Cabanga nje uma ubuwenza umsebenzi wakho ojwayelekile bese ngokuzumayo, ngaphandle kwesixwayiso, uba nekhanda elibuhlungu kakhulu kunawo wonke owake wabhekana nalo. Kwakuyibuhlungu obukhulu kakhulu empilweni yakho. Ubuhlungu buzofinyelela esicongweni ngemizuzwana embalwa. Kwezokwelapha, lokhu buhlungu obubuhlungu obungazelelwe nobunzima sibubiza ngokuthi "ikhanda elibuhlungu elidumayo." Lokhu akulona nje noma yiliphi ikhanda elibuhlungu. Lokhu kuvame ukuba yisixwayiso esingathi sína esisinikezwa yimizimba yethu. I-RCVS ingenye yezimo ezinjalo esinikeza isixwayiso esinjalo.
Kalula nje, iyini i-RCVS?
Igama eliphelele le-RCVS yi- Reversible Cerebral Vasoconstriction Syndrome . Igama lingase libonakale lide futhi liyinkimbinkimbi, kodwa masiligcine lilula.
- Okungaguquki: kusho ukuthi "kungaguqulwa." Lokhu kusho ukuthi lesi simo asihlali njalo futhi singelapheka ngokwelashwa okufanele .
- Ubuchopho: kusho "okuphathelene nobuchopho."
- I-Vasoconstriction: kusho "ukuncipha noma ukucinana kwemithambo yegazi."
Kalula nje, i-RCVS yisimo lapho imithambo yegazi ebuchosheni iqina khona, ivaleke, futhi ivaleke . Kodwa-ke, lokhu kungalungiswa ngokwelashwa okufanele.
Cabanga ngepayipi lamanzi. Kwenzekani uma sicindezela ingxenye eyodwa yepayipi? Livimba amanzi ukuthi angagelezi, akunjalo? Kwenzeka into efanayo emithanjeni yegazi ebuchosheni bethu. Lapho le mithambo yegazi iqina ngokuzumayo (sikubiza ngokuthi "i-vasospasm"), ubuchopho abutholi inani elidingekayo legazi. Yingakho sithola lezo zinhlungu zekhanda ezinzima ezizwakala sengathi zishaya umbani. Lesi simo singase futhi ngezinye izikhathi sibonise izimpawu ezifana ne -migraines, i-stroke, noma ukopha ebuchosheni .
Kubaluleke kakhulu: "Ikhanda Elibuhlungu Elidumayo", eliqala ngokuzumayo, ikhanda elibuhlungu elizwakala njengekhanda elibi kakhulu owake walizwa, liyisimo esiphuthumayo sezokwelapha . Lokhu kungaba uphawu lokopha ngaphakathi kobuchopho. Uma wena noma othile omaziyo enalolu hlobo lwekhanda, hamba esibhedlela esiseduze noMnyango Wezimo Eziphuthumayo (ETU) ngokushesha.
Ziyini izimpawu ze-RCVS?
Ku-RCVS, ukugeleza kwegazi ebuchosheni kuyaphazamiseka, okubangela izimpawu ezahlukahlukene. Uphawu oluyinhloko ikhanda elibuhlungu kakhulu, kodwa kunezinye izimpawu.
| Isibonakaliso | Incazelo |
|---|---|
| Ikhanda elibuhlungu "elikhalayo" | Ikhanda elibuhlungu eliqala ngokuzumayo, lifinyelele esicongweni ngemizuzwana embalwa, futhi lingase liphinde libuye phakathi nesonto noma amane. |
| Ukuzwela okwandisiwe | Ukungabekezeleli ukukhanya okukhulu (`(Photophobia)`) kanye nomsindo omkhulu (`(Phonophobia)`). |
| Ezinye izici | Ukucanuzela nokuhlanza, ukushintsha kombono (umbono ofiphele, umbono ophindwe kabili), ubuthakathaka bemisipha engxenyeni yomzimba, ukudideka. |
| Izimpawu ezinkulu | Ukuquleka, ubunzima bokukhuluma noma ukuqonda okushiwo abanye (`(Aphasia)`). |
Kwezinye izimo, i-RCVS ingabangela ukopha phakathi kobuchopho nogebhezi. Lokhu kubizwa ngokuthi `(Subarachnoid Hemorrhage - SAH)`. Lokhu futhi kuyisimo esiphuthumayo sezokwelapha esibucayi kakhulu. Ngaphezu kwezimpawu ezingenhla, i-SAH ingabonisa nezimpawu ezilandelayo:
- Ukuqina kwentamo, ubuhlungu bemisipha entanyeni nasemahlombe.
- Izinguquko ekuziphatheni nasemizweni (ukuthukuthela ngaphandle kwesizathu).
- Ukuba ndikindiki engxenyeni ethile yomzimba.
Yiziphi izici ezibangela ukuthuthukiswa kwe-RCVS?
Nakuba imbangela eqondile ye-RCVS ingakatholakali, kuye kwatholakala izici eziningana eziyingozi ezingaba nomthelela ekuthuthukisweni kwalesi simo.
Ukukhulelwa nokubeletha
Isici esivame kakhulu nesivame kakhulu sengozi ye-RCVS ukukhulelwa. Ingozi iphezulu kakhulu emasontweni ayisithupha okuqala ngemva kokubeletha (ngemuva kokubeletha). Odokotela bakholelwa ukuthi izinguquko zamahomoni ngesikhathi sokukhulelwa zingadlala indima. I-RCVS ingenzeka ngisho noma kungekho izinkinga ezifana ne-preeclampsia, okuyisimo somfutho wegazi ophezulu esenzeka ngesikhathi sokukhulelwa.
Ukusetshenziswa kwemithi ethile kanye nezidakamizwa
Eminye imithi nemithi ethinta uhlelo lwethu lokujikeleza kwegazi yandisa ingozi ye-RCVS.
| Uhlobo lwemithi/izidakamizwa | Izibonelo |
|---|---|
| Imithi yokucindezeleka | Ikakhulukazi imithi yohlobo lwe-SSRI (`(Selective Serotonin Reuptake Inhibitors)`). |
| Imithi yokwelapha ikhanda elibuhlungu | Ama-Triptan kanye nemithi equkethe i-ergot. |
| Imithi yokuvimbela amasosha omzimba | Imithi enciphisa amasosha omzimba enikezwa izifo ezithile. |
| Izikhuthazi kanye nezidakamizwa | Izidakamizwa ezifana nama-amphetamine, i-cocaine, insangu, ama-nicotine patches, iziphuzo zamandla, i-LSD, kanye ne-MDMA. |
Ezinye izimo zempilo
Izimo ezithile zezokwelapha nazo zandisa ingozi yokuthola i-RCVS.
- I-Migraine: Abantu abane-migraine banamathuba amaningi okuthola i-RCVS.
- Amazinga aphezulu e-calcium egazini (i-Hypercalcemia): Uma amazinga e-calcium egazini enyuka, angaphazamisa ukusebenza kwemithambo yegazi.
- Izinkinga zama-hormone: Kusolwa ukuthi i-estrogen ye-hormone ihilelekile kulokhu. Yingakho lesi sifo sivame kakhulu kwabesifazane.
- Izifo ezidluliselwa ngofuzo: Izifo ezibangela izimila ezikhiqiza i-adrenaline hormone eningi, njenge-``Pheochromocytoma``.
Yiziphi izinkinga ezingaba khona ze-RCVS?
Esikhathini esidlule, odokotela babecabanga ukuthi i-RCVS iyisimo esingenangozi, esingenangozi, kodwa ucwaningo olusha lukhombisile ukuthi lokhu akunjalo ngaso sonke isikhathi.
Cishe ama-30% eziguli ze-RCVS angase ashiywe nokukhubazeka okuncane okuhlala njalo (isibonelo, ubuthakathaka bemisipha, izinkinga zokulinganisela lapho uhamba). Cishe ama-8% angase abe nezinkinga ezinkulu zesikhathi eside.
Ngaphezu kwalokho, izinkinga ezinkulu zingase zivele zingakapheli izinsuku ezimbalwa kusukela izimpawu zokuqala zivele.
- I-Ischemic Stroke: I-stroke ebangelwa ukuvaleka kwemithambo yegazi ehambisa igazi ebuchosheni.
- Ukopha ebuchosheni: Isimo esifana ne-SAH.
- Isifo Sokuxhuzula (`(Ukuxhuzula)`).
Yingakho sisho ngokuphindaphindiwe ukuthi kubaluleke kakhulu ukufuna usizo lwezokwelapha ngokushesha uma uzwa ikhanda elibuhlungu ngokuzumayo. Ukwelashwa okusheshayo kungavimbela eziningi zalezi zinkinga ezinkulu.
Itholakala kanjani i-RCVS?
Uma uya eMnyangweni Wezimo Eziphuthumayo (i-ETU), odokotela balandela izinyathelo eziningana ukuze bathole lesi simo.
1. Ukuhlolwa kwesimiso somzimba nesezinzwa: Ngaphezu kokubuza ngezimpawu zakho, ukusebenza kwesimiso sakho sezinzwa (isib. inkulumo, umbono, ibhalansi yomzimba) kuzohlolwa.
2. Ukuhlolwa kwegazi: Ukuhlolwa kwegazi kwenziwa ukuze kubhekwe izinto ezifana nezinkinga zokujiya kwegazi, izifo, kanye nokungalingani kosawoti womzimba.
3. Ama-Imming Scan: Lawa ma-scan abaluleke kakhulu ekuxilongeni ama-RCVS. Angabheka ngaphakathi kobuchopho futhi abone izindawo eziyinkinga.
Yiziphi izinhlobo zokuskena ezenziwayo?
- I-CT Scan (`(I-Computed Tomography - I-CT scan)`): I-scan ebizwa ngokuthi `(I-CT angiogram)` ingasetshenziswa ukubona isimo semithambo yegazi ebuchosheni. I-CT scan ibaluleke kakhulu ekuxilongeni ngokushesha isifo sohlangothi, ngoba umzuzwana ngamunye ubalulekile lapho welapha isifo sohlangothi.
- Ukuskena kwe-MRI (I-Magnetic Resonance Imaging - I-MRI scan): Ukuskena okubizwa ngokuthi i-Magnetic Resonance Angiogram - i-MRA kungabonisa ngokucacile ukuminyana kwemithambo yegazi (i-vasospasm) kanye nemiphumela ebangelwa yiyo ebuchosheni.
- I-Transcranial Doppler ultrasound: Lokhu kulinganisa ijubane lokugeleza kwegazi ebuchosheni futhi kunganikeza umbono wokuthi imithambo yegazi ivaliwe yini.
Ngokuvamile, ngemva kokuqeda isifo sohlangothi, kudingeka i-MRI/MRA scan ukuqinisekisa i-RCVS.
Iphathwa kanjani i-RCVS?
Njengoba igama lisho ("Kuyaguquguquka"), lesi yisimo esingelapheka . Kunezinhloso ezimbili eziyinhloko zokwelapha.
1. Ukususa imbangela: Uma imbangela yesimo se-RCVS ingabonakala ngokucacile (isib., umuthi othile), isinyathelo sokuqala ukuqeda leyo nkinga.
2. Ukulawula ukuminyana kwemithambo yegazi: Kunikezwa imithi yokulawula ukuminyana kwemithambo yegazi (`(vasospasm)`).
Uhlobo lomuthi olusetshenziswa kakhulu kulokhu yi -calcium channel blockers (`(Calcium Channel Blockers - CCBs)`).Le mithi isebenza ngokuvimbela i-calcium ukuthi ingangeni emaseli emisipha ebushelelezi ezindongeni zemithambo yegazi. Imisipha ibe isiphumula, imithambo yegazi iphinde ivuleke, bese ukugeleza kwegazi ebuchosheni kuyabuyiselwa.
Ezimweni ezingavamile kakhulu, lapho lesi sifo singaphenduli emithini, inqubo ebizwa ngokuthi ``endovascular'' ingasetshenziswa. Kulesi simo, ipayipi elincane kakhulu (``catheter'') lidluliselwa emthanjeni wegazi engalweni noma emlenzeni liye emthanjeni wegazi osebuchosheni, bese kufakwa ibhaluni elivuvukele ngalo (``angioplasty'') ukuze kwandiswe umthambo ovalekile noma kunikezwe imithi ngqo.
Yini ongayilindela uma kwakheka i-RCVS?
Uma une-RCVS, into yokuqala ongase uyizwe ikhanda elibuhlungu elinzima, elingazelelwe. Lesi yisimo esiphuthumayo sezokwelapha futhi sidinga ukwelashwa ngokushesha. Uma ukwelashwa sekuqalile, abantu abaningi bayalulama ezinsukwini noma emavikini ambalwa .
Iningi labantu (cishe u-80% - 85%) liyalulama ngokuphelele ngaphandle kwezinkinga zesikhathi eside . Yilokho okuhle kakhulu ngalesi sifo. Cishe u-10% bangase babe nokungakhululeki okuncane. Kodwa-ke, kunengozi encane yezinkinga ezinkulu, njengesifo sohlangothi esixoxe ngaso ekuqaleni, ngakho-ke ukuxilongwa kusenesikhathi kanye nokwelashwa kubaluleke kakhulu.
Yini okufanele siyenze ukuze sivimbele ama-RCVS ukuthi angabuyi?
Uma uke waba ne-RCVS, udokotela wakho angase akucebise ukuthi wenze izinguquko ezithile endleleni yokuphila ukuze uvimbele ukuthi ingaphinde ivele.
- Ukuyeka umuthi obangele i-RCVS: Uma umuthi ubangele lesi simo, yeka njengoba kuqondiswe udokotela wakho futhi ugweme ukuthatha lowo muthi esikhathini esizayo.
- Thatha imithi enqunywe udokotela njalo: Thatha imithi enqunywe udokotela ngesikhathi ukuze uvimbele izimpawu ukuthi zingabuyi.
- Gwema ngokuphelele ukusebenzisa izidakamizwa ngokungadingekile: Gwema izinto ezivuselela umzimba, ikakhulukazi lezo ezithinta uhlelo lokujikeleza kwegazi, njengensangu.
- Lawula i-caffeine neziphuzo ezinikeza amandla: Kuwukuhlakanipha ukunciphisa inani oliphuzayo noma ukuyeka ngokuphelele ukuziphuza.
Udokotela wakho uzokucela ukuthi ubuye emtholampilo ukuze uqaphe isimo sakho. Qiniseka ukuthi uya khona kulezo zikhathi zokubonana.
Umlayezo Wokuya Nawe Ekhaya
- Ukuqala ngokuzumayo, ikhanda elibuhlungu kakhulu ("Thunderclap Headache") kuyisimo esiphuthumayo sezokwelapha. Yiya eMnyangweni Wezimo Eziphuthumayo wesibhedlela esiseduze (i-ETU) ngokushesha.
- I-RCVS yisimo esenzeka lapho imithambo yegazi ebuchosheni incipha futhi incipha ngokuzumayo. Kodwa njengoba igama lisho, kuyisimo esilungiseka ngokuphelele ngokwelashwa okufanele .
- Lokhu kuvame kakhulu ngemva kokubeletha, ngenxa yokusetshenziswa kwemithi ethile, noma kungenzeka nakwezinye izimo zezokwelapha.
- Ukuxilongwa kusenesikhathi kanye nokwelashwa kungavimbela izinkinga ezinkulu ezifana nesifo sohlangothi, futhi abantu abaningi bayalulama ngokugcwele.
- Khuluma nodokotela wakho ngokukhululekile ngesimo sakho, ukwelashwa, kanye nezinto ezikukhathazayo esikhathini esizayo.
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