Subarachnoid Hemorrhage yog dab tsi?
Subarachnoid hemorrhage (SAH) hais txogKev kho mob syndrome tshwm sim los ntawm rupture ntawm cov hlab ntsha nyob rau hauv qab los yog saum npoo ntawm lub paj hlwb, thiab ncaj qha ntws ntawm cov ntshav mus rau hauv lub subarachnoid kab noj hniav.Nws tseem hu ua thawj SAH, uas suav txog kwv yees li 10% ntawm tus mob stroke.SAH yog ib hom kab mob uas muaj qhov hnyav heev.
WHO cov kev tshawb fawb qhia tias qhov xwm txheej tshwm sim hauv Suav teb yog kwv yees li 2 rau 100,000 tus neeg hauv ib xyoos, thiab tseem muaj cov lus ceeb toom ntawm 6-20 rau 100,000 tus neeg hauv ib xyoos.Kuj tseem muaj cov kab mob subarachnoid hemorrhage tshwm sim los ntawm intracerebral hemorrhage, epidural lossis subdural hlab ntsha tawg, cov ntshav nkag mus rau hauv lub hlwb cov ntaub so ntswg thiab ntws mus rau hauv cov kab noj hniav subarachnoid.
Dab tsi yog Etiology ntawm Subarachnoid Hemorrhage?
Txhua yam ua rau lub hlwb hemorrhage tuaj yeem ua rau subarachnoid hemorrhage.Feem ntau yog vim li cas:
1. Intracranial aneurysm: nws suav txog 50-85%, thiab nws muaj feem yuav tshwm sim ntawm ceg ntawm lub aorta ntawm lub paj hlwb;
2. Cerebral vascular malformation: feem ntau arteriovenous malformation, feem ntau pom nyob rau hauv cov hluas, accounting txog li 2%.Arteriovenous malformations feem ntau yog nyob rau hauv lub paj hlwb ntawm cov hlab ntsha hlwb;
3. Abnormal cerebral vascular network kab mob(Moyamoya kab mob): nws suav txog li 1%;
4. Lwm tus:Dissecting aneurysm, vasculitis, intracranial venous thrombosis, connective cov ntaub so ntswg kab mob, hematopathy, intracranial qog, coagulation disorders, anticoagulation kev nyuaj siab, thiab lwm yam.
5. Qhov ua rau los ntshav hauv qee cov neeg mob tsis paub, xws li thawj peri midbrain hemorrhage.
Cov kev pheej hmoo ntawm subarachnoid hemorrhage yog qhov tseem ceeb uas ua rau muaj kev cuam tshuam ntawm intracranial aneurysms, suav nrogntshav siab, haus luam yeeb, haus dej ntau, yav dhau los keeb kwm ntawm ruptured aneurysm, tsub zuj zuj ntawm aneurysms, ntau aneurysms,lwm.Piv nrog rau cov neeg tsis haus luam yeeb, cov neeg haus luam yeeb muaj qhov mob hnyav dua thiab lawv yuav muaj ntau yam aneurysms.
Cov tsos mob ntawm Subarachnoid Hemorrhage yog dab tsi?
Cov tsos mob tshwm sim ntawm SAH yogmob taub hau sai heev, xeev siab, ntuav thiab meningeal irritation, nrog los yog tsis muaj cov cim qhia.Thaum lub sij hawm los yog tom qab kev ua si strenuous, yuav muajtawg ntawm lub zos los yog tag nrho lub taub hau mob, uas yog intolerable.Nws tuaj yeem ua rau tsis tu ncua lossis tsis tu ncua, thiab qee zaum, yuav muajmob nyob rau hauv lub caj dab sab sauv.
Lub hauv paus chiv keeb ntawm SAH feem ntau muaj feem xyuam rau qhov chaw tawg ntawm lub qhov txhab.Cov tsos mob tshwm sim yogntuav, cuam tshuam ib ntus ntawm kev nco qab, mob nraub qaum lossis qis qis, thiab photophobia,etc. Feem ntau,meningeal irritationtshwm sim nyob rau hauv ib teev tom qab pib ntawm tus kab mob, nrogcaj dab rigidityyog qhov pom tseeb tshaj plaws.Kernig's thiab Brudzinski cov cim qhia tau zoo.Kev ntsuam xyuas nyiaj txiag tuaj yeem pom cov ntshav tawm ntawm cov hlab ntsha thiab papilledema.Tsis tas li ntawd, kwv yees li 25% ntawm cov neeg mob yuav muajcov tsos mob ntawm lub hlwb, xws li euphoria, delusions, hallucinations, thiab lwm yam.
Tej zaum kuj muajqaug dab peg, focal neurological deficit cov cim xws li oculomotor tuag tes tuag taw, aphasia, monoplegia los yog hemiplegia, kev puas siab puas ntsws,thiab lwm yam. Qee cov neeg mob, tshwj xeeb tshaj yog cov neeg laus, feem ntau muaj cov tsos mob atypical kho xws limob taub hau thiab meningeal irritation,thaum cov tsos mob ntawm kev puas siab puas ntsws yog pom tseeb.Cov neeg mob uas muaj thawj midbrain hemorrhage muaj cov tsos mob me, qhia hauv CT lihematocele nyob rau hauv mesencephalon los yog peripontine cistern tsis muaj aneurysm los yog lwm yam txawv txav ntawm angiography.Feem ntau, tsis muaj qhov rov los ntshav lossis qhov pib vasospasm lig yuav tshwm sim, thiab qhov kev xav tau ntawm kev kho mob yuav zoo.
Post lub sij hawm: May-19-2020