedzera njodzi yekubatwa neRCVS.

• Migraine: Vanhu vane migraine vanowanzobatwa neRCVS.
• Kuwanda kwecalcium muropa (Hypercalcemia): Kuwedzera kwecalcium muropa kunogona kukanganisa mashandiro emhasuru dziri mutsinga dzeropa.
• Matambudziko emahormone: Hormone inonzi estrogen inonyanya kufungidzirwa kuti inobatanidzwa, ndosaka chirwere ichi chichiwanzoitika kuvakadzi.
• Zvimwe zvirwere zvinoberekwa senhaka, zvakaita se'Pheochromocytoma'' (bundu rinoburitsa adrenaline hormone yakawandisa) uye 'Porphyria'', zvinogona kuwedzera njodzi.

Ndezvipi zvinetso zvinogona kuitika nekuda kweRCVS?

Kare, vanachiremba vaifunga kuti RCVS yakanga isiri chirwere chakakomba. Asi tsvakiridzo itsva inoratidza kuti dzimwe nguva inogona kukonzera matambudziko. Vanhu vanosvika 30% vane RCVS vanogona kunge vaine zvimwe zvirwere zvidiki zvechigarire (sekushaya simba kwetsandanyama). Vanhu vanosvika 8% vanogona kuva nematambudziko akakomba kwenguva refu.

Uye zvakare, matambudziko akakomba akadai anogona kuitika mukati memazuva mashoma kubva pazviratidzo zvekutanga:

• Ischemic stroke: Kuvharika kwetsinga yeropa inoendesa ropa kuuropi.
• Kubuda ropa muuropi (SAH kana rumwe rudzi rwekubuda ropa muuropi): Kubuda ropa pakati peuropi nedehenya.
• Kubatwa nepfari.

Vanachiremba vanozviwana sei izvi?

Chiremba anoshandisa nzira dzakasiyana-siyana kuongorora chirwere ichi.

• Kuongororwa kwemuviri netsinga: Kushanda kwako nesimba, uye kunzwa kwako zvinoongororwa.
• Kuongororwa kweropa: Tarisa matambudziko ekugwamba kweropa, hutachiona, uye kusaenzana kwehuwandu hwemunyu.
• Kuongororwa kwemifananidzo: Iyi ndiyo nzira inonyanya kukosha yekuongorora RCVS.

Kuskena mifananidzo

Mhando idzi dzekuongorora dzinogona "kuona" mukati memusoro nepfungwa. Dzinogona kutarisa kana mitsipa yeropa yakavharika kana kuti ropa rakadzikira.

• Kuongororwa kweComputed Tomography (CT): Kunyanya, CT angiograms inogona kubatsira kuongorora zviri nani mamiriro etsinga dzeropa.
• Kuongororwa kweMagnetic Resonance Imaging (MRI): Kuongororwa kweMRI kunonzi Magnetic Resonance Angiogram (MRA) kunogonawo kuona kusimba kweropa mutsinga dzeropa.
• Kuongororwa kweTranscranial Doppler ultrasound: Izvi zvinogona kuyera kumhanya kweropa rinoyerera muuropi.

Kazhinji, CT scan ndiyo inotanga yaitwa. Nekuti inokurumidza. Inogona kuona nekukurumidza kana paine emergency senge sitiroko kana kubuda ropa. Pakurohwa, sekondi yega yega inoverengwa, saka kumhanya ikoko kwakakosha zvikuru. Zvadaro, kana zvichidikanwa, MRI scan inoitirwa kusimbisa kuvharika kwetsinga dzeropa.

Ndeapi marapirwo eRCVS?

Sezvinoratidzwa nezita racho, RCVS chirwere chinorapika zvikuru . Kurapa kune zvinangwa zviviri zvikuru.

1. Kana paine chikonzero (semuenzaniso mushonga), bvisa chikonzero ichocho.

2. Kuderedza kusimba kwetsinga dzeropa uye kuita kuti dzidzokere pakare.

Mhando yemushonga inonyanya kushandiswa kurapa chirwere ichi (vasospasm) icalcium channel blockers (CCBs) . Mishonga iyi inoshanda nekudzivirira calcium kupinda mumasero emhasuru mutsinga dzeropa. Tsandanyama dzinozozorora, tsinga dzeropa dzinokura zvakare, uye kuyerera kweropa kunodzokera pakare.

Kashoma, mune dzimwe nguva, kurapwa kunogona kuitwa uchishandisa nzira inonzi "endovascular". Izvi zvinosanganisira kupinza chubhu yakatetepa (catheter) nepatsinga yeropa iri muruoko kana gumbo kuenda kutsinga yeropa yakavharika iri muuropi, wobva wabaya mushonga kana kushandisa chimwe chinhu chakaita sebharumu kuwedzera tsinga yeropa (angioplasty).

Tingatarisira sei mamiriro ezvinhu aya?

Vanhu vazhinji vane RCVS (inenge 80% - 85%) vanopora zvachose vasina matambudziko enguva refu. Saka pane tariro yakanaka yeizvi. Asi chinhu chakakosha pane izvi ndechekuongorora chirwere ichi nekukurumidza uye kutanga kurapwa kwakakodzera.

Zvinhu zvaunogona kuita kudzivirira kuti RCVS isadzokorore

Nekuti hazvinyatsojeka kuti sei RCVS ichikura, hazvigone kudzivirirwa nguva dzose. Zvisinei, pane zvimwe zvinhu zvaunogona kuita kuderedza njodzi yako. Chiremba wako achakupa mamwe mazano nezveizvi.

• Kana paine mishonga inofungidzirwa kuti yakakonzera RCVS, irege uye usaishandise mune ramangwana.
• Kutora mishonga yakanyorerwa nachiremba sezvakanyorerwa uye nemazvo.
• Usashandise chero mishonga kana zvinodhaka (kunyanya zvinokurudzira muviri nembanje) usina kupiwa mazano nachiremba.
• Deredza kana kurega zvachose kunwa caffeine nezvinwiwa zvinopa simba.

Unofanira kuona chiremba rini uye kuenda kuETU?

Kana uine RCVS, chiremba wako achakuudza kuti urambe uchiuya kukiriniki. Zvakakosha kuti ugare uchienda kukiriniki nguva dzose. Nenzira iyi, mamiriro ako ezvinhu anogona kutariswa uye kurapwa kwako kunogona kugadziriswa sezvinodiwa.

Nguva yekuenda kuEmergency Treatment Unit (ETU) nekukasika:

Kana uine musoro unobaya kana zviratidzo zvakaita sestroke (semuenzaniso, kushaya simba kune rumwe rutivi rwemuviri, kuoma kutaura, kuchinja kwekuona) zvakare, nguva dzose idambudziko rehutano. Usamirire kusvika zvanyanya. Enda kuchipatara nekukurumidza sezvinobvira.