Ingabe uvame ukuthola ubuhlungu obungavamile obuqala ngemuva kwekhanda lakho buhambe entanyeni yakho? Ingabe lobu buhlungu buyanda ikakhulukazi uma ukhwehlela, uthimula, noma uphakamisa into esindayo? Ingabe ngezinye izikhathi uzizwa unesizungu , ulahlekelwa ibhalansi yakho lapho uhamba, noma uzwa ukungabi namandla ezandleni zakho? Ngisho noma ucabanga ukuthi lezi yizinhlungu zekhanda ezivamile, ngezinye izikhathi kungase kube nesinye isizathu esifihliwe ngemuva kwazo. Leso ngesinye sezimo ezingavamile kodwa ezibalulekile okufanele uziqaphele.
Kalula nje, kuyini i-Chiari Malformation?
Leli igama eliyinkimbinkimbi kancane, kodwa masiligcine lilula. Ubuchopho bethu buvikelwe ngaphakathi kwekhanda lethu. Ngaphansi kwaleli khanda, lapho intamo ihlangana khona nekhanda, kukhona imbobo lapho intambo yomgogodla ingena khona. Lokhu kubizwa ngokuthi "i-foramen magnum" ngokwezokwelapha.
Esimweni esibizwa ngokuthi i-Chiari malformation, ingxenye engezansi yobuchopho bethu, ikakhulukazi ingxenye ebizwa ngokuthi i-cerebellum , icindezelwa noma icindezelwe phansi nge-foramen magnum, iye esikhaleni lapho kukhona khona umgogodla. Cabanga ngakho njengokuzama ukufaka into enkulu kunalokho engangena endaweni encane.
I-cerebellum yethu yiyo elawula ukunyakaza kwethu, ibhalansi lapho sihamba, ukulawula ukuma, kanye nokunaka kwethu ngezinga elithile. Ngakho-ke uma le ngxenye ithintekile, kungavela izinkinga ezihlobene.
Lokhu kucindezela kuphazamisa ukugeleza koketshezi lomgogodla (CSF), olujikeleza ubuchopho kanye nomgogodla. Lokhu kufana nepayipi lamanzi elivalekile. Lokhu kubeka ingcindezi ezingxenyeni zobuchopho kanye nomgogodla, okubangela izimpawu ezahlukahlukene.
Kungani lokhu kwenzeka? Yiziphi izizathu?
Ngokuvamile, ukukhubazeka kwe-Chiari kuyisimo sokuzalwa . Lokhu kusho ukuthi lesi simo senzeka ngenxa yephutha ekukhuleni kobuchopho kanye nogebhezi ngenkathi umntwana ekhula esibelethweni. Lokhu kungenxa yokuthi abanye abantu banesikhala esincane kunesivamile ogebhezini esibizwa ngokuthi i-posterior fossa, okuyilapho ubuchopho bukhona khona. Kodwa abacwaningi abakaqiniseki ukuthi kungani lokhu kwenzeka.
Ngezinye izikhathi lokhu kungaba ngenxa yembangela yofuzo .
Akuvamile ukuthi lesi simo sivele ngemva kokuzalwa, okungukuthi, lapho umuntu esemdala . Singabangelwa yilokhu:
- Isimila sobuchopho.
- Ukulimala ekhanda kungabangela isikhwama esigcwele uketshezi (i-cyst) noma i-blood clot (i-hematoma) ebuchosheni.
- Isimo esibizwa ngokuthi "i-hydrocephalus", okuwukuqongelela kwamanzi ebuchosheni.
- Ezinye izimo ezihlobene nomgogodla njenge-tethered cord syndrome.
Ingabe kunezinhlobo ezahlukene zalesi simo?
Yebo, lesi simo sihlukaniswe ngezinhlobo eziningana eziyinhloko kuye ngokuthi sibucayi kangakanani nokuthi izingxenye zobuchopho zithinteka kangakanani.
| Uhlobo | Incazelo elula |
|---|---|
| Uhlobo I | Lolu uhlobo oluvame kakhulu nolungabi kakhulu . Ingxenye engezansi ye-cerebellum kuphela ephonswa emgudwini womgogodla. Abanye abantu bangaphila ngaphandle kwezimpawu. Kuvame ukutholakala ngengozi ngesikhathi sokuhlolwa kwe-MRI ngesinye isizathu. |
| Uhlobo II | Lokhu kubizwa nangokuthi `(ukukhubazeka kuka-Arnold-Chiari).` Lapha, kokubili i-cerebellum kanye nesiqu sobuchopho kucindezelwa phansi. Lokhu kuvame ukubonakala kanye nokukhubazeka kokuzalwa `(i-spina bifida).` |
| Uhlobo III | Lolu uhlobo olungavamile kakhulu futhi olubucayi . Izingxenye zobuchopho ziphuma ekhanda ziye ngemuva kwentamo. Lokhu kungaba yingozi empilweni. |
| Uhlobo IV | Lokhu futhi akuvamile kakhulu. Kulokhu, i-cerebellum ayikhuli ngokugcwele. Noma, izingxenye azikho. |
Yiziphi izimpawu ezivame kakhulu zohlobo lokuqala?
Akuwona wonke umuntu onesifo sohlobo lokuqala ozobhekana nezimpawu. Kodwa-ke, uma kuvela izimpawu, ezinye zazo zifaka:
- Ikhanda elibuhlungu le-occipital kanye nobuhlungu bentamo:Lolu uphawu oluyinhloko noluvame kakhulu. Ubuhlungu buyanda uma ukhwehlela, uthimula, noma uphakamisa izinto ezisindayo.
- Izinkinga Zokuzila Nokulinganisela : Ukuzizwa unesizungu, njengokungathi uzoquleka uma uhamba.
- Ubuthakathaka bemisipha.
- Ukuba ndikindiki noma eminye imizwa engavamile ezandleni nasezinyaweni .
- Izinkinga zokubona: ukubona okufiphele, ukubona okukabili.
- Ubunzima bokugwinya.
- Ukukhala ezindlebeni (i-tinnitus) kanye nokukhubazeka kokuzwa.
- Izinkinga zokulala: Ukungalali, noma ukuyeka ukuphefumula isikhathi esifushane ngenkathi ulele (i-sleep apnea).
- Isicanucanu nokuhlanza.
Into ebalulekile ukuthi lezi zimpawu zingahluka kakhulu kumuntu nomuntu. Futhi azifani ngaso sonke isikhathi. Ngezinye izinsuku zingaba zimbi kakhulu, ngezinye izinsuku zingaba ngcono.
Ukuthola kanjani lokhu, Dokotela?
Uma usuzichazile izimpawu zakho, udokotela wakho uzokuhlola ngokucophelela kuqala, ikakhulukazi ukuhlolwa kwezinzwa . Lokhu kuzohlola ibhalansi yakho, amandla emisipha, ukusabela komzimba, kanye nomuzwa.
Uma kukhona ukungabaza ngalesi simo, bazokudlulisela ezivivinyweni eziningana ukuze bakuqinisekise.
- Iskeni se-MRI (Magnetic Resonance Imaging): Lesi isivivinyo esingcono kakhulu nesibaluleke kakhulu sokuxilonga ukukhubazeka kwe-Chiari. I-MRI ingabona kahle isakhiwo sobuchopho kanye nomgogodla. Ingabona kahle ukuthi ubuchopho bucindezelwe kangakanani nokuthi ngabe ukugeleza koketshezi lwe-'CSF' kuvimbekile yini.
- I-Cine MRI: Lolu uhlobo olukhethekile lwe-MRI. Kufana nevidiyo. Ungabona i-CSF ijikeleza ubuchopho ngesikhathi sangempela, okungukuthi, bukhoma.
- I-CT (Computed Tomography) Scan: Lokhu kungahlola noma yikuphi ukukhubazeka emathanjeni ekhanda.
Yiziphi izindlela zokwelapha?
Ukwelashwa kuncike ohlotsheni onalo, ubukhulu bezimpawu zakho, nokuthi zithinta kanjani impilo yakho yansuku zonke.
1. Azikho Izimpawu: Uma une-Type I futhi ungenazo izimpawu, noma uma zingakukhathazi, cishe awudingi ukwelashwa . Udokotela wakho uzokutshela ukuthi uze uzohlolwa njalo ukuze aqaphe isimo sakho.
2. Imithi:Uma unezimpawu ezifana nekhanda elibuhlungu kanye nobuhlungu bentamo, udokotela wakho angase akunike imithi yokunciphisa ubuhlungu (ama-NSAID) kanye nemithi yokukhulula imisipha ukuze uzilawule.
3. Ukuhlinzwa: Uma unezimpawu ezinzima ezingenakulawuleka ngemithi, noma uma ama-scan ebonisa umonakalo ebuchosheni noma emgogodleni, udokotela wakho angase akuncome ukuhlinzwa.
Imigomo emibili eyinhloko yokuhlinzwa yile:
- Ukunciphisa ingcindezi ebuchosheni nasemgogodleni.
- Ukubuyisela ukugeleza koketshezi lwe-CSF.
Ukuhlinzwa okuvamile kakhulu yi- Posterior Fossa Decompression Surgery . Kulokhu, udokotela ohlinzayo ususa ingxenye encane yethambo esisekelweni sekhanda, lapho ihlangana khona nentamo. Lokhu kudala isikhala esengeziwe sobuchopho kanye nentambo yomgogodla. I-membrane ezungeze ubuchopho (i-dura) nayo iyavulwa bese kuthungwa indawo yayo. Lokhu kuvumela uketshezi lwe-cerebrospinal (CSF) ukuthi lugeleze ngokukhululeka.
Uma une-hydrocephalus (ukwakheka kwamanzi ebuchosheni), kungadingeka ukuthi ubeke i -shunt ukuze kususwe uketshezi oluthe xaxa.
Umlayezo Wokuya Nawe Ekhaya
- I-Chiari Malformation iyiphutha lesakhiwo elenzeka lapho ingxenye engezansi yobuchopho icindezelwa emgudwini womgogodla.
- Kuhlobo I, uhlobo oluvame kakhulu, abantu abaningi abanazo izimpawu. Ngisho noma izimpawu zikhona, uphawu oluyinhloko ikhanda elibuhlungu ngemuva kwekhanda nentamo.
- Ukuhlolwa okuyinhloko okusetshenziselwa ukuxilonga lesi simo yi -MRI scan .
- Uma kungekho zimpawu, akukho ukwelashwa okudingekayo. Uma kunezimpawu, zelashwa ngemithi noma ngokuhlinzwa.
- Uma unokungabaza noma izimpawu, into engcono kakhulu ongayenza ukubona udokotela wakho ukuze akunike iseluleko . Kubaluleke kakhulu ukwenza ngokweseluleko sezokwelapha kunokufuna ulwazi kwi-inthanethi.
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