I-atherosulinosis yemithambo ye-intracranial yobuchopho iyimbangela evame kakhulu yokuhlaselwa yisifo sohlangothi. Kuyaphawuleka ukuthi ubungozi balesi sifo buxhomeke kumbala wesikhumba, abantu baseYurophu abasengozini yokuthola i-pathology ukwedlula abamele izinhlanga zase-Asia neNegroid.
Izimbangela zokwephula umthetho wukuba khona kwamathafa asesiswini emthanjeni omncane we-artery, arterio-arterial embolism, hyperfunction yezicubu zobuchopho. Imvamisa yokubuyela emuva ibangelwa ukulahleka kwekhono lokugcina ukuhamba kwegazi okujwayelekile.
I-Pathology ibanga ukuphazamiseka kokujikeleza okubucayi ebuchosheni, okufana nezinguquko ze-atherosulinotic emithanjeni yemithambo yegazi. Usongo luhambisana nokuvuvukala ekwenzekeni, ekuqhubekeni phambili kanye nasekulimaleni kwama-atherosulinotic plaques.
Ngokuqina, lesi sifo sisendaweni yesibili ngemuva kwe-atherosulinosis yemithambo yenhliziyo ethinta inhliziyo. Izimpawu zesifo yilezi:
- ukukhubazeka kwenkumbulo;
- ukwehla kokusebenza kwengqondo;
- ukukhathala.
Iziguli zilahlekelwa ukuqina kwemizwelo, kuphakama ingcindezi yokungena, amakhanda ahlabayo aqala, ikakhulukazi lapho esuka ekujikeni uye endaweni ethe mpo. Iziguli zinezinkinga ezinzima zengqondo, ukungajabuli emgogodleni wesibeletho.
Izindlela zokuxilongwa kwe-pathology
Ekutholakalweni kwe-atherosulinosis yemithambo ye-intracranial, ukuhlolwa kwe-ultrasound, imaging yama-magnetic resonance, i-compact tomography, i-angiography yedijithali yokususa okudingekayo. Izinga legolide lokuxilonga liyindlela ngqo, kepha ngasikhathi sinye, lifuna ukwethulwa kwesiqalo esiphakathi. Ibuye ihlinzeke nengozi yokushoda kwe-neurological okuqhubekayo.
Ngokuphathelene nokunemba kwezindlela ezingadingi ukusetshenziswa kwamathuluzi ezokwelapha namadivayisi, imininingwane ayikho. Njengoba ukubonwa kwe-lumen kuncike ekuhambeni kwegazi, ubukhulu bezilonda ze-vascular bungase buhlanekezelwe.
Ukuze ungafaki ukulimala kwemithambo ye-intracranial, i-transcranial dopplerography, i-MRI iyenziwa, kepha ayithembekile ngokwanele ukuthola ubukhona be-stenosis futhi ithole ubulukhuni bayo. I-Dopplerography inika umbono wesimo semikhumbi ebambisene, isiza ekuboneni ukusebenza kabusha kwe-cerebrovascular.
Indlela yendabuko yokuxilonga ihlose kuphela ukuthola ubunzima bokuthi imincane imincane imithambo.
Ngakho-ke, kunezingqinamba eziningi, ikakhulukazi ukungakwazi ukubona:
- ukwakheka komlando kwe-plaque;
- ubungako bokuqina kokuqina
- ezinye izimbangela ze-stenosis.
Okwamanje, i-magnetic resonance imaging, ukuhlolwa kwe-intravascular ultrasound ithole ukubaluleka okukhethekile. Amasu okusiza ukutadisha lesi sifo ngemininingwane eminingi. Lokhu kubaluleke kakhulu ezigabeni zokuqala zesifo, lapho i-lumen ye-vascular ithinteka kancane.
I-MRI isiza ukubona ngeso lengqondo ijazi legazi, ukubona ukwakheka kwaso, ukumisa ukwakheka, ukuba khona kwe-hemorrhage, izinga lomsebenzi we-neoplasm. Ucwaningo lwe-Intravascular futhi lwembula i-hemorrhage ku-plaque, ukwakheka kwayo, ubukhulu. Amasu ahlinzeka ithuba lokuthonya ubungozi namaqhinga okuphathwa kwe-atherosulinosis yemithambo ye-intracranial.
Izindlela zokucwaninga ezithuthukayo zibaluleke kakhulu ekulimazekeni nasekulimazeni okungahambi kahle emithanjeni, uma isimo sezindawo ezinamatshe singatholakali ngenxa yezindlela zokuxilonga zakudala.
Izimpawu zomtholampilo
Ukuxilongwa, izimpawu zendawo zalesi sifo zibaluleke kakhulu. Uma umuntu enesifo sokuqina kwamathambo esihlinzeka nge-medulla oblongata, uthola ukuphefumula kukaCheyne-Stokes. Ngokulimala isikhathi eside esikhungweni sokuphefumula, i-cyanosis, ukusonteka kwemisipha yobuso kuyabonakala. Ukulahlekelwa ukukhuluma, ubumpumputhe, ukungaboni, ukukhubazeka kwamalunga nakho kungenzeka.
Ukuqala kwezimpawu zesikhashana esifushane kubangelwa yimisuka yemithambo ebuchosheni, enomlingiswa ongaguquki, ama-lumen ayavala, nezinto zemithambo-luvo zithamba esigabeni esilandelayo sesifo.
Nge-occlusion ye-arterial, izicubu zomqondo ziyafa. Ngokuqhekeka kwezindonga zemithambo yegazi, kutholakala ukuthi kuphuma izicubu ezithweni. I-Thrombosis icashula ukwephulwa komsebenzi wobuchopho, ukuphuma kwesibindi ngokushesha. Ukulimala ezikhungweni ezibalulekile kubangela ukufa. Iziguli kufanele zigadwe udokotela wezifo zengqondo nodokotela wezifo zengqondo.
Izimpawu eziyingozi ze-atherosulinosis yemithambo ye-intracranial yilezi:
- ukuhlaselwa kwesikhashana kwe-ischemic;
- umfutho wegazi ophakeme
- isifo sohlangothi.
I-Stenosis yomgogodla ophakathi kwe-cerebral artery infarction lacunar, ischemia endaweni yokunakekelwa kwegazi eseduze. I-Stenosis ye-carotid artery ephezulu ibonakaliswa yi-foci enamandla, i-grey taba nayo ibandakanyeka kwinqubo ye-pathological. Kulokhu, ukwehluleka kwemizwa kudalulwa kakhulu kunokubangelwa yi-stenosis ye-cerebral artery.
Ngaphezu kokulimazeka kwemizwa kanye ne-motor in izilonda ze-caudate nucleus, i-grey daba noma i-thalamus, umuntu onesifo sikashukela angaba nokukhubazeka kwengqondo. Akhula ngaphandle kokuhlaselwa yisifo senhliziyo ngenxa yokwehla kwamandla emizwa. Inkambo ye-asymptomatic yalesi sifo ayibandakanywa, esimweni lapho i-pathology izenza izizwe kuphela ngemuva kokuqala kwezici ezimbalwa.
I-Atherosulinosis yemithambo ye-intracranial iyakwazi:
- ukuthuthuka;
- ukuzinza;
- ukucindezela.
Uma kungekho zimpawu, umphumela wesifo kukholakala ukuthi uthandeka impela. Ngama-plaque omthambo we-cerebral artery, amandla ayisimangaliso abikezelwa. Ama-Neoplasms ayabalwa, abonakala ngokuchichima kokuvelela kokuqina. Ngesikhathi sokufunda, odokotela bakhomba umehluko phakathi kwenkathi ye-stenosis kanye nokwenza kwasekhaya.
Lapho esethole indlela yesifo sokuqala, udokotela angabikezela indlela yamacala aphindwe ngayo alesi sifo.
Imvamisa, kutholakala ukuthi kutholakala izilonda ze-atherosclerotic ku-artery e-cerebral artery kanye ne-carotid artery yangaphakathi.
Ukwelashwa Nokuvimbela
Ukwelashwa kwe-atherosulinosis yemithambo ye-intracranial kunikela ukuvikela kokuphazanyiswa kokuphazamiseka kwegazi okujikelezayo.
Ngalezi zinhloso, ukubhekisisa okujwayelekile kwamazinga omfutho wegazi, kukhonjiswa okujwayelekile kwezinkomba zento efana namafutha. Ukulungiswa okunolaka kwezinto ezingozini ezisele kuyenziwa: ukuncipha kwesisindo, ukwanda kokuzivocavoca umzimba, ukwenqaba imikhuba emibi, ukugcinwa kwe-glycemia ejwayelekile. Ngokwengeziwe, ukwelashwa kwe-antithrombotic kuzodingeka.
I-monotherapy enama-antiplatelet agents iyathandwa, ekuvinjelweni kokuphindeka kwesifo sohlangothi emabangeni okuqala, kukhonjiswa ukwelashwa kwe-antiplatelet therapy kabili. Ukuphuza umuthi kuhlanganiswa nokulungiswa okunzulu kwezinto ezisongela ukubekezela.
Isikhathi eside, kwenziwa imizamo yokuhlinza i-atherosulinotic stenosis yemithambo ye-intracranial, imiphumela yalesi sifo. Indlela yokuqala efundwe kwakungukusebenzisa i-anastomosis eyengeziwe ye-intracranial. Kodwa-ke, okwamanje indlela ayisetshenziswa kabanzi.
Kaningi, izindlela zanamuhla zokwelashwa zenziwa:
- ukungenelela kwe-endovascular using i-balloon angioplasty enamafutha;
- ibhaluni angioplasty.
Ukungenelela kokuhlinzwa kuhlinzeka njalo ngomphumela omuhle, i-stent ilungele ukufaka. Ngaphezu kwalokho, kwezinye izimo, ukukhetha kunikezwa ekwelashweni kwezidakamizwa.
Ku-asymptomatic atherossteosis, ukuvimbela okuyinhloko kwe-ischemia yamakhowe kufanele kwenziwe, kucatshangelwa izici zobungozi. Njengoba kunethuba lokuthuthuka kwezilonda ze-atherosclerotic, kubalulekile ukubheka isimo semithambo yegazi okungenani kanye njalo eminyakeni emibili.
I-Stenosis yemithambo ye-intracranial ihamba ngokumelene nesizinda sokuphuma kwegazi lokugeleza kwengqondo, ukwakheka kwezindawo zokuthambisa okuphansi. Lezi ziguli kudingeka zinikeze imishanguzo ngemiphumela:
- i-neurotrophic;
- i-antihypoxic;
- umzimba.
I-Actovegin inalezi zakhiwo, inephrofayli yokuphepha evumayo.
Ucwaningo luye lwabonisa ukusebenza kahle kwe-Actovegin ngesikhathi sokwelashwa kweziguli esezikhulile ezinokuwohloka komqondo okuphathelene nokuwohloka komqondo okulinganiselwe, kufaka phakathi i-vasology etiology. Ukwelashwa kuhambisana nokwenza ngcono okukhulu ezimweni zokuziphatha, imiphumela yezifundo ze-neuropsychological.
I-Actovegin ithinta kahle ukunakwa, inkumbulo, ithuthukisa isimo sezengqondo sikashukela, futhi ivimbela ukuthuthukiswa kwezinkinga ze-atherossteosis. Kungenzeka ukunciphisa ubukhulu be-asthenic, izimpawu ezicindezelayo, kuthuthukisa ukulala, inhlala-kahle jikelele.
Umphumela we-Endoterioprotective, umthelela omuhle ku-microcirculation nawo uye wafakazelwa kaningi. Ukufakwa kwesidakamizwa ohlelweni lokwelashwa kweziguli ezine-intracranial atherosulinosis, kanye nezindlela zokuvimbela, kusiza ukuqeda ukwehluleka kokujikeleza ebuchosheni futhi kuthuthukise isimo sesiguli.
Njengoba ubona, i-atherosulinosis yemithambo ye-intracranial iyisici esibucayi ekuthuthukiseni ukuphazamiseka kokujikeleza kwezifo ezinzima, inikeza indlela ekhethekile yokuxilongwa nokwelashwa. Ngenxa yenqubekela phambili ocwaningweni lwalesi sifo nezindlela zalo zocwaningo, umuntu angathembela ngokuguquguquka okuhle kwenqubo ye-pathological.
Izindlela zokwelapha i-atherossteosis zixoxwa kuvidiyo kule ndatshana.
