Subarachnoid Hemorrhage

He aha ka Subarachnoid Hemorrhage?

ʻO ka Subarachnoid hemorrhage (SAH) pili ihe maʻi maʻi ma muli o ka haki ʻana o nā kīʻaha koko maʻi ma lalo a i ʻole ka ʻili o ka lolo, a me ke kahe pololei ʻana o ke koko i loko o ka lua subarachnoid.Ua ʻike ʻia ʻo ia ʻo SAH mua, ʻo ia ka mea ma kahi o 10% o ka hahau ʻana.ʻO SAH kahi maʻi maʻamau o ka maʻi maʻamau.

Hōʻike nā noiʻi WHO e pili ana ka nui o ka maʻi ma Kina ma kahi o 2 i kēlā me kēia 100,000 poʻe i kēlā me kēia makahiki, a aia pū kekahi mau hōʻike o 6-20 no 100,000 mau kānaka i kēlā me kēia makahiki.Aia kekahi lua o ka subarachnoid hemorrhage i hoʻokumu ʻia e ka intracerebral hemorrhage, epidural a i ʻole subdural hemorrhage moku, ke koko komo i ka lolo a kahe i loko o ka lua subarachnoid.

He aha ke kumu o ka Subarachnoid Hemorrhage?

Hiki i kekahi kumu o ka hemorrhage cerebral ke kumu o ka hemorrhage subarachnoid.ʻO nā kumu maʻamau:
1. Intracranial aneurysm: he 50-85% ia, a he oi aku paha ia ma ka lala o ke aorta o ke apo o ke a'a cerebral;
2. ʻO ka pōʻino o ka puʻuwai cerebral: ka hapa nui o ka arteriovenous malformation, ka hapanui i ikeia i ka poe opiopio, e helu ana ma kahi o 2%.Loaʻa ka hapa nui o nā maʻi ʻino i ka lolo o nā ʻaʻa cerebral;
3. ʻO ka maʻi maʻi maʻi ʻāʻī o ka cerebral vascular network(ʻO ka maʻi Moyamoya): aia ma kahi o 1%;
4. Nā mea ʻē aʻe:ʻO ka wehe ʻana i ka aneurysm, vasculitis, intracranial venous thrombosis, connective tissue maʻi, hematopathy, intracranial tumor, coagulation disorders, anticoagulation treatment complications, etc.
5. ʻAʻole ʻike ʻia ke kumu o ke kahe ʻana o ke koko i kekahi mau maʻi, e like me ka hemorrhage peri midbrain.
ʻO nā kumu pilikia o ka hemorrhage subarachnoid ka mea nui e hoʻomaka ai ka haki ʻana o nā aneurysms intracranial, me kake kiʻekiʻe kiʻekiʻe, ka puhi paka, ka inu nui, ka mōʻaukala mua o ka aneurysm ruptured, ka hōʻiliʻili o nā aneurysms, nā aneurysms lehulehu,etc.Ke hoʻohālikelike ʻia me ka poʻe ʻaʻole puhipuhi, ʻoi aku ka nui o nā aneurysms a ʻoi aku ka nui o nā aneurysms.

He aha nā hōʻailona o ka Subarachnoid Hemorrhage?

ʻO nā hōʻailona maʻamau o SAHʻO ke poʻo nui hikiwawe, nausea, luaʻi a me ka maningeal irritation, me ka ʻole a i ʻole nā ​​hōʻailona focal..I ka wā a i ʻole ma hope o nā hana koʻikoʻi, aiapohā o ka ʻeha poʻo kūloko a i ʻole holoʻokoʻa, ʻaʻole hiki ke ʻae ʻia.Hiki ke hoʻomau a hoʻomau mau ʻia paha, a i kekahi manawa, aia nōʻeha ma ka ʻāʻī luna.

ʻO ke kumu o ka SAH e pili pinepine ana i ka wahi rupture o ka aneurysm.ʻO nā hōʻailona maʻamauka luaʻi ʻana, ka hoʻohaunaele manawa o ka ʻike, ka ʻeha hope a i ʻole nā ​​lālā lalo, a me ka photophobia,etc. Ma ka hapanui o na hihia,maningeal irritationua puka mai i loko o nā hola ma hope o ka hoʻomaka ʻana o ka maʻi, meʻāʻī ʻoʻoleʻaʻo ia ka hōʻailona maopopo loa.Hiki ke maikaʻi nā hōʻailona o Kernig a me Brudzinski.Hiki i ka hoʻokolokolo fundus ke hōʻike i ka retinal hemorrhage a me ka papilledema.Eia kekahi, ma kahi o 25% o nā maʻi i loaʻanā hōʻailona noʻonoʻo, e like me ka euphoria, delusions, hallucinations, etc.

Aia nō pahanā maʻi epileptic, nā hōʻailona deficit neurological focal e like me ka oculomotor paralysis, aphasia, monoplegia a hemiplegia, nā maʻi sensory,etc. ʻO kekahi mau maʻi, ʻoi aku ka poʻe maʻi ʻelemakule, loaʻa pinepine nā hōʻailona maʻi atypical e like meʻeha ʻeha a me ka maningeal irritation,ʻoiai ua maopopo nā hōʻailona noʻonoʻo.ʻO nā maʻi me ka hemorrhage midbrain mua loaʻa nā hōʻailona maʻalahi, i hōʻike ʻia ma CT e like mehematocele i loko o ka mesencephalon a i ʻole peripontine cistern me ka aneurysm a i ʻole nā ​​​​mea ʻino ʻē aʻe ma ka angiography.ʻO ka mea maʻamau, ʻaʻole hiki ke kahe hou a i ʻole ka hoʻomaka ʻana o ka vasospasm, a maikaʻi nā hopena lapaʻau i manaʻo ʻia.