Malformation Umhlinzi: izimbangela, izimpawu, uphethwe futhi ukwelashwa

Uma e inqubo yentuthuko embryonic iphazamisekile kumiswa isimiso sokujikeleza kwegazi, kwakheka malformation semithambo yegazi. Lona uxhumano engalungile emithanjeni yegazi, esizibonakalisa usakhula. Konke kuqala ikhanda, migraines kanye nokuquleka. Ezimweni ezimbi kakhulu, izingane kufanele nokuquleka.

definition

isakhiwo semithambo kuyahluka kulo isimiso sokujikeleza kwegazi. Ezinye makhula, abanye basuke odongeni kwemisipha, abanye babe ama-valve, kodwa wonke axhumene nezinye ilandelane ethile. Uma ngasizathu simbe sinqamukile uhlobo omisiwe ukulandelana, le conglomerates akhiwa izitsha convoluted, ngokuthi kombungu.

Ngokuvamile, lesi sifo azalwa naso imbangela ayaziwa. Senzeka nesishiyagalolunye aphume eziyikhulu izinsana unyaka ngamunye. Kungabangela malformation ukuntshontsha syndrome, cindezela emgogodleni ubuchopho izicubu, ukwakha useshonile futhi kubangele sohlangothi ukopha meninges. Ngokuvamile yezinkinga kwenzeke endaweni engu avuthiwe, ekupheleni kweminyaka emine.

ngezigaba

Kukhona izinhlobo eziningana ukuthi kungathatha malformation semithambo. Ukuze ngezigaba zabo esetshenziswa wamukelwa ngonyaka ka 1996, i-American ngezigaba ISSVA. umehluko zalo eziyisisekelo kusuka kwamanye ngeengaba - ukwehlukana zonke anomalies e izimila kanye kombungu.

1. izimila Umhlinzi:
   - hemangioma kwezinsana (livela ebuntwaneni);
   - hemangioma azalwa naso;
   - bunchy hemangioma;
   - veretenopodobnaya hemangioendothelioma;
   - kaposhiformnaya hemangioendothelioma;
   - zitholwa yesimila.
2. kombungu:
   - capillary (telangiectasias, angoikeratomy);
   - emithambo yegazi (oqabukelayo, glomangioma, Mafuchchi syndrome);
   - lymph;
   - lwemithambo;
   - arteriovenous;
   - kuhlanganiswe.

Malformation emithanjeni

Emithambo yegazi Malformation kuyinto ukuthuthukiswa okungavamile vein, kulandele isandiso yabo sokugembula. Kuyinto kakhulu phakathi kwazo zonke izinhlobo kombungu. Lesisifo azalwa naso, kodwa kungase ukuzibonakalisa beseyizingane, kwathi lapho usukhulile. Shintsha indawo izitsha kungaba noma yini: a sezinzwa letindzala, izitho zangaphakathi isikhumba, amathambo noma imisipha.

kombungu emithambo yegazi angase abe phezu noma amanga umzimba mkhulu bodwa noma elula ezingxenyeni umzimba eziningana. Ngaphezu kwalokho, eduze kuto ebusweni isikhumba, kulapho ayegcwele inzuzo umbala.

Ngenxa ukuma okungavamile nombala kungaba kudidaniswe hemangiomas. Ukuze ukuxilongwa umehluko ingcindezi ngempela kancane ingxenye ukushintshwa. Kombungu zithambile futhi kulula ukushintsha umbala. Uma kwenzeka nesenzakalo wegazi izitsha okungavamile ezijulile emzimbeni womuntu ngaphandle zokugula ayinakuboniswa.

Bekanye sokukhula kwengane kanye malformation anda, kodwa ngaphansi kwethonya inhlamvu izici, ezifana nokuhlinzwa, ukuhlukumezeka, ukutheleleka, izidakamizwa hormone, ukuzalwa kwezingane noma menopause wazibonela ukukhula Lubanzi imithambo yegazi.

Chiari malformation

Lokhu malformation semithambo, okuyinto libhekene amalaka ephansi amanga cerebellar. Lesi sifo ezichazwe ngasekupheleni nesishiyagalolunye udokotela Austrian ekhulwini Hans Chiari obubusa udumo futhi yaqanjwa lomkhuba. Yasho ezinye izinhlobo ezivamile lokhu anomaly. Ngenxa ongaphakeme indawo idlala kuthiye outflow uketshezi yobuchopho emgogodleni, idala okhushuliwe ingcindezi intracranial futhi wenza intuthuko iphimbo.

Chiari malformation uhlobo uchaza ukufuduka amalaka cerebellar phansi futhi baphokophelele kubo ngokusebenzisa Magnum foramen. Leli lungiselelo kubangela ukunwetshwa umsele umgogodla, okuyinto emtholampilo kuzibonakalisa phakathi nokuthomba. Izimpawu ezivame kakhulu ubuhlungu bekhanda, tinnitus, ongagxilile uma uhamba, diplopia, ukuhambisana kahle, ukugwinya izinkinga, futhi ngezinye izikhathi nokuhlanza. Intsha libhekene ubuhlungu kwehle futhi lokushisa ukuzwela engxenyeni engaphezulu kuphela yomzimba nasemilenzeni.

Chiari malformation Uhlobo lwesibili eba uma anda ubukhulu foramen. Kulokhu, amalaka cerebellar ningaweli, futhi uyowela kuwo. Lokhu kuholela kokucindezelwa ka emgogodleni cerebellum ngokulandelana. Ngesikhathi esifanayo kukhona izimpawu okungenzeka nokugcinwa uketshezi ebuchosheni, ukukhubazeka inhliziyo, ukwephulwa embryonic ipheshana wokugaya ukudla bese uhlelo urogenital.

emgogodleni

Malformation ka emgogodleni - iyisifo ezingavamile eholela myelopathy ezithuthukayo. kombungu Arteriovenous ukhetha kahle phakathi amashidi noma kanzima igobolondo amanga phezu amaphiko ebuchosheni yomgogodla thoracic noma lumbar. I zokugula ezivamile kuvamile amadoda omdala.

Lesi sifo sifana izimpawu multiple sclerosis Ungafaka kudokotela oyisazi sezinzwa ngezindleko edukisayo. Ukuwohloka abukhali kwenzeka ngemva ukudabuka yegazi kanye ukopha esikhaleni subarachnoid. Iziguli kuyagcinwa iziyaluyalu zindawo ezikhombisa ukuzwela kanye motor, ukuphazamiseka kwezitho okhalo. Uma ijoyina izimpawu cortical, lesi sifo liba njenge-ALS (yesifo sokuwohloka kwezinzwa nemisipha).

Uma isiguli ekhononda nobuntu iziyaluyalu ezimbili ezahlukene izinzwa, udokotela kufanele esolwa malformation semithambo nokuziphatha kuhlolwe ngamehlo sokukhubazeka komgogodla. Izibonakaliso kokuba okushintshiwe semithambo lipoma futhi izindawo lesikhumba anda. Umuntu onjalo kufanele ithunyelwa-magnetic resonance imaging noma myelography ekhompyutha. Lokhu kuzokuvumela ukuba uqinisekise uphethwe.

izimpawu

malformation Umhlinzi libukeka ibhomu isikhathi noma isibhamu ngesando cocked ezandleni ingane - akekho owaziyo lapho inhlekelele uzoqala. Naphezu kweqiniso lokuthi lesi sifo singumbulali anomaly azalwa naso, uqala ukuzibonakalisa kamuva kakhulu. Kunezinhlobo ezimbili zama-ukugeleza semithambo kombungu:

- ukopha (70% amacala);
- torpid (ku asele 30%).

Akekho ongakhetha ayikwazi kubhekwe ezikhangayo umuntu nale uphethwe. Endabeni oluhambisana ukugeleza isiguli-high blood pressure, futhi iyunithi semithambo incane futhi itholakala entanyeni. Isigamu sabantu nge oluhambisana unhlangothi kwenzeka uhlobo malformation eholela ukukhubazeka noma ukufa. Ingozi ukopha kwandisa ngeminyaka, futhi abesifazane isici eyengeziwe kuyinto ekhulelwa noma ebeletha.

Uma umuntu uthuthwa ngokuphumelelayo lo mvimbo kuqala, bese nge okungenzeka 1: 3 phakathi nonyaka sizophinda ukopha. Bese yesithathu. Ngeshwa, ngemva ekulandiseni okuthathu, ambalwa asinde. Cishe isigamu iziguli ziye nzima izimo yakha nokopha intracranial, hematomas noma okuxubile podobolochechnyh tamponade nobuchopho ventricles.

Indlela yesibili ukugeleza enkulu elisemandleni ekujuleni cortex cerebral malformation semithambo. Izimpawu zayo abasakwazi ejwayelekile:

- ukulungela convulsive noma khona ukuhlaselwa epileptiform;
- zekhanda ezinamandla;
- khona izimpawu kusilela efana ukuthi unesimila ebuchosheni.

nakwisyncope

Cishe bonke abantu kombungu semithambo elise ubuchopho, manje noma ngokuhamba kwesikhathi uzovela nakwisyncope (ie, nakwisyncope). Lokhu kungenxa yokwenqatshwa zesikhashana kwegazi cerebral palsy. Phakathi nakwisyncope isiguli okhanyayo, embozwe obondayo, izandla nezinyawo uyabanda, ishayela ababuthakathaka kanye ukuphefumula engajulile. Ukuhlaselwa eyathatha imizuzwana mayelana amabili, futhi ekupheleni kwayo isiguli olele akakhumbuli lutho.

Minyaka yonke kukhona ngaphezulu kwengxenye yesigidi amacala amasha nakwisyncope, futhi kuphela ingxenye encane kubo has a ecacile ubuhlobo imbangela nemphumela. Syncope kungadalwa ukushukuma ngokweqile itheku carotid, neuralgia trigeminal noma ezinzwa glossopharyngeal, ukulawulwa esingamahlalakhona autonomic nesimiso sezinzwa, inhliziyo isigqi isiphithiphithi uphazamise nezimoto Yiqiniso, kombungu semithambo. imithambo okungavamile kanye emithanjeni ukunikeza shunting wegazi futhi ukusheshisa flow yayo. Ngenxa yalokho, ubuchopho awutholi umsoco ngokwanele, lokhu kubonakala iziyaluyalu ukwazi.

yezinkinga

Ngisho nangaphambi kokuba malformation ukuzibonakalisa emtholampilo e abantu kufihliwe ozokhula engelapheki imihlola sokugembula. Lokhu kungenxa hypoxic ubuchopho izicubu ingxenye, ke sokuwohloka nabafayo. Kuye indawo endaweni ethintekile is waphawula izimpawu isici esiyinhloko (inkulumo kwezinso, Gait, ukunyakaza yokuzithandela, ukuhlakanipha kanye t. N.) Kungaba zesifo sokuwa.

yezinkinga ezinzima uqale kakade lapho usukhulile. imithambo yegazi okungavamile abe izindonga mncane futhi bethambekele ekubeni waphuka, ngakho iziguli ezine kombungu kwande imivimbo ischemic. conglomerates elikhulu ekhipha igazi enhliziyweni nelifakayo cindezela izicubu elibazungezile, okubangela iphimbo. I esiyingozi kakhulu kuyinto ukopha ngenxa ukudabuka imithambo eziningana. Kungase noma kungase kube nemiphumela ebulalayo, futhi iphethwe nemiphumela kangako noma abangafundile nhlobo. Konke kuncike inani legazi olusakazwayo. Oluhambisana unhlangothi kuyinto sinesimo sengqondo ingasaphathwa ethembisayo bangase ziyabuya ngokuhamba kwesikhathi.

ukuhlola

Kokuqala luhlolo zezinzwa kungase cha phendla phi kwezinso abantu nge kombungu semithambo. Ngokuvamile kudinga kuhloswe futhi ahlolwe kahle emzimbeni kakhulu ukukhomba ukuphulwa. Uma isiguli ekhononda ka ikhanda njalo ezinzima, ukundindizela, ukuphazamiseka ngezikhathi ukwazi umbono kahle noma ukuhamba, ke yithuba ukuba umthume ukuqhuba neuroimaging. Ngamafuphi nje, i-computer noma resonance kazibuthe a imaging zobuchopho.

Enemininingwane kakhulu futhi kunembile isakhiwo semithambo libonisa Ngokuphambene angiography. Ngenxa yalesi bekezela ngaphakathi the ezivamile carotid Umthambo ukuthi injected ketshezi radiopaque futhi wenze uchungechunge isibhamu. Le ndlela linenani ngenxa yezinkinga side effects, ngakho-ke, kusebenza kuphela uma nobunzima ekwenzeni ngoba uyayazi imbangela.

Ukuhlola ijubane, futhi ngesilinganiso igazi ligeleze ushintsho isigaba, usebenzisa Doppler ultrasound. Le ndlela ivumela ukuba sibone ukudedelwa igazi phakathi ekhipha igazi enhliziyweni nelifakayo, ukucacisa uhlobo izitsha, ukusungula khona aneurysms kanye nezinye izinkinga.

ukwelashwa

Kungakhathaliseki semithambo kombungu amenable ukusolwa? izindlela Ukwelashwa incike uhlobo angahlangani, indawo yayo, usayizi nento ayegxila kuyo umlando imivimbo.

Kukhona izindlela ezintathu eziyinhloko ukwelashwa:

- Ukuhlinzwa okukhulu;
- embolization kancane koda;
- ukwelashwa radiosurgical non-koda.

Ukuze ngamunye wabo zikhona izimpawu, contraindications, kanye nohlu yezinkinga kungenzeka.

I okubuhlungu kakhulu kuyinto Ukuhlinzwa okukhulu. Ukuze uthole banikelwe emlilweni, wenze kokuvula Nogebhezi lwawo, klipiruyut izitsha niwele kubo. i samuntu okunjalo kungenzeka endabeni malformation esisogwini ebusweni ngobuchopho unamahlangothi encane. Imizamo ukufinyelela izilonda olujulile kungaholela ukulimala amaphuzu ezibalulekile kanye nomphumela ebulalayo.

Yini engenziwa uma isiguli malformation ngokujulile? Ukwelashwa kwemfuyo kusebenza embolization endovascular. Lena inqubo sasivumela mnene, phakathi kwesikhathi lapho isitsha ezinkulu feeds nhlanganisela normal, ipayipi mncane sifakwe ngaphansi kolawulo-X-ray kanye udokotela uthola kuya malformation. Khona-ke semithambo inesikhala hypoallergenic izidakamizwa iqondiswa ayizwayo atholakalayo Isikhala amabhlogo ukugeleza kwegazi kulesi sifunda. Ngeshwa, le ndlela akusho kusiqinisekisa ngokuphelele ukuthi umkhumbi is fully obliterans. Ngakho-ke, ngokuvamile eziningi lisetshenziswa njengendlela yokwelapha aphelele.

Indlela eziphambili kakhulu Umhlinzi kombungu Kusolwa operation usebenzisa ummese Cyber (radiosurgery). Ingqikithi yalo ndlela unciphise ukusingatha imisebe enemisebe kwemizi normal ngezindlela ezihlukahlukene. Lokhu kukuvumela ukuba ngokushesha abhubhise izinguquko semithambo, ngaphandle kokulimaza inyama ephilile. Inqubo ukuqina imithambo yegazi ngokwesilinganiso ithatha izinyanga ezimbalwa. Inzuzo iyona sokungabi nhlobo izinkinga e isimiso sezinzwa. Kodwa ukuthi kulinganiselwe ukusetshenziswa le ndlela:

1. ubukhulu jikelele izitsha kumele singeqi ngamasentimitha amathathu.
2. umlando akufanele kube unhlangothi noma ezinye ukopha. Njengoba odongeni mncane futhi abakwazi ukumelana ukudabuka ku isikhawu phakathi ukubulawa kwabo inqubo kanye ukuqina yokugcina malformation.