I-Subarachnoid Hemorrhage

Yintoni i-Subarachnoid Hemorrhage?

I-Subarachnoid hemorrhage (SAH) ibhekisela kwii-syndrome yeklinikhi ebangelwa ukugqabhuka kwemithambo yegazi enesifo emazantsi okanye kumphezulu wobuchopho, kunye nokuhamba ngokuthe ngqo kwegazi kwi-subarachnoid cavity.Ikwabizwa ngokuba yi-primary SAH, eyenza malunga ne-10% ye-acute stroke.I-SAH sisifo esixhaphakileyo sobuqatha obungaqhelekanga.

Uphando lwe-WHO lubonisa ukuba izinga lezehlo e-China limalunga ne-2 kubantu abayi-100,000 ngonyaka, kwaye kukho neengxelo ze-6-20 kubantu abayi-100,000 ngonyaka.Kukwakho ukopha kwesibini kwe-subarachnoid okubangelwa ukopha kwe-intracerebral, i-epidural okanye i-subdural blood vessel rupture, igazi elingena kwizicubu zobuchopho kwaye ligeleza kwi-subarachnoid cavity.

Yintoni i-Etiology ye-Subarachnoid Hemorrhage?

Nawuphi na unobangela we-cerebral hemorrhage unokubangela ukopha kwe-subarachnoid.Oonobangela abaxhaphakileyo zezi:
1. I-aneurysm ye-Intracranial: i-akhawunti ye-50-85%, kwaye kunokwenzeka ukuba kwenzeke kwisebe le-aorta ye-cerebral artery ring;
2. Ukonakala kwemithambo yeCerebral: ubukhulu becala i-arteriovenous malformation, ibonwa kakhulu kwishumi elivisayo, ibalwa malunga ne-2%.I-Arteriovenous malformations ifumaneka kwiindawo zobuchopho kwi-cerebral arteries;
3. Isifo esingaqhelekanga se-cerebral vascular network(isifo seMoyamoya): ithatha malunga ne-1%;
4. Abanye:Ukukhupha i-aneurysm, i-vasculitis, i-intracranial thrombosis ye-venous, isifo se-tissue edibeneyo, i-hematopathy, i-tumor ye-intracranial, ukuphazamiseka kwe-coagulation, iingxaki zonyango lwe-anticoagulation, njl.
5. Isizathu sokopha kwezinye izigulane ayaziwa, njengeprimary peri midbrain hemorrhage.
Imiba yomngcipheko we-subarachnoid hemorrhage zizinto eziphambili ezibangela ukugqabhuka kwe-aneurysms ye-intracranial, kubandakanywauxinzelelo lwegazi oluphezulu, ukutshaya, ukusela kakhulu, imbali yangaphambili yokukrazuka kwe-aneurysm, ukuqokelelana kwee-aneurysms, ii-aneurysms ezininzi,njl.Xa kuthelekiswa nabantu abangatshayiyo, abantu abatshayayo banee-aneurysms ezinkulu kwaye kunokwenzeka ukuba babe nee-aneurysms ezininzi.

Ziziphi iimpawu ze-Subarachnoid Hemorrhage?

Iimpawu eziqhelekileyo zeklinikhi ze-SAH zeziintloko ebuhlungu ngesiquphe, isicaphucaphu, ukugabha kunye nokucaphuka kwe-meningeal, kunye okanye ngaphandle kweempawu ezigxile.Ngexesha okanye emva kwemisebenzi enzima, kuya kubakhoukuqhuma kweentlungu zentloko zasekhaya okanye ezipheleleyo, ezingenakunyamezeleka.Isenokuzingisa okanye iqhubeke ibe mandundu, kwaye ngamanye amaxesha, kuya kubakhointlungu entanyeni ephezulu.

Imvelaphi ye-SAH ihlala ihambelana nendawo yokukrazula kwe-aneurysm.Iimpawu eziqhelekileyo ezihamba nazoukuhlanza, ukuphazamiseka kwengqondo okwethutyana, iintlungu zangasemva okanye ezisezantsi, kunye ne-photophobia;njl. Kwiimeko ezininzi,ukucaphuka kwe-meningealwabonakala kwiiyure ezimbalwa emva kokuqala kwesi sifo, ngeubulukhuni bentamoolona phawu lucacileyo.Iimpawu ze-Kernig's kunye ne-Brudzinski zinokuba ne-positive.Ukuhlolwa kwe-fundus kunokubonisa ukopha kweretina kunye ne-papilledema.Ukongeza, malunga ne-25% yezigulane zinokuba nazoiimpawu zengqondo, ezifana ne-euphoria, inkohliso, i-hallucinations, njl.

Kusenokubakho kwakhonaUkuxhuzula, iimpawu zokunqongophala kwe-neurological ezifana nokukhubazeka kwe-oculomotor, i-aphasia, i-monoplegia okanye i-hemiplegia, ukuphazamiseka kwengqondo,njllintloko ebuhlungu kunye nokucaphuka kwe-meningeal;ngelixa iimpawu zengqondo zibonakala.Izigulane ezine-primary midbrain hemorrhage zineempawu ezincinci, eziboniswe kwi-CT njengei-hematocele kwi-mesencephalon okanye i-peripontine qula elingenayo i-aneurysm okanye ezinye izinto ezingaqhelekanga kwi-angiography.Ngokuqhelekileyo, akukho kukhutshwa kwakhona okanye i-vasospasm emva kwexesha iya kwenzeka, kwaye iziphumo ezilindelekileyo zeklinikhi zilungile.