Hahau

Hana ʻia kahi hahau ke kū ke koko i kahi ʻāpana o ka lolo. Kapa ʻia ka hahau i kekahi manawa he "hoʻouka lolo."

Inā ʻoki ʻia ke kahe o ke koko ma mua o kekona kekona, ʻaʻole hiki i ka lolo ke loaʻa nā meaola a me ka oxygen. Hiki i nā pūnaewele lolo ke make, e hōʻino ana i ka hopena mau loa.

Hiki i ke kahamaha ke puka mai kahi kīʻaha koko ma loko o ka lolo e hiki ai i ke kahe ʻana i loko o ke poʻo.

ʻElua ʻano nui o ka hahau ʻana:

• ʻAha ischemic
• Hahau hemorrhagic

Kū ʻia ka maʻi Ischemic ke pale ʻia kahi kīʻaha koko e hāʻawi i ke koko i ka lolo e kahi kōpē koko.Hiki paha kēia i nā ala ʻelua:

• Hiki i kahi ʻōpala ke hana i loko o ke aʻa a ʻololī loa. Kapa ʻia kēia he thrombotic stroke.
• E haki paha kahi ʻōpala mai kahi ʻē aʻe i nā kīʻaha koko o ka lolo, a mai kekahi ʻāpana ʻē aʻe o ke kino, a piʻi i ka lolo. Kāhea ʻia kēia he cerebral embolism, a i ʻole he embolic stroke.

Hoʻokumu pū ʻia nā kahakaha Ischemic e kahi mea lāpala i kapa ʻia he plake e hiki ke hoʻopili i nā aʻa.

Kū ka maʻi hemorrhagic ke hele a nawaliwali kahi kīʻaha koko i kahi ʻāpana o ka lolo a hāmama ka hāmama. ʻO kēia ke kumu o ke kahe ʻana o ke koko i ka lolo. Loaʻa i kekahi poʻe nā kīnā i nā kīʻaha koko o ka lolo e hana ana i kēia. Pili pū paha kēia mau hemahema:

• Aneurysm (wahi nāwaliwali i ka paia o kahi kīʻaha koko e hoʻoheheʻe ai ka ipu koko)
• Malformation Arteriovenous (AVM; pili pono ʻole ma waena o nā aʻa a me nā uaua)
• Cerebral amyloid angiopathy (CAA; kahi a nā protein i kapa ʻia ʻo amyloid e kūkulu ai ma nā paia o nā aʻa i ka lolo)

Hiki ke loaʻa nā hahau hemorrhagic ke lawe nei kekahi i nā mea lahilahi o ke koko, e like me warfarin (Coumadin). Hiki i ke kahe koko kiʻekiʻe ke kumu o ka haki ʻana o nā kīʻaha koko, e alakaʻi ana i ka maʻi hemorrhagic.

Hiki i kahi maʻi ischemic ke hoʻomohala i ke kahe ʻana a lilo i maʻi hemorrhagic.

ʻO ke koko kiʻekiʻe ke kumu nui o ka maʻi ahulau. ʻO nā kumu weliweli ʻē aʻe kekahi:

• Kuʻi puʻuwai ʻole, i kapa ʻia ʻo atrial fibrillation
• Diabetes
• ʻO ka mōʻaukala ʻohana o ka maʻi ʻōiwi
• Ke kāne
• Kolesterol kiʻekiʻe
• Ke hoʻonui nei i ka makahiki, keu hoʻi ma hope o ka makahiki 55
• Lāhui (e make paha nā ʻAmelika ʻApelika i ka hahau)
• Ka momona
• ʻO ka mōʻaukala o ka hahau mua ʻana a i ʻole hoʻouka ischemic kuikawa (kū ʻia ke kahe o ke koko i kahi ʻāpana o ka lolo e kū no kahi manawa pōkole)

ʻOi aku ka kiʻekiʻe o ka maʻi ahuna i:

• ʻO ka poʻe i loaʻa ka maʻi puʻuwai a i ʻole ke kahe o ke koko i ko lākou mau wāwae i hoʻokumu ʻia e nā aʻa liʻiliʻi
• ʻO ka poʻe i loaʻa ka nohona olakino olakino e like me ka puhipaka, hoʻohana nui ʻana i ka wai ʻona, hoʻohana i nā lāʻau leʻaleʻa, kahi papa momona momona, a me ka nele i ka hoʻoikaika kino.
• ʻO nā wahine e lawe i nā pika mālama hānau (ʻo ka mea puhi a ʻoi aku ka makahiki ma mua o 35)
• ʻO nā wahine hāpai ua hoʻonui i ka makaʻu i ka wā e hāpai ana
• ʻO nā wahine e lawe i ka hoʻoliʻiliʻi hormone
• Patent foramen ovale (PFO), kahi puka ma waena o ka atria hema a me ka akau (keena kiʻekiʻe) o ka puʻuwai

Pili nā ʻōuli o ka hahau i ka ʻāpana o ka lolo i hōʻino ʻia. I kekahi mau hihia, ʻaʻole paha ʻike kekahi kanaka ua kū ka maʻi hahau.

ʻO ka hapanui o ka manawa, ulu koke nā ʻōuli a me ka ʻole o ka ʻōlelo aʻoaʻo. Akā hiki ke loaʻa nā ʻōuli ma ka a i ʻole no ka lā mua ʻelua paha. ʻOi aku ka nui o nā ʻōuli ma ke kū mua ʻana o ka hahau, akā e ʻemi mālie paha lākou.

Hiki ke hōʻeha i ke poʻo ke kū ka maʻi maʻi i ke kahe ʻana i ka lolo. Ka ʻeha poʻo:

• Hoʻomaka koke a kaumaha paha
• E ʻoi aku paha ka hewa i kou wā e moe pālahalaha ana
• E ala ʻoe mai ka hiamoe ʻana
• Hiki ke ʻino ke hoʻololi ʻoe i nā kūlana a i ke kūlou ʻana, kānana, a i ʻole ka ʻū

Pili nā ʻōuli ʻē i ka nui o ka hahau ʻana, a he aha ka ʻāpana o ka lolo e pili ana. Pākuʻi ʻia paha nā ʻōuli:

• Hoʻololi i ka makaʻala (me ka hiamoe, ʻike ʻole, a me ke koma)
• Hoʻololi i ka hoʻolohe a ʻono paha
• Nā loli e hoʻopili i ka hoʻopā a me ka hiki ke ʻeha, kaomi, a me nā mahana like ʻole
• Huikau a nalo paha o ka hoʻomanaʻo
• Pilikia i ka ale ʻana
• Nā pilikia e kākau a heluhelu paha
• Ka paupau a me ka manaʻo neʻe o ka neʻe (vertigo)
• Nā pilikia o ka maka, e like me ka hoʻoliʻiliʻi o ka hihiʻo, ka ʻike pālua, a i ʻole ka nalo ʻana o ka hihiʻo
• Ka nele o ka kaohi ma luna o ka bladder a i ʻole ka ʻōpū
• Ka nele o ke kaulike a i ʻole ka hoʻohui ʻana, a i ʻole ka pilikia e hele wāwae
• Ka nāwaliwali o ka mākala i ka maka, ka lima, a me ka wāwae (ma ka ʻaoʻao hoʻokahi wale nō)
• Pōpō a ʻālani paha ma kekahi ʻaoʻao o ke kino
• ʻO ke kanaka, ke ʻano, a i ʻole nā ​​loli manaʻo
• Pilikia i ka ʻōlelo ʻana a i ʻole ka hoʻomaopopo ʻana i nā poʻe ʻē aʻe e ʻōlelo nei

E hana ana ke kauka i kahi hoʻokolohua kino i:

• E hōʻoia no nā pilikia me ka hihiʻo, ka neʻe, ka manaʻo, reflexes, ka hoʻomaopopo ʻana, a me ka ʻōlelo. E hana hou kāu kauka a me nā kahu hānai i kēia hōʻike ma ka manawa e ʻike ai inā e ʻoi aku ana ka maikaʻi o kāu hahau ʻana a i ʻole ka hoʻomaikaʻi ʻana.
• E hoʻolohe i nā aʻa carotid i ka ʻāʻī me kahi stethoscope no kahi kani maʻamau, i kapa ʻia he bruit, i kumu ʻia e ke kahe o ke koko ʻokoʻa.
• E hōʻoia no ke kiʻekiʻe o ke koko.

Loaʻa paha iā ʻoe nā hōʻike aʻe e kōkua ai e ʻike i ke ʻano, ka wahi, a me ke kumu o ka hahau ʻana a haʻalele i nā pilikia ʻē aʻe.

• CT scan o ka lolo e hoʻoholo inā aia kekahi kahe
• MRI o ka lolo e hoʻoholo i ka wahi o ka hahau
• Angiogram o ke poʻo e nānā i kahi kīʻaha koko i ālai ʻia a hoʻokahe paha i ke kahe
• ʻO Carotid duplex (ultrasound) e ʻike inā pili ka aʻa o ka carotid i kou ʻāʻī
• ʻO Echocardiogram e ʻike inā hiki ke loaʻa ʻia ka hahau ʻana e kahi kōkō koko mai ka puʻuwai
• Angiography resonance ʻume mākenēki (MRA) a i ʻole CT angiography e nānā ai no nā kīʻaha koko ʻole ma ka lolo

ʻO nā hōʻike ʻē aʻe kekahi:

• Nā hoʻāʻo koko
• Electroencephalogram (EEG) e hoʻoholo inā loaʻa kahi hopu
• ʻO ka Electrocardiogram (ECG) a me ka nānā ʻana o ka puʻuwai puʻuwai

ʻO ka hahau kahi pilikia olakino. Pono ka mālama wikiwiki ʻana. Kāhea koke iā 911 a i ʻole ka helu kūloko kūloko a i ʻole ʻimi i ka mālama olakino wikiwiki i nā hōʻailona mua o ka hahau.

Pono nā poʻe e loaʻa nei nā ʻōuli o ka hahau e hele i ka haukapila e like me ka hiki.

• Inā hopena ʻia ka hahau e ke kōkō o ke koko, hāʻawi ʻia i kahi lāʻau hoʻowalewale e hoʻopau i ke kō.
• I mea e pono ai, pono e hoʻomaka kēia mālama ma waena o 3 a 4 1/2 mau hola o ka wā i hoʻomaka ai nā ʻōuli. ʻO ka wikiwiki o ka hoʻomaka ʻana o kēia lapaʻau, ʻo ka ʻoi aku ka maikaʻi o ka hopena maikaʻi.

ʻO nā lāʻau lapaʻau ʻē aʻe i hāʻawi ʻia i ka haukapila e pili ana i ke kumu o ka maʻi ahulau. Pākuʻi ʻia kēia mau mea:

• ʻO nā mea lahilahi e like me heparin, warfarin (Coumadin), aspirin, a i ʻole clopidogrel (Plavix)
• ʻO ka lāʻau e kāohi ai i nā mea pilikia, e like me ke kiʻekiʻe o ke koko, diabetes, a me nā kolesterol kiʻekiʻe
• ʻO nā kaʻina hana kūikawā a i ʻole ke ʻoki kino e hoʻomaha ai i nā ʻōuli a i ʻole ke pale ʻana i nā hahau hou aʻe
• Nutrients a me nā wai

E hoʻomaka i ka haukapila ka hoʻomaʻamaʻa kino, ka hoʻomaʻamaʻa ʻoihana, a me ka hoʻōla ʻōlelo ʻana. Inā pilikia nui ke kanaka i ka ale ʻana, e pono ana kahi ʻōmele hānai i loko o ka ʻōpū (ʻōpū gastrostomy).

ʻO ka pahuhopu o ka mālama ʻana ma hope o ka hahau ʻana e kōkua iā ʻoe e hoʻōla i nā hana i hiki a pale i nā hahau o ka wā e hiki mai ana.

E hoʻomaka ana ka hoʻōla ʻana mai kāu hahau ʻoiai ʻoe ma ka haukapila a i ʻole kahi kikowaena rehabilitation. E hoʻomau ia ke hele ʻoe i ka home mai ka haukapila a kikowaena paha. E nānā pono me kāu kauka olakino ma hope o kou hoʻi ʻana i ka home.

Loaʻa ke kākoʻo a me nā kumuwaiwai mai ka American Stroke Association - www.stroke.org/en/help-and-support.

Pehea ka maikaʻi o ke kanaka ma hope o ka hahau ʻana ma muli o:

• Ke ʻano o ka hahau
• ʻEhia ka nui o ka lolo i hōʻino ʻia
• He aha nā hana a ke kino i hoʻopili ʻia
• Pehea ka wikiwiki e hāʻawi ʻia ai ka lāʻau

ʻO nā neʻe ʻana, ka noʻonoʻo ʻana, a me ke kamaʻilio ʻana e hoʻomaikaʻi pinepine i nā pule i nā mahina ma hope o ka hahau ʻana.

ʻO nā poʻe he nui i loaʻa i ka hahau e hoʻomau i ka hoʻomaikaʻi i nā mahina a i ʻole mau makahiki ma hope o kā lākou hahau.

Ma luna o ka hapalua o ka poʻe i loaʻa ka maʻi hahau e hiki ke hana a noho i ka home. ʻAʻole hiki i nā poʻe ʻē aʻe ke mālama iā lākou iho.

Inā kūleʻa ka lāʻau lapaʻau me nā lāʻau lāʻau lāʻau, e hala paha nā ʻōuli o ka hahau. Eia nō naʻe, ʻaʻole hele pinepine ka poʻe i ka haukapila e loaʻa ai kēia mau lāʻau, a i ʻole hiki ʻole iā lākou ke lawe i kēia mau lāʻau no ke ʻano olakino.

ʻO ka poʻe i loaʻa kahi maʻi kīʻaha mai ke kīʻaha koko (ischemic stroke) ʻoi aku ka manawa kūpono o ke ola ʻana ma mua o ka poʻe i loaʻa i ka maʻi kōkō mai ke kahe ʻana o ka lolo (hemorrhagic stroke).

ʻO ka makaʻu no ka hahau ʻelua ka mea kiʻekiʻe i nā pule a i ʻole mau mahina ma hope o ka hahau mua. Hoʻomaka ka hōʻemi o ka makaʻu ma hope o kēia wā.

ʻO Stroke kahi pilikia olakino e pono e mālama koke ʻia. ʻO ka acronym F.A.S.T. he ala maʻalahi e hoʻomanaʻo i nā hōʻailona o ka hahau a me ka mea e hana ai inā manaʻo ʻoe ua kū ka maʻi hahau. ʻO ka hana nui e pono ai e kāhea iā 911 a i ʻole ka helu kūloko kūloko koke no ke kōkua pilikia.

ʻO F.A.S.T. kū no:

• ALOHA. E noi i ke kanaka e minoʻaka. Nānā inā hāʻule kekahi ʻaoʻao o ka maka.
• KOA. E noi i ke kanaka e hāpai i nā lima ʻelua. E nānā inā e neʻe i lalo kekahi lima.
• HAIOLELO. E noi i ke kanaka e hana hou i kahi ʻōlelo maʻalahi. E hōʻoia inā slurred nā huaʻōlelo a inā pololei ka ʻōlelo ʻana.
• MANAWA. Inā hōʻike kekahi i kekahi o kēia mau ʻōuli, pono ka manawa. He mea nui e hele i ka haukapila e like me ka hiki. Kāhea iā 911 a i ʻole ka helu kūloko kūloko. Hana ʻo F.A.S.T.

ʻO ka hōʻemi ʻana i kāu mau pilikia kūpilikiʻi e hoʻemi i kou manawa i loaʻa i kahi maʻi ʻōiwi.

Maʻi Cerebrovascular; CVA; Infarction Cerebral; Cerebral hemorrhage; Hahau Ischemic; Hahau - ischemic; Ulia Cerebrovascular; Pā - hemorrhagic; ʻO ke aʻa Carotid - hahau

• Hoʻokomo ʻia ka Angioplasty a me stent - carotid artery - hoʻokuʻu
• Ke hana nei inā loaʻa ka maʻi puʻuwai
• Hoʻoponopono ka lolo aneurysm - hoʻokuʻu
• ʻO ka pata, ka margarine, a me nā aila kuke
• Ke mālama nei i ka spasticity muscle a i ʻole nā ​​spasms
• ʻOki kino aʻa Carotid - hoʻokuʻu
• Ke kamaʻilio nei me kekahi me ka aphasia
• Ke kamaʻilio nei me kekahi me ka maʻi disarthria
• Constipation - mālama pono iā ʻoe iho
• Dementia a me ka hoʻokele
• Dementia - nā pilikia a me nā pilikia hiamoe
• Dementia - mālama i kēlā me kēia lā
• Dementia - mālama palekana i ka home
• Dementia - he aha e nīnau aku ai i kāu kauka
• Keʻai nei i nā calorie keu ke maʻi - nā mākua
• Headache - he aha e nīnau aku ai i kāu kauka
• Ke koko kiʻekiʻe - he aha e nīnau aku ai i kāu kauka
• Pāleʻa ka pale ʻana
• Hahau - hoʻokuʻu
• Pilikia i nā pilikia

• Lolo
• Carotid stenosis - X-ray o ke aʻa hema
• Carotid stenosis - X-ray o ke aʻa pono
• Hahau
• Hana Brainstem
• Cerebellum - hana
• Kaapuni o Willis
• ʻO ka hemisphere cerebral hema - hana
• Hemisphere cerebral ʻākau - hana
• Kahikina
• Kūkulu plaque i nā aʻa
• Hahau - moʻo
• ʻO dissection Carotid

ʻO Biller J, Ruland S, Schneck MJ. ʻO ka maʻi cerebrovascular Ischemic. Ma Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 65.

ʻO Crocco TJ, Meurer WJ. Hahau. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 91.

Ianuali CT, Wann LS, Alpert JS, et al. 2014 AHA / ACC / HRS alakaʻi no ka mālama ʻana i nā mea maʻi me ka fibrillation atrial: hōʻuluʻulu mana: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā kulekele hana a me ka Heart Rhythm Society. Kaapuni. 2014; 130 (23): 2071-2104. PMID: 24682348 pubmed.ncbi.nlm.nih.gov/24682348/.

Ianuali CT, Wann LS, Calkins H, et al. Ua hoʻolālā hou ʻia ʻo 2019 AHA / ACC / HRS i ke alakaʻi ʻo 2014 AHA / ACC / HRS no ka mālama ʻana i nā mea maʻi me ka fibrillation atrial: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force e pili ana i nā kulekele hana a me ka Heart Rhythm Society. J AM Coll Cardiol. 2019; 74 (1): 104-132. PMID: 30703431 pubmed.ncbi.nlm.nih.gov/30703431/.

Meschia JF, Bushnell C, Boden-Albala B, et al. Nā ʻōkuhi no ka pale mua ʻana i ka hahau: kahi ʻōlelo no ka poʻe ʻoihana ola kino mai ka American Heart Association / American Stroke Association. Hahau. 2014; 45 (12): 3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.

Nā Mana WJ, Rabinstein AA, Ackerson T, et al; ʻAha ʻAha ʻAha ʻAmelika Hui Pū ʻIa. Nā kulekele 2018 no ka mālama mua ʻana i nā maʻi me ka hahau ischemic huʻi: kahi alakaʻi no nā ʻoihana olakino mai ka American Heart Association / American Stroke Association. Hahau. 2018; 49 (3): e46-e110. PMID: 29367334 pubmed.ncbi.nlm.nih.gov/29367334/.

Riegel B, Moser DK, Buck HG, a me al. ʻAha ʻAha ʻAhahui ʻAmelika Hui Pū ʻIa e pili ana i ka hanai hānai maʻi hānai a me ka hahau hahau; ʻAha Kūkākūkā no ka maʻi maʻi ākea Peripheral; a me ka ʻaha kūkā e pili ana i ke ʻano o ka mālama a me nā noiʻi e pili ana i nā hopena. Ka mālama ponoʻī ʻana no ka pale ʻana a me ka mālama ʻana i ka maʻi puʻuwai me ka hahau ʻana: kahi ʻōlelo ʻepekema no nā ʻoihana olakino mai ka American Heart Association. ʻO J Am Heart Assoc. 2017; 6 (9). pii: e006997. PMID: 28860232 pubmed.ncbi.nlm.nih.gov/28860232/.

Wein T, Lindsay MP, Côté R, et al. Nā ʻōlelo hoʻomaʻamaʻa ʻoi loa o ka hahau ʻana ma Kanada: ka pale ʻana i ka maʻi ahulau, nā papa kuhikuhi ʻeono puka, hōʻano hou i ka 2017. Int J Kahuna. 2018; 13 (4): 420-443. PMID: 29171361pubmed.ncbi.nlm.nih.gov/29171361/.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Alakaʻi no ka pale ʻana, ʻike, loiloi, a me ka mālama ʻana i ke kahe kiʻekiʻe i nā mākua: kahi hōʻike o ke Kulanui ʻAmelika o Cardiology / ʻAmelika. Pūʻulu Hana ʻAhahui Puʻuwai e pili ana i nā ʻōkuhi hoʻomaʻamaʻa lapaʻau. ʻO J Am Coll Cardiol. 2018; 71 (19): e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.

ʻO Wilson PWF, Polonsky TS, Miedema MD, Khera A, Kosinski AS, Kuvin JT. Nānā ʻōnaehana no ka AHA / ACC / AACVPR / AAPA / ABC / ACPM / ADA / AGS / APhA / ASPC / NLA / PCNA alakaʻi no ka mālama ʻana i ke kōkōkō koko: nā ʻāpana o ke Kulanui o Cardiology / American Heart Association Task Force on Nā Kuhi Haʻawina Haʻapila [hōʻike ʻia ka hoʻoponopono ma J Am Coll Cardiol. 2019 Jun 25; 73 (24): 3242]. ʻO J Am Coll Cardiol. 2019; 73 (24): 3210-3227. PMID: 30423394 pubmed.ncbi.nlm.nih.gov/30423394/.

Winstein CJ, Stein J, Arena R, et al. Nā ʻōkuhi no ka hoʻoponopono hou ʻana o ka ʻōpuna makua a me kahi ola hou: kahi alakaʻi no nā ʻoihana ola kino mai ka American Heart Association / American Stroke Association. Hahau. 2016; 47 (6): e98-e169. PMID: 27145936 pubmed.ncbi.nlm.nih.gov/27145936/.