Cishe uke wezwa "ngesifo sohlangothi," isimo esibangela ukukhubazeka, akunjalo? Sonke siyazi ukuthi kuyinto engathi sína kakhulu. Namuhla sizokhuluma ngohlobo lohlangothi oluyingozi ngokulinganayo, kodwa mhlawumbe olungakhulunywa kangako ngalo, okufanele wazi ngalo. Lokho kubizwa ngokuthi i-Pontine Stroke . Lokhu kuyinto ethinta ubuchopho. Ungakhathazeki, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.

Iyini ngempela i-Pontine Stroke?

Kalula nje, i-Pontine Stroke ukuphazamiseka kokugeleza kwegazi engxenyeni ebaluleke kakhulu yobuchopho bethu ebizwa ngokuthi "ama-Pons" . Cabanga nje ngakho, kunemithambo ethwala igazi kuzo zonke izingxenye zomzimba wethu, futhi kunjalo nangobuchopho. Ngakho-ke, uma umthambo othwala igazi kuma-pons uvaleka, amangqamuzana lapho awatholi umoya-mpilo nezakhamzimba. Yilapho-ke lesi simo senzeka khona. Lolu uhlobo lwe -ischemic stroke , okuyi-stroke lapho umthambo wegazi uvaleka khona yinto efana ne-blood clot. Lokhu kuvinjelwa kungenzeka ngokuzumayo, noma kungakhula kancane kancane ngokuhamba kwesikhathi.

Manje ungase uzibuze ukuthi iyini le "Pons". Iyingxenye enkulu kakhulu ye -brainstem yethu. I-brainstem ifana negumbi lokulawula lomzimba wethu. I-Pons nayo inemisebenzi ebaluleke kakhulu. I-Pons isiza ekulawuleni ukuphefumula, ukusebenza kwemisipha yobuso, ukunyakaza kwamehlo, kanye nokulinganisela.

Isifo sohlangothi i-Pontine siyisimo esiphuthumayo sezokwelapha esisongela ukuphila, ngakho-ke ukwelashwa okusheshayo kubalulekile.

Lokhu kubizwa ngokuthi okunye, kungenzeka ukuthi uke wezwa ngakho:

• Isifo sohlangothi noma i-brainstem infarction
• Isifo sohlangothi noma i-infarction

Ivame kangakanani i-Pontine Stroke?

Isifo sohlangothi siyisifo esivame kakhulu, kodwa uma siqhathaniswa nezinye izinhlobo zesifo sohlangothi, i-Pontine Stroke ayivamile kangako.

Isifo sohlangothi lwe-Pontine sibanga cishe u-7% wazo zonke izifo zohlangothi lwe-ischemic emhlabeni. Isibonelo, e-United States kuphela, abantu abangaba ngu-48,000 bahlushwa yilesi simo minyaka yonke. Ngakho-ke, lelo inani elibalulekile, akunjalo?

Ziyini izimpawu ze-Pontine Stroke?

Lena yingxenye ebalulekile. Izimpawu ze- Pontine Stroke zingahluka kancane kwezinye izimpawu ze-stroke esivame ukuzwa ngazo. Ngakho-ke kufanelekile ukuqaphela lokhu.

I-Pontine Stroke ingabangela eyodwa noma ngaphezulu kwalezi zimpawu ezilandelayo:

• Ubuthakathaka bemisipha ohlangothini olulodwa lomzimba (hemiparesis). Kuzwakala sengathi isitho siyaphela amandla.
• Ubuthakathaka noma ukugoba kohlangothi olulodwa noma zombili zobuso (i-facial nerve palsy). Umlomo ungase udonswe ohlangothini olulodwa ngezinye izikhathi.
• Imizwa engavamile kolunye uhlangothi lobuso. Kungase kuzwakale sengathi kuyisithutha noma njengezintuthwane ezihambahambayo.
• Imizwa engavamile kolunye uhlangothi lomzimba (ukulahlekelwa yi-hemisensory).
• Ubunzima bokukhuluma, ukungingiza (dysarthria). Amagama abonakala exabene.
• Ubunzima bokugwinya (dysphagia). Ubunzima bokugwinya ukudla neziphuzo.
• Ubunzima bokuphefumula.
• Ukulahlekelwa ibhalansi, ubunzima bokuhamba (i-ataxia). Njengokungathi unesizungu.
• Isiyezi, umuzwa wokujikeleza nxazonke zakho (i-vertigo).
• Ukulahlekelwa ukuzwa.
• Ukukhala noma ukuhleka okungalawuleki (ithonya le-pseudobulbar). Lokhu kuyimpawu engajwayelekile, okusho ukuthi ungakhala ngaphandle kokuzizwa udangele noma uhleke ngaphandle kokuzizwa ujabule.
• Ukulahlekelwa yizo zonke izitho ezine (quadriplegia).
• Ukulahlekelwa ukwazi.

Izimpawu ezihlobene namehlo nokubona zingase zihlanganise:

• Ukubona okubili, ikakhulukazi uma ubheka ohlangothini (ngenxa yesifo sesithupha se-nerve palsy).
• Ukunyakaza kwamehlo okusheshayo nokungalawuleki (i-nystagmus).
• Ukungakwazi ukuhambisa amehlo womabili ohlangothini olufanayo ngesikhathi esisodwa (i-conjugate gaze palsy).
• Izinkinga zokuphazima.

Uma wena noma othile oseduze nawe eba nanoma yiziphi zalezi zimpawu, kufanele ufune usizo lwezokwelapha ngokushesha ngaphandle kokulibala, njengoba i-Pontine Stroke iyisimo esisongela ukuphila esingabangela umonakalo ongenakulungiseka.

Ingabe zikhona izinhlobo zePontine Stroke?

Yebo, kunezinhlobo eziningana ze-Pontine Stroke, kuye ngokuthi igazi ligeleza kuphi ezingxenyeni ezahlukene ze-pons. Izimpawu zingase zihluke kancane kuye ngohlobo ngalunye, kodwa izimpawu eziningi zivamile. Odokotela bazibiza ngamagama ngokusekelwe endaweni ye-pons.

Ngokwesibonelo:

• I-Medial pontine stroke: Lokhu kwenzeka lapho ukugeleza kwegazi kuma phakathi kwe-pons. Izimpawu zivame ukuhlanganisa ubuthakathaka ohlangothini olulodwa lomzimba, ubuthakathaka bemisipha yamehlo, kanye nokungakwazi ukuhambisa amehlo ukusuka kolunye uhlangothi kuya kolunye (horizontal gaze palsy).
• I-lateral pontine stroke: Lokhu kwenzeka kolunye uhlangothi lwe-pons. Izimpawu zingase zihlanganise ukungazweli kolunye uhlangothi lomzimba (ukulahlekelwa yi-hemisensory) kanye nokulahlekelwa ibhalansi (i-ataxia). Kungaba uhlangothi olulodwa noma uhlangothi olulodwa.
• Isifo sohlangothi lwe-Caudal pontine: Lokhu kuthinta umhlane we-pons. Ukukhubazeka kwemizwa yobuso, ukulahlekelwa ukuzwa, kanye ne-vertigo kuyizimpawu ezivamile.

Yini ebangela i-Pontine Stroke?

Njengoba sishilo ekuqaleni, lokhu kwenzeka lapho ukugeleza kwegazi kuma-pons kuvinjiwe. Kunezizathu ezimbili eziyinhloko zalokhu kuvinjelwa:

1. Isifo semithambo emincane: Uma unengcindezi ephezulu yegazi noma isifo sikashukela isikhathi eside, imithambo yegazi emincane e-pons ingonakala. Ngokuhamba kwesikhathi, ukugeleza kwegazi kungavinjelwa, futhi ekugcineni umthambo ungavaleka ngokuphelele, okubangela isifo sohlangothi. Lena imbangela evame kakhulu.

2. I-Large artery atherosclerosis: I-atherosclerosis ukwakheka kancane kancane kwamafutha (i-plaque) ngaphakathi kwemithambo yegazi, okubangela ukuba iqine. Lapho lolu hlobo lwe-plaque luqongelela emithanjeni emikhulu ethwala igazi liye ebuchosheni (isb., i-vertebral artery , i-basilar artery ), lungavimba ukugeleza kwegazi liye emithanjeni emincane e-pons.

Yiziphi izici eziyingozi ze-Pontine Stroke?

Izici eziyinhloko eziyingozi ze-Pontine Stroke ziyafana nalezo zezinye izifo zohlangothi lwe-ischemic. Ziwumfutho wegazi ophakeme kanye nesifo sikashukela . Zombili lezi zimo zingalimaza imithambo yegazi yakho, okuhlanganisa nemithambo yegazi e-pons.

Ezinye izinto eziyingozi yilezi:

• Ukubhema.
• I-cholesterol ephezulu egazini.
• Ukuba nomlando wangaphambilini wesifo senhliziyo esibangelwa yi-ischemic ( isifo senhliziyo esibangelwa ukuvaleka kwemithambo yegazi enhliziyweni).
• Izimo ezikwazi ukujiya kakhulu.
• I-Vasculitis.

Uma unezinye zalezi zici eziyingozi, kubaluleke kakhulu ukubona udokotela wakho njalo ukuqinisekisa ukuthi uhlelo lokwelashwa olunikiwe lusebenza kahle.

Ihlolwa kanjani i-Pontine Stroke?

Uma unezimpawu zesifo sohlangothi, kufanele uye ekamelweni eliphuthumayo (ETU) ngokushesha okukhulu. Lapho, udokotela uzokwenza izivivinyo eziningana ukuze axilonge i-Pontine Stroke futhi ahlole impilo yakho. Lokhu kungafaka:

• Ukuhlola umfutho wegazi lakho kanye nokushaya kwenhliziyo .
• Ukuhlola ukuphefumula kwakho (inqubo yokuphefumula) .
• Ukuhlolwa ngokomzimba kanye nomlando wezokwelapha .
• Ukuhlolwa kwezinzwa. Lokhu kungabona izimpawu eziphawulekayo zesifo sohlangothi futhi kulinganisele ukuthi iyiphi ingxenye yobuchopho ethintekile.
• Ukuhlolwa kwezithombe zobuchopho.Isibonelo, i -CT scan kanye/noma i- MRI scan . Lokhu kuhlolwa kungaqinisekisa ukuthi isifo sohlangothi sisezimpondweni.

Udokotela wakho angase akucele ezinye izivivinyo ukuze kuhlolwe ezinye izici zempilo yakho, njengokuhlolwa kwegazi kanye ne- EKG (ECG) .

Iphathwa kanjani i-Pontine Stroke?

Umgomo oyinhloko wokwelashwa kwe-Pontine Stroke ukubuyisela ukugeleza kwegazi kuma-pons. Lokhu kungenxa yokuthi ukubuyisela ukugeleza kwegazi ngokushesha kungavimbela umonakalo ohlala njalo noma okungenani kunciphise ubukhulu besifo sohlangothi. Futhi, uma unezimpawu zesifo sohlangothi, kubalulekile ukuya esibhedlela ngokushesha ukuze uthole ukwelashwa okusheshayo.

Ukuze kubuyiselwe ukugeleza kwegazi, uhlobo lomuthi olubizwa ngokuthi i-thrombolytics luvame ukunikezwa. Lokhu kusebenza ngokuncibilikisa ihlule legazi. Futhi, uma kukhona ukuvaleka emthanjeni omkhulu, ukuhlinzwa okubizwa ngokuthi i-mechanical thrombectomy kungenziwa ukuze kususwe ihlule legazi.

Eminye imigomo yokwelashwa yile:

• Ukuvimbela izinkinga. Ithimba lakho lezokwelapha lizosebenzisa ezinye izindlela zokwelapha ukuvimbela noma ukwelapha izinkinga ezahlukahlukene.
• Ukuvuselelwa ukuze kwelashwe imiphumela emibi noma izinkinga zesimiso sezinzwa.
• Ukusebenzisa amasu okuvimbela esinye isifo sohlangothi , njengemithi, ukushintsha ukudla, kanye nokwandisa umsebenzi womzimba.

Ukuvuselelwa kwePontine Stroke

Ukuvuselelwa kuyingxenye ebalulekile yokululama kubantu abaningi abake baba nesifo sohlangothi. Kuye ngezimpawu zakho, lokhu kungaba ngezindlela eziningi:

• Ukwelashwa kokukhuluma: Lokhu kukusiza ukuthi uphinde uthole amakhono akho olimi nokukhuluma, futhi kulawule imisipha ekusiza ukuthi uphefumule, udle, uphuze, futhi ugwinye.
• Ukwelashwa ngokomzimba: Lokhu kungakusiza ukuthi uthuthukise noma uphinde usebenzise izingalo nemilenze yakho. Kungasiza futhi ngezinto ezifana nezinkinga zokulinganisela kanye nobuthakathaka bemisipha.
• Ukwelashwa Komsebenzi: Lokhu kuqeqesha kabusha ubuchopho bakho ukuze kukusize wenze imisebenzi yansuku zonke, njengokudla nezitsha nokugqoka.
• Ukufundiswa kabusha kwezinzwa: Lokhu kusiza ukuqeqesha kabusha noma ukuvuselela izinzwa zakho. Isibonelo, uzoqeqeshwa ukuqaphela izinhlobo ezahlukene zokuthinta, ukudlidliza, ukucindezela, kanye nokushisa.
• Ukwelashwa kwengqondo:Lokhu kungaba usizo uma unezinkinga zokukhumbula. Kungasiza futhi uma unenkinga yokugxila emisebenzini obukwazi ukuyenza.

Iyini iphrojekthi kubantu abaye baba nePontine Stroke?

Umbono wokululama komuntu oke waba ne-Pontine Stroke uncike ezintweni eziningana, okuhlanganisa:

• Iyiphi ingxenye yama-pons eyathinteka yi-stroke?
• Ubunzima besifo sohlangothi.
• Indlela othole ukwelashwa ngokushesha ngayo.
• Impilo yakho iyonke kanye nobudala bakho.

Isibonelo, imivimbo ethinta uhlangothi olulodwa kuphela lwe-pons (uhlangothi olulodwa) ngokuvamile inemiphumela engcono yokululama kunemivimbo ethinta izinhlangothi zombili (uhlangothi olubili) kanye nalezo ezithinta umhlane we-pons (uhlangothi oluqondile).

Ithimba lakho lezokwelapha lizokunikeza umbono omuhle wokuthi ukululama kuzoba njani ngemva kwe-Pontine Stroke. Thola usizo kubangani bakho bese ubabuza nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.

Yimiphi imiphumela yesikhathi eside ye-Pontine Stroke?

I-Pontine Stroke ingabangela izinkinga eziningana zesikhathi eside noma ezihlala njalo. Lokhu kungenxa yokuthi i-brainstem, ehlanganisa ama-pons, iyisakhiwo sobuchopho esibalulekile esinemisebenzi eminingi ebalulekile. Ingozi yakho yokuthola izinkinga incike ezintweni eziningi, okuhlanganisa uhlobo kanye nobunzima be-Pontine Stroke.

Izinkinga zingafaka:

• Ukulimala kobuchopho okungapheli.
• Kungase kudingeke ukuphakelwa ngamapayipi ngenxa yobunzima bokudla.
• Ukulahlekelwa ukulawula umchamo (ukungakwazi ukuzibamba umchamo), okudinga ukusetshenziswa kwe-catheter yomchamo.
• Ubuthakathaka bemisipha isikhathi eside, okuholela ekuweni njalo.
• Ukucindezeleka ngemva kokuhlaselwa yisifo sohlangothi.
• Izinkinga ezibangelwa ukuphumula embhedeni isikhathi eside, isibonelo, izilonda zokulala kanye ne-deep vein thrombosis (DVT).
• Ukukhubazeka kwesikhathi eside.
• I-Locked-in syndrome. Kulokhu, awukwazi ukulawula noma yini enye emzimbeni wakho ngaphandle kokunyakaza kwamehlo, kodwa uyaqaphela.
• I-pneumonia yokuphefumula, ikakhulukazi kubantu abane -pseudobulbar palsy noma i-locked-in syndrome, ibangelwa ukudla noma isiphuzo esingena endleleni yokuphefumula.
• Ukufa.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma wena (noma othile oseduze nawe) uke waba ne-Pontine Stroke, kungaba usizo ukubuza udokotela wakho le mibuzo:

• Uhlobo luni lwe-Pontine Stroke enganginalo?
• Yimiphi imisebenzi ebuchosheni nasemzimbeni eyathintwa yisifo sohlangothi?
• Kuzoba njani ukululama kwami? Yiziphi izinyathelo ezilandelayo ekunakekelweni kwami?
• Yiziphi izindlela zokuvuselela engizidingayo?
• Yini engizokwazi ukuyenza ezinyangeni ezimbalwa ezizayo?
• Yini engingayilindela ngonyaka?
• Yimaphi amakhono mina nabathandekayo bami esiwadingayo ukuze banginakekele?
• Yiziphi izinsizakalo nezinsiza ezitholakalayo zokungisiza mina nabathandekayo bami?
• Yiziphi izinto ezingenza ngibe nesifo sohlangothi futhi?

Ungakuvimbela kanjani i-Pontine Stroke?

Isifo sohlangothi lwe-Pontine asikwazi ukuvinjelwa ngaso sonke isikhathi. Kodwa-ke, ungasebenzisana nodokotela wakho ukuze uphathe izici zakho zengozi yesifo sohlangothi. Amasu okuphatha angafaka:

• Lawula umfutho wegazi lakho, uhlose u-140/90 mmHg noma ngaphansi. Udokotela wakho angase akuncomele imithi kanye/noma izinguquko emsebenzini kanye nokudla.
• Ukwelashwa kwe-cholesterol ephezulu (i-dyslipidemia), isibonelo, ukwanda komsebenzi womzimba, izinguquko ekudleni, kanye/noma imithi ye-statin .
• Phatha isifo sikashukela, uhlose ukugcina i-A1C iku-7% noma ngaphansi.
• Ukuyeka ukubhema, okungasizwa ukwelashwa nge-talk therapy kanye nokwelashwa kokufaka i-nicotine esikhundleni (NRT) .
• Ukwenza izinguquko ohlelweni lwakho lokudla, isibonelo, ukulandela ukudla kwe-DASH noma ukudla kwaseMedithera .
• Yenza umsebenzi womzimba ojwayelekile okungenani imizuzu engama-40 ngosuku, izinsuku ezintathu kuya kwezine ngesonto.
• Ukugcina noma ukufinyelela isisindo esinempilo.
• Uma une -atrial fibrillation (i-Afib) (ukushaya kwenhliziyo okungajwayelekile), thatha imithi yokunciphisa igazi (imithi yokunciphisa igazi) njenge -aspirin noma i-warfarin .

Ekugcineni, umyalezo okufanele uwuthathe uye ekhaya:

I-Pontine Stroke ingaguqula impilo yakho ngokushesha. Ngakho-ke, kubalulekile ukuqaphela izimpawu zayo nokuya esibhedlela ngokushesha okukhulu uma wena noma othile omaziyo ebhekana nazo. Impilo ngemva kwe-stroke ingaba yinselele ngempela futhi ingashintsha ngezindlela ongazicabangi. Ungakhohlwa ukufuna ukwesekwa eqenjini lakho lezokwelapha kanye nabathandekayo bakho phakathi nohambo lwakho lokululama. Khumbula, isinyathelo sokuqala kanye nokwelashwa okufanele kungenza umehluko omkhulu.

'Isifo sohlangothi sikaPontine, isifo sohlangothi lobuchopho, izimpawu zohlangothi, ukwelashwa kwesifo sohlangothi, i-pons, isiqu sobuchopho, izifo zezinzwa, ukunakekelwa okuphuthumayo