Ukuxilongwa ngesifo socansi kudinga ukuhlolwa ngokucophelela futhi okusheshayo kwezokwelapha, ngokuvamile ngokusiza kwezobuchwepheshe kwezokwelapha. Uma uke wahlolwa ngokuhlolwa kwesimo, ukuhlola kwakho kungabandakanya amathuluzi alandelayo.
Ukuhlolwa Kwama-Neurological
Lokhu kuhlolwa kwenziwa ngudokotela ukuze kutholakale ukuthi kunenkinga ekusebenzeni kobuchopho okungase kuqinisekiswe ukusola ukuthi umuntu empeleni une-stroke.
Ingxenye ngayinye yokuhlolwa kwengqondo ihlola indawo ehlukene yobuchopho, kuhlanganise:
- Ukuqwashisa nokuqonda
- Umsebenzi wokukhuluma, ulimi, nomemori
- Umbono nokunyakaza kwamehlo
- Ukuzwa nokuhamba emaceleni nasemilenzeni
- I-Reflexes
- Ukuhamba nokuqonda kokulinganisela
I-Computed Tomography Scan
Lokhu kuhlolwa kwenziwa ekamelweni eliphuthumayo ukuze kutholakale isifo esibuhlungu .
Izibalo ze-computed tomography (CT) ziyizivivinyo ezinhle kule njongo hhayi kuphela ngoba zibona kalula ukuphuma ngaphakathi kobuchopho, kodwa futhi ngoba zingenziwa ngokushesha.
Izikrini ze-CT nazo zingabonisa imivimbo ye-ischemic, kodwa kaningi abakwazi ukuthola ukushaywa kwe-ischemic kuze kufike amahora angu-6-12 ngemva kokuqala kwawo.
I-Lumbar Ukuvala
Eyaziwa nangokuthi " umgogodla womgogodla " lokhu kuhlolwa ngezinye izikhathi kuqhutshwa ekamelweni eliphuthumayo uma kunesimo esinamandla sokushaya isifo esibuhlungu. Ukuhlolwa kuhilela ukwethulwa kwenaliti endaweni ethile engxenyeni engezansi yekholomu yomgogodla lapho iphephile ukuqoqa i-cerebrospinal fluid (CSF).
Uma kuphuma igazi ebuchosheni, igazi lingabonakala ku-CSF.
Ukufaniswa kwe-Magnetic Resonance (MRI)
Lokhu kungenye yezivivinyo eziwusizo kakhulu ekuxilongweni kwesifo sohlangothi ngoba singathola ukushaywa phakathi kwamaminithi okuqala kwawo. Izithombe ze-MRI zobuchopho nazo ziphakeme kakhulu kwikhwalithi yezithombe ze-CT. Uhlobo olukhethekile lwe-MRI olubizwa ngokuthi i- magnetic resonance angiography , noma i-MRA, lumela odokotela ukubona ngeso lengqondo ukumisa noma ukuvinjelwa kwemithwalo yegazi ebuchosheni.
I-Transcranial Doppler (TCD):
Lolu hlelo lusebenzisa amagagasi omsindo ukukala ukugeleza kwegazi emifuleni emikhulu yegazi ebuchosheni . Izindawo ezingenalutho ngaphakathi kwesitsha segazi zibonisa izinga elihlukile lokugeleza kwegazi kunezindawo ezivamile. Lolu lwazi lungasetshenziswa odokotela ukulandela inqubekela phambili yemikhumbi yegazi evinjiwe kancane.
Okunye ukusetshenziswa okubalulekile kwe-TCD ukuhlolwa kwegazi okugeleza emithanjeni yegazi endaweni yesifo esiyingozi, njengoba le mithini yegazi inesibindi sokungena "i-vasospasm" isisindo segazi esingaba yingozi futhi esingalindelekile esingavimba ukugeleza kwegazi.
I-Angiography ye-Cerebral:
Odokotela abanochotshoza basebenzise lolu cwaningo ukubona ngeso lengqondo imithambo yegazi entanyeni nasebuchosheni. Ngalesi sivivinyo idayi ekhethekile, engabonakala besebenzisa i-X-ray, ifakwe ku-artery carotid, ehambisa igazi ebuchosheni. Uma umuntu enesisindo esithile noma esiphelele kwenye yale mithini yegazi, iphethini ledayi lingasiza ukuxilonga isitsha segazi esingavamile.
Isizathu esivamile sokushaywa yisisu sinciphisa umthambo we-carotid, i- carotid stenosis, ngokuvamile ewumphumela wezinhlamvu ze-cholesterol ezindongeni zale mithini yegazi. Lesi simo singabuye sitholwe yi-test ebizwa ngokuthi i-Carotid Duplex, lapho amagagasi omsindo asetshenziselwa ukuhlola ukugeleza kwegazi kulo mzila yegazi.
Kuye ngesilinganiso sokunciphisa kanye nezimpawu ezithandwa umuntu, kungase kudingeke ukuthi kudingeke ukuba kusetshenzwe ukukhipha i-plaque emthonjeni ochaphazelekayo.
Ukwelashwa kwe-Carotid Stenosis
I-cerebral angiography ingasiza futhi odokotela ukuxilonga lezi zimo ezivamile eziziwa ukuthi zihlotshaniswa nesifo esibi
Ngemuva kokuthi kutholakale isifo, ngezinye izikhathi, ukuhlolwa kwebhethri entsha kudingeke kwenziwe ukuze uthole ukuthi kungani imbangela yesifo.
I-Electrocardiogram
Lokhu kuhlolwa, okuyaziwa nangokuthi i-EKG noma i-ECG, kusiza odokotela ukubona izinkinga nge-conduction kagesi yenhliziyo.
Ngokujwayelekile, inhliziyo ishaya ngendlela ejwayelekile, ehambisana nesigqi ekhuthaza ukugeleza kwegazi okubhebhethekele ebuchosheni nezinye izitho. Kodwa uma inhliziyo inesici ekuqhubeni kagesi, ingase ishaywe ngesigqi esingavamile. Lokhu kubizwa ngokuthi i-arrhythmia, noma ukushaya kwenhliziyo okungavamile .
Amanye ama-arrhythmias, njenge-fibrillation ye-atrial, enza ukuthi ukwakhiwa kwezingxube zegazi ngaphakathi kwamagumbi enhliziyo. Lezi zibazi zegazi ngezinye izikhathi ziyathuthela ebuchosheni futhi zidale isifo.
I-echocardiogram ye-Transthoracic (TTE)
Lokhu kuhlolwa, owaziwa nangokuthi 'i-echo' isebenzisa amagagasi omsindo ukuze afune ama-blood clots noma eminye imithombo engaphakathi ngaphakathi kwenhliziyo. Ibuye isetshenziselwe ukubukeka okungavamile emsebenzini wenhliziyo ongaholela ekubunjweni kwegazi ngaphakathi kwendawo yamagumbi enhliziyo. Ama-TTE asetshenziselwa ukuphenya uma i-blood clots emilenzeni ingahamba ngenhliziyo futhi ifinyelele ebuchosheni.
Umlenze we-Ultrasound
Odokotela bavame ukwenza lokhu kuhlolwa ngeziguli ezihlaselwe isifo sofuba esitholwe nge- patent foramen ovale. Isivivinyo sisebenzisa amagagasi omsindo ukubuka ama-blood clots emithanjeni ejulile yemilenze, eyaziwa nangokuthi i- thromboses ejulile noma i-DVTs ejulile . Ama-DVTs angabangela imivimbo ngokwenza uhambo olude oluphelela ebuchosheni. Okokuqala, i-fragment encane ye-DVT iphuma futhi ihambela enhliziyweni nge-circulation evangelisayo. Kanye enhliziyweni i-clot yegazi iwela kusukela ohlangothini lwesokudla kuya ohlangothini lwesobunxele senhliziyo nge-PFO, lapho ixoshwa ngaphandle nge-aorta ne-carotids eya ebuchosheni, lapho ingabangela khona isifo.
Izivivinyo zegazi
Ngokuyinhloko, ukuhlolwa kwegazi kusiza odokotela ukuba babheke izifo ezaziwayo ukwandisa ingozi yokushaya , okufaka:
Umthombo
UBradley G Walter, uDaroff B uRobert, uFenichel M Gerald, uJancovic, uJoseph Neurology ngokuzikhandla, izimiso zokuxilongwa nokuphathwa. Philadelphia Elsevier, 2004.
Ihlelwe nguHeidi Moawad MD