Pseudotumor cerebri maʻi

ʻO Pseudotumor cerebri syndrome kahi ʻano e hoʻonui ʻia ai ke kaomi o loko o ka iwi poʻo. Hoʻopili ʻia ka lolo ma ke ʻano he ʻano ke ʻano, akā ʻaʻole ia, he tumo.

Kū pinepine ke ʻano i nā wahine ma mua o nā kāne, keu hoʻi i nā wahine ʻōpio ʻōpio 20 a 40 mau makahiki. He kākaʻikahi ia i nā pēpē akā hiki i nā keiki. Ma mua o ka wā ʻōpio, kū like ia i nā keikikāne a me nā kaikamahine.

ʻAʻole ʻike ʻia ke kumu.

Hiki i kekahi mau lāʻau lapaʻau ke hoʻonui i ka makaʻu o ka hoʻomohala ʻana i kēia ʻano. Hoʻopili kēia mau lāʻau:

• Amiodarone
• ʻO nā lāʻau kaohi hānau e like me levonorgestrel (Norplant)
• Cyclosporine
• ʻO Cytarabine
• Hone ulu
• Isotretinoin
• Levothyroxine (keiki)
• ʻO ka lithium carbonate
• Minocycline
• ʻAkika Nalidixic
• Nitrofurantoin
• ʻO Phenytoin
• Steroids (e hoʻomaka a hoʻopaʻa ana paha iā lākou)
• Nā lāʻauʻaeʻa Sulfa
• ʻO Tamoxifen
• Kālailai
• ʻO kekahi mau lāʻau i loaʻa ka Vitamin A, e like me ka cis-retinoic acid (Accutane)

Pili ʻia nā kumu aʻe i kēia ʻano:

• Down syndrome
• Maʻi maʻi Behcet
• Ka hōʻeha kīnā ʻole
• Endocrine (hormone) maʻi e like me Addison maʻi, Cushing maʻi, hypoparathyroidism, polycystic ovary syndrome
• Ma hope o ka mālama ʻana (embolization) o kahi malformation arteriovenous
• Nā maʻi maʻi e like me HIV / AIDS, maʻi Lyme, e ukali ana i ka moa moa i nā keiki
• Anemia hemahema hao
• Ka momona
• ʻAha moe hiamoe
• Hapai keiki
• ʻO Sarcoidosis (ʻōhū o nā lymph node, akemāmā, ake, maka, ʻili, a me nā mea ʻē aʻe)
• ʻErythematosis ʻōnaehana lupus
• Turner maʻi maʻi

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• ʻO ka headache, ka uhu, kēlā me kēia lā, kūpono ʻole a ʻoi aku ka maikaʻi i ke kakahiaka
• ʻEha ʻāʻī
• ʻIke makapō
• Kani kani i nā pepeiao (tinnitus)
• Puʻupuʻu
• ʻIke lua (diplopia)
• Nualea, luaʻi
• Nā pilikia e ʻike e like me ka uila a i ʻole ka nalo ʻana o ka hihiʻo
• ʻEha ʻeha haʻahaʻa, e pā pono ana ma nā wāwae ʻelua

Eʻoi aku ka maikaʻi o ka ʻeha o ke poʻo i ka wā o ke kino, keu hoʻi ke hoʻopaʻa ʻoe i nā mākala o ka ʻōpū i ka wā o ka ʻeha a paʻakikī paha.

E hana ka mea mālama ola i kahi hoʻokolohua kino. ʻO nā hōʻailona o kēia ʻano me:

• ʻO ka momona o mua fontanelle i nā pēpē
• Hoʻonui ʻia ka nui o ke poʻo
• ʻO ka pehu ʻana o ke aʻalolo optic i ka hope o ka maka (papilledema)
• Huli i loko o ka maka i ka ihu (ʻeono cranial, a i ʻole nā ​​abducens, palsy nerve)

ʻOiai ua hoʻonui ʻia ke kaomi o ka iwi poʻo, ʻaʻohe hoʻololi o ka makaʻala.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• ʻImi Funduscopic
• CT scan o ke poʻo
• ʻO ka hoʻokolohua maka, me nā hoʻokolohua kahua ʻike
• MRI o ke poʻo me MR venography
• Lumbar puncture (iwi kuamoʻo tap)

Hana ʻia ka diagnostical ke hōʻole ʻia nā kūlana olakino ʻē aʻe. Pākuʻi ʻia kēia mau mea i kumu e hoʻonui ai i ke kaomi i ka iwi poʻo, e like me:

• ʻO Hydrocephalus
• Tumo
• Trombosis sinus Venous

Hoʻolālā ʻia ka mālama ʻana i ke kumu o ka pseudotumor. ʻO ka pahuhopu nui o nā mālama ʻana e mālama i ka hihiʻo a hoʻemi i ke koʻikoʻi o nā poʻo hina.

Hiki i kahi lumbar puncture (spinal tap) ke kōkua i ke kōkua ʻana i ke kaomi i ka lolo a pale i nā pilikia o ka ʻike. Kōkua hou nā lumbar punctures no nā wahine hāpai i mea e hoʻopaneʻe ai i ke kaha ʻana a ma hope o ka hānau ʻana.

Hiki i nā mālama ʻē aʻe ke:

• Ka palena o ka wai a paʻakai paha
• ʻO nā lāʻau e like me corticosteroids, acetazolamide, furosemide, a me topiramate
• ʻO nā kaʻina hana Shunting e hoʻomaha i ke kaomi mai ke kūkulu ʻana i ka wai o ka iwi
• ʻO ke ʻoki kino e hoʻomaha ai i ke kaomi ma ke aʻalolo optic
• Kaumaha emi
• Hoʻomaʻamaʻa i ka maʻi kumu, e like me ka wikamina A overdose

Pono e nānā ka maka o ka poʻe. Hiki ke lilo ka hihi, kahi paʻa mau i kekahi manawa. Hana ʻia ka MRI hāhai a CT paha e kāpae i nā pilikia e like me nā tumors a i ʻole hydrocephalus (kūkulu ʻia o ka wai i loko o ka iwi poʻo).

I kekahi mau hihia, kiʻekiʻe ke kaomi i loko o ka lolo no nā makahiki he nui. Hiki i nā hōʻailona ke hoʻi i kekahi poʻe. Loaʻa i kahi helu liʻiliʻi o ka poʻe i nā ʻōuli e hele mālie i ka maikaʻi a alakaʻi i ka makapō.

Nalo ke kūlana ma kāna iho i loko o 6 mau mahina. Hiki i nā hōʻailona ke hoʻi i kekahi poʻe. Loaʻa i kahi helu liʻiliʻi o ka poʻe i nā ʻōuli e hele mālie i ka maikaʻi a alakaʻi i ka makapō.

ʻO ka nalo ʻana o ka hihiʻo kahi pilikia koʻikoʻi o kēia ʻano.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe a ʻo kāu keiki paha kekahi o nā ʻōuli i helu ʻia ma luna.

Hypertension intracranial Idiopathic; ʻO ke kiʻekiʻe kiʻekiʻe intracranial Benign

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

ʻO Miller NR. Pseudotumor cerebri. I: Winn HR, hoʻoponopono. ʻO Youmans a me Winn Neurological Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 164.

ʻO Rosenberg GA. ʻO ka edema lolo a me nā maʻi o ka holo ʻana o ka wai cerebrospinal. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 88.

ʻO Varma R, ʻo Williams SD. Neurology. I: Zitelli BJ, McIntire SC, Nowalk AJ, eds. ʻO Zitelli lāua ʻo Davis 'Atlas o ka Pediatric Physical Diagnosis. ʻEpekema 7 Piladelapia, PA: Elsevier, 2018: chap 16.