Hydrocephalus ndi mankhwala ake

Hydrocephalus amakhala ndi kuwonjezeka mu CSF danga, motero kucheperachepera buku la ubongo minofu. Chifukwa kuwonjezeka makulidwe a ventricles angakhale occlusion mowa umayenda mwa dongosolo yamitsempha yamagazi (occlusive hydrocephalus) kapena kulemala outflow (resorption) mowa subarachnoid malo mwa villi arachnoid mu dural M'mimbamo ubongo, ndiwo njira chachikulu cha outflow wa magazi venous ku ubongo (lotseguka hydrocephalus.) Kuti kuti mankhwalawa hydrocephalus wakhala bwino kwambiri mu lodziwa za njira ya pakuwonekera kwake. Zochizira hydrocephalus ntchito njira onse ndiwofatsa komanso opaleshoni. Mankhwalawa opaleshoni ya hydrocephalus zambiri khazikitsa ventriculoperitoneal shunt endoscopic perforation pansi III zheludochka- endoscopic triventrikulostomiya. Mwatsoka, ntchito imeneyi si nthawi zonse bwino ndipo nthawi yomweyo zingachititse kuti pakhale mavuto (Syndrome giperdrenirovaniya, mapangidwe subdural hematomas, matenda a dongosolo shunt, ndi zina zotero. D.). Choncho, funso la kusankha njira yoyenera kwambiri ya chithandizo cha hydrocephalus opaleshoni ndiwofatsa n'kofunika kwambiri. Mofanana kwambiri ndi nkhani ya ntchito kwa dongosolo anaika kulambalala ndi adequacy ake. Chifukwa cha zofufuza anapanga likulu la ubongo anavumbula nthawi mwachilungamo pakati pa hydrocephalus poyera ndi obstructive. Mu hydrocephalus lotseguka anali anaona ngati mfundo zimene zimachitika pa elasticity zili craniovertebral, ndi kuchuluka kwake kwambiri kuchepa kwambiri poyerekeza ndi mwakale. Pa nthawi yomweyo, hydrocephalus obstructive zinachitika yekha mfundo wabwinobwino ndi kuchuluka elasticity. Mu njira imeneyi opaleshoni ya hydrocephalus (ventrikuloperitonalnoe kulambalala, endoscopic triventrikulostomiya) zinachititsa kuti yokulirapo ndi chidwi kusintha oziziritsa magazi ndi venous craniovertebral magawanidwe volumetric. The kuchepa elasticity wa mwakale poyerekeza asanachite opareshoni anali wapezeka kokha odwala ndi hydrocephalus lotseguka. Komabe, pamene occlusive hydrocephalus kuchepetsa elasticity kuposa zachibadwa asanachite opareshoni silinkachitidwa. Pa nthawi yomweyo pambuyo ntchito ku chipatala ndi elasticity obstructive hydrocephalus kwambiri utachepa poyerekeza ndi zotsatira za maphunziro preoperative. Open hydrocephalus bwino zimayamba ndi zinthu zosiyanasiyana etiological. Ziyenera adzanyamula kukumbukira kuti anthu wathanzi mu ukalamba ndi kupitirizabe pa imfa ya manyuroni, imbaenda kukhwinyata wa chinthu ubongo ndi chifukwa ndi kuwonjezeka mu malo otetezedwa craniovertebral patsekeke. ndondomeko zachilengedwe wotchedwa aputosisi. Pamene matenda a Alzheimer ndi inapita patsogolo okalamba ndi nthenda okhudza maselo ambiri kudzikundikira chiwonongeko cha nyumba okhudza maselo ambiri ndi imfa pamapeto pake okhudza mitsempha. Pakati ambiri mawonekedwe matenda otsegula hydrocephalus allocated hydrocephalus yachibadwa kuthamanga, umene ndi chigawo chimodzi chachikulu cha chizindikiro Hakima- Adams (1965) (Hakim S, Adams R). Pakuti syndrome imeneyi amakhala ndi kuwonjezeka mu ventricles ubongo pa intracranial kuthamanga bwinobwino. Komanso mbali khalidwe la matenda Hakima- Adams ndi chitukuko cha maganizo, unsteadiness ndi incontinence mkodzo. Chikhalidwe cha odwala ambiri ndi matenda Hakim -Adamsa kwambiri kusintha pambuyo shunting ntchito. Komabe, nthawi zina, izi operatsii operewera. Komabe ntchito shunt pafupipafupi kuyambitsa mavuto (mu 13-50% Ofufuza osiyanasiyana). Choncho, kusankha odwala matenda Hakim - Adams mankhwala opaleshoni n'kofunika kwambiri. Panopa, chifukwa chaichi, izo chimagwiritsidwa ntchito olanda njira zosiyanasiyana (kulowetsedwa wa saline mu malo CSF kuphunzira kusintha komwe kumachitika pamene kuthamanga intracranial, ngalande za mowa ndi kafukufuku wa kusintha za minyewa, ndi zina zotero. D.). Ivazivnost zoyesa kwambiri zimasokoneza ntchito zawo kuchipatala . Mtengo wapatali kwambiri wa kafukufuku kachulukidwe craniovertebral buku chiŵerengero ndi ana ndi hydrocephalus, komanso okalamba ndi kuwonjezeka ventriculomegaly (kuwonjezeka kukula kwa ventricles ubongo) ndi mitundu yosiyanasiyana ya matenda Hakima- Adams (kukumbukira kuwonongeka, gait, chikhodzodzo). Mu maphunziro athu, pamene Hakim syndrome - Adams sichisinthasinthanso Kawirikawiri labwinobwino kapena zayamba yafupika, ndi odwala ndi zotsatira za travmy- craniocerebral ndi aakulu mavuto a m'maganizo elasticity zimakhalira kapena kuchuluka, ndi kusiyana pakati pa magulu awiriwa odwala anafika tanthauzo zowerengera. Chifukwa cha maganizo okalamba kungakhale azingokhala njira zambiri mu ubongo chifukwa cha njira zosiyanasiyana (osachiritsika, mtima, njira kagayidwe kachakudya). Chifukwa chimodzi matenda okalamba kungakhale chitukuko cha matenda a Alzheimer. Pankhaniyi, pali chikhulupiriro chakuti kusiyanitsidwa pamaziko a deta matenda yekha mtima maganizo ndi matenda a Alzheimer ndi kovuta. Komabe, anakhazikitsa kuti matenda a Alzheimer nthenda yotaya magazi m'zotengera extracranial ndi intracranial mu kwambiri yafupika poyerekeza ndi anthu athanzi. matenda a Alzheimer amakhala ndi kuchepetsa kuthamanga intracranial ndi kuchepa mu mlingo kupanga mowa.

Elasticity zili craniovertebral, kukhala ndi khalidwe makina a dongosolo Komabe, correlates pamlingo winawake ndi chikhalidwe zinchito ubongo. Tinaona ndi pang'onopang'ono normalization M'mimbamo craniovertebral nkhani zomwe zinachitika imodzi ndi normalization wa boma zinchito za ubongo (bwino kukumbukira, ntchito nzeru, gait, normalization wa pokodza). kusintha zimenezi mchikakamizo cha mtima yogwira, kagayidwe kachakudya ndi mankhwala degitratatsionnoy.

Mu hydrocephalus lotseguka anali anaona ngati mfundo zimene zimachitika pa elasticity zili craniovertebral, ndi kuwonjezeka ake chidwi kapena chidwi kuchepa poyerekeza ndi mwakale. Pa nthawi yomweyo pamene occlusal hydrocephalus anati mfundo titadziwa ndi kuchuluka elasticity, pamene kuchepetsa elasticity ndi poyerekeza ndi makhalidwe yachibadwa anali anaona. Opaleshoni chithandizo cha obstructive hydrocephalus ventriculoperitoneal kulambalala, endoscopic triventrikulostomiya) zinachititsa chidwi, powerengera kwambiri kuchepetsa elasticity zili craniovertebral ndi maonekedwe a makhalidwe otsika kwambiri za elasticity wa chomwecho, monga odwala ena ndi hydrocephalus zoonekera) Choncho opaleshoni hydrocephalus amachititsa kuti kusintha zimagwirira thupi, kuchititsa occlusive hydrocephalus akhala ngati analogue shonale lotseguka hydrocephalus.

Pa nthawi yomweyo pambuyo endoscopic triventrikulostomii anati kuchepa powerengera kwambiri yekha elasticity ndi liwiro otaya venous magazi, koma palibe kusintha kwakukulu mu malo thanki zili craniovertebral zimachokeradi. A kuchepa powerengera kwambiri elasticity pambuyo triventrikulostomii endoscopic kuliganizira wapadera, monga pamene ntchito olanda kulowetsedwa mayeso kusintha odalirika elasticity zavumbulutsidwa. Chotero zotsatira zoipa chifukwa olanda mayesero kulowetsedwa Zikuoneka kuti kumayambiriro saline mu CSF pa dongosolo kulowetsedwa zimasiyanasiyana zinthu mayeso mogwirizana buku craniovertebral chachikulu okhutira (ubongo minofu, magazi ndi likovora), kungachititse zotsatira olakwika. Choncho, si olanda kuphunzira venous krovobrascheniya ubongo, cerebrospinal mphamvu madzimadzi ndi craniovertebral buku chiŵerengero amapereka invormatsiyu zofunika za patafiziologicheskih njira intracranial gipetenzii ndi hydrocephalus, komanso kuunikira mphamvu ya mankhwala pathogenetic.