Ukufa kweBrains ngenye yezinto ezinzulu kakhulu ezinokuthi uhlolisise i- neurologist . Ngokungafani neendlela ezinzima ze-coma, ukuxilongwa kwengqondo yokufa kuthetha ukuba akukho kubuya. Ngokomzimba, ukufa kwengqondo kukufa.
Ukuba ukuxilongwa kwenziwa ngokufanelekileyo, kungenziwa kuphela ngokuqinisekisa isigulane sise-coma yeso sizathu esaziwayo nesingenakuphikiswa, kwaye iziphumo ezithile zokuhlolwa kweziphumo azikho, kuquka i- brainst reflexes kunye nenzame yokuphefumula ngexesha lokuhlolwa kwe-apnea .
Uvavanyo lwe-apnea luquka ukumnika i-oksijeni yesigulane kodwa ukucima i-ventilator ukwenzela ukuba i-carbon dioxide yakhelwe kwinkqubo, ngokuqhelekileyo ibangela isilingo sokuphefumula. Akunakho amaphepha afanelekileyo okuxilongwa ngokufa kwengqondo ngokucwangciswa ngenyameko apho isigulane safumana ukufumana kwakhona.
Nangona kunjalo, kukho amaxesha apho ukuhlangabezana nazo zonke iziqinisekiso zobugcisa bobuchopho bokufa kungenakwenzeka. Ngokomzekelo, kwintlungu ebusweni, kungenakwenzeka ukwenza uvavanyo oluchanekileyo lweentsimbi ze-cranial. Kwezinye izigulane, akunakwenzeka ukwenza uvavanyo lwe-apnea, mhlawumbi ngenxa yokuba isigulane asizinzile okanye ngenxa yokuba zakha ukunyamezela kwekhabhoni dioxide, njengoko kubonakala kwezinye izigulane ezinezifo ezingapheliyo zokuphazamiseka kwesifo okanye ukugula okungapheliyo. Kule meko, uvavanyo olongezelelweyo lubizwa ngokuba.
Ukongezelela, ngenxa yokuba ukuxilongwa kwengqondo yokufa kwengqondo kunzima kakhulu, iintsapho ezininzi zikhetha ukuba zenze uvavanyo olongezelelweyo ngaphambi kokuba zenze izigqibo malunga nokuyeka ukungena kwamanzi okanye ukuqwalasela umnikelo womzimba.
Electroencephalography (EEG)
I- EEG isetyenziselwa ukulinganisa umsebenzi wombane kwingqondo. Kuqhelekileyo kusetyenziswa xa ugqirha echaphazelekayo ukuba umntu unqabile okanye uhluthe. Kwiingqondo zokufa, kunokubheka umsebenzi ongaqhelekanga, i-EEG ikhangele nawuphi na uhlobo lo msebenzi nhlobo. Olunye umlinganiselo omncinci womsebenzi wombane unokubonakala ngathi ukhona, kodwa oku kumelela umzobo ngenxa yesigonakaliso esivela kwizixhobo ezikufuphi okanye intliziyo, kwaye akumele kudlule umda othile ukuze uhlangabezane nemigangatho yokuxilongwa kwengqondo yokufa.
I-Somatosensory Evoked Potential (SSEP)
Njenge-EEG, i- SSEP ihlola indlela umbane ohamba ngayo emzimbeni, kubandakanya ubuchopho. Esikhundleni sokujonga nje umsebenzi wezobuchopho, ii-SSEs zibandakanya inkqubo ye-nervous is stimulated by shock electrical shocks, ngokuqhelekileyo ukuya kwi- nerve median . Ngokuqhelekileyo, le rejista yokubhalisa njengombonakaliso ofunyenwe kwingqondo, enokulinganiswa ngombane onikwe intloko yesigulane. Ukungabikho kwezi zimpawu kubonisa ukuba ingqondo ayisakwazi ukufumana le miyalezo.
Angiography
Kwi-cerebral angiogram, idayi eyahlukileyo ifakwe kwiinqwelo zomzimba, kwaye ingqondo iyabonwa kweso sigxina ngelixa isigulane sibheke uluhlu lwe-X-ray. Oku kuvumela ukuhlolwa okufutshane malunga nendlela igazi elihamba ngayo umzimba. Kwiingqondo zokufa, izitya zengqondo azizalisi njengoko ziqhelekile.
Transcranial Dopplers
Ukuhlolwa kwe-doppler i-transcranial isebenzisa amagagasi e-ultrasound ukuhlola ukuhamba kwegazi kwingqondo. Ngethuba lokufa kwengqondo, ingqondo ingakhula ngeendlela ezongeza ukwanda kumigodi yegazi, ukunciphisa ukuhamba kwegazi. Ezi tshintsho ekuphumeni kwegazi zingabonwa kwi-doppler ye-transcranial.
Uvavanyo lweeNyukliya
Iicyulo zenyukliya ziquka ukujova kwe-radiosotope kwingqondo.
Le isotopi yikhemikhali ehamba kunye nokuhamba kwegazi. Ukubola kwe-isotope, okubangele ukukhululwa kwamandla afunyenwe ngabavoki kwaye aguqulelwe umfanekiso wesigodi. Ukuba ubuchopho buphilile kwaye busebenzayo, buya kubonakala ngathi bukhanyisa kwi-esweni njengoko igazi ligeleza kwiisishu zobuchopho. Kuvavanyo lokufa kwengqondo, i-isotope eqhelekileyo ibizwa ngokuthi i-technetium-99m hexamethylpropyleneamine oxime. Ukuba isiguli sisifo sebuchopho, ke akuyi kubakho uphawu oluvela kwingqondo ekukhangekeni. Ngamanye amaxesha ayaziwa ngokuba "yinto engummangaliso weekull."
Ukuzisa konke ndawonye
Ezi zixhobo ziyakwamkelwa ngokubanzi njengento eyongezelelweyo, nangona kunjalo ingaqhelekanga, iimvavanyo zokuhlolwa kobuchopho.
Eminye imilinganiselo yobugcisa ingahluka ukusuka kummandla ukuya kwimeko kwaye mhlawumbi isibhedlele esibhedlele, nangona kunjalo. Njengawuphi na uhlobo lovavanyo, nganye mvavanyo ifuna ukutolika ngokucophelela kwaye kwimeko yomlando wezokwelapha owaziwayo. Akukho vavanyo lugqibeleleyo, kwaye ngoko ke kubalulekile ukuba ingqalelo ekufutshane ihlawulwe kwiinkcukacha zendlela uvavanyo oluqhutyelwa ngayo ukuze ithuba lokungaqondwanga kweziphumo linciphise.
Ukufa kobomi komntu othandekayo kuyinto ephazamisayo kwiintsapho, kodwa uvavanyo olongezelelweyo lunokukunceda ukuqinisekisa ukuba abenzi bokuthatha isigqibo banokuqhubela phambili bathemba ukuba bahlonela oko isiguli sifuna.
Imithombo:
Eelco FM Wijdicks, MD, Ph.D., iPanayiotis N. Varelas, MD, Ph.D., uGary S. Gronseth, MD David M. Greer, MD, Isiqinisekiso esisekelwe kwizikhokelo-ndlela: Ukucacisa ukufa kwengqondo kubantu abadala, ingxelo Ikomidi leMigangatho yeMigangatho ye-American Academy ye-Neurology, i-Neurology 74, ngoJuni 8, 2010.
UJerome B. Posner noFred Plum. I-plum kunye ne-Posner's Diagnosis ye-Stupor neComa. ENew York: i-Oxford University Press, ngo-2007.