Khawuthelekelele udidekile, uze ngequbuliso, ngaphantsi komzuzwana, ufumane intloko ebuhlungu kakhulu owakha wayiva ebomini bakho... njengombane obetha intloko yakho. Kwizonyango, oku sikubiza ngokuba yi "Thunderclap Headache." Olu lolona phawu luqhelekileyo nolunzima lwesi sifo sithetha ngaso namhlanje, i-RCVS. Intloko ebuhlungu efana nale yimeko engxamisekileyo yezonyango efuna unyango olukhawulezileyo.
Yintoni i-RCVS ngokulula?
Ngamafutshane, iReversible Cerebral Vasoconstriction Syndrome (RCVS) yimeko apho imithambo yegazi engqondweni yakho iqina ngequbuliso ize ivaleke. Kufana nombhobho wamanzi ocinezelwa ngequbuliso. Xa imithambo yegazi ivalekile ngale ndlela, ingqondo ayifumani gazi lifunekayo. Yiyo loo nto ufumana intloko ebuhlungu efana nombane endikhankanyileyo ngaphambili.
Igama elithi "reversible" egameni lale meko lithetha ukuba inokuguqulwa ngonyango olufanelekileyo . Nangona kunjalo, ukuba ayinyangwa, inokukhokelela kwiimeko ezinzulu ezifana nestroke okanye ukopha kobuchopho. Ngamanye amaxesha, iimpawu zifana kakhulu nezo ze-migraine okanye istroke, okwenza kube nzima ukwahlula phakathi kwezi zimbini.
Okubaluleke kakhulu: Ukuba wena okanye umntu omaziyo unentloko ebuhlungu ngequbuliso, ebuhlungu kakhulu evakalelwa njengentloko ebuhlungu kakhulu ebomini bakhe, yingxamiseko yezonyango. Yiya kwigumbi likaxakeka lesibhedlele esikufutshane (ETU) ngoko nangoko. Musa ukuchitha ixesha.
Zithini iimpawu zale meko?
Zonke iimpawu ze-RCVS zibangelwa kukuphazamiseka kokuhanjiswa kwegazi engqondweni. Makhe sijonge ukuba zeziphi ezi mpawu.
| Uphawu | Ingcaciso elula |
|---|---|
| Iintloko ezibuhlungu zeNdudumo | Intloko ebuhlungu kakhulu endakha ndayiva ebomini bam, eqala ngequbuliso. |
| Uvakalelo ekukhanyeni nakwisandi | Ukuziva ungakwazi ukujonga ukukhanya okanye ukuva izandi (i-Photophobia kunye ne-Phonophobia) |
| Isicaphucaphu nokuhlanza | Intloko ebuhlungu ehamba nokuhlanza. |
| Utshintsho lombono | Umbono ofipheleyo, umbono ophindwe kabini, okanye umbono onciphileyo. |
| Ubuthathaka bemisipha | Ukuziva ngathi kukho into engathi yindindisholo kwelinye icala lomzimba. |
| Ukudideka | Ukulibala indawo nexesha, ukulahlekelwa zingqondo. |
| Ukuxhuzula | Imeko efana nokufaneleka. |
| Ubunzima bokuthetha (i-Aphasia) | Ubunzima bokuthetha okanye ukuqonda oko kuthethwa ngabanye abantu. |
| Iimpawu ezongezelelweyo ezinokwenzeka xa igazi liphuma engqondweni (i-Subarachnoid Hemorrhage - SAH) | |
| Ukuqina kwentamo | Ukuqina kwemisipha kunye nentlungu entanyeni nasemagxeni. |
| Utshintsho kwindlela yokuziphatha | Umsindo okhawulezileyo, ukucaphuka. |
| Ukungabi nangqondo emzimbeni | Ukuva imvakalelo yokurhawuzelela kwindawo ethile yomzimba. |
Yintoni ebangela ii-RCVS?
Imithambo yethu yegazi inomaleko wemisipha egudileyo ngaphakathi. Ezi misipha zilawula ukuhamba kwegazi ngokufinyeza nokuphumla. Kodwa ngamanye amaxesha ezi misipha ziyaxina kwaye zifinyeze kakhulu. Oku sikubiza ngokuba yi-"vasospasm". Le yeyona nto ibangela i-RCVS.
Kukho izizathu ezininzi zokuba le meko (vasospasm) inokwenzeka.
Ukukhulelwa kunye nexesha lokuphuma emva kokubeleka
Eyona nto ixhaphakileyo ebangela i-RCVS kukukhulelwa. Umngcipheko wale meko uphezulu kwiiveki ezintandathu zokuqala emva kokubeleka. Oku kukholelwa ukuba kungenxa yotshintsho olukhawulezileyo kumanqanaba eehomoni. Lo mngcipheko unokwenzeka nokuba awunazo iimeko ezifana ne-preeclampsia ngexesha lokukhulelwa.
Amanye amayeza kunye nokusetyenziswa kweziyobisi
I-RCVS inokubangelwa ngamayeza athile kunye namayeza achaphazela inkqubo yakho yokujikeleza kwegazi.
- Amanye amayeza okunyanga ukudakumba, ingakumbi lawo akwiqela le-SSRIs.
- Amayeza e-migraine (ii-triptan kunye namayeza ohlobo lwe-ergot).
- Amayeza okunciphisa amajoni omzimba.
- Amanye amayeza esifo sikaParkinson.
- Izinto ezivuselela ingqondo (amphetamines, cocaine, pseudoephedrine).
- Intsangu.
- Ukusela kakhulu icaffeine kunye neziselo ezinika amandla.
- Iipatches zeNicotine.
- Iziyobisi ezifana ne-`LSD` okanye i-`MDMA` (i-ecstasy).
Ezinye iimeko zonyango
Ezinye iimeko zonyango ezichaphazela ingqondo okanye ukujikeleza kwegazi nazo zinokunyusa umngcipheko we-RCVS.
- Iintloko ezibuhlungu: Abantu abaneentloko ezibuhlungu banamathuba amaninzi okufumana ii-RCVS.
- Amanqanaba aphezulu e-calcium egazini (i-Hypercalcemia): Amanqanaba aphezulu e-calcium anokuphazamisana nokusebenza kwemisipha kwimithambo yegazi.
- Iingxaki zehomoni: I-hormone i-estrogen ngokukodwa kurhanelwa ukuba ibandakanyeka, yiyo loo nto esi sifo sixhaphake kakhulu kubafazi.
- Ezinye izifo ezidluliselwa kwilifa, ezifana ne-"Pheochromocytoma" (isisu esivelisa i-adrenaline hormone engaphezulu) kunye ne-"Porphyria", zinokunyusa umngcipheko.
Ziziphi iingxaki ezinokubakho ze-RCVS?
Ngaphambili, oogqirha babecinga ukuba i-RCVS ayisiyongxaki imbi kakhulu. Kodwa uphando olutsha lubonisa ukuba ngamanye amaxesha inokubangela iingxaki. Malunga nama-30% abantu abane-RCVS banokushiyeka beneziphene ezincinci ezingapheliyo (njengobuthathaka bemisipha). Malunga nama-8% banokuba neengxaki ezinkulu zexesha elide.
Ukongeza, iingxaki ezinkulu ezifana nezi zinokuvela kwiintsuku ezimbalwa emva kweempawu zokuqala:
- I-Ischemic stroke: Ukuvaleka komthambo wegazi ohambisa igazi engqondweni.
- Ukopha kwegazi ngaphakathi kwemithambo yegazi (i-SAH okanye olunye uhlobo lokopha igazi engqondweni): Ukopha igazi phakathi kwengqondo kunye nentloko.
- Ukuxhuzula.
Oogqirha bayifumana njani le nto?
Ugqirha usebenzisa iindlela ezahlukeneyo zokuxilonga le meko.
- Uvavanyo lomzimba nolwemithambo-luvo: Ubuchule bakho bokusebenza, amandla, kunye neemvakalelo ziyajongwa.
- Uvavanyo lwegazi: Jonga iingxaki zokujiya kwegazi, usulelo, kunye nokungalingani kwamanqanaba etyuwa.
- Iiskeni zemifanekiso: Le yeyona ndlela ibalulekileyo yokuxilonga ii-RCVS.
Izikrini zomfanekiso
Olu hlobo lweziskeni lunokubona "ingaphakathi" lentloko nengqondo. Lunokujonga ukuba imithambo yegazi ivaliwe okanye ukuhamba kwegazi okunciphileyo.
- Iiskeni zeComputed Tomography (CT): Ngokukodwa, ii-CT angiograms zinokunceda ekuhloleni ngcono imeko yemithambo yegazi.
- Iiskeni zeMagnetic Resonance Imaging (MRI): Iskeni ekhethekileyo ye-MRI ebizwa ngokuba yiMagnetic Resonance Angiogram (MRA) ikwanokubona i-vasospasm kwimithambo yegazi.
- I-Transcranial Doppler ultrasound: Oku kunokulinganisa isantya sokuhamba kwegazi engqondweni.
Ngokwesiqhelo, kwenziwa i-CT scan kuqala. Kuba ikhawuleza. Ingafumanisa ngokukhawuleza ukuba kukho imeko engxamisekileyo efana nestroke okanye ukopha. Kwistroke, umzuzwana ngamnye uyabalwa, ngoko ke isantya sibaluleke kakhulu. Emva koko, ukuba kuyimfuneko, kwenziwa i-MRI scan ukuqinisekisa ngakumbi ukuvaleka kwemithambo yegazi.
Ziziphi iindlela zonyango ze-RCVS?
Njengoko igama lisitsho, i-RCVS yimeko enyangeka kakhulu . Unyango luneenjongo ezimbini eziphambili.
1. Ukuba unobangela ungafunyanwa (umz. amayeza athile), susa loo nobangela.
2. Ukunciphisa ukuxinana kwegazi (ukuqina) kwemithambo yegazi nokuyibuyisela kwimeko yesiqhelo.
Uhlobo oluqhelekileyo lwamayeza asetyenziswa ukunyanga le meko (i-vasospasm) zii -calcium channel blockers (ii-CCB) . La mayeza asebenza ngokuthintela i-calcium ukuba ingangeni kwiiseli zemisipha kwimithambo yegazi. Emva koko izihlunu ziyakhululeka, imithambo yegazi iyanda kwakhona, kwaye ukuhamba kwegazi kubuyele esiqhelweni.
Kunqabile kakhulu, kwezinye iimeko, unyango lunokwenziwa kusetyenziswa inkqubo ebizwa ngokuba yi-"endovascular". Oku kuquka ukudlulisa ityhubhu encinci kakhulu (i-catheter) ngemithambo yegazi engalweni okanye emlenzeni ukuya kwimithambo yegazi evalekileyo engqondweni, uze emva koko ufake amayeza okanye usebenzise into efana nebhaluni ukwandisa imithambo yegazi (i-angioplasty).
Singalithemba njani eli thuba?
Uninzi lwabantu abane-RCVS (malunga ne-80% - 85%) bayaphila ngokupheleleyo ngaphandle kweengxaki zexesha elide. Ngoko ke kukho ithemba elihle koku. Kodwa eyona nto ibalulekileyo koku kukufumanisa isifo kwangethuba kwaye uqale unyango olufanelekileyo.
Khumbula, ukuxilongwa kwangoko kunye nonyango yeyona ndlela ilungileyo yokufumana iziphumo ezilungileyo. Ukulibaziseka kunokukhokelela kwiingxaki eziyingozi.
Izinto onokuzenza ukuthintela ii-RCVS ukuba zingaphindi zenzeke
Ngenxa yokuba akucaci ngokupheleleyo ukuba kutheni i-RCVS ikhula, ayinakuthintelwa rhoqo. Nangona kunjalo, kukho izinto onokuzenza ukunciphisa umngcipheko wakho. Ugqirha wakho uza kukunika iingcebiso ezingakumbi malunga noku.
- Ukuba kukho amayeza ekucingelwa ukuba abangele ii-RCVS, yeka ukuwasebenzisa kwaye uwaphephe kwixesha elizayo.
- Ukusela amayeza achazwe ngugqirha njengoko eyalelwe nangokuchanekileyo.
- Musa ukusebenzisa amayeza okanye iziyobisi (ingakumbi izinto ezivuselelayo kunye nentsangu) ngaphandle kwengcebiso kagqirha.
- Nciphisa okanye uyeke ngokupheleleyo ukusela i-caffeine kunye neziselo ezinika amandla.
Ufanele uye nini kugqirha uze uye kwi-ETU?
Ukuba une-RCVS, ugqirha wakho uza kukuxelela ukuba uqhubeke usiza ekliniki. Kubaluleke kakhulu ukuya kwezi ntlanganiso rhoqo. Ngale ndlela, imeko yakho inokuhlolwa kwaye unyango lwakho lunokulungiswa njengoko kufuneka.
Ixesha lokuya kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ngoko nangoko:
Ukuba uneentloko ezibuhlungu okanye iimpawu ezifana nestroke (umz., ubuthathaka kwelinye icala lomzimba, ubunzima bokuthetha, utshintsho lokubona) kwakhona, kusoloko kuyingxamiseko yezonyango. Musa ukulinda de kube sebusuku kakhulu. Yiya esibhedlele ngokukhawuleza.
Umyalezo Wokuya Ekhaya
- Intloko ebuhlungu nengxamisekileyo ("Thunderclap Headache") yimeko engxamisekileyo yezonyango. Yiya kwiSebe lezeMpilo eziNgxamisekileyo lesibhedlele esikufutshane (ETU) ngokukhawuleza.
- I-RCVS yimeko ebangelwa kukuvaleka ngequbuliso kwemithambo yegazi engqondweni. Kodwa njengoko igama lisitsho, yimeko eguqukayo ngokupheleleyo xa inyangwa ngokufanelekileyo.
- Umngcipheko wale meko uphezulu ngexesha lokukhulelwa kwaye ingakumbi kwiiveki ezintandathu zokuqala emva kokubeleka.
- Uninzi lwabantu luyachacha ngokupheleleyo ngaphandle kweengxaki zexesha elide, kodwa ukuxilongwa kwangoko kunye nonyango kubalulekile.
- Landela imiyalelo kagqirha wakho. Sela amayeza owanikiweyo kwaye uphephe iziyobisi ezinobungozi kunye notywala.
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