Zicabange udidekile, futhi ngokuzumayo, ngaphansi komzuzwana, uthola ikhanda elibuhlungu kakhulu owake waba nalo empilweni yakho... njengombani oshaya ikhanda lakho. Kwezokwelapha, lokhu sikubiza ngokuthi "ikhanda elibuhlungu elidumayo." Lolu uphawu oluvame kakhulu nolubi kakhulu lwesimo esikhuluma ngaso namuhla, i-RCVS. Ikhanda elibuhlungu elinjengaleli liyisimo esiphuthumayo sezokwelapha esidinga ukwelashwa ngokushesha.
Kuyini i-RCVS kalula?
Kalula nje, i-Reversible Cerebral Vasoconstriction Syndrome (RCVS) yisimo lapho imithambo yegazi ebuchosheni bakho iqina khona ngokuzumayo bese ivaleka. Kufana nombhobho wamanzi ocindezelwa ngokuzumayo. Lapho imithambo yegazi ivaleka ngale ndlela, ubuchopho abutholi inani legazi elilidingayo. Yingakho uthola lelo khanda elibuhlungu elifana nombani engikhulume ngalo ekuqaleni.
Igama elithi "reversible" egameni lalesi simo lisho ukuthi singaguqulwa ngokwelashwa okufanele . Kodwa-ke, uma singelashwa, singaholela ezimweni ezimbi kakhulu njengesifo sohlangothi noma ukopha kobuchopho. Ngezinye izikhathi, izimpawu zifana kakhulu neze-migraine noma isifo sohlangothi, okwenza kube nzima ukuhlukanisa phakathi kwalezi ezimbili.
Okubaluleke kakhulu: Uma wena noma othile omaziyo enesifo sekhanda esibuhlungu ngokuzumayo, esibuhlungu kakhulu esizwakala njengesifo sekhanda esibi kakhulu empilweni yakhe, kuyisimo esiphuthumayo sezokwelapha. Yiya ekamelweni lezimo eziphuthumayo esibhedlela esiseduze (ETU) ngokushesha. Ungachithi isikhathi.
Ziyini izimpawu zalesi simo?
Zonke izimpawu ze-RCVS zibangelwa ukuphazamiseka kokunikezwa kwegazi ebuchosheni. Ake sibheke ukuthi ziyini lezi zimpawu.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ubuhlungu bekhanda obubangelwa yizulu | Ikhanda elibuhlungu kakhulu engake ngabhekana nalo empilweni yami, eliqala ngokuzumayo. |
| Ukuzwela ukukhanya nomsindo | Ukuzizwa ungakwazi ukubuka ukukhanya noma ukuzwa imisindo (i-Photophobia kanye ne-Phonophobia) |
| Isicanucanu nokuhlanza | Ikhanda elibuhlungu elihambisana nokuhlanza. |
| Izinguquko zombono | Umbono ofiphele, ukubona okuphindwe kabili, noma ukubona okunciphile. |
| Ubuthakathaka bemisipha | Ukuzwa sengathi kukhona ukungakhululeki ohlangothini olulodwa lomzimba. |
| Ukudideka | Ukukhohlwa indawo nesikhathi, ukulahlekelwa ukwazi. |
| Ukuquleka | Isimo esifana nokufaneleka. |
| Izinkinga zokukhuluma (i-Aphasia) | Ubunzima bokukhuluma noma ukuqonda lokho abanye abakushoyo. |
| Izimpawu ezengeziwe ezingase zenzeke lapho igazi liphuma ebuchosheni (i-Subarachnoid Hemorrhage - SAH) | |
| Ukuqina kwentamo | Ukuqina kwemisipha kanye nobuhlungu entanyeni nasemahlombe. |
| Izinguquko zokuziphatha | Intukuthelo engazelelwe, ukucasuka. |
| Ukuba ndikindiki emzimbeni | Ukuzwa umuzwa wokucasuka engxenyeni ethile yomzimba. |
Yini ebangela i-RCVS?
Imithambo yethu yegazi inemisipha ebushelelezi ngaphakathi. Le misipha ilawula ukugeleza kwegazi ngokufinyela nokuphumula. Kodwa ngezinye izikhathi le misipha ivele iqine futhi ifinyele kakhulu. Lokhu sikubiza ngokuthi "i-vasospasm". Lena imbangela eyinhloko ye-RCVS.
Kunezizathu eziningana zokuthi kungani lesi simo (i-vasospasm) singenzeka.
Ukukhulelwa kanye nesikhathi sokubeletha
Imbangela evame kakhulu ye-RCVS ukukhulelwa. Ingozi yalesi simo iphezulu kakhulu emasontweni ayisithupha okuqala ngemva kokubeletha. Lokhu kukholakala ukuthi kungenxa yezinguquko ezisheshayo emazingeni ama-hormone. Le ngozi ingenzeka ngisho noma ungenazo izimo ezifana ne-preeclampsia ngesikhathi sokukhulelwa.
Eminye imithi kanye nokusetshenziswa kwezidakamizwa
I-RCVS ingabangelwa imithi ethile kanye nemithi ethinta uhlelo lwakho lokujikeleza kwegazi.
- Eminye imithi yokucindezeleka, ikakhulukazi leyo eseqenjini lama-SSRI.
- Imithi ye-migraine (ama-triptan kanye nemithi yohlobo lwe-ergot).
- Imithi ecindezela amasosha omzimba.
- Eminye imithi yesifo sikaParkinson.
- Izikhuthazi (ama-amphetamine, i-cocaine, i-pseudoephedrine).
- Insangu.
- Ukusetshenziswa ngokweqile kwe-caffeine neziphuzo zamandla.
- Ama-patches e-nicotine.
- Izidakamizwa ezifana ne-`LSD` noma i-`MDMA` (i-ecstasy).
Ezinye izimo zezokwelapha
Ezinye izimo zezokwelapha ezithinta ubuchopho noma ukujikeleza kwegazi nazo zingandisa ingozi ye-RCVS.
- I-Migraines: Abantu abane-migraines banamathuba amaningi okuthola i-RCVS.
- Amazinga aphezulu e-calcium egazini (i-Hypercalcemia): Amazinga aphezulu e-calcium angaphazamisa ukusebenza kwemisipha emithanjeni yegazi.
- Izinkinga zama-hormone: Kusolwa ukuthi i-estrogen ye-hormone ihilelekile, yingakho lesi sifo sivame kakhulu kwabesifazane.
- Ezinye izimo zofuzo, njenge-"Pheochromocytoma" (isimila esikhiqiza i-adrenaline hormone eningi) kanye ne-"Porphyria", zingandisa ingozi.
Yiziphi izinkinga ezingaba khona ze-RCVS?
Esikhathini esidlule, odokotela babecabanga ukuthi i-RCVS akuyona inkinga enkulu. Kodwa ucwaningo olusha lubonisa ukuthi ngezinye izikhathi ingabangela izinkinga. Cishe abantu abangu-30% abane-RCVS bangase bashiywe benokukhubazeka okuncane okungapheli (njengobuthakathaka bemisipha). Cishe abangu-8% bangase babe nezinkinga ezinkulu zesikhathi eside.
Ngaphezu kwalokho, izinkinga ezinkulu ezifana nalezi zingavela ezinsukwini ezimbalwa emva kwezimpawu zokuqala:
- I-Ischemic stroke: Ukuvaleka komthambo wegazi ohambisa igazi ebuchosheni.
- Ukopha ngaphakathi kobuchopho (i-SAH noma olunye uhlobo lokopha ebuchosheni): Ukopha phakathi kobuchopho nogebhezi.
- Ukuquleka.
Odokotela bakuthola kanjani lokhu?
Udokotela usebenzisa izindlela eziningana ukuxilonga lesi simo.
- Ukuhlolwa ngokomzimba nangokwezinzwa: Ukuzindla kwakho, amandla, kanye nemizwa yakho kuyahlolwa.
- Ukuhlolwa kwegazi: Hlola izinkinga zokujiya kwegazi, izifo, kanye nokungalingani kwamazinga kasawoti.
- Ukuskena izithombe: Lena yindlela ebaluleke kakhulu yokuxilonga i-RCVS.
Ukuskena izithombe
Lezi zinhlobo zokuskena "zingabona" ingaphakathi lekhanda nobuchopho. Zingahlola imithambo yegazi evalekile noma ukugeleza kwegazi okunciphile.
- Ukuskena kwe-Computed Tomography (CT): Ikakhulukazi, ama-CT angiogram angasiza ekuhloleni kangcono isimo semithambo yegazi.
- Ukuskena kwe-Magnetic Resonance Imaging (MRI): Ukuskena okukhethekile kwe-MRI okubizwa ngokuthi i-Magnetic Resonance Angiogram (MRA) nakho kungabona i-vasospasm emithanjeni yegazi.
- I-Transcranial Doppler ultrasound: Lokhu kungalinganisa ijubane lokugeleza kwegazi ebuchosheni.
Ngokuvamile, kwenziwa i-CT scan kuqala. Ngoba kuyashesha. Kunganquma ngokushesha ukuthi kukhona yini isimo esiphuthumayo njenge-stroke noma ukopha. Uma kwenzeka i-stroke, umzuzwana ngamunye uyabalwa, ngakho-ke leso sivinini sibaluleke kakhulu. Ngemuva kwalokho, uma kudingeka, kwenziwa i-MRI scan ukuqinisekisa ukuvaleka kwemithambo yegazi.
Yiziphi izindlela zokwelapha i-RCVS?
Njengoba igama lisho, i-RCVS iyisimo esingelapheka kakhulu . Ukwelashwa kunemigomo emibili eyinhloko.
1. Uma imbangela ingatholakala (isib. umuthi othile), susa leyo nkinga.
2. Ukuqeda i-vasospasm (ukuqina) kwemithambo yegazi nokuyibuyisela esimweni sayo esijwayelekile.
Uhlobo oluvame kakhulu lomuthi olusetshenziswa ukwelapha lesi simo (i-vasospasm) ama -calcium channel blockers (ama-CCB) . Le mithi isebenza ngokuvimbela i-calcium ukuthi ingangeni emaseli emisipha emithanjeni yegazi. Imisipha ibe isiphumula, imithambo yegazi iphinde ivuleke, bese ukugeleza kwegazi kubuyela esimweni esijwayelekile.
Akuvamile kakhulu, kwezinye izimo, ukwelashwa kungenziwa kusetshenziswa inqubo ebizwa ngokuthi "i-endovascular". Lokhu kuhilela ukudlulisa ipayipi elincane kakhulu (i-catheter) ngomthambo wegazi engalweni noma emlenzeni uye emthanjeni wegazi ovalekile ebuchosheni, bese ujova umuthi noma usebenzise into efana nebhaluni ukuze wandise umthambo (i-angioplasty).
Singathemba kanjani lesi simo?
Iningi labantu abane-RCVS (cishe u-80% - 85%) bayalulama ngokuphelele ngaphandle kwezinkinga zesikhathi eside. Ngakho-ke kunethemba elihle ngalokhu. Kodwa into ebaluleke kakhulu kulokhu ukuxilonga lesi sifo kusenesikhathi bese uqala ukwelashwa okufanele.
Khumbula, ukuxilongwa kusenesikhathi kanye nokwelashwa kuyindlela engcono kakhulu yokuthola imiphumela emihle kakhulu. Ukubambezeleka kungaholela ezinkingeni eziyingozi.
Izinto ongazenza ukuvimbela i-RCVS ukuthi ingaphinde ivele
Ngenxa yokuthi akucaci kahle ukuthi kungani i-RCVS ikhula, ayikwazi ukuvinjelwa ngaso sonke isikhathi. Kodwa-ke, kunezinto ezithile ongazenza ukuze unciphise ingozi yakho. Udokotela wakho uzokunikeza iseluleko esengeziwe ngalokhu.
- Uma kunemithi okucatshangwa ukuthi ibangele i-RCVS, yiyeke bese uyigwema esikhathini esizayo.
- Ukuthatha imithi ebhalwe udokotela njengoba kuchazwe futhi ngendlela efanele.
- Ungasebenzisi noma yimiphi imithi noma izidakamizwa (ikakhulukazi izikhuthazi kanye nensangu) ngaphandle kweseluleko sikadokotela.
- Yehlisa noma uyeke ngokuphelele ukuphuza i-caffeine neziphuzo ezinikeza amandla.
Kufanele ubonane nini nodokotela bese uya ku-ETU?
Uma une-RCVS, udokotela wakho uzokutshela ukuthi uqhubeke nokuza emtholampilo. Kubaluleke kakhulu ukuya kulezi zikhathi njalo. Ngale ndlela, isimo sakho singaqashwa futhi ukwelashwa kwakho kungalungiswa njengoba kudingeka.
Isikhathi sokuya e-Emergency Treatment Unit (ETU) ngokushesha:
Uma unekhanda elibuhlungu noma izimpawu ezifana nohlangothi (isib. ubuthakathaka ohlangothini olulodwa lomzimba, ubunzima bokukhuluma, ukushintsha kombono) futhi, kuhlale kuyisimo esiphuthumayo sezokwelapha. Ungalindi kuze kube sekwephuzile. Fika esibhedlela ngokushesha okukhulu.
Umlayezo Wokuya Nawe Ekhaya
- Ikhanda elibuhlungu ngokuzumayo, elibi kakhulu ("Thunderclap Headache") liyisimo esiphuthumayo sezokwelapha. Yiya eMnyangweni Wezimo Eziphuthumayo wesibhedlela esiseduze (i-ETU) ngokushesha.
- I-RCVS yisimo esibangelwa ukuvaleka kwemithambo yegazi ebuchosheni ngokuzumayo. Kodwa njengoba igama lisho, yisimo esingalungiseka ngokuphelele uma singelashwa ngendlela efanele.
- Ingozi yalesi simo iphakeme ngesikhathi sokukhulelwa futhi ikakhulukazi emasontweni ayisithupha okuqala ngemva kokubeletha.
- Iningi labantu lilulama ngokuphelele ngaphandle kwezinkinga zesikhathi eside, kodwa ukuxilongwa kusenesikhathi kanye nokwelashwa kubalulekile.
- Landela imiyalelo kadokotela wakho. Thatha imithi oyinikezwe udokotela futhi ugweme izidakamizwa eziyingozi kanye notshwala.
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