Malformation o ka cerebral arteriovenous

ʻO kahi malformation cerebral arteriovenous (AVM) kahi pilina maʻamau ma waena o nā aʻa a me nā uaua i ka lolo e hana maʻamau ma mua o ka hānau ʻana.

ʻAʻole ʻike ʻia ke kumu o ka cerebral AVM. Kū kekahi AVM ke pili pono nā aʻa i ka lolo i nā veins kokoke me ka loaʻa ʻole o nā moku liʻiliʻi liʻiliʻi (capillaries) ma waena o lākou.

Hoʻololi ka AVM i ka nui a me kahi i ka lolo.

Kū kekahi AVM rupture ma muli o ke kaomi a me ka pōʻino o ka ipu koko. ʻAe kēia i ke koko e kahe (hemorrhage) i ka lolo a i ʻole nā ​​mea pili a hoʻoliʻiliʻi i ke kahe o ke koko i ka lolo.

Kākaʻikahi nā Cerebral AVMs. ʻOiai aia ke ʻano i ka wā hānau, hiki i nā ʻōuli ke kū i kēlā me kēia makahiki. Kū pinepine nā Ruptures i nā makahiki 15 a 20. Hiki nō ke hana ma hope i ke ola. Loaʻa i kekahi poʻe me kahi AVM i ka aneurysms lolo.

Ma kahi o hoʻokahi hapalua o ka poʻe me AVM, ʻo nā ʻōuli mua nā maʻi hahau i hoʻokumu ʻia e ke kahe ʻana o ka lolo i ka lolo.

ʻO nā ʻōuli o ka AVM e kahe ana ke koko:

• Huikau
• Nani ka pepeiao / kani (i kapa ʻia he tinnitus pulsusive)
• ʻO ke poʻo hina i hoʻokahi a ʻoi paha mau ʻāpana o ke poʻo, e like paha me ka migraine
• Hele pilikia
• Ka hopu ʻana i nā maʻi

Nā hōʻailona ma muli o ke kaomi ma kahi o ka lolo.

• Nā pilikia ʻike
• Puʻupuʻu
• Ka nāwaliwali o ka mākala ma kahi o ke kino a i ʻole ke alo
• Numbness ma kahi o ke kino

E hana kāu mea mālama ola i kahi hoʻokolokolo kino. E nīnau ʻia ʻoe e pili ana i kāu mau hōʻailona, ​​me ka nānā ʻana i kāu pilikia ʻōnaehana. Hiki ke hoʻohana ʻia nā hoʻokolohua e kuhikuhi ai i kahi AVM:

• Angiogram lolo
• Pūnaewele tomography Compute (CT)
• Poʻo MRI
• Electroencephalogram (EEG)
• Poʻomanaʻo CT poʻo
• Mākēneki resonance angiography (MRA)

Ke loaʻa nei i kahi lāʻau ʻoi loa no kahi AVM i loaʻa ma kahi hoʻokolohua kiʻi, akā ʻaʻole ia ke kumu o nā ʻōuli, hiki ke paʻakikī. E kūkākūkā kāu mea lawelawe me ʻoe:

• ʻO ka makaʻu e wāwahi ai kāu AVM (haki). Inā kū kēia, aia paha he pōʻino lolo paʻa.
• ʻO ka makaʻu o ka hōʻino o ka lolo inā loaʻa iā ʻoe kekahi o nā ʻoki i helu ʻia ma lalo.

E kūkākūkā paha kāu mea hāʻawi i nā kumu like ʻole i hoʻonui i kou makaʻu i ke kahe ʻana, e like me:

• ʻO nā hāpai hāpai i kēia manawa a i ʻole hoʻolālā ʻia
• Pehea ke ʻano o ka AVM ma nā hoʻāʻo kiʻi
• Ka nui o ka AVM
• Kou makahiki
• Kou mau hōʻailona

He AVM kahe koko kahi pilikia olakino. ʻO ka pahuhopu o ka mālama ʻana e pale i nā pilikia hou aʻe ma o ka kaohi ʻana i ke kahe ʻana a me ka hopu ʻana, a inā hiki, e hemo ana i ka AVM.

Loaʻa ʻekolu mau lāʻau lapaʻau. Hoʻohana pū ʻia kekahi mau lāʻau.

ʻO ka ʻoki ʻana o ka lolo hāmama e kāpae i ka pilina maʻamau. Hana ʻia ke ʻoki ma o ka wehe i hana ʻia i ka iwi poʻo.

Embolization (endotherapy lapaʻau):

• Alakaʻi ʻia kahi catheter ma o kahi ʻoki liʻiliʻi i kou ʻūlū. Komo ia i loko o ke aʻa a laila i loko o nā kīʻaha koko liʻiliʻi i kou lolo kahi o ka aneurysm.
• Hoʻokomo ʻia kahi mea like lemu i loko o nā moku kū ʻole. Kū kēia i ke kahe o ke koko i ka AVM a hoʻemi i ka makaʻu o ke kahe ʻana. ʻO kēia paha ke koho mua loa no kekahi ʻano AVM, a i ʻole inā ʻaʻole hiki ke hana ʻia ke kaukō.

Nā radiosurgery Stereotactic:

• Hoʻonohonoho pololei ʻia ka uila ma ka wahi o ka AVM. ʻO kēia ke kumu o ka scarring a me ka shrinkage o ka AVM a hoʻemi i ka makaʻu o ke kahe.
• He mea kūpono ia no nā AVM liʻiliʻi i loko o ka lolo paʻakikī e hemo e ke kahakaha.

Hoʻouna ʻia nā lāʻau e hoʻōki i ka hopu ʻana inā pono.

ʻO kekahi poʻe, nona ka ʻōuli mua o ke kahe ʻana o ka lolo nui, e make lākou.Loaʻa i nā poʻe ʻē aʻe ka hopu ʻana a me ka lolo a me nā pilikia ʻōnaehana. AVMs i kumu ʻole i nā ʻōuli ma ka manawa i hiki ai i ka poʻe i ka hopena o 40 a i ʻole 50 mau makahiki e noho paʻa mau paha, a ma nā hanana kakaikahi, ke kumu o nā ʻōuli.

Komo pū nā pilikia:

• Poino lolo
• Hemorrhage intracerebral
• Pilikia ʻōlelo
• Pōpō o kēlā me kēia ʻāpana o ke alo a i ʻole ke kino
• ʻEha poʻo mau
• Ka hopu ʻana i nā maʻi
• ʻO ka hemorrhage Subarachnoid
• Hoʻololi ka hihiʻo
• Ka wai ma ka lolo (hydrocephalus)
• Nāwaliwali i kahi ʻāpana o ke kino

Hiki i nā pilikia o ka ʻoki ʻana o ka lolo hāpau me:

• Huʻi lolo
• Hemorrhage
• Ka hopu ʻana
• Hahau

E hele i ka lumi pilikia a kāhea paha i ka helu pilikia kūloko (e like me 911) inā loaʻa iā ʻoe:

• Pōpō i nā ʻāpana o ke kino
• Ka hopu ʻana i nā maʻi
• ʻEha poʻo poʻo
• ʻO ka luaʻi
• Nawaliwali
• Nā ʻōuli ʻē aʻe o kahi AVM ruptured

E ʻimi koke i ka lāʻau lapaʻau inā loaʻa iā ʻoe ka hopu mua, no ka mea ʻo AVM paha ke kumu o ka hopu ʻana.

AVM - cerebral; Arteriovenous hemangioma; Hahau - AVM; Pāʻi hemorrhagic - AVM

• ʻOki kino o ka lolo - hoʻokuʻu
• Headache - he aha e nīnau aku ai i kāu kauka
• ʻO radiosurgery Stereotactic - hoʻokuʻu

• Nā aʻa o ka lolo

Lazzaro MA, Zaidat OO. Nā manaʻo o ka neurointerventional therapy. 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 56.

Ortega-Barnett J, Mohanty A, Desai SK, Patterson JT. Neurosurgery. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 67.

ʻO Stapf C. Arteriovenous malformations a me nā anomalies vascular ʻē aʻe. I: Grotta JC, Albers GW, Broderick JP, et al, eds. ʻOhana: Pathophysiology, Diagnosis, a me Management. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2016: chap 30.