Ingabe ingxenye yobuchopho bakho iphuma iye phansi ekhanda lakho? Ake sifunde nge-Chiari Malformation!

Ingabe ngezinye izikhathi uphathwa yikhanda nentamo ebuhlungu? Noma uzizwa sengathi ulahlekelwa yibhalansi yakho noma uhambahamba uzizwa sengathi uzokhubeka? Mhlawumbe lezi zinto aziveli nje ngokungahleliwe. Namuhla sizokhuluma ngesimo esiyinkimbinkimbi kancane, kodwa abantu abaningi abazi ngaso. Leso yi-Chiari Malformation. Ungakhathazeki, ake sixoxe ngakho kalula.

Kuyini i-Chiari Malformation?

Kalula nje, i-Chiari malformation yisimo lapho izicubu zobuchopho ezingemuva kwekhanda lakho, phansi, zisunduza phansi futhi zikhule eduze kwentambo yakho yomgogodla. Cabanga ngekhanda lakho njengendlu. Ngezinye izikhathi asikho isikhala esanele sokuba ubuchopho bakho bungene ngaphakathi kwaleyo ndlu. Uma lokho kwenzeka, ingxenye yobuchopho bakho, ikakhulukazi i-cerebellum yakho, isunduza ngembobo yemvelo phansi kwekhanda lakho - sikubiza ngokuthi i-foramen magnum - bese isunduza phansi naphansi iye entanjeni yakho yomgogodla.

I-cerebellum yakho iyingxenye ebaluleke kakhulu yobuchopho bakho. Ilawula izinto eziningi, okuhlanganisa ukunyakaza kwemisipha yakho, ukuma, ibhalansi, inkulumo, kanye nokuxhumana . Ngakho-ke, lapho lesi sifo sithinta i-cerebellum, izimpawu ezihlobene nayo ziqala ukuvela. Isibonelo, izinto ezifana nokulahlekelwa ibhalansi.

Uma ingxenye yobuchopho icindezelwa phansi kanje, icindezela phansi kwekhanda. Lokhu kuvimbela ukugeleza koketshezi lomgogodla (CSF). Lolu ketshezi luvikela ubuchopho bakho kanye nomgogodla, luhambisa izakhamzimba namakhemikhali, futhi lususe imfucuza. Ngakho-ke lapho ukugeleza kwalolu ketshezi kuphazamiseka, kungavela izinkinga ezahlukahlukene.

Yiziphi izinhlobo ze-Chiari Malformation?

Kunezinhlobo eziningana eziyinhloko zalesi simo. Ake sibone ukuthi ziyini:

• Uhlobo lwe-Chiari malformation 0: Lokhu akuvamile kakhulu. Kulolu hlobo, izingxenye ze-cerebellum yakho ziphuma kancane kakhulu noma aziphumi nhlobo emngxunyeni ongaphansi kwekhanda lakho (i-foramen magnum). Kodwa-ke, kunezinga elithile lokuminyana. Izimpawu zibangelwa ukugeleza okungavamile koketshezi lwe-cerebrospinal (CSF) eduze kwesisekelo sekhanda lakho.

• Uhlobo lwe-Chiari malformation I: Lolu uhlobo oluvame kakhulu. Yilapho ingxenye engezansi ye-cerebellum ingena khona embotsheni esezansi kwekhanda (i-foramen magnum). Umgogodla wakho uvame ukudlula kulo mbobo. Abanye abantu abanohlobo lwe-I bangase bangabi nazimpawu. Izimpawu zingase zivele ebudaleni noma kamuva ekuphileni.

• Uhlobo lwe-Chiari malformation II:Lokhu kwenzeka ngesikhathi sokukhulelwa, lapho umntwana ekhula esibelethweni. Lapha, i-cerebellum kanye nesiqu sobuchopho zikhula ngendlela engavamile, okubangela ingcindezi ngaphakathi kwekhanda. Lolu hlobo luvame ukwenzeka kanye ne -myelomeningocele, uhlobo olubi lwe-spina bifida. I-Myelomeningocele yisimo lapho umgogodla kanye nomsele womgogodla kungavaleki kahle ngaphambi kokuba umntwana azalwe. Umgogodla uvalwa ngokuhlinzwa ngemva kokuzalwa, kodwa izimo ezifana nokukhubazeka zingavela.

• Uhlobo lwe-Chiari malformation III: Lolu futhi luyivelakancane kakhulu, futhi uhlobo olubi kakhulu lwe-Chiari malformation. Kulesi simo, izingxenye ze-cerebellum kanye nesiqu sobuchopho ziphuma ngesikhala esingavamile ngemuva kwekhanda (hhayi i-foramen magnum). Ngaphezu kwalokho, ezinye ze-membrane ezizungeze ubuchopho noma umgogodla nazo ziphuma ngaleli sikhala. Lokhu kubangela ukuvuvukala ngemuva kwekhanda, okubizwa ngokuthi i-encephalocele . Uhlobo lwesithathu lubangela izimpawu ezinzima, ezisongela ukuphila ezivela ebuntwaneni. Lezi zingane zingase zibe nezinkinga zezinzwa, ukubambezeleka kokufunda, kanye nokuxhuzula . Lokhu kuvame ukudinga ukuhlinzwa.

• Uhlobo lwesine lwe-Chiari malformation: Lokhu nakho akuvamile kakhulu. Yilapho i-cerebellum ngokwayo ingakakhuli ngokugcwele, noma izingxenye zayo zingekho. Lolu hlobo nalo lubi kakhulu, ngokuvamile luba yingozi empilweni ebuntwaneni.

Sivame kangakanani lesi simo?

Ucwaningo lubonisa ukuthi cishe umuntu oyedwa kwabayi-1,000 e-United States kuphela angase abe ne-Chiari Malformation. Kodwa-ke, lesi simo singase sivame kakhulu ngoba abanye abantu abanazo izimpawu noma izimpawu zivela ebuntwaneni noma ebudaleni.

Kuzwakala kanjani ukuba ne-Chiari Malformation?

Uma une-Chiari Malformation, ungase ube nezimpawu ezifana nalezi:

• Ikhanda libonakala ngobuhlungu obuhlabayo, ikakhulukazi ngemuva kwekhanda, entanyeni, noma emahlombe. Lobuhlungu bungaba bubi nakakhulu uma ukhwehlela noma uthimula .
• Izinkinga ngokulinganisela kanye nokuxhumana. Ungase uzizwe uqhaqhazela lapho uhamba, sengathi awunawo amandla okulawula.
• Isiyezi kanye ne-vertigo (ukuzizwa sengathi indawo okuzungezile iyajikeleza).
• Ubuthakathaka bemisipha.
• Ukuba ndikindiki ezandleni noma ezinyaweni, noma umuzwa wokushisa eminweni, ezinyaweni, noma ezindebeni.
• Ukuzizwa sengathi inhliziyo yakho iyagxumagxuma (ukushaya kwenhliziyo).
• Ukungalali kanye nokukhathala okungapheli.

Yiziphi ezinye izimpawu ze-Chiari Malformation?

Nazi ezinye izimpawu ezivamile:

• Ukushintsha kombono: Ukubona kabili, ukubona okufiphele, ukunyakaza kwamehlo okungavamile, kanye nokuzwela ukukhanya.
• Izinkinga zokuzwa: Ukukhala ezindlebeni (i-tinnitus) noma ukulahlekelwa ukuzwa.
• Ubunzima bokugwinya: ukuvuza amathe, ukuhlanza, ukuzwa sengathi umphimbo wakho uvalekile, okwenza kube nzima ukudla, ukuphuza, nokukhuluma.
• I-Scoliosis.
• Ukungakwazi ukulawula umchamo noma indle.
• Ukuquleka.
• Ubunzima bokuphefumula ngesikhathi sokulala (i-sleep apnea).

Okubalulekile: Lezi zimpawu zingahluka kuye ngomuntu nomuntu. Abanye abantu abanazo izimpawu, abanye banezimpawu ezincane, kanti abanye banezimpawu ezinzima kakhulu. Abanye abantu bangase babe nezimpawu kusukela ekuzalweni. Abanye bangase babe nezimpawu kamuva, lapho sebekhulile noma sebekhulile. Izimpawu zingase zinciphe futhi zinciphe ngokuhamba kwesikhathi.

Yiziphi izimbangela ze-Chiari Malformation?

Lesi simo senzeka lapho ingxenye engezansi yobuchopho bakho icindezelwa emgodini womgogodla noma i-foramen magnum (lapho ubuchopho nomgogodla kuhlangana khona). Imbangela eyinhloko yalokhu ukungajwayelekile ekuthuthukisweni kwesakhiwo sobuchopho bakho nomgogodla. Lokhu kusho ukuthi ubukhulu bekhanda endaweni lapho i-cerebellum ikhona buncane kunokulindelekile. Lokhu kubeka ingcindezi kuleyo ngxenye yobuchopho, okubangela ukuba i-cerebellum ikhule iye phansi endaweni engalindelekile. Lokhu kuvame ukwenzeka ngesikhathi sokuthuthukiswa komntwana osanda kuzalwa.

Ukukhubazeka kwe-Chiari kuvame ukuzalwa nakho. Kodwa-ke, izimpawu zingavela kamuva ekuphileni. Lokhu kungabangelwa ukuguquka kwezakhi zofuzo okuvame ukutholwa emndenini wakho, noma kungaba yinto eyenzeka ngokungahleliwe ngemva kokukhulelwa.

Kodwa-ke, akuvamile kakhulu, umuntu ongazalwanga nalesi simo angaba nokukhubazeka kwe-Chiari kamuva ekuphileni. Ezimweni ezinjalo, ukuma kogebhezi noma komgogodla kungashintsha ngenxa yezizathu ezilandelayo:

• Isimila sobuchopho.
• I-cyst.
• I-Hematoma (igazi eliqhekekile).
• I-Hydrocephalus.
• Umfutho wegazi ophakeme ngaphakathi kwekhanda noma i-pseudotumor cerebri.

Ngezinye izikhathi, ukukhubazeka kwe-Chiari kungenzeka kanye nezinye izimo zempilo eziyisisekelo, njenge:

• I-Goldenhar syndrome.
• I-Achondroplasia.
• Izimo zezicubu ezixhumene njenge-Ehlers-Danlos syndrome.
• I-spina bifida.

Yiziphi izici eziyingozi ze-Chiari Malformation?

Lesi simo singathinta noma ubani, kodwa uma othile emndenini wakho enaso, kungenzeka kakhulu ukuthi ube nesifo se-Chiari malformation.

Yiziphi izinkinga ze-Chiari Malformation?

Ukukhubazeka kwe-Chiari kungabangela izinkinga ezinkulu zempilo kanye nokubambezeleka kokukhula. Ezinye zezinkinga zifaka:

• I-Hydrocephalus: Lesi yisimo esisongela impilo. Lokhu kwenzeka lapho uketshezi lomgogodla (CSF) luqongelela ngaphakathi kobuchopho bakho. Lokhu kwenzeka lapho i-CSF ingakwazi ukuphuma kahle. Lapho i-CSF iqongelela, ingcindezi ngaphakathi kogebhezi iyanda. Lokhu kungabangela izinkinga zokusebenza kwengqondo kanye nesimo sekhanda esiphambene . Uma ingelashwa, ingaba yingozi empilweni. Lesi simo sivame ukubonakala ku-Chiari malformation type II.

• I-Syringomyelia kanye ne-Hydromyelia: Uma uketshezi lwe-cerebrospinal (CSF) phakathi kobuchopho bakho nomgogodla lungagelezi kahle, lunganqwabelana ngaphakathi komgogodla. Lokhu kuqoqana koketshezi kungalimaza umgogodla futhi kubangele izimpawu ezifana nezinkinga zokunyakaza nokulinganisela, ubuhlungu, ubuthakathaka bemisipha, ukuqaqamba kwemisipha, ukungazweli, ukwehla kokuzwela ukushisa nokubanda, kanye nokulahlekelwa ukulawula isinyi kanye namathumbu .

• I-Tethered cord syndrome: Izingane ezizalwa zine-myelomeningocele (uhlobo olubi lwe-spina bifida) zisengozini enkulu yokuthola i-tethered cord syndrome njengoba zikhula. Lokhu kwenzeka lapho umgogodla wazo unamathela emgogodleni ngenxa yezibazi ngemva kokuhlinzwa komgogodla. Lesi simo singabangela ukulimala kwemizwa kancane kancane okuthinta imisipha yomzimba ongezansi kanye nemilenze. Kungathinta nokusebenza kwamathumbu kanye nomchamo.

Ngaphezu kwalokho, izimpawu zokukhubazeka kwe-Chiari zingathinta imizwa yakho, ikakhulukazi uma unesifo sokungalali noma ikhanda elibuhlungu kakhulu. Abanye abantu bangase babe nezimo ezifana nokucindezeleka . Uma lesi simo sithinta imizwa yakho, khuluma nodokotela wakho noma umeluleki wezempilo yengqondo .

Itholakala kanjani i-Chiari Malformation?

Udokotela uzoxilonga lesi simo ngemva kokuhlolwa okuphelele ngokomzimba. Udokotela wakho uzohlola ukunyakaza kwakho, ibhalansi, kanye nomuzwa ezingalweni nasemilenzeni yakho . Ngaphezu kwalokho, bazobheka izimpawu zezinkinga zokukhumbula, izinselele zokufunda, kanye nokubambezeleka kokukhula ezinganeni.

Ukuqinisekisa ukuxilongwa, udokotela uzoyala ukuhlolwa kwezithombe ukuze kuthathwe izithombe ezinemininingwane yobuchopho bakho kanye nomgogodla. Lokhu kungafaka:

• Iskena se-MRI (Magnetic Resonance Imaging): Lokhu kungabona ngokucacile izicubu namathambo athambile. Kusiza udokotela ukubona ubuchopho bakho, intambo yomgogodla, kanye noketshezi lwe-cerebrospinal (CSF). Kungabona nokuthi i-cerebellum ifinyelele kude kangakanani emgudwini womgogodla.
• I-Cine MRI: Lokhu kufana ne-MRI evamile, kodwa kuvumela udokotela ukubona iphethini yokugeleza koketshezi lwe-cerebrospinal (CSF) eduze kwesisekelo sekhanda.
• I-CT (Computed Tomography) Scan: I-CT scan isiza ekuboneni izinkinga ngamathambo esisekelo sogebhezi kanye nomgogodla.
• I-X-ray: Kuthathwa i-X-ray ukuze kuhlolwe ukukhubazeka emathanjeni ekhanda nasentanyeni.

Ngezinye izikhathi, ukukhubazeka kwe-Chiari kungabonakala nangesikhathi sokuhlolwa kwe-ultrasound ngaphambi kokubeletha , okuyizivivinyo ezisebenzisa amaza omsindo ukudala izithombe zezicubu ezithambile.

Uma ungenazo izimpawu zokukhubazeka kwe-Chiari, ungase utholakale unalesi simo uma wenza ukuhlolwa kwesithombe ngesizathu esingahlobene.

Iphathwa kanjani i-Chiari Malformation?

Udokotela wakho uzokwakha uhlelo lokwelashwa olusekelwe ebunzimeni bezimpawu zakho. Uma ungenazo izimpawu, akukho ukwelashwa okudingekayo. Udokotela wakho uzoqapha impilo yakho ngokuskena njalo kwe-MRI.

Uma unezimpawu ezincane njengekhanda elibuhlungu noma ubuhlungu bentamo, ungazama lezi zinto:

• Ukuthatha imithi yobuhlungu noma imithi yokusiza ukulawula izimpawu.
• Ukubamba iqhaza ekwelashweni kokubhucungwa noma ekwelashweni ngokomzimba.
• Ukunciphisa imisebenzi yomzimba njengokuphakamisa izinsimbi.
• Ukusebenzisa amadivayisi anjengezinsiza zokuzwa noma izibuko zokubona uma unenkinga yokuzwa noma yokubona.

Ukuhlinzwa kwe-Chiari malformation

Ezimweni ezimbi kakhulu zokukhubazeka kwe-Chiari, ukuhlinzwa kungadingeka. Kunezinketho eziningana zokuhlinzwa:

• Ukuhlinzwa kwe-craniectomy: Udokotela ohlinzayo ususa ingxenye encane yethambo ekhanda lakho ukuze anciphise ingcindezi ebuchosheni futhi asize ukugeleza koketshezi lomgogodla (CSF).
• Ukususwa kwe-posterior fossa: Lena inqubo evame kakhulu esetshenziswa ukwelapha i-Chiari malformation. Udokotela ohlinzayo ususa ingxenye yangemuva yogebhezi (ebizwa ngokuthi i-posterior fossa) ukuze anciphise ingcindezi ebuchosheni futhi adale isikhala esengeziwe sobuchopho.
• Ukuhlinzwa kwe-Laminectomy:Kuye ngokuthi i-Chiari malformation inzima kangakanani, udokotela ohlinzayo uzosusa ingxenye encane yamathambo amboze umgogodla wakho ukuze abuyisele ukugeleza koketshezi lwe-cerebrospinal (CSF) futhi adale isikhala esengeziwe sentambo yomgogodla.
• I-Duraplasty: Kulolu hlinzeko lokunciphisa ukucindezeleka, udokotela ohlinzayo uvula i-dura (ulwelwesi lwangaphandle lobuchopho bakho). Ngemuva kwalokho, udokotela ohlinzayo uthunga i-patch ukuze akhulise ulwelwesi, enze isikhala esengeziwe sobuchopho. Le nqubo yandisa indawo futhi inciphise ingcindezi ebuchosheni.
• I-Electrocautery: Ukuze kudalwe isikhala esengeziwe futhi kuvunyelwe uketshezi lomgogodla (CSF) ukuthi lugeleze, odokotela abahlinzayo basebenzisa inani elincane likagesi ukuze banciphise indawo encane yobuchopho bakho ebizwa ngokuthi ama-cerebellar tonsils. Lawa ma-tonsils ayancipha ngaphandle kokulimaza ubuchopho noma imizwa.
• Ukubekwa kwe-shunt: Uma une-hydrocephalus, udokotela wakho ohlinzayo uzofaka i-shunt, noma ithubhu, ekhanda lakho ukuze aqoqe uketshezi olwengeziwe lwe-cerebrospinal (CSF). Lolu ketshezi luzophuma ekhanda lakho nasebuchosheni bese luqoqana kwenye ingxenye yomzimba wakho.

Ingabe ikhona imiphumela emibi yokwelashwa?

Ngaphambi kokuba uqale ukwelashwa, udokotela wakho uzokhuluma nawe ngemiphumela emibi yokwelashwa ukuze ukwazi ukwenza isinqumo esinolwazi mayelana nempilo yakho. Zonke izihlinzeko zinezingozi. Ukuhlinzwa ebuchosheni nasekhanda lakho kunengozi enkulu ngoba ukusikwa nezinqubo kuseduze nobuchopho. Kungase kudingeke futhi ukuthi uhlinzwe kakhulu njengoba ukhula.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Kuye ngohlelo lokwelashwa olukhethwa nguwe nodokotela wakho, ungathola impumuzo ezimpawini ezincane ngokushesha ngemva kokuthatha amaphilisi obuhlungu noma ngemva kokuya ekwelashweni. Ukululama ngemva kokuhlinzwa kungathatha noma yikuphi kusukela emavikini ambalwa kuya ezinyangeni ezimbalwa. Ungase uqaphele ukuthi izimpawu zakho ziyanyamalala noma zinciphe kakhulu ngemva kokuhlinzwa.

Ingabe i-Chiari Malformation iyisimo esibucayi?

Ngezinye izikhathi, ukukhubazeka kwe-Chiari kungaba kubi kakhulu, kodwa hhayi njalo. Ezimweni eziningi, izingane zizalwa zinenkinga ye-Chiari. Kodwa-ke, izimpawu azibonakali ngaso sonke isikhathi, futhi ukuxilongwa kungenziwa sekwephuzile, kungaba sebuntwaneni noma ebudaleni, lapho udokotela eyala ukuhlolwa kwezithombe ngesizathu esingahlobene.

Nakuba kungekho ukwelashwa okuphelele kokukhubazeka kwe-Chiari, ukwelashwa okufana nokuhlinzwa kungasiza ekulawuleni izimpawu zakho, kukugcine uphilile, futhi kuvimbele izinkinga ezisongela ukuphila.

Iyini ikusasa elibikezelwe ngalesi simo?

Umbono wakho uncike ebunzimeni kanye nohlobo lokukhubazeka kweChiari. Kubalulekile ukusebenzisana eduze nodokotela wakho kanye nethimba lokunakekela. Bangaqapha izimpawu zakho futhi banqume uhlelo lokwelashwa olungcono kakhulu kuwe.

Ingakanani iminyaka yokuphila komuntu one-Chiari Malformation?

Uma ungenazo izimpawu noma izimpawu ezincane kuphela ngemva kokuxilongwa ukuthi une-Chiari malformation, cishe uzoba nesikhathi sokuphila esijwayelekile . Izimpawu ezinzima kanye nezinhlobo ezithile ze-Chiari malformation zingaba yingozi. Khuluma nodokotela wakho ngalokho ongakulindela ngemva kokuxilongwa.

Ingabe i-Chiari Malformation ingavinjelwa?

Okwamanje ayikho indlela eyaziwayo yokuvimbela lesi simo.

Uma uhlela ukukhulelwa, khuluma nodokotela wakho ngezindlela zokugcina impilo enhle. Udokotela wakho angancoma ukuthi uphuze amavithamini anjenge-folic acid njalo . Lokhu kunganciphisa ingozi yokuthola umntwana one-spina bifida. Udokotela wakho angaphakamisa nokuhlolwa kwezakhi zofuzo , ukuze uqonde ingozi yakho yokuthola umntwana onesimo sezakhi zofuzo.

Kufanele ngimbone nini udokotela?

Bona udokotela uma uzwa izimpawu zokukhubazeka kwe-Chiari, noma uma izimpawu zakho ziba zimbi kakhulu. Uma unengane enenkinga ye-Chiari futhi iphuthelwa yizigaba zokukhula ezifanele iminyaka, khuluma nodokotela wayo. Ngemva kokuhlinzwa, uma ikhombisa izimpawu zokutheleleka, njengobuhlungu obukhulu, ukuvuvukala, noma isilonda sokuhlinzwa esingapholi , shayela udokotela wakho.

Isimo Esiphuthumayo! Uma wena noma othandekayo wakho eba nesifo sokuwa okokuqala, shayela izinsizakalo eziphuthumayo zendawo noma ku-1990 ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

• Uhlobo luni lwe-Chiari malformation enginayo?
• Hlobo luni lokwelashwa olunconywayo?
• Kukangaki udinga ukwenza i-MRI scan ukuze uqaphe lesi simo?
• Ingabe uncoma ukuhlinzwa?
• Ingabe ikhona imiphumela emibi yokwelashwa?
• Ingabe lokhu kuzokwenzeka ezinganeni zami zesikhathi esizayo?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ukukhubazeka kwe-Chiari kuthinta wonke umuntu ngendlela ehlukile. Ungase ungabi nazimpawu nhlobo, noma zingase zibe zincane kangangokuthi azithinti kakhulu imisebenzi yakho yansuku zonke. Abanye bangase babe nezimpawu ezinzima, ezivame ukukhubazeka futhi badinge ukuhlinzwa. Izindaba ezinhle ukuthi kunezindlela zokwelapha ezinye izinhlobo zalesi simo ezingasiza ekunciphiseni izimpawu futhi zivimbele izinkinga ezisongela ukuphila.Uma izimpawu zakho zingathuthuki, ziba zimbi kakhulu, noma uba nezinkinga ezifana nokutheleleka ngemva kokuhlinzwa, qiniseka ukuthi ushayela udokotela wakho ucingo. Ungakhathazeki, ngeseluleko sezokwelapha esifanele kanye nokusekelwa, ungaphila ngempumelelo nalesi simo.

Ukukhubazeka kwe - Chiari, Isifo Sobuchopho, I-Cerebellum, Ikhanda Elibuhlungu, I-Neurology, Uketshezi Lomgogodla