ʻO ka hemorrhage Subarachnoid

Subarachnoid hemorrhage ke kahe nei i ka mahele ma waena o ka lolo a me nā mea lahilahi e uhi ana i ka lolo. Kapa ʻia kēia wahi ʻo ka subarachnoid space. ʻO ke kahe ʻana o Subarachnoid kahi pilikia a pono ka lāʻau lapaʻau e pono ai.

Hiki ke kumu ʻia ka hemorrhage Subarachnoid e:

• Kahe ana mai kahi tangle o nā kīʻaha koko i kapa ʻia kahi malformation arteriovenous (AVM)
• Maʻi maʻi hōʻeha
• Kahe ʻana mai kahi aneurysm cerebral (kahi nāwaliwali i ka paia o kahi kīʻaha koko e hoʻoheheʻe ai ka kīʻaha koko)
• Poino poʻo poʻo
• Kumu ʻike ʻole ʻia (idiopathic)
• Hoʻohana o nā mea lahilahi o ke koko

Subarachnoid hemorrhage ma muli o ka hōʻeha ʻike pinepine ʻia i ka poʻe kahiko i hāʻule a pā i ko lākou poʻo. Ma waena o nā ʻōpio, ʻo ka hōʻeha maʻamau e alakaʻi ʻia ai i ka hemorrhage subarachnoid ka hāʻule ʻana o ka kaʻa kaʻa kaʻa.

Nā pilikia me:

• Aneurysm i hoʻopō ʻole ʻia i ka lolo a me nā kīʻaha koko ʻē aʻe
• Fibromuscular dysplasia (FMD) a me nā maʻi pilina ʻē aʻe
• Piʻi koko kiʻekiʻe
• Mōʻaukala o ka maʻi polycystic kidney
• Puhipaka
• Hoʻohana i nā lāʻau lapaʻau kūpono ʻole e like me ka cocaine a me ka methamphetamine
• Hoʻohana o nā mea lahilahi o ke koko e like me warfarin

Hiki i ka mōʻaukala ʻohana ikaika o ka aneurysms ke hoʻonui i kou makaʻu.

ʻO ka hōʻailona nui kahi maʻi ʻeha nui e hoʻomaka koke (i kapa ʻia he headache thunderclap). ʻOi aku ka maikaʻi ma mua o ka hope o ke poʻo. Hōʻike ka hapa nui o nā kānaka iā ia ma ke ʻano he "headache headache ever ever" a ʻokoʻa i nā ʻano ʻeha ʻeha ʻeha ʻē aʻe. E hoʻomaka paha ka ʻeha poʻo ma hope o ka popping ʻana a i ʻole ke kiʻi ʻana i ka manaʻo i ke poʻo.

Nā ʻōuli ʻē aʻe:

• Hoemi i ka ʻike a me ka makaʻala
• Ka makaʻu ʻole o ka maka i nā kukui ʻōlinolino (photophobia)
• Hoʻololi ka moʻo a me ke ʻano, e like me ka huikau a me ka huhū
• ʻEha nā ʻiʻo (ʻoiai ʻeha o ka ʻāʻī a me ka ʻeha poʻohiwi)
• ʻO Nusea a me ka luaʻi
• Numbness ma kahi ʻāpana o ke kino
• Ka hopu ʻana
• ʻĀʻī ʻoʻoleʻa
• Nā pilikia o ka hihiʻo, e like me ka hihiʻo lua, nā wahi makapō, a i ʻole ka nalo ʻana o ka hihiʻo pokole ma ka maka hoʻokahi

Nā ʻōuli ʻē aʻe i hiki ke loaʻa me kēia maʻi.

• E hāʻule ana ka ʻōmaka
• ʻOkoʻa haumāna
• Pā paʻakikī o ka hope a me ka ʻāʻī, me ka hoʻopaʻa ʻana o ke kua (opisthotonos; ʻaʻole maʻamau)

Aia nā hōʻailona me:

• Hōʻike kahi hoʻokolohua kino i ka ʻāʻī ʻoʻoleʻa.
• Hiki i kahi lolo a me ka ʻōnaehana ʻōnaehana ke hōʻike i nā hōʻailona o ka hōʻemi ʻana o ke aʻalolo a me ka hana o ka lolo (deficit neurologic deficit).
• Hōʻike kahi hoʻokolohua maka i ka hoʻemi ʻana o ka neʻe ʻana o ka maka. Kahi hōʻailona o ka hōʻino ʻana i nā ʻalalā cranial (i nā hihia momona, ʻaʻohe pilikia e ʻike ʻia ma ka hōʻike maka).

Inā manaʻo kāu kauka he hemorrhage kāu subarachnoid, e hana koke ʻia kahi scan CT poʻo (me ka ʻole ke kala ʻokoʻa. I kekahi mau hihia, maʻamau ka scan, ʻoiaʻiʻo hoʻi inā he koko liʻiliʻi wale nō. Inā maʻamau ka CT scan, hiki ke hana ʻia kahi lumbar puncture (spinal tap).

Nā hoʻokolohua ʻē aʻe i hana ʻia e hoʻopili ʻia:

• Cerebral angiography o nā kīʻaha koko o ka lolo
• CT scan angiography (e hoʻohana ana i ka pena kala)
• ʻO Transcranial Doppler ultrasound, e nānā i ke kahe o ke koko i nā aʻa o ka lolo
• Mākēneki resonance kiʻi (MRI) a me ka magnetic resonance angiography (MRA) (i kekahi manawa)

ʻO nā pahuhopu o ka mālama ʻana i:

• Mālama i kou ola
• Hoʻoponopono i ke kumu o ke kahe ʻana o ke kahe
• Hōʻoluʻolu i nā ʻōuli
• Kāohi i nā kūpilikiʻi e like me ka poino o ka lolo paʻa (stroke)

Hiki ke hana ʻoki ʻia i:

• Wehe i nā hōʻiliʻili nui o ke koko a hoʻomaha i ke kaomi ma ka lolo inā pili ka hemorrhage i kahi ʻeha
• Hoʻoponopono i ka aneurysm inā he hemorrhage ma muli o kahi rupture aneurysm

Inā maʻi nui ke kanaka, kali paha ke ʻoki a kūpaʻa ke kanaka.

Pili paha ke ʻoki kino:

• Craniotomy (ʻoki ʻana i kahi puka ma ka iwi poʻo) a me ka ʻoki ʻana o aneurysm, e pani ai i ka aneurysm
• ʻO ka wili endovascular: ke waiho nei i nā wili i ka aneurysm a me nā stents i loko o ka ipu koko e hoʻopaʻa i nā wili e hoʻoliʻiliʻi i ka makaʻu o ke kahe hou.

Inā ʻaʻole loaʻa kahi aneurysm, pono ke kiaʻi pono ʻia ke kanaka e kahi hui mālama ola a pono paha i nā hoʻokolohua kiʻi hou aʻe.

ʻO ka mālama ʻana no ka coma a i ʻole ka hōʻemi ʻana i ka makaʻala e komo pū:

• Kau ʻia ka paipu hoʻowahāwahā i ka lolo e hōʻoluʻolu i ke kaomi
• Kākoʻo ola
• Nā hana e pale ai i ke alaloa
• Kūlana kūikawā

Pono paha ke kanaka e noʻonoʻo nei e kau i ka moena nui. E haʻi ʻia i ke kanaka e hōʻalo i nā hana i hiki ke hoʻonui i ke kaomi i loko o ke poʻo, e like me:

• Kulou ana
• Ke hoʻopololei nei
• Ke hoʻololi koke nei i ke kūlana

Hoʻokomo pū ʻia ka mālama ʻana:

• Hāʻawi ʻia nā lāʻau i loko o ka laina IV e kaohi ai i ke kahe o ke koko
• ʻO ka lāʻau e pale ai i nā spasms artery
• ʻO nā painkillers a me nā lāʻau anti-hopohopo e hoʻōla i ka ʻeha o ke poʻo a hoʻemi i ke kaomi o ka iwi poʻo
• Nā lāʻau lapaʻau e pale a mālama paha i ka hopu ʻana
• ʻO nā mea palupalu o ka Stool a i ʻole nā ​​laxatives e pale ai i ke kānana i ka wā o ka ʻōpū
• Nā lāʻau lapaʻau e pale aku ai i ka hopu ʻana

Aia ke ʻano o ke kanaka me ka hemorrhage subarachnoid i ka nui o nā kumu like ʻole, e like me:

• Kahi a me ka nui o ke kahe ʻana o ke kahe
• Nā pilikia

Hiki i nā makahiki ʻelemakule a me nā hōʻailona ʻoi loa ke alakaʻi i kahi hopena ʻilihuna.

Hiki i nā kānaka ke ola āpau ma hope o ka lapaʻau. Akā make kekahi poʻe, ʻoiai me ka lāʻau.

ʻO ke kahe hou ʻana ka pilikia nui loa. Inā he kahe o ka cerebral aneurysm no ka lua o ka manawa, ʻoi aku ka maikaʻi o ka nānā.

ʻO nā loli i ka ʻike a me ka makaʻala ma muli o kahi hemorrhage subarachnoid e lilo i mea ʻino a alakaʻi i ka coma a i ʻole ka make.

ʻO nā pilikia ʻē aʻe:

• Nā pilikia o ke kaha ʻana
• Nā hopena ʻaoʻao lāʻau
• Ka hopu ʻana i nā maʻi
• Hahau

E hele i ka lumi pilikia a kāhea paha i ka helu kūloko kūloko (e like me 911) inā ʻo ʻoe a ʻo kekahi mea āu e ʻike ai he mau ʻōuli kou o ka hemorrhage subarachnoid.

Hiki ke kōkua i nā ana aʻe i ka pale ʻana i ka hemorrhage subarachnoid:

• Kaohi ʻana i ka paka
• Ka mālama ʻana i ke koko kiʻekiʻe
• ʻIke a mālama maikaʻi ʻana i kahi aneurysm
• ʻAʻole hoʻohana i nā lāʻau lapaʻau kapu

Hemorrhage - subarachnoid; Ke kahe ʻana o Subarachnoid

• Headache - he aha e nīnau aku ai i kāu kauka

Mayer SA. Maʻi maʻi hemorrhagic cerebrovascular. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 408.

Szeder V, Tateshima S, Duckwiler GR. Nā aneurysms intracranial a me ka hemorrhage subarachnoid. 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 67.