Impembelelo yoKhuselo lwe-Intracranial In Brain
Kuthetha ukuthini ukuba umntu unyuke ingcinezelo yongcinezelo? Ziziphi iimpawu zengcinezelo ephezulu ye-intracranial, yintoni ebangela ukuba ibe yintoni, kwaye iphathwa njani? Yintoni eyenzekayo kwingqondo xa uxinzelelo entloko luhlala luphezulu?
Ukunyuka kwe-Intracranial Pressure - Inkcazo
Uxinzelelo lwe-intracranial ngumlinganiselo woxinzelelo kwingqondo kunye ne-cerebrospinal fluid ejikelezayo.
Xa lo xinzelelo lunyuka ngenxa yezizathu ezithile-nokuba kungenxa yokuphuma kwintsholongwane (ukubola), ukusuleleka, okanye ukulimala kwentloko-ingqondo ingaba nomonakalo omkhulu. Enyanisweni, ingcinezelo ephakamileyo ye-intracranial ingenye yeengxaki ezinxungukisayo zokulimala kwengqondo ebuhlungu. Masichaze isizathu sokuba
Ubunjani, i-Cerebrospinal Fluid, kunye ne-Intracranial Pressure
Ikhanda, xa ucinga ngako, akukukhulu kakhulu. Kule mizolo embalwa yesikwere esityebileyo ithambo yonke into oyikhumbulayo, yonke impawu zobuntu, zonke izakhono zakho ezikhethekileyo okanye iitalente, zonke ezigcinwe kwiiplani ezimbalwa zeengqondo.
Njengento encinci njengale ndawo, ingqondo kufuneka ibelane ngayo. I-Cerebrospinal fluid (CSF) iyakujikeleza ingqondo, idibanise kwaye ikhusele ingqondo ukuba ingabhinqa kwikrele kunye nazo zonke i-jolt yentloko yakho. Igazi ligeleza kulowo mhlaba ongenakunyango, ukubonelela ngengqondo nge-oksijini oyifunayo nokukhupha ingqondo yezinto ezinobuthi.
Ezinye izixhobo zomzimba kufuneka zikwabelane ngezikhalazo, kodwa ezo ndawo zingenakunqanyaniswa ngokugqithiseleyo njengengqondo. Kukho ukuvula okumbalwa okuphuma kwilungu apho iimbilini kunye nentambo yomgogodla ihamba khona. Ngaphandle koko, akukho ndlela yokuphuma okanye yokuphuma kuloo ndawo.
Konke oku kusemgangathweni ubomi bemihla ngemihla.
Kuyinto enhle ukuba ingqondo yethu ikhuselwe kakuhle kunye nelolu hlobo lwesigqoko somzimba, okanye siyakwazi ukunyamekela kuzo zonke iintlobo zokulimala kwengqondo. Noko ke, iingxaki zivela xa enye yezona zigaba ezintathu eziphambili zendawo efuna ukungena kuyo zidinga indawo. Ezi zixhobo ziquka:
- Intracranial igazi
- Iibuncu zobomi
- Cerebrospinal fluid
Ukuba kukho into efuna indawo engaphezulu, enye into kufuneka inike. Ekuqaleni, izenzo ezihlawulwayo zenzeke phakathi kwezi zinto zintathu. Xa oku kusenakwenzeka, nangona kunjalo, ekubeni oku kwenzekayo kwisithintelo esinzima skull, ukunyanzeliswa kwengcinezelo kuqala ukunyuka ngokukhawuleza.
Ziziphi Iingxaki Eziphakamileyo Zengcinezelo Zengqondo?
Kukho iinkqubo ezahlukeneyo kunye neendlela ezinokubangela ukwanda kweengcinezelo zengcinezelo.
Ngamanye amaxesha, into enentloko engafanele ibe khona. Imizekelo ibandakanya i- tumor yeengqondo , igazi ngenxa yokugaya isisu kwindawo yengqondo. Ngamanye amaxesha ukusuleleka okanye ukuvuvukala kubangela ukuvuvukala nokugqithisa kwengqondo.
Ngamanye amaxesha, indlela eqhelekileyo yokuphuma kwamanzi iphuma kunye nokuphuma kwendawo ephazamisayo ingaphazamiseka. Ngokomzekelo, ii-CSF zivame ukuhamba ukusuka kwii-ventricles phakathi kwendawo yengqondo ngokusebenzisa ukuvuleka kwamancinci okubizwa ngokuba yi-foramina. Ukuba lo kuhamba kwe-CSF kuvaliwe ngandlela-thile, kwaye i-CSF iyaqhubeka yenziwe, uxinzelelo luyabakha.
Eminye imingcipheko yokunyuka kwengcinezelo ephezulu iquka:
- Intlungu yentlekele
- Izidumbu ezifana nezicubu zeengqondo okanye i-metastase kwiingqondo ezivela kwezinye izicubu
- Ukuphazamiseka kwegazi, okanye i- intrarebral hemorrhage okanye i- subarachnoid
- Utyando lweShekemikhali
- Hydrocephalus
- Izifo ezifana ne- meningitis kunye ne-encephalitis
Ngamanye amaxesha kukho ukwanda kweengcinezelo ezingenakunyango ngenxa yezizathu ezingaziwa. Oku kubizwa ngokuthi "idiopathic" ingcinezelo ephakamileyo yokunyanzelisa.
Ziziphi iiMpawu kunye neZigqirha zokuPhathwa kwee-intracranial eziphakamileyo?
Uxinzelelo oluqhelekileyo lwe- intracranial liphakathi kwe-8 ukuya kwe-20 imithamitha ye-mercury (mm Hg). Naluphi na oku kunye nalezi zakhiwo kwiingqondo ziqala ukuchaphazeleka.
Enye yezakhiwo zokuqala ukuziva uxinzelelo yizicubu ezibizwa ngokuba ngama-mening ajikeleze ingqondo. Nangona ingqondo ngokwayo ayinayo i-receptors yeentlungu, i-meninges ingakwazi ukutshabalalisa imiyalezo yentlungu eyenza intloko ebuhlungu.
Uxinzelelo oluphezulu lwe-intracranial ludla ngokubangelwa intloko yamakhanda okanye ukuvalelwa kwengcinezelo entloko xa ulele; ngenxa yokuba uxinzelelo oluphezulu lwe-intracranial luphuculwe ngokuma kwaye lubuhlungu ngokulala phantsi. Ukuma kuvumela ezinye zeengcinezelo ukuba zehla phantsi komqolo wamagxa, kanti ukulala kwintlanzi kukukhupha i-gradient yexinzelelo, okubangele ukuxinzelelo oluphezulu olujikeleze ingqondo.
Esinye isakhiwo kufuneka sibe nefuthe ngokukhawuleza njengoko ukunyuka kwengcinezelo ye-intracranial i-optic nerves, iimbilini ezihamba emva kwelanga (i-retina) kwindawo yengqondo apho umbono ubonakala khona (i-occipital lobes). Abantu abane-ICP ephezulu bangaqala ukukhalaza ngokugqithisa kombono wabo njengoko ama-optic nerves abonakaliswe. Ukongeza kwilahleko ebonakalayo, kukho ukulahlekelwa kwintsimi ekuboneni kwaye udokotela angayiphawula i-papilledema kwi-fundoscopic test-xa ugqirha esebenzisa isixhobo esilandela kwisixhobo esibheka ezindlebeni zakho ukujonga i-retina-yamehlo. Ukuba ingcinezelo ye-intracranial ingagqibekanga kwisixa esaneleyo, ukulahleka kombono ongapheliyo kunokubangelwa.
Ezinye iimpawu zokunyuka kwengcinezelo enganyanzelekanga zingabandakanywa izibilini kunye nokuhlanza, ukuguquka kokuziphatha kunye nokuthinjelwa. Utshintsho kwisimo sengqondo, njengengxaki yokunyaniseka kwaye ekugqibeleni i-coma ngumqondiso omkhulu.
Kwiintsana, umqondiso wokunyuka kwengcinezelo yokunyuka kwengcinezelo yongxowankulu i-fontanelle (indawo esithambileyo) kunye namaxesha athile ukwahlukana kwee-sutures (iinqonga kwi-kaga yengane.)
Iingxaki zoPhuculo oluPhakamileyo lwe-Intracranial
Eminye malunga nokulimala kwentsimbi (kunye nomonakalo obangela umboniso) yindlela i-ICP inokuchaphazela ngayo ubuchopho ngokwayo. Xa iingcinezelo ziphakama ngaphakathi kweengqayi, ubuchopho buyakwazi ukuqhutyelwa kwindawo engaphantsi kwengcinezelo. I-lobes yengqondo ihlukaniswe ngamaqabunga aqinileyo weethambo. Ngokomzekelo, i-hemisphere ekhohlo ihlukaniswe ukusuka kwi-hemisphere ephezulu kwi-brain engama-tissue ebizwa ngokuba yi-falx cerebri. Ukuba igazi kwi-hemisphere ekhohlo lenza uxinzelelo olwaneleyo, luyakuchukumisa ubuchopho be-hemisphere ngaphantsi kwe-falx cerebri, ukuchoboza izicubu zeengqondo kunye nokuvimba imithana yegazi. Umonakalo wobunongo kunye nesifo sobungozi kunokubangelwa.
Ngokufanayo, i-cerebellum iyahlukana nayo yonke ingqondo yengqamlezo. Ukuba uxinzelelo lwakhiwe ngaphezu kwelo membrane, izicubu zengqondo zingaphoxiswa ngaphantsi komnyango omncinci osondelene ne-brainstem, obangela ukungonakali komonakalo wengqondo. Oku kunokukhokelela ekukhubazekeni, ku- coma, nokufa.
Ukuchonga ukuphakanyiswa kwe-Intracranial Pressure
Uxinzelelo olunzulu lwe-intracranial lungatholakala kwiindlela ezahlukeneyo. Iimpawu ezichazwe ngasentla zinokubonisa ukuba uxinzelelo luphakanyisiwe. Uvavanyo lwe-fundoscopic liso lungaveza i-papilledema. Umpompo ungasinika ulwazi malunga noxinzelelo lwe-intracranial, nangona oku kunokuba yingozi xa uxinzelelo luphezulu kakhulu.
Indlela ethembekileyo yokulinganisa ukunyanzeliswa kwengcinezelo ngokufaka i-monitor phantsi kwegazi. Le nkqubo inikezela ngokuqhubekayo ukunyanzeliswa kwengcinezelo. Ngaphandle kokuhlinzwa okwenziwe ngengqondo okanye ukulimala kwengqondo ngokugqithiseleyo, ukubeka ingcinezelo yongcinezelo ngokuqhelekileyo kufakwe ngokukhawuleza.
Izinyango zokwelapha ukwenzela ukunyuka kwe-Intracranial Pressure
Kufuneka ngoku ngokucacileyo ukuba uxinzelelo oluphezulu lwe-intracranial lungaba yingozi. Nangona kunjalo, i-neurologists inamandla kakhulu ekuxilongeni kwaye ngokusoloko ilapha le meko, eyinto eqhelekileyo yengxaki yezifo ezininzi kwizigulane ezininzi ezigulayo.
Uninzi lwexesha, ukunyanzeliswa kwengcinezelo engaphezu kwama-20 kuya kwe-25 kuphathwa kakubi.
Ngethamsanqa, izazi ze-neurologists zineendlela eziliqela zokulawula i-ICP ephezulu xa ixesha liyilo. Nangona akukho nto iqinisekisiwe, ukungenelela ngexesha elifanelekileyo kunokuthintela ukuxothwa okukhulu.
Injongo yokuqala ukuzinzisa isigulane, ukubonelela ngesilwanyana xa kuyimfuneko, kunye nokunciphisa intlungu. Ukuba ukwanda kunomlinganiselo omncinci, amanyathelo alula njengokuphakamisa intloko anganciphisa uxinzelelo olungaphelelanga kwizinga elincinci ngokuvumela igazi entanyeni ukuba libuyele entliziyweni.
Isinyathelo esilandelayo kukuba ukwandisa igumbi kwingqondo yeethambo zesisu. Iisombululo ezinjenge-mannitol okanye i-hypertonic saline zihlala zinikezwa njengoko zihambisa umthamo kwigazi kunye neengqondo. I-Steroids inokunciphisa ukuvuvukala kwengqondo. Amayeza afana ne-acetazolamide anganciphisa umveliso we-cerebrospinal fluid. Ukuba isiguli sisesipini, izinga lokuphefumula livame ukwanda kwakhona. Isigaba sesithathu sonyango singabandakanya i-hypothermia, ukuxhatshazwa kwamanzi, okanye i-craniectomy. I-craniectomy iquka ukususa inxalenye yeckull ukuze unike ubuchopho ithuba lokunyuka njengoko liqhubela.
Funda kabanzi malunga nophatho lwezonyango kunye nokunyangwa koxinzelelo olusenyongweni oluphezulu .
Ukuxhamlaliswa kweNtshukumo yokuHlalwa kwee-intracranial ephakamileyo
Ukugxekwa kwenkxalabo ephakamileyo ye-intracranial ingadlukana ngokubanzi, kuxhomekeke kwisizathu esiphezulu, ukuphakama kwengcinezelo ephakamileyo, kwaye ixesha elide ukunyanzelwa kwengcinezelo kuphakanyisiwe. Kuya kuxhomekeka kwiinkqubo ezithile ezonyango ezisetyenziswayo.
Ngaphantsi kweNqanaba eliPhakamileyo lwe-Intracranial Pressure
Uxinzelelo oluphezulu lwe-intracranial luyinto eqhelekileyo kunye nengxaki eninzi yeemeko ezichaphazela ingqondo. Oko kwathiwa, ukuqaphela kwangaphambili kunye nogonyamelo lunokuthi luhambe ngendlela ende ekunciphiseni iingxaki. Ukuba ujongene nale nkxalabo nomntu othandekayo, cela imibuzo. Nayiphi na inkxalabo yezokwelapha inokuyikrakra, kodwa ezo zichaphazela amandla ethu okucinga nokufunda nokuphupha zinexhala ngakumbi. Ukuqonda into eyenzekayo kunye nawaphi amanqanaba alandelayo anokunceda unokujamelana nayo njengoko ujamelana nale ngxaki nzima.
Imithombo
- Czosnyka, M., Pickard, J., noL. Steiner. Imigaqo ye-Intracranial Pressure Monitoring and Treatment. I-Handbook ye-Clinic Neurology . 2017. 140: 67-89.
- de Oliveira Manoel, A., Goffi, A., Zampieri, F. et al. Ukulawulwa Kwempilo Yobunzima beMithi yokuHlulwa kweNtsholongwane: I-Contemporary Review. Unonophelo oluBalulekileyo . 2016. 20: 272.
- Kasper, uDennis L .., u-Anthony S. Fauci, noStephen L .. Hauser. Iinqununu zeHarrison zeMithi yoPhakathi. ENew York: iMac Graw-Hill Education, 2015. Phrinta.