Subarachnoid Hemorrhage

Chii chinonzi Subarachnoid Hemorrhage?

Subarachnoid hemorrhage (SAH) zvinorevachirwere chekiriniki chinokonzerwa nekuputika kwemidziyo yeropa ine chirwere pasi kana pamusoro pehuropi, uye kubuda kweropa zvakananga mugomba re subarachnoid.Iyo inozivikanwa zvakare seyekutanga SAH, iyo inoverengera ingangoita gumi muzana yeacute sitiroko.SAH chirwere chakajairika chekuomarara kusingawanzo.

Ongororo yeWHO inoratidza kuti huwandu hwezviitiko muChina hunosvika 2 pa100,000 vanhu pagore, uye kune zvakare mishumo ye6-20 pa100,000 vanhu pagore.Kune zvakare yechipiri subarachnoid hemorrhage inokonzerwa ne intracerebral hemorrhage, epidural kana subdural blood vessel rupture, ropa rinopinda muuropi tishu uye kuyerera musubarachnoid cavity.

Chii chinonzi Etiology yeSubarachnoid Hemorrhage?

Chero chikonzero checerebral hemorrhage chinogona kukonzera subarachnoid hemorrhage.Zvikonzero zvinowanzoitika ndezvi:
1. Intracranial aneurysm: inotora 50-85%, uye inowanzoitika pabazi re aorta ye cerebral artery ring;
2. Cerebral vascular malformation: kunyanya arteriovenous malformation, inonyanya kuonekwa muvechiri kuyaruka, inoverengera inenge 2%.Arteriovenous malformations inonyanya kuwanikwa munzvimbo dzeuropi dzecerebral arteries;
3. Abnormal cerebral vascular network chirwere(Chirwere cheMoyamoya): chinotora chikamu chimwe chete kubva muzana;
4. Zvimwe:Dissecting aneurysm, vasculitis, intracranial venous thrombosis, connective tishu chirwere, hematopathy, intracranial bundu, coagulation kusagadzikana, anticoagulation kurapwa matambudziko, nezvimwe.
5. Chikonzero chekubuda ropa mune vamwe varwere hachizivikanwi, zvakadai seprimary peri midbrain hemorrhage.
Izvo zvinokonzeresa zve subbarachnoid hemorrhage ndizvo zvinonyanya kukonzera kuputika kwe intracranial aneurysms, kusanganisira.hypertension, kusvuta, kudhakwa, nhoroondo yekare yekuputika kweaneurysm, kuunganidza aneurysms, multiple aneurysms,etc.Kuenzaniswa nevasiri kuputa, vanoputa vane aneurysms yakakura uye vanogona kunge vaine aneurysms yakawanda.

Ndezvipi Zviratidzo zveSubarachnoid Hemorrhage?

Zviratidzo zvekliniki zveSAH ndizvokutemwa nemusoro, kusvotwa, kurutsa uye kushatirwa kwemeningeal, uine kana pasina zviratidzo zvemukati.Mukati memibato inonetesa kana kuti yapera, paizovakuputika kwemarwadzo emunharaunda kana akazara musoro, izvo zvisingagoneki.Inogona kuramba ichienderera kana kuramba ichiwedzera, uye dzimwe nguva, pangavakurwadziwa mumutsipa wepamusoro.

Mhedzisiro yeSAH inowanzoenderana nenzvimbo inoputika yeaneurysm.Zvakajairika zviratidzo zvinoperekedza ndizvokurutsa, kuvhiringidzika kwenguva pfupi kwekuziva, musana kana marwadzo emakumbo, uye photophobia;etc. Kazhinji,meningeal irritationakaonekwa mukati maawa mushure mekutanga kwechirwere, pamwekuoma kwemutsipakuva chiratidzo chiri pachena.Kernig's naBrudzinski zviratidzo zvinogona kunge zviri positive.Kuongororwa kwe fundus kunogona kuratidza retinal hemorrhage uye papilledema.Mukuwedzera, inenge 25% yevarwere vanogona kuva nayozviratidzo zvepfungwa, zvakadai se euphoria, kunyengera, kufungidzira, nezvimwewo.

Panogona kuvawopfari pfari, focal neurological deficit zviratidzo zvakaita seoculomotor paralysis, aphasia, monoplegia kana hemiplegia, kusagadzikana kwekunzwa,etc. Vamwe varwere, kunyanya vakwegura varwere, kazhinji vane atypical kliniki zviratidzo zvakadaikutemwa nemusoro uye meningeal irritation;nepo zviratidzo zvepfungwa zviri pachena.Varwere vane primary midbrain hemorrhage vane zviratidzo zvinyoro, zvinoratidzwa muCT sehematocele mu mesencephalon kana peripontine chirongo chisina aneurysm kana zvimwe zvisiri izvo pa angiography.Kazhinji, hapana kubuda ropa kana kunonoka-kutanga vasospasm kwaizoitika, uye zvinotarisirwa mhedzisiro yekiriniki yakanaka.