I-Subarachnoid Hemorrhage

Iyini I-Subarachnoid Hemorrhage?

I-Subarachnoid hemorrhage (SAH) ibhekisela kuisifo somtholampilo esibangelwa ukuphuka kwemithambo yegazi enesifo phansi noma ngaphezulu kobuchopho, kanye nokugeleza kwegazi okuqondile emgodini we-subarachnoid.Yaziwa nangokuthi yi- primary SAH, eyenza cishe u-10% we-acute stroke.I-SAH yisifo esivamile esinzima esingajwayelekile.

Ucwaningo lwe-WHO lukhombisa ukuthi izinga lezehlakalo eChina lilinganiselwa ku-2 kubantu abayizi-100,000 ngonyaka, kanti futhi kukhona imibiko yabantu abayi-6-20 kubantu abayizi-100,000 ngonyaka.Kukhona futhi ukopha kwesibili kwe-subarachnoid okubangelwa ukopha kwe-intracerebral, ukuphuka kwe-epidural noma i-subdural blood vessel, igazi elingena ezicutshini zobuchopho futhi ligeleze emgodini we-subarachnoid.

Iyini i-Etiology ye-Subarachnoid Hemorrhage?

Noma iyiphi imbangela yokopha ebuchosheni ingabangela ukopha kwe-subarachnoid.Izimbangela ezijwayelekile yilezi:
1. I-Intracranial aneurysm: kubalwa ku-50-85%, futhi kungenzeka kakhulu ukuthi kwenzeke egatsheni le-aorta yendandatho ye-cerebral artery;
2. Ukukhubazeka kwe-cerebral vascular: ikakhulukazi i-arteriovenous malformation, ebonakala kakhulu entsheni, okubalelwa ku-2%.Ukukhubazeka kwe-Arteriovenous ngokuvamile kutholakala ezindaweni zobuchopho zemithambo yobuchopho;
3. Isifo esingavamile se-cerebral vascular network(Isifo sikaMoyamoya): silinganiselwa ku-1%;
4. Abanye:Ukukhipha i-aneurysm, i-vasculitis, i-intracranial venous thrombosis, isifo sezicubu ezixhumeneyo, i-hematopathy, isimila se-intracranial, ukuphazamiseka kwe-coagulation, izinkinga zokwelashwa kwe-anticoagulation, njll.
5. Imbangela yokopha kwezinye iziguli ayaziwa, njengokopha kwe-primary peri midbrain.
Izingozi zokopha kwe-subarachnoid ikakhulukazi yizici ezibangela ukugqashuka kwe-intracranial aneurysms, okuhlanganisaumfutho wegazi ophakeme, ukubhema, ukuphuza ngokweqile, umlando wangaphambilini we-aneurysm ephukile, ukunqwabelana kwama-aneurysms, i-aneurysms eminingi,njll.Uma kuqhathaniswa nabangabhemi, ababhemayo banama-aneurysm amakhulu futhi maningi amathuba okuba babe nama-aneurysms amaningi.

Yiziphi Izimpawu Ze-Subarachnoid Hemorrhage?

Izimpawu ezijwayelekile zomtholampilo ze-SAH yilezikungazelelwe ikhanda elibuhlungu elibuhlungu, isicanucanu, ukuhlanza kanye nokucasuka kwe-meningeal, noma ngaphandle kwezimpawu zokugxila.Phakathi noma ngemva kwemisebenzi ekhandlayo, kwakuyoba khonaukuqhuma kobuhlungu bekhanda bendawo noma obuphelele, obungenakubekezelelwa.Kungase kube okuphikelelayo noma okuqhubeka kube kubi, futhi ngezinye izikhathi, kungaba khonaubuhlungu entanyeni engenhla.

Imvelaphi ye-SAH ivame ukuhlotshaniswa nendawo yokuphuka kwe-aneurysm.Izimpawu ezihambisanayo ezijwayelekile ziyiukuhlanza, ukuphazamiseka kwengqondo okwesikhashana, ubuhlungu beqolo noma obuphansi, kanye ne-photophobia,njll. Ezimweni eziningi,ukucasuka kwe-meningealkwavela emahoreni ambalwa ngemva kokuqala kwesifo, ngeukuqina kwentamoukuba uphawu olusobala kakhulu.Izimpawu zika-Kernig kanye ne-Brudzinski zingaba phozithivu.Ukuhlolwa kwe-fundus kungabonisa ukopha kwe-retina kanye ne-papilledema.Ngaphezu kwalokho, cishe ama-25% eziguli angase abe nawoizimpawu zengqondo, njengokujabula, ukukhohlisa, ukubona izinto ezingekho, njll.

Kungenzeka futhiisithuthwane, izimpawu zokushoda kwezinzwa ezigxile njenge-oculomotor paralysis, aphasia, monoplegia noma hemiplegia, ukuphazamiseka kwezinzwa,njll. Ezinye iziguli, ikakhulukazi iziguli esezikhulile, zivame ukuba nezimpawu zomtholampilo ezingavamile njengeikhanda kanye nokucasuka kwe-meningeal,kuyilapho izimpawu zengqondo zisobala.Iziguli ezine-primary midbrain hemorrhage zinezimpawu ezithambile, eziboniswe ku-CT njengei-hematocele ku-mesencephalon noma kumgodi we-peripontine ongenawo i-aneurysm noma okunye okungavamile ku-angiography.Ngokuvamile, akukho ukopha kabusha noma i-vasospasm engaqala sekwephuzile, futhi imiphumela elindelekile yomtholampilo mihle.