Ingabe une-blood clot emthanjeni ebuchosheni bakho? (Cerebral Venous Sinus Thrombosis - CVST) Ake sifunde ngakho.

Wake waba nekhanda elibuhlungu elibonakala liba libi kakhulu nsuku zonke? Noma uke waba nesimo esifana nesithuthwane ngokuzumayo? Lokhu kungaba uphawu lwento ethile engathi sína. Namuhla sizokhuluma ngesimo esisodwa esithile esingabangela lokhu, okuwukuqhekeka kwegazi emthanjeni omkhulu wobuchopho.

Kuyini i-Cerebral Venous Sinus Thrombosis (CVST)?

Kalula nje, i-Cerebral Venous Sinus Thrombosis , noma i-CVST ngamafuphi, i-blood clot eyakheka ngaphakathi komthambo omkhulu wegazi, umthambo, ebuchosheni bakho. Lesi yisimo esingavamile, kodwa sibangela cishe i-1% yazo zonke izinhlungu zomjovo ezaziwayo.

Cabanga nje, lapho kwakheka ihlule legazi emthanjeni omkhulu ebuchosheni bakho, igazi liqala ukugeleza ngendlela engafanele esikhundleni sendlela efanele. Lokhu kubangela ukwanda kwengcindezi ngaphakathi kobuchopho, okubangela ukuvuvukala kobuchopho. Lokhu kufana nepayipi lamanzi elivalekile futhi okubangela ukuba amanzi abuyele emuva.

Amahlule egazi anjengalawa ngokuvamile angakheka ema-sinuses ebuchosheni bakho:

• I-sinus eguquguqukayo
• I-sinus ye-sagittal ephezulu
• I-inferior sagittal sinus
• Ama-sinuses e-Sigmoid
• I-Cavernous sinus
• Ama-sinus ajulile e-cortex yakho

Ubani othinteka kakhulu yilesi simo (i-CVST)?

Lesi simo (i-CVST) sivame kakhulu kwabesifazane . Sivame kakhulu kubantu abaneminyaka ephakathi kuka-40 no-50, kodwa singase senzeke ebancane, ngisho nasezinsaneni .

Kungenzeka kakhulu ukuthi ube ne-CVST uma unezinye zezimo ezilandelayo noma izici eziyingozi:

• I-Nephrotic syndrome - Lesi yisimo esihlobene nezinso.
• Izimo zomdlavuza.
• I-Vasculitis - Lokhu ukuvuvukala kwemithambo yegazi.
• I-Sarcoidosis.
• Ukukhuluphala ngokweqile.
• Ukutheleleka kwe-Covid-19 ('COVID-19').
• I-Thrombophilia - Lesi yisimo esizuzwe njengefa lapho igazi lakho ligoba kalula.
• Isifo sesibindi.

Ivame kangakanani i-CVST?

I-CVST empeleni iyisimo esingavamile kakhulu . Abacwaningi balinganisela ukuthi ithinta abantu ababili (`2`) nabayishumi nanhlanu (`15`) kubantu abayisigidi minyaka yonke. Kulinganiselwa nokuthi cishe izingane eziyisikhombisa (`7`) kweziyisigidi kanye nezinsana ziba ne-CVST minyaka yonke. Ngakho-ke ungabona, akuvamile kangako.

Yimiphi imiphumela i-CVST engaba nayo emzimbeni wami?

Kunezinkinga eziningana ezingase zenzeke ngenxa ye-CVST. Lezi yizi:

• Ukulahlekelwa umbono.
• Ukopha kwegazi ngaphakathi kobuchopho (`ukopha`) - okungukuthi, ukulahlekelwa igazi okuvela emthanjeni wegazi oqhumile.
• Ikhanda elibuhlungu kakhulu.
• Ukuquleka.
• Isimo esifana nesohlangothi.

Ziyini izimpawu ze-CVST?

Izimpawu ze-CVST zingahluka kuye ngokuthi ihlule legazi lingakanani nokuthi litholakala kuphi ebuchosheni .

Izimpawu eziyinhloko ezingabonakala yilezi:

• Ikhanda elibuhlungu elikhula kancane kancane, elinzima (lesi yisibonakaliso esivame kakhulu).
• Ukuquleka.
• Isimo sengqondo esishintshile kanye/noma ukuntuleka okusha kwemizwa, njengasesimeni sokopha okukhulu kobuchopho.

Yiziphi izimbangela ze-CVST?

Kunezici eziningana ezingabangela i-CVST:

• Ukukhulelwa .
• Ukusetshenziswa kwamaphilisi okuvimbela inzalo (izivimbela-nzalo eziphuzwa ngomlomo).
• Ukubhekana nengozi ethile enkulu (ukuhlukumezeka).
• Ukuba nesimo esizuzwe njengefa esibangela ukuba igazi lijiye kalula, isibonelo, i-thrombophilia.
• Ukwenzeka kokutheleleka (isibonelo, ukutheleleka kwe-COVID-19).

Futhi, inani elincane kakhulu labantu libikwe ukuthi linesifo se-CVST ngemuva kokuthola umuthi wokugomela i-COVID-19. Kodwa-ke, kubalulekile ukukhumbula ukuthi lokhu kuyinto engavamile kakhulu .

Odokotela baxilonga kanjani i-CVST?

Udokotela wakho uzosebenzisa izivivinyo zokuhlola ubuchopho ukuze anqume ukuthi une-CVST. Ukuxilongwa ngokushesha kubalulekile ukuze kugwenywe izinkinga.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga i-CVST?

Ukuze axilonge i-CVST, udokotela wakho angenza izivivinyo zesithombe ezifana nalezi:

• Ukuhlolwa kwe-MRI yobuchopho (magnetic resonance imaging) kwenziwe kusetshenziswa idayi yokuhlukanisa.
• Ukuskena kwe-brain CT (`Brain CT - computed tomography`) kwenziwa kusetshenziswa udayi.
• I-Magnetic Resonance Venography (MRV), i-CT Venography (CT venography) noma i-Cerebral Angiography (Cerebral Angiography).

Ngaphezu kwalokho, ukuhlolwa kwegazi, njengephaneli yokubola kwegazi ngokweqile, kungenziwa ukuze kuhlolwe noma yiziphi izinkinga zokubola kwegazi.

Iphathwa kanjani i-CVST?

Kunezindlela eziningana zokwelapha i-CVST, okuhlanganisa:

• Ama-anticoagulant : Isibonelo, i-heparin. Lawa anganikezwa ngisho nangesikhathi sokukhulelwa.
• I-Thrombolytics (izidakamizwa zokuqeda amahlule).
• Uma ihlule legazi lakho libangelwa ukutheleleka, kunikezwa ama-antibiotic .
• Ezimweni ezimbi kakhulu, kwenziwa ukuhlinzwa kokususa ihlule legazi (`Thrombectomy`) .
• I-Acetazolamide noma ezinye izindlela zokwelapha zokunciphisa ingcindezi ngaphakathi kobuchopho bakho (ingcindezi yangaphakathi kobuchopho).
• Uma kuvela ukuxhuzula, kunikezwa imithi yokulwa nesifo sokuxhuzula .

Kuye ngembangela ye-CVST yakho, kungadingeka ukuthi uthathe i-warfarin (isib. i-Coumadin®, i-Jantoven®) noma i-anticoagulant yomlomo eqondile (isib. i-Rivaroxaban, i-Apixaban noma i-Dabigatran) izinyanga ezintathu kuya kweziyi-12. Abantu abanesimo esifana ne-thrombophilia kungadingeka bathathe i-warfarin impilo yabo yonke.

Yiziphi izinkinga noma imiphumela emibi yokwelashwa?

Uma uthatha i-warfarin, kubaluleke kakhulu ukuthatha umthamo oqondile owunikezwe . Yingakho udokotela wakho ezohlola njalo ukujiya kwegazi lakho. Umthamo owunikezwayo kufanele wanele ukuvimba ukwakheka kwamahlule egazi angakulimaza, kodwa hhayi phezulu kangangokuthi ngeke ukwazi ukuyeka ukuphuma kwegazi uma usika ingalo noma umlenze wakho. Ngakho-ke udinga ukuthola ibhalansi efanele.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Uma uthola i-heparin, kungaba nge-IV noma ngomjovo, iqala ukusebenza ngokushesha okukhulu . I-Warfarin ingathatha cishe isonto ukusebenza, ngakho udokotela wakho uzokugcina usebenzisa i-heparin ize isebenze. Ngemva kwalokho, ungayeka ukuthatha i-heparin bese uthatha i-warfarin kuphela.

Noma, uma udokotela wakho ekhetha umuthi oqondile womlomo wokuvimbela ukugabha kwegazi, unganciphisa igazi lakho liye ezingeni olifunayo phakathi namahora ambalwa. Njengoba ihlule legazi liqala ukuncibilika futhi ingcindezi ngaphakathi kobuchopho yehla, kancane kancane uzoqala ukuzizwa ungcono.

Ngingayinciphisa kanjani ingozi yami yokuthola i-CVST?

Uma uke waba ne-CVST ngesikhathi sokukhulelwa, ukuthatha umuthi wokulwa nokuvuvukala kwamangqamuzana ezinzwa ngesikhathi sokukhulelwa okulandelayo kunganciphisa le ngozi.

Izindlela zokuvimbela inzalo eziphuzwayo nazo ziyimbangela ye-CVST. Ngakho-ke, unganciphisa le ngozi ngokungasebenzisi amaphilisi okuvimbela inzalo. Ungasebenzisa indlela yokuvimbela inzalo ene-progestin kuphela esikhundleni salokho.

Ukubhema ngenkathi uthatha amaphilisi okuvimbela inzalo kwandisa ingozi ye-CVST . Ukugwema kokubili lokhu kungasiza ekuvimbeleni i-CVST.

Uma ngine (CVST), yini okufanele ngiyilindele?

Esikhathini esidlule, cishe abantu abangu-50% kuphela ababene-CVST basindile. Kodwa manje isimo sesingcono kakhulu.Izinga lokufa ngenxa yalesi sifo manje seliphansi kakhulu, phakathi kuka-5% no-10%. Lokhu kungenxa yobuchwepheshe obuthuthukisiwe bokuthwebula izithombe kanye nezindlela zokwelapha ezithuthukisiwe.

Kodwa-ke, i-CVST ingaphinde ivele . Yingakho udokotela wakho ezokunikeza imithi yokunciphisa igazi (ama-anticoagulant).

Isimo (se-CVST) sihlala isikhathi esingakanani?

(CVST) ingahlala amahora amaningi kuya emavikini. Isimo sakho cishe sizowela kwesinye salezi zigaba:

• Okubukhali: Kufika emahoreni angu-48.
• I-Subacute: Amahora angaphezu kwangu-48, kodwa kufika ezinsukwini ezingu-30. (Lolu uhlobo oluvame kakhulu.)
• Okungapheli: Okuhlala inyanga noma ngaphezulu.

Iyini inhloso yesimo (i-CVST)?

Umbono wabantu abane-CVST abathola ukuxilongwa nokwelashwa okufanele muhle . Kodwa-ke, i-CVST ingaba yingozi uma ingatholakali futhi yelashwe kusenesikhathi. Yingakho kubalulekile ukufuna iseluleko sezokwelapha ngokushesha nje lapho kuvela izimpawu.

Kufanele ngizinakekele kanjani?

Ngemva kokuba usuthole i-CVST, udokotela wakho uzofuna ukukuvimbela ukuthi ungaphinde uthole ihlule legazi. Lokhu kusho ukuthi kuzodingeka uqhubeke nokuthatha umuthi wokulwa nokuvuvukala kwegazi noma “umshini wokunciphisa igazi” njenge-warfarin.

Nakuba lokhu kukuvikela ekuqhekekeni kwegazi okuyingozi, kwandisa ingozi yokopha ngisho noma kungokulimala okuncane kwansuku zonke. Ngakho-ke, kufanele uqaphele kakhulu uma usebenzisa izinto ezibukhali njengemimese . Kungaba ngcono ukusebenzisa i-razor kagesi esikhundleni se-razor evamile.

Kufanele ngimbone nini udokotela wami?

Kufanele ubonane nodokotela wakho njalo (mhlawumbe njalo ezinyangeni ezimbalwa) ngenkathi uthatha imithi yokunciphisa igazi (ama-anticoagulant). Uma uphuthelwa umthamo we-warfarin, shayela udokotela wakho ngokushesha.

Ezinyangeni ezintathu kuya kweziyisithupha ngemva kokuba une-CVST, kungase kudingeke ukuthi uphinde wenze i-CT scan noma i-MRI enedayi ukuze kuhlolwe isimo se-clot yegazi ebuchosheni bakho.

Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Uma uthatha i-Warfarin futhi unezinye zalezi zimpawu zokopha, shayela u-1990 (insizakalo ye-ambulensi ephuthumayo yaseSri Lanka) ngokushesha, noma uye emnyangweni wezimo eziphuthumayo wesibhedlela esiseduze ngokushesha okukhulu :

• Ukopha okungenakunqandeka .
• Ikhanda elibuhlungu kakhulu .
• Igazi elibomvu elikhanyayo uma ukhwehlela, uhlanza, noma ukhipha indle.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungabuza udokotela imibuzo efana nale:

• Kungani ngibe nalesi simo (i-CVST)?
• Kuzodingeka ngithole ukwelashwa isikhathi esingakanani?
• Iyini ingozi yami yokuthola i-CVST futhi?

Ngenxa yokuthi i-CVST ingaphinde ivele, kubalulekile ukugcina wonke ama-aphoyintimenti okulandelela nodokotela wakho. Bazofuna ukuqinisekisa ukuthi uthatha inani elifanele lemithi ukuvimbela i-CVST ukuthi ingaphinde yenzeke. Uma uthatha imithi yokunciphisa igazi, kufanele futhi ugweme imisebenzi engabangela ukulimala. Ngisho nezinto zansuku zonke njengemimese nesikele zingabangela ukopha. Ngakho-ke kuwumqondo omuhle ukusebenzisa ezinye izindlela eziphephile njengensingo kagesi.

Ngakho-ke, yimuphi umyalezo okufanele siwukhumbule kule ndaba?

Kalula nje, i-CVST yisimo esingavamile kodwa esibucayi lapho kwakheka khona ihlule legazi emthanjeni wegazi ebuchosheni. Uma uhlangabezana nezimpawu ezifana nobuhlungu obukhulu, obuqhubekayo bekhanda kanye nokuquleka, bona udokotela ngokushesha . Ukuxilongwa kusenesikhathi kanye nokwelashwa kungaholela emiphumeleni engcono. Izinto zokunciphisa igazi ziyisisekelo sokwelashwa. Kufanele futhi uqaphele ngokuphuma kwegazi lapho uthatha le mithi. Kubalulekile ukuthatha imithi yakho njengoba nje udokotela wakho ekutshela futhi ulandelele nodokotela wakho. Khumbula, awuwedwa, futhi udokotela wakho ukhona ukuze akhulume nawe futhi akusize.

` Ukushaqeka kwe-sinus yemithambo yobuchopho, i-CVST, ukugoba kwegazi ebuchosheni, ikhanda elibuhlungu, izinto ezinciphisa igazi, isifo sohlangothi, ukuxhuzula