Subarachnoid Hemorrhage

Kodi Subarachnoid Hemorrhage ndi Chiyani?

Subarachnoid hemorrhage (SAH) amatanthauzachipatala syndrome chifukwa cha kusweka kwa mitsempha yodwala pansi kapena pamwamba pa ubongo, ndi kutuluka kwa magazi mwachindunji mumtsempha wa subarachnoid.Imadziwikanso kuti SAH yoyamba, yomwe imakhala pafupifupi 10% ya sitiroko yowopsa.SAH ndi matenda ofala kwambiri owopsa kwambiri.

Kafukufuku wa WHO akuwonetsa kuti chiwopsezo cha anthu ku China ndi pafupifupi 2 mwa anthu 100,000 pachaka, ndipo palinso malipoti a 6-20 mwa anthu 100,000 pachaka.Palinso kukha magazi kwachiwiri kwapang'onopang'ono komwe kumachitika chifukwa cha kukha magazi kwa intracerebral, epidural kapena subdural blood chotengera, magazi kulowa mu minofu yaubongo ndikuyenderera m'mitsempha ya subarachnoid.

Kodi Etiology ya Subarachnoid Hemorrhage ndi Chiyani?

Chifukwa chilichonse cha kukha magazi muubongo chingayambitse kukha magazi kwa subarachnoid.Zomwe zimayambitsa ndi izi:
1. Intracranial aneurysm: imawerengera 50-85%, ndipo imatha kuchitika panthambi ya aorta ya mphete yaubongo;
2. Cerebral vascular malformation: makamaka arteriovenous malformation, yomwe imawonedwa kwambiri ndi achinyamata, pafupifupi 2%.Mitsempha ya arteriovenous imakhala makamaka m'madera a ubongo wa mitsempha ya ubongo;
3. Matenda osadziwika bwino a cerebral vascular network(Matenda a Moyamoya): amatenga pafupifupi 1%;
4. Zina:Kuchotsa aneurysm, vasculitis, intracranial venous thrombosis, connective minofu matenda, hematopathy, intracranial chotupa, coagulation kusokonezeka, anticoagulation mankhwala mavuto, etc.
5. Zomwe zimayambitsa magazi mwa odwala ena sizidziwika, monga kukha mwazi kwapakati pa ubongo.
Zowopsa za kukha magazi kwa subarachnoid ndizomwe zimayambitsa kupasuka kwa intracranial aneurysms, kuphatikizamatenda oopsa, kusuta, kuledzera, mbiri yakale ya kupasuka kwa aneurysm, kudzikundikira kwa aneurysms, angapo aneurysms,ndi zina.Poyerekeza ndi osasuta, osuta amakhala ndi ma aneurysms akuluakulu ndipo amatha kukhala ndi ma aneurysms angapo.

Kodi Zizindikiro za Subarachnoid Hemorrhage ndi Chiyani?

Zizindikiro zodziwika bwino za SAH ndimutu waukulu mwadzidzidzi, nseru, kusanza ndi kukwiya kwa meningeal, kapena popanda zizindikiro.Panthawi kapena pambuyo pa ntchito zolemetsa, pangakhalekuphulika kwa ululu wa m'deralo kapena mutu wonse, zomwe sizingatheke.Zitha kukhala zowonjezereka kapena zowonjezereka, ndipo nthawi zina zingakhalepokupweteka kwa khosi lapamwamba.

Chiyambi cha SAH nthawi zambiri chimagwirizana ndi malo ophulika a aneurysm.Zizindikiro zotsatizana nazo ndizokusanza, kusokonezeka kwakanthawi kwa chidziwitso, kupweteka kumbuyo kapena kumunsi kwa miyendo, photophobia,etc. Nthawi zambiri,kuyabwa kwa meningealanaonekera pasanathe maola isanayambike matenda, ndikhosi lolimbakukhala chizindikiro chodziwika bwino kwambiri.Zizindikiro za Kernig ndi Brudzinski zitha kukhala zabwino.Kuyesedwa kwa fundus kumatha kuwonetsa kukha magazi kwa retina ndi papilledema.Kuphatikiza apo, pafupifupi 25% ya odwala angakhale nawozizindikiro za m'maganizo, monga kukondwa, chinyengo, kuyerekezera zinthu m'maganizo, ndi zina zotero.

Pakhoza kukhalansokhunyu, zizindikiro zakusokonekera kwa minyewa monga kukomoka kwa oculomotor, aphasia, monoplegia kapena hemiplegia, kusokonezeka kwamalingaliro,etc. Odwala ena, makamaka odwala okalamba, nthawi zambiri atypical matenda zizindikiro mongakupweteka kwa mutu ndi meningeal,pamene zizindikiro za m'maganizo zikuwonekera.Odwala ndi primary midbrain hemorrhage ali ndi zizindikiro zochepa, zomwe zikuwonetsedwa mu CT mongahematocele mu mesencephalon kapena peripontine chitsime popanda aneurysm kapena zolakwika zina pa angiography.Nthawi zambiri, palibe vasospasm yobwereranso kapena mochedwa, ndipo zotsatira zake zachipatala zimakhala zabwino.