Ingaba inxalenye yengqondo yakho iphuma iyehla iye ekhakhayini lakho? Masifunde ngeChiari Malformation!

Ngaba ngamanye amaxesha ukhe ube nentloko ebuhlungu nentamo ebuhlungu? Okanye uzive ngathi ulahlekelwa yibhalansi yakho okanye uhambahamba uziva ngathi uza kukhubeka? Mhlawumbi ezi zinto azizenzeki nje ngequbuliso. Namhlanje siza kuthetha ngemeko enzima kancinci, kodwa abantu abaninzi abazi ngayo. YiChiari Malformation leyo. Ungakhathazeki, masithethe ngayo ngokulula.

Yintoni iChiari Malformation?

Ngamafutshane, i-Chiari malformation yimeko apho izicubu zengqondo ezingasemva kwentloko yakho, ezantsi, zityhala ziye ezantsi zize zikhule ecaleni kwentambo yakho yomqolo. Cinga ngentloko yakho njengendlu. Ngamanye amaxesha akukho ndawo yaneleyo yokuba ingqondo yakho ingene ngaphakathi kuloo ndlu. Xa oko kusenzeka, inxalenye yengqondo yakho, ngakumbi i-cerebellum yakho, ityhala ngesithuba sendalo esisezantsi kwentloko yakho - siyibiza ngokuba yi-foramen magnum - ize ityhale iye ezantsi nasezantsi ukuya kwintambo yakho yomqolo.

I-cerebellum yakho yinxalenye ebaluleke kakhulu yobuchopho bakho. Ilawula izinto ezininzi, kuquka iintshukumo zemisipha yakho, ukuma, ukulinganisela, intetho, kunye nokulungelelanisa . Ngoko ke, xa esi sifo sichaphazela i-cerebellum, iimpawu ezinxulumene nayo ziqala ukubonakala. Umzekelo, izinto ezifana nokulahlekelwa yibhalansi.

Xa inxalenye yengqondo ityhalelwa phantsi ngolu hlobo, icinezela isiseko sentloko. Oku kuthintela ukuhamba kolwelo lwe-cerebrospinal (CSF). Olu lwelo lukhusela ingqondo yakho kunye nomqolo, lujikeleza izondlo kunye neekhemikhali, kwaye lususa inkunkuma. Ngoko ke xa ukuhamba kolu lwelo kuphazamiseka, iingxaki ezahlukeneyo zinokwenzeka.

Ziziphi iintlobo zeChiari Malformation?

Kukho iintlobo ezininzi eziphambili zale meko. Masibone ukuba zithini:

• Uhlobo lweChiari malformation 0: Oku kunqabile kakhulu. Kolu hlobo, iindawo ze-cerebellum yakho ziphuma kancinci kakhulu okanye aziphumi konke konke emngxunyeni osezantsi kwentloko yakho (i-foramen magnum). Nangona kunjalo, kukho inqanaba elithile lokuxinana. Iimpawu zibangelwa kukuhamba okungaqhelekanga kolwelo lwe-cerebrospinal (CSF) kufutshane nesiseko sentloko yakho.

• Uhlobo lweChiari malformation I: Olu lolona hlobo luqhelekileyo. Kulapho inxalenye esezantsi yecerebellum ityhala khona isithuba esisezantsi kwekhakayi (i-foramen magnum). Umqolo wakho udla ngokudlula kwesi sithuba. Abanye abantu abanohlobo lwe-I basenokungabi nazo iimpawu. Iimpawu zinokubonakala xa umntu eselula okanye kamva ebomini.

• Uhlobo lweChiari malformation II:Oku kwenzeka ngexesha lesigaba somntwana osandul’ ukuzalwa, xa umntwana ekhula esibelekweni. Apha, i-cerebellum kunye ne-brain stem zikhula ngendlela engaqhelekanga, nto leyo ebangela uxinzelelo ngaphakathi kwentloko. Olu hlobo ludla ngokuvela kunye ne -myelomeningocele, uhlobo olubi lwe-spina bifida. I-Myelomeningocele yimeko apho intambo yomqolo kunye nomjelo womqolo zingavali kakuhle ngaphambi kokuba umntwana azalwe. Umqolo uvalwa ngotyando emva kokuzalwa, kodwa iimeko ezifana nokukhubazeka zinokwenzeka.

• Uhlobo lwe-Chiari malformation III: Olu nalo lunqabile kakhulu, kwaye lolona hlobo lubi kakhulu lwe-Chiari malformation. Kwimeko enjalo, iindawo ze-cerebellum kunye ne-brain stem ziphuma ngomngxuma ongaqhelekanga ngasemva kwe-skull (hayi i-foramen magnum). Ukongeza, ezinye zee-membranes ezijikeleze ingqondo okanye umqolo nazo ziphuma ngomngxuma. Oku kubangela ukudumba ngasemva kwe-skull, okubizwa ngokuba yi-encephalocele . Uhlobo lwe-III lubangela iimpawu ezinzima nezisongela ubomi eziqala ebuntwaneni. Aba bantwana banokuba neengxaki ze-neurological, ukukhubazeka kokufunda, kunye nokuxhuzula . Oku kudla ngokufuna utyando.

• Uhlobo lwesine lweChiari malformation: Oku kunqabile kakhulu. Kulapho i-cerebellum ngokwayo ingakhulanga ngokupheleleyo, okanye ezinye iindawo zayo zingekho. Olu hlobo nalo lunzima, ludla ngokuba yingozi ebomini xa lusengumntwana.

Ixhaphake kangakanani le meko?

Izifundo zibonisa ukuba malunga nomntu omnye kwabayi-1,000 eMelika kuphela unokuba neChiari Malformation. Nangona kunjalo, le meko isenokuba yinto eqhelekileyo kuba abanye abantu abanazo iimpawu okanye iimpawu zibonakala ebantwaneni okanye ebudaleni.

Kuvakala njani ukuba neChiari Malformation?

Ukuba uneChiari Malformation, unokufumana iimpawu ezifana nezi:

• Intloko ebuhlungu ibonakala ngentlungu ebukhali nehlabayo, ingakumbi ngasemva kwentloko, entanyeni, okanye emagxeni. Le ntlungu inokuba mandundu xa ukhohlela okanye uthimla .
• Iingxaki zokulinganisela kunye nokulungelelanisa. Usenokuziva ungcangcazela xa uhamba, ngokungathi awunalawulo.
• Isiyezi kunye ne-vertigo (ukuziva ngathi indawo okuyo iyajikeleza).
• Ubuthathaka bemisipha.
• Ukuba ndindisholo ezandleni okanye ezinyaweni, okanye ukutsha kweminwe, ezinyaweni, okanye emilebeni.
• Ukuziva ngathi intliziyo yakho iyatsiba (ukubetha kwentliziyo).
• Ukungalali nokudinwa okungapheliyo.

Ziziphi ezinye iimpawu zeChiari Malformation?

Nazi ezinye iimpawu eziqhelekileyo:

• Utshintsho embonweni: Ukubona kabini, ukubona okufipheleyo, iintshukumo zamehlo ezingaqhelekanga, kunye novakalelo ekukhanyeni.
• Iingxaki zokuva: Ukurhawuzelela ezindlebeni (i-tinnitus) okanye ukulahlekelwa kukuva.
• Ubunzima bokuginya: ukuvuza amathe, ukuhlanza, ukuziva ngathi umqala wakho uvalekile, okwenza kube nzima ukutya, ukusela, nokuthetha.
• I-Scoliosis.
• Ukungakwazi ukulawula umchamo okanye ilindle.
• Ukuquleka.
• Ubunzima bokuphefumla ngexesha lokulala (sleep apnea).

Kubalulekile: Ezi mpawu zinokwahluka kumntu nomntu. Abanye abantu abanazo iimpawu, abanye baneempawu ezingephi, kwaye abanye baneempawu ezinzima kakhulu. Abanye abantu banokuba neempawu kwasekuzalweni. Abanye banokubonakalisa iimpawu kamva, ebuntwaneni okanye ebudaleni. Iimpawu zinokwahluka kwaye zinciphe ngokuhamba kwexesha.

Zithini izizathu zeChiari Malformation?

Le meko yenzeka xa inxalenye esezantsi yobuchopho bakho ityhalelwa kumjelo womgogodla okanye kwi-foramen magnum (apho kudibana khona ingqondo nomqolo). Eyona nto ibangela oku kukungaqheleki kophuhliso lobuchopho bakho nomqolo. Oku kuthetha ukuba ubukhulu bekhaka kwindawo apho i-cerebellum ikhoyo buncinci kunokuba bekulindelwe. Oku kubeka uxinzelelo kuloo nxalenye yobuchopho, okubangela ukuba i-cerebellum ikhule iye ezantsi kwindawo engalindelekanga. Oku kudla ngokwenzeka ngexesha lophuhliso lomntwana ongekazalwa.

Iingxaki zeChiari zihlala zizalwa. Nangona kunjalo, iimpawu zinokuvela kamva ebomini. Oku kunokubangelwa kukuguquka kwezakhi zofuzo okuhlala kuzuzwe kusapho lwakho, okanye kungaba yinto eyenzeka ngokungacwangciswanga emva kokukhulelwa.

Nangona kunjalo, kunqabile kakhulu ukuba umntu ongazalwanga enale meko afumane ukukhubazeka kweChiari kamva ebomini. Kwiimeko ezinjalo, imo yekhakhayi okanye umqolo inokutshintsha ngenxa yezi zizathu zilandelayo:

• Umhlaza wobuchopho.
• I-cyst.
• Ihlwili legazi (iHematoma).
• I-Hydrocephalus.
• Uxinzelelo lwegazi oluphezulu lwe-intracranial okanye i-pseudotumor cerebri.

Ngamanye amaxesha, i-Chiari malformation inokwenzeka kunye nezinye iimeko zempilo ezingaphantsi, ezinje:

• Isifo seGoldenhar.
• I-Achondroplasia.
• Iimeko zezicubu ezidityanisiweyo ezifana ne-Ehlers-Danlos syndrome.
• I-spina bifida.

Ziziphi izinto ezibangela umngcipheko weChiari Malformation?

Le meko inokuchaphazela nabani na, kodwa ukuba kukho umntu kusapho lwakho onayo, unokuba nengxaki yeChiari.

Ziziphi iingxaki zeChiari Malformation?

Ukukhubazeka kweChiari kunokubangela iingxaki zempilo ezinkulu kunye nokulibaziseka kokukhula. Ezinye zeengxaki ziquka:

• I-Hydrocephalus: Le yimeko esongela ubomi. Oku kwenzeka xa ulwelo lwe-cerebrospinal (CSF) luqokelelana ngaphakathi kwengqondo yakho. Oku kwenzeka xa i-CSF ingakwazi ukuphuma kakuhle. Xa i-CSF iqokelelana, uxinzelelo ngaphakathi kwekhakayi luyanda. Oku kunokubangela iingxaki zokusebenza kwengqondo kunye nokuma kwentloko okuphazamisekileyo . Ukuba ayinyangwa, inokuba yingozi ebomini. Le ngxaki idla ngokubonakala kwi-Chiari malformation type II.

• I-Syringomyelia kunye ne-Hydromyelia: Xa ulwelo lwe-cerebrospinal (CSF) phakathi kwengqondo yakho kunye nomqolo lungahambi kakuhle, lunokuqokelelwa ngaphakathi komqolo. Olu qokelelo lolwelo lungonakalisa umqolo kwaye lubangele iimpawu ezifana neengxaki zokuhamba kunye nokulinganisela, iintlungu, ubuthathaka bemisipha, ukuxinana kwemisipha, ukungaziva, ukuncipha kokuziva ubushushu nokubanda, kunye nokulahlekelwa kulawulo lwesinyi kunye namathumbu .

• Isifo sentambo egobileyo: Abantwana abazelwe bene-myelomeningocele (uhlobo olubi lwe-spina bifida) basengozini enkulu yokuba ne-tethered cord syndrome njengoko bekhula. Oku kwenzeka xa intambo yabo yomqolo inamathela kwintambo yomqolo ngenxa yamanxeba emva kotyando lomqolo. Le meko inokubangela umonakalo wemithambo-luvo ochaphazela izihlunu zomzimba ongezantsi kunye nemilenze. Ingachaphazela nokusebenza kwamathumbu kunye nomchamo.

Ukongeza, iimpawu zeChiari malformation zinokuchaphazela imo yakho, ingakumbi ukuba unesifo sokungalali okanye iintloko ezibuhlungu kakhulu. Abanye abantu banokuba neemeko ezifana nokudakumba . Ukuba le meko ichaphazela imo yakho, thetha nogqirha wakho okanye nomcebisi wezempilo yengqondo .

Ifunyanwa njani iChiari Malformation?

Ugqirha uza kuyixilonga le meko emva kovavanyo olupheleleyo lomzimba. Ugqirha wakho uza kujonga intshukumo yakho, ulungelelwano, kunye neemvakalelo zakho ezingalweni nasemilenzeni . Ukongeza, baza kujonga iimpawu zeengxaki zenkumbulo, imingeni yokufunda, kunye nokulibaziseka kokukhula kwabantwana.

Ukuqinisekisa ukuxilongwa, ugqirha uya kuyalela uvavanyo lwemifanekiso ukuze kuthathwe imifanekiso eneenkcukacha zobuchopho bakho kunye nomqolo. Oku kungabandakanya:

• Iskeni se-MRI (Magnetic Resonance Imaging): Oku kungabona ngokucacileyo izicubu ezithambileyo kunye namathambo. Kunceda ugqirha ukuba abone ubuchopho bakho, umqolo, kunye nolwelo lwe-cerebrospinal (CSF). Kungabona nokuba i-cerebellum ifikelele kangakanani kumjelo womgogodla.
• I-Cine MRI: Oku kufana ne-MRI eqhelekileyo, kodwa kuvumela ugqirha ukuba abone indlela oluhamba ngayo ulwelo lwe-cerebrospinal (CSF) olujikeleze isiseko sentloko.
• I-CT (Computed Tomography) Scan: I-CT scan inceda ekuchongeni iingxaki ngamathambo esiseko sekhakhayi kunye nomqolo.
• I-X-reyi: Kuthathwa ii-X-reyi ukujonga iingxaki emathanjeni entloko nasentanyeni.

Ngamanye amaxesha, ukukhubazeka kweChiari kunokubonwa nakwi-ultrasounds yokukhulelwa , eziluvavanyo olusebenzisa amaza esandi ukwenza imifanekiso yezicubu ezithambileyo.

Ukuba awunazo iimpawu zeChiari malformation, unokufunyanwa unale meko xa uvavanywa umfanekiso ngesizathu esingahambelaniyo.

Iphathwa njani iChiari Malformation?

Ugqirha wakho uza kuyila isicwangciso sonyango ngokusekelwe kubukhali beempawu zakho. Ukuba awunazo iimpawu, akukho nyango lufunekayo. Ugqirha wakho uza kujonga impilo yakho nge-MRI scans rhoqo.

Ukuba uneempawu ezincinci ezifana neentloko ebuhlungu okanye iintlungu zentamo, ungazama ezi zinto:

• Ukusela amayeza okubulala iintlungu okanye amayeza okunceda ukulawula iimpawu.
• Ukuthatha inxaxheba kunyango lokumasaja okanye unyango lomzimba.
• Ukunciphisa imisebenzi yomzimba efana nokuphakamisa iintsimbi.
• Ukusebenzisa izixhobo ezifana nezixhobo zokuva okanye iiglasi xa unengxaki yokuva okanye yokubona.

Utyando lweChiari malformation

Kwiimeko ezinzima zeChiari malformation, utyando lunokufuneka. Kukho iindlela ezahlukeneyo zotyando:

• Utyando lweCraniectomy: Ugqirha ususa iqhekeza elincinci lethambo ekhayeni lakho ukuze anciphise uxinzelelo engqondweni aze ancede ukuhamba kolwelo lwe-cerebrospinal (CSF).
• Ukunciphisa uxinzelelo lwe-posterior fossa: Le yeyona ndlela ixhaphakileyo esetyenziswa ukunyanga i-Chiari malformation. Ugqirha ususa inxalenye yomqolo wentloko (ebizwa ngokuba yi-posterior fossa) ukuze anciphise uxinzelelo engqondweni aze adale indawo engaphezulu yengqondo.
• Utyando lweLaminectomy:Ngokuxhomekeke kubunzima beChiari malformation, ugqirha uza kususa inxalenye encinci yamathambo agqume umqolo wakho ukuze abuyisele ukuhamba kolwelo lwe-cerebrospinal (CSF) kwaye enze indawo engakumbi yomqolo.
• I-Duraplasty: Kolu tyando lokunciphisa uxinzelelo, ugqirha uvula i-dura (i-membrane yangaphandle yengqondo yakho). Emva koko, ugqirha uthunga i-patch ukuze andise i-membrane, enze indawo engakumbi yengqondo. Le nkqubo iyandisa indawo kwaye inciphise uxinzelelo engqondweni.
• I-Electrocautery: Ukuze benze indawo engakumbi kwaye bavumele ulwelo lwe-cerebrospinal (CSF) luhambe, oogqirha basebenzisa umbane omncinci ukunciphisa indawo encinci yobuchopho bakho ebizwa ngokuba yi-cerebellar tonsils. Ezi tonsils ziyancipha ngaphandle kokonakalisa ingqondo okanye imithambo-luvo.
• Indawo yokubeka i-shunt: Ukuba une-hydrocephalus, ugqirha wakho uza kubeka i-shunt, okanye ityhubhu, ekhayeni lakho ukuze aqokelele ulwelo olongezelelweyo lwe-cerebrospinal (CSF). Olu lwelo luza kuphuma ekhayeni lakho nasebuchotsheni luze luqokelele kwenye indawo yomzimba wakho.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

Ngaphambi kokuba uqale unyango, ugqirha wakho uza kuthetha nawe ngemiphumo emibi yonyango ukuze ukwazi ukwenza isigqibo esinolwazi malunga nempilo yakho. Zonke iintlobo zotyando zinemingcipheko. Utyando engqondweni nasekhayeni lakho lunomngcipheko omkhulu kuba ukusikwa kunye neenkqubo zisondele ebuchotsheni. Kusenokufuneka wenze utyando olongezelelweyo njengoko ukhula.

Ndiza kuziva ngcono ngokukhawuleza kangakanani emva konyango?

Ngokuxhomekeke kwisicwangciso sonyango osikhethileyo wena nogqirha wakho, unokufumana isiqabu kwiimpawu ezingephi ngokukhawuleza emva kokusela iintlungu okanye emva kokuya kunyango. Ukuchacha emva kotyando kunokuthatha naphi na ukusuka kwiiveki ezimbalwa ukuya kwiinyanga ezimbalwa. Ungaphawula ukuba iimpawu zakho ziyaphela okanye zincipha kakhulu emva kotyando.

Ngaba iChiari Malformation yimeko enzulu?

Ngamanye amaxesha, ukukhubazeka kweChiari kunokuba nzima kakhulu, kodwa akusoloko kunjalo. Kwiimeko ezininzi, abantwana bazalwa benesifo seChiari. Nangona kunjalo, iimpawu azibonakali rhoqo, kwaye ukuxilongwa kungenziwa kade, nokuba kusebuntwaneni okanye ebudaleni, xa ugqirha eyalela uvavanyo lwemifanekiso ngesizathu esingahambelaniyo.

Nangona kungekho unyango olupheleleyo lweChiari malformation, unyango olufana notyando lunokunceda ukulawula iimpawu zakho, ukukugcina uphilile, kunye nokuthintela iingxaki ezisongela ubomi.

Iyintoni ikamva elilindelekileyo kule meko?

Imbono yakho ixhomekeke kubukhali kunye nohlobo lwesifo seChiari. Kubalulekile ukusebenzisana ngokusondeleyo nogqirha wakho kunye neqela lakho lokhathalelo. Banokujonga iimpawu zakho baze bamisele isicwangciso sonyango esifanelekileyo kuwe.

Ingakanani iminyaka yobomi bomntu oneChiari Malformation?

Ukuba awunazo iimpawu okanye uneempawu ezincinci emva kokuba ufunyaniswe ukuba une-Chiari malformation, kusenokwenzeka ukuba uphile ubomi obuqhelekileyo . Iimpawu ezinzima kunye nezinye iintlobo ze-Chiari malformation zinokubulala. Thetha nogqirha wakho malunga nento omawuyilindele emva kokuba ufunyaniswe ukuba unayo.

Ngaba iChiari Malformation ingathintelwa?

Okwangoku akukho ndlela eyaziwayo yokuthintela le meko.

Ukuba uceba ukukhulelwa, thetha nogqirha wakho ngeendlela zokugcina impilo yakho intle. Ugqirha wakho unokucebisa ukuba usele iivithamini ezifana ne-folic acid rhoqo . Oku kunokunciphisa umngcipheko wokuba nomntwana one-spina bifida. Ugqirha wakho unokucebisa novavanyo lwe-genetic , ukuze uqonde umngcipheko wokuba nomntwana one-genetic disorder.

Ndifanele ndimbone nini ugqirha?

Bona ugqirha ukuba ufumana iimpawu zokukhubazeka kweChiari, okanye ukuba iimpawu zakho ziya zisiba mandundu. Ukuba unomntwana oneengxaki zokukhubazeka kweChiari kwaye akakwazi kukhula kakuhle ngokweminyaka yakhe, thetha nogqirha wakhe. Emva kotyando, ukuba ubonisa iimpawu zosulelo, njengentlungu enzima, ukudumba, okanye inxeba lotyando elingapholiyo , tsalela umnxeba ugqirha wakho.

Ingxamiseko! Ukuba wena okanye umntu omthandayo unesithuthwane okokuqala, fowunela iinkonzo zongxamiseko zasekuhlaleni okanye ku-1990 ngoko nangoko.

Ndingayibuza yiphi imibuzo ugqirha wam?

• Luhlobo luni lwe-Chiari malformation endinayo?
• Luhlobo luni lonyango olucetyiswayo?
• Kukangaphi kufuneka uhlolwe i-MRI scan ukuze ujonge le meko?
• Ngaba ucebisa utyando?
• Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?
• Ngaba oku kuya kwenzeka kubantwana bam bexesha elizayo?

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ukukhubazeka kweChiari kuchaphazela wonke umntu ngokwahlukileyo. Usenokungabi nazimpawu konke konke, okanye zinokuba buthathaka kangangokuba azichaphazeli kakhulu imisebenzi yakho yemihla ngemihla. Abanye banokufumana iimpawu ezinzima, ezihlala zikhubaza kwaye zifune utyando. Iindaba ezimnandi zezokuba kukho unyango lwezinye iintlobo zale meko olunokunceda ukunciphisa iimpawu kunye nokuthintela iingxaki ezisongela ubomi.Ukuba iimpawu zakho aziphucuki, ziya ziba mandundu, okanye uhlangabezana neengxaki ezifana nosulelo emva kotyando, qiniseka ukuba ufowunela ugqirha wakho. Ungakhathazeki, ngeengcebiso zonyango ezifanelekileyo kunye nenkxaso, ungaphila ngempumelelo nale meko.

Ukukhubazeka kweChiari , Isifo sobuchopho, iCerebellum, Intloko ebuhlungu, iNeurology, iCerebrospinal Fluid