Ikhanda elibuhlungu kakhulu empilweni yakho? Kungaba ukuphuma kwegazi okungaphansi kwe-subarachnoid (SAH)!

Wake waba nekhanda elibuhlungu ngokuzumayo, elinzima, elizwakala sengathi umbani ushaya ikhanda lakho? Abantu abaningi balichaza ngokuthi "ikhanda elibuhlungu elibi kakhulu owake waba nalo." Ikhanda elibuhlungu ngokuzumayo, elinzima njengaleli yinto okungafanele siyithathe kalula. Kungaba uphawu lokopha okukhulu ngaphakathi kobuchopho. Namuhla, sizokhuluma ngesinye sezimo eziphuthumayo zezokwelapha, ukopha okungaphansi kwe-subarachnoid (SAH).

Kalula nje, kuyini i-Subarachnoid Hemorrhage (SAH)?

Kulungile, leli gama lingase lizwakale liyinkimbinkimbi kancane, kodwa masiligcine lilula. Ubuchopho bakho abugcini nje ngokuba semuva kwekhanda lakho. Buvikelwe isembozo sezicubu esinezingqimba ezintathu. Ngokwezokwelapha, lokhu sikubiza ngokuthi ama-meninges.

Cabanga ngakho njengo-anyanisi. Ingxenye engaphakathi ka-anyanisi inesikhumba esincane esizungezile, futhi yileyo ndlela la ma-membrane atholakala ngayo azungeze ubuchopho.

1. I-Dura mater: Lena yi-membrane engaphandle kakhulu, eqinile elele ngaphansi kwekhanda.

2. I-Arachnoid: Lena yi-membrane encane, efana ne-spider-like-web ephakathi.

3. I-Pia mater: Lena yi-membrane engaphakathi enamathele ezicutshini zobuchopho uqobo.

Manje, isikhala esiphakathi kwe-membrane ye-arachnoid phakathi nendawo kanye ne-pia mater esendlalelo esingaphakathi sibizwa ngokuthi `isikhala se-Subarachnoid`. `I-Sub` isho ukuthi "ngaphansi". Ngakho-ke lokhu kubhekisela esikhaleni esingaphansi kwe-membrane ye-arachnoid. Uma ngesizathu esithile, ukuphuma kwegazi kwenzeka kulesi sikhala, yilokho esikubiza ngokuthi i-Subarachnoid Hemorrhage (SAH) .

Uyini umehluko phakathi kwe-SAH ne-Subdural Hematoma?

Kungenzeka ukuthi uke wezwa ngesimo esibizwa ngokuthi 'i-Subdural Hematoma'. Zombili ziphuma igazi endaweni yobuchopho. Kodwa umehluko uwukuthi lapho ukuphuma kwegazi kwenzeka khona. Ake sikuchaze kahle lokhu.

Izimpawu zazo zombili lezi zimo ngezinye izikhathi zingafana. Futhi zombili ziyizimo eziphuthumayo ezingabangela ukulimala kobuchopho. Ngakho-ke kubalulekile ukufuna iseluleko sezokwelapha ngokushesha nje lapho kuvela izimpawu.

Ubani okungenzeka kakhulu ukuthi athole lesi simo? Yiziphi izinto ezibangela ingozi?

Nakuba noma ubani angaba ne-subarachnoid hemorrhage (SAH), ivame kakhulu kubantu abaneminyaka ephakathi kuka-40 no-60 .

I-SAH ivame ukubangelwa ukulimala ekhanda kubantu asebekhulile. Kungenzeka uma bewa bese beshaya ikhanda labo. Kwabantu abasebasha, imbangela eyinhloko izingozi zezimoto.

Ngaphezu kwalokho, kunezinye izici eziningana ezandisa ingozi yokuthola i-SAH. Ake sibone ukuthi ziyini.

• Ukuba ne-aneurysm engaqhekekile ebuchosheni noma kwenye indawo emzimbeni: I-aneurysm iwukuba buthaka kodonga lomthambo wegazi oluvuvukala njengebhaluni. Lokhu kungaqhuma nganoma yisiphi isikhathi.
• Ukuba nomlando we-aneurysm yobuchopho eqhume ngaphambilini.
• Ukubhema: Ukubhema kulimaza kakhulu imithambo yegazi.
• Umfutho wegazi ophezulu (Umfutho wegazi ophakeme): Umfutho wegazi ophezulu ongalawulwa ungalimaza imithambo yegazi, wandise ingozi yokwakheka nokuqhuma kwe-aneurysm.
• Ezinye izimo zofuzo: Izifo ezithinta izicubu ezixhumeneyo, njenge-Fibromuscular Dysplasia (FMD) kanye ne-Ehlers-Danlos syndrome.
• Ukuba Nesifo Sezinso Esibizwa Nge-Polycystic.
• Ukusetshenziswa kwezidakamizwa: Ikakhulukazi izidakamizwa ezivuselelayo njenge-cocaine ne-methamphetamine.
• Ukuphuza utshwala ngokweqile.
• Ukusetshenziswa kwemithi yokunciphisa igazi: Isibonelo, i-Warfarin.
• Ukuba nomlando oqinile womndeni we-aneurysms.

Ziyini izimpawu ze-SAH?

Njengoba sixoxile ngaphambili, uphawu oluyinhloko nolusheshayo kakhulu ikhanda elibuhlungu ngokuzumayo, elibizwa ngokuthi "i-Thunderclap Headache." Lokhu kufinyelela ubuhlungu obukhulu ngemizuzwana embalwa.

Cabanga nje, wenza umsebenzi wakho ojwayelekile. Ngaphandle kwesixwayiso, ngokuzumayo, uzwa ubuhlungu obukhulu ekhanda lakho, njengokungathi ibhomu liqhumile ngaphakathi kuwe, noma othile ukushaye ngesando. Yilokho okuzwakalayo.

Yiziphi izimbangela eziyinhloko ze-SAH?

Manje ake sibheke izizathu eziyinhloko zalesi simo esiyingozi.

• Ukulimala okukhulu ekhanda: Imbangela evame kakhulu ye-SAH ukushaywa kanzima ekhanda, njengokuwa okukhulu noma ingozi yemoto.
• Ukuqhuma kwe-Aneurysm: Lokhu kuyimbangela yokuthi cishe ama-85% ama-SAH avele ngaphandle kwengozi. Indawo ebuthakathaka emthanjeni wegazi ebuchosheni ivuvukala njengebhaluni bese iqhuma ngokuzumayo. Igazi bese livuza esikhaleni se-subarachnoid ngaphansi kokucindezeleka okuphezulu.
• Ukukhubazeka kwemithambo yegazi: Ukopha kungenzeka futhi ngenxa yezimo lapho imithambo yegazi ihlangana khona, njenge-arteriovenous malformation (AVM).
• Izinkinga zokopha: Izimo lapho igazi lingavimbi kalula.
• Ukusetshenziswa kwemithi yokunciphisa igazi.
• Ukusetshenziswa kwezidakamizwa: Izidakamizwa ezifana ne-cocaine zingabangela ukwanda okungazelelwe komfutho wegazi futhi zibangele ukuqhuma kwemithambo yegazi.

Odokotela basithola kanjani lesi sifo?

Uma uya esibhedlela unezimpawu ezinjengalezi, odokotela bakuthatha njengokuphuthumayo futhi bakwenze ngokushesha ukuhlolwa.

1. I-CT Scan (I-Computerized Tomography Scan): Lesi isivivinyo sokuqala nesibaluleke kakhulu. Lokhu kuthatha izithombe zengaphakathi lekhanda futhi kungabona ngokucacile ukuthi kukhona igazi elizungeze ubuchopho. Ngezinye izikhathi kwenziwa i-scan ekhethekile ebizwa ngokuthi i-CT Angiography (CTA). Kulokhu, kufakwa idayi emthanjeni ukuze kuhlolwe isimo semithambo yegazi.

2. Ukubhoboza Kwethambo: Ngezinye izikhathi i-CT scan ingase ingakuboni ukopha okuncane kakhulu. Ezimweni ezinjalo, odokotela benza lokhu kuhlola. Kulokhu, kufakwa inaliti encane kakhulu emhlane ongezansi bese kususwa inani elincane loketshezi lwe-cerebrospinal (CSF) endaweni ezungeze ubuchopho nomgogodla. Uketshezi luhlolwa ukuthi alunamangqamuzana egazi abomvu noma i-xanthochromia (ukuphuzi). Lolu ketshezi luphenduka lube phuzi ngemva kwesikhathi esifushane sokopha.

3. I-MRI Scan (I-Magnetic Resonance Imaging): Uma kukhona ukusolakala kokuphuma kwegazi muva nje, lolu vivinyo lungakuthola.

Uma ukuxilongwa sekuqinisekisiwe, kungenziwa ezinye izivivinyo, njenge-cerebral angiogram, ukuze kutholakale imbangela eqondile yokopha.

Iphathwa kanjani?

Ngenxa yokuthi i-SAH isongela ukuphila, isiguli sivame ukungeniswa egunjini lokunakekelwa okujulile esibhedlela (ICU) futhi selashwe yithimba lodokotela abangochwepheshe bezifo zezinzwa. Imigomo eyinhloko yokwelashwa yile:

• Ukusindisa impilo yesiguli.
• Lungisa imbangela yokopha.
• Ukulawula izimpawu.
• Ukuvimbela izinkinga (isib. i-vasospasm, i-hydrocephalus).

Izindlela zokwelapha zokusindisa impilo nokulawula izimpawu:

• Ukunikeza ukwesekwa kokuphila.
• Ukufaka ipayipi lokukhipha amanzi ukuze kuncishiswe ingcindezi ebuchosheni.
• Ukuthatha izinyathelo zokuvikela umgudu wokuphefumula.
• Ukunikeza umuthi we-IV (ofakwa emthanjeni) ukulawula umfutho wegazi.
• Ukunikeza imithi yokuvimbela ukuminyana kwemithambo yegazi (i-vasospasm).
• Ukunikeza imithi yokuqeda izinhlungu kanye nemithi yokwelapha ukukhathazeka ngenxa yekhanda elibuhlungu kakhulu.
• Ukunikeza imithi yokuvimbela noma yokulawula ukuxhuzula.

Ukwelapha imbangela yokopha:

• Uma i-aneurysm iqhumile: Kwenziwa ukuhlinzwa ukuze kulungiswe. Lokhu kungenziwa kusetshenziswa amasu anjengo-'Surgical Clipping' (ukuvala intamo ye-aneurysm nge-clip) noma i-'Endovascular Coiling' (ukuvala i-aneurysm nge-wire coil ngemithambo yegazi).
• Uma igazi liqongelelene ngenxa yengozi: Kungadingeka ukuhlinzwa ukuze kuncishiswe ingcindezi ebuchosheni futhi kususwe igazi eliqongelelene.

Ngokuvamile, umuntu one-SAH kungadingeka ahlale esibhedlela izinsuku eziyi-10 kuya kwezingama-20 noma ngaphezulu, kuye ngesimo kanye nezidingo zokuvuselelwa.

Yimiphi imiphumela yesikhathi eside kanye nezinkinga zalesi simo?

Lesi yisimo esibi kakhulu. Ngokwezibalo, cishe ingxenye yabantu abane-SAH bafa ngokuzumayo. Kulabo abeza esibhedlela:

• Ingxenye eyodwa kwezintathu ishonela esibhedlela.
• Umuntu oyedwa kwabathathu uphila nokukhubazeka okuthile.
• Ingxenye yesithathu ibuyela empilweni evamile.

I-SAH ingabangela ukulimala kobuchopho, okungaholela ezinkingeni zesikhathi eside noma ezingapheli.

• Izinkinga zomzimba: Ukukhathala njalo kanye nokulala, ukungazweli noma ubuthakathaka ezingxenyeni zomzimba, ubunzima bokugwinya, ukulahlekelwa yibhalansi.
• Izinkinga zokuqonda: izinkinga zenkumbulo, ubunzima bokugxilisa ingqondo, ubunzima bokuhlela nokwenza imisebenzi eyinkimbinkimbi.
• Ubunzima bokukhuluma: inkulumo engacacile, inkulumo ehamba kancane, ubunzima bokuthola amagama afanele.
• Izinkinga zempilo yengqondo: Njengoba lokhu kuyinhlekelele enkulu empilweni, izimo ezinjengokucindezeleka, ukukhathazeka okuvamile, kanye nesifo sokucindezeleka ngemva kwenhlekelele (PTSD) zingase zivele.

Ukuze kulawulwe lezi zinkinga zesikhathi eside, ukwelashwa okufana nokwelashwa ngokomzimba, ukwelashwa ngokomsebenzi, ukwelashwa ngenkulumo, kanye nokwelashwa kwengqondo kunganikeza impumuzo enkulu.

Yini esingayenza ukuze sinciphise ingozi?

Njengoba izimbangela eziyinhloko ze-SAH kuwukulimala ekhanda kanye nokuqhekeka kwe-aneurysm, kungcono ukuthatha izinyathelo zokuvimbela zombili lezi zenzakalo.

Ukuvimbela ukulimala ekhanda:

• Gqoka isigqoko njalo uma ugibela amabhayisikili noma izithuthuthu noma udlala imidlalo eyingozi.
• Shayela ngokuphepha futhi ulalele imithetho yomgwaqo.
• Uma uvame ukuwa, funa iseluleko kudokotela wezokwelapha umzimba futhi ufunde izindlela zokuvimbela ukuwa nokwenza ikhaya lakho liphephe.

Ukunciphisa ingozi ye-aneurysm:

• Lawula umfutho wegazi ophakeme. Phuza imithi yakho njengoba nje udokotela wakho ekuyalele. Yenza izinguquko endleleni yokuphila (nciphisa usawoti odlayo, uvivinye umzimba).
• Yeka ukubhema ngokuphelele.
• Vivinya umzimba njalo, kodwa gwema ukuphakamisa izinsimbi ezisindayo ngesikhathi esisodwa, njengoba ukuzikhandla ngokweqile kungabangela ukuqhuma kwe-aneurysm.
• Yidla ukudla okunempilo.
• Gwema ngokuphelele ukusebenzisa utshwala nezidakamizwa, ikakhulukazi izinto ezivuselela ingqondo njenge-cocaine.

Uma udokotela wakho ekutshelile ukuthi une-aneurysm engakaqhekeki, khuluma naye ngezinketho zokwelapha kanye nezindlela zokuphatha ezitholakalayo.