Isizathu Esivamile Sokuphathwa Kwekhanda ku-Young Women
I-Idiopathic Intracranial Hypertension (IIH) yisimo sezokwelapha esibangelwa ukunyuka kwengcindezi yomgogodla ojikelezayo ebuchosheni, ekungabikho kwesisu noma esinye isifo sengqondo. Iyaziwa ngokuthi yi-pseudotumor cerebri. I-II ivame kakhulu kubantu besifazane abanomzimba okhuluphele futhi eminyakeni yabo yokubeletha.
Izimpawu ze-IIH
Izinguquko zomzimba kanye nezinguquko zombono yizimpawu zakudala ezitholakala ku-IIH.
Ekuhlolweni kwamehlo, odokotela bazobona i- papilledema -isimo esibonakala ngokuvuvukala kwe-optic disc, ngenxa yokucindezela okwandayo ebuchosheni. Itholakala ngudokotela ngesikhathi sokuhlolwa kwe-ophthalmoscopic.
Ezinye izimpawu ezivamile (kodwa hhayi ezikhethekile) ezitholakala ezigulini ezine-IIH zihlanganisa:
- izinguquko zesikhashana ezibonakalayo
- i-pulsatile tinnitus (ukuzwa umsindo wokuqhuma noma ukuphuza ekhanda lakho)
- i-photopsia (ukubona ukukhanya kokukhanya)
- ubuhlungu ngemuva kwamehlo
- umbono kabili
- ukulahleka kombono
Uthini ukuphathwa kwengqondo ye-IIH?
Ikhanda elivela ku-IIH lingalingisa lokho kwekhanda le-migraine noma lezinkinga zokuhlukumezeka, okwenza ukuxilongwa kukhanye. Ngaphezu kwalokho, akukho "uhlobo oluthile" lwezinhloko ezikhishwa abantu abane-IIH. Lokho kuthiwa i-classic i-headache ye-IIH ilukhuni futhi iphoqa, njenge-migraine. Ubuhlungu bungaba okuphakathi noma okuqhubekayo futhi kungahle kuhlotshaniswe nesicathulo kanye / noma ukuhlanza. Ngezinye izikhathi, abantu abanesifo sekhanda se-IIH bazobona ubuhlungu ngemuva kwamehlo abo kanye / noma nobuhlungu ngokunyakaza kwamehlo.
I-IIH ihlolwe kanjani?
Uma udokotela ephika i-IIH futhi ebona i-papilledema ekuhlolweni kwamehlo, uzoyala i- MRI yobuchopho ngaphandle kokuphambene nokuhlola isizathu esiyimbangela yokucindezela kwakho okungekho emthethweni. Izimbangela ezisemqoka zokugonywa komfutho wegazi ezifakwe emzimbeni zihlanganisa (kepha azikhawulelwe):
- I-thrombosis ene-cerebral venous
- I-tumor ye-Brain noma i-abscess (iqoqo le-fluid infect)
- I-hydrocephalus evimbelayo
- Ukubhujiswa kwe-Subarachnoid
- I-Hypertension embi
Uma kungekho sizathu esibonwe kwi-MRI, uzobe usuqalile ukufaka ingcindezi ephakeme ukuze uqinisekise ukucindezelwa okuphakeme futhi ukulawula ukutheleleka ngokusebenzisa ukuhlaziywa kwe- cerebrospinal fluid noma i-CSF. Ku-IIH, akukho ukutheleleka, ngakho ukwakheka kwe-CSF kuvamile. Kodwa ukukhishwa kwe-lumbar kuzobonisa ingcindezi yokuvula engaphezu kwama-250 mmH2O, okuyi-diagnostic yokucindezela okuphakeme okungekho emthethweni.
Ukwelashwa kwe-IIH
Ukwelashwa kwe-IIH kudinga ukulandelwa okusheshayo ne-neurologist kanye ne-opthamalogist. Ukwelashwa okuyisisekelo kwe-IIH yimithi yokwelapha ebizwa nge-acetazolamide, eyanciphisa izinga lokukhiqizwa kwe-CSF. Udokotela wakho angacabangela ezinye izindlela zokwelashwa uma une-sulfa yokungezwani komzimba noma ukhulelwe. Ngezinye izikhathi, ama-pctures angama-lumbar nama-corticosteroids asetshenziswa esikhathini esifushane ukuze asize ukunciphisa ingcindezi ye-CSF-kodwa, akuzona izixazululo zesikhathi eside.
Uma ikhanda lomuntu lingavumelani nokwelashwa kwezokwelapha kanye / noma uhlangabezana nokulahlekelwa kombono okuqhubekayo, kudingeka ukuhlinzwa. Ukungenelela kokuhlinzwa kuhlanganisa izinqubo ezibizwa ngokuthi i-optic nerve sheath fenestration (ONSF) kanye / noma inqubo yokuzikhandla kwe-CSF.
Ekulweni kwe-optic ye-heath fenestration, i-slit noma iwindi lenziwa emgodini wesibindi se-optic. Lokhu kuvumela i-CSF ukuthi ikwazi ukukhipha, ukunciphisa ingcindezi emndenini, evumela umbono ukuba ubuyiselwe kancane noma ngokugcwele. Ucwaningo lubonisa ukuthi i-ONSF iyasebenza ngokuphumelelayo ekuthuthukiseni ukulahleka kombono, ikakhulukazi uma kwenziwa ngaphambi kwesikhathi. Uma i-CSF igxuma, uketshezi lomgogodla kuhanjiswe kwezinye izingxenye zomzimba, futhi kunciphise ukucindezela ebuchosheni.
Izwi kusuka
Inhloko ye-IIH iyahlukahluka futhi ikhiqizwa ukunyuka kwengcindezi engaphezu komzimba , okuboniswa yi-papilledema ekuhlolweni kweso. Ukwelashwa kubalulekile futhi kuphuthumayo ukuvimbela ukulahlekelwa kombono futhi kudinga ukulandela okulandelayo ne-neurologist yakho ne-opthamalogist.
Imithombo:
I-Lee AG ne-Wall M. Idiopathic ingcindezi yokungena emzimbeni (i-pseudotumor cerebri): Izici zomtholampilo nokuxilongwa. Ku: UpToDate, iBasow DS (ed), UpToDate, Waltham, MA, 2015.
I-Lee AG ne-Wall M. Idiopathic engenayo ingozi yegazi (i-pseudotumor cerebri): Isibikezelo kanye nokwelashwa. Ku: UpToDate, iBasow DS (ed), UpToDate, Waltham, MA, 2015.
I-National Institute of Neurological Disorders and Stroke. Ikhasi Lolwazi lwe-Cerebri.
Obi EE, Lakhani BK, Burns J, & Sampath R. Ukuvalwa kwesibindi semisipha ye-hypertension ye-idiopathic yokungena emzimbeni: ukubuyekezwa konyaka wamaminithi ayisikhombisa esikoleni esiphakeme. I-Clin Neurol Neurosurg . 2015 Oct; 137: 94-101.
I-Pineles SL, i-Volpe NJ. Imiphumela Yesikhathi Eside Yokwamazinga Okushisa Okungenayo Ukuvalwa Kwe-Idiopathic Intracranial Hypertension: Izikhathi Eziphambili Zokunciphisa Iziphumo Eziphuthumayo Imiphumela. I-Neuro-Ophthalmology. 2013; 37 (1): 12-19.