Hydrocephalus and ngonyango

Hydrocephalus luphawulwa ngokwanda isithuba CSF, ngokulandelelanayo nokunciphisa umthamo isicwili sobuchopho. Isizathu sokuba ngokwandisa ubukhulu ventricles isenokuba utywala occlusion aqukuqela ngaphakathi kwinkqubo ventricular (hydrocephalus occlusive) okanye outflow kakuhle (resorption) utywala isithuba subarachnoid ngokusebenzisa villi arachnoid engqondweni kwisisu dural, ezo umendo engundoqo nencindi yegazi lwemithambo yobuchopho (hydrocephalus evulekileyo.) Ukuze kwimpatho hydrocephalus iye yaba nempumelelo kakhulu wokuqonda indlela ingenzeka yayo. Kuba unyango lwe hydrocephalus kusetyenziselwa iindlela emithethweni futhi yotyando. Unyango zoqhaqho hydrocephalus ngokufuthi ukufaka ventriculoperitoneal shunt perforation endoscopic ezantsi III triventrikulostomiya zheludochka- endoscopic. Ngelishwa, ezi imisebenzi ayisoloko esebenzayo ngexesha efanayo kukhokelela kuphuhliso iingxaki (Syndrome giperdrenirovaniya, ukubunjwa hematomas subdural, usulelo inkqubo shunt, njalo njalo. D.). Ngoko ke, lo mbuzo yokukhetha indlela ifanelekileyo zonyango kotyando hydrocephalus endala kubaluleke kakhulu. Okubaluleke ngokulinganayo umba ukusebenza kwenkqubo bypass efakiweyo kunye nokwanela yayo. Ngenxa yophando olwenziwe kumbindi Neurology watyhila ixesha ocacile phakathi hydrocephalus ezivulekileyo kunye obstructive. Xa hydrocephalus evulekileyo babonakala njengoko amaxabiso eqhelekileyo luthambe isiqulatho craniovertebral, kunye neendyebo zalo okubonakalayo ukuncitshiswa kuthelekiswa eqhelekileyo. Kwangaxeshanye, hydrocephalus obstructive kwenzeka kuphela amaxabiso eziqhelekileyo kunye nokwanda luthambe. Kule unyango zoqhaqho hydrocephalus (esa ventrikuloperitonalnoe, triventrikulostomiya endoscopic) kwakhokelela utshintsho yobuchopho igazi enkulu nebalulekileyo zizalwa lwemithambo craniovertebral womthamo. Ukwehla kwi luthambe le norm kuthelekiswa phambi utyando zabonwa kuphela izigulane kunye hydrocephalus evulekileyo. Noko ke, xa hydrocephalus occlusive ukunciphisa luthambe kunesiqhelo phambi kokuba ayizange kwaphawulwa uqhaqho. Ngelo xesha emva kotyando esibhedlele kunye luthambe obstructive hydrocephalus zehla kakhulu xa kuthelekiswa iziphumo zophando ipreoperative. hydrocephalus Vula ezinokubangelwa imiba eyahlukeneyo etiological. Kufuneka Mayisoloko ikhunjulwa into yokuba abantu baphile kwinkqubo walupheleyo njalo kwi ukufa zemithambo-luvo, nto leyo ekhokelela yoma ukwimo ingqondo yaye ekugqibeleni ekwandeni kwizikhewu reserve kwisisu craniovertebral. Le nqubo yemvelo kuthiwa apoptosis. Xa isifo i-Alzheimer kwandiswa ukuguga kunye nokwanda engaqhelekanga intracellular ukutshatyalaliswa kwezakhiwo intracellular kunye nokufa ekugqibeleni neuronal. Phakathi hydrocephalus xi eqhelekileyo ixhaphakileyo uhlobo lwezonyango hydrocephalus evulekileyo eyabelwe, enye yezinto eziphambili uphawu Hakima- Adams (1965) (Hakim S, Adams R,). Ngokuba lo sifo luphawulwa kukwanda ventricles ingqondo ngamandla oluqhelekileyo intracranial. Ukongeza iimpawu uphawu le syndrome Hakima- Adams na uphuhliso dementia, nedumbe kunye ngumchamo womchamo. Imeko izigulane ezininzi kunye syndrome Hakim -Adamsa ngcono kakhulu emva zokushenxisela imisebenzi. Noko ke, kwezinye iimeko, ezi operatsii angasebenzi. Kodwa imisebenzi shunt rhoqo kungakhokelela kubunzima (ngo-13-50% ngokungqinelana kubaphandi ezahlukeneyo). Ngoko ke, ukukhethwa izigulane Hakim syndrome - Adams unyango ngotyando kubaluleke kakhulu. Okwangoku, le njongo, lisetyenziswa iindlela ezahlukahlukeneyo invasive (nokubandakanywa ye-saline kwi isithuba CSF ukufunda iinguqu ezenzeka xa xi intracranial, kutsalwe kotywala kunye uqikelelo yeenguqu imo-luvo, njalo njalo. D.). Ivazivnost kwezi mvavanyo umda kakhulu ukusetyenziswa kwazo apha ekliniki . Ixabiso eliphezulu uphando oluninzi volume craniovertebral ratio na abantwana hydrocephalus, kwakunye kwi abadala kunye ukwandisa ventriculomegaly (ukwanda ubungakanani ventricles ubuchopho) kunye ezahlukeneyo ezahlukeneyo syndrome Hakima- Adams (memory ongaboniyo, umlenze ahambe, isinye). Xa izifundo zethu, xa Hakim syndrome - Adams ukomelela yaba ngokuqhelekileyo eqhelekileyo okanye lincipha kakhulu, kwaye izigulane kunye neziphumo travmy- craniocerebral kwaye kakhulu nokuphazamiseka engqondweni okubuyela kwimo eqhelekileyo okanye anda, kwaye umahluko phakathi kwala maqela mabini ezigulane bafikelela ngokubaluleka kwezobalo. Unobangela yingqondo kwi abakhulileyo isenokuba sokonakalisa iinkqubo zolwazi ebuchotsheni okubangelwa iindlela ezahlukeneyo (sisiba mandundu, imithambo, iinkqubo pathways). Esinye isizathu sokuba ukuphazamiseka kwi abalupheleyo ibe uphuhliso isifo i-Alzheimer. Kulo mzekelo, kukho inkolelo yokuba yenza ngokusekelwe data onyango kuphela semithambo dementia kunye nesifo i-Alzheimer kuba nzima kakhulu. Noko ke, oko yasekwa ukuba isifo i-Alzheimer igazi flow kwimikhumbi extracranial kwaye intracranial ekuncipheni kakhulu xa kuthelekiswa nabantu esempilweni. isifo i-Alzheimer iphawulwa ukwehliswa xi intracranial ukuhla kwireyithi yemveliso kotywala kunye.

Luthambe Umxholo craniovertebral, ukuba ube luphawu ngomatshini le nkqubo, kunjalo, correlates ukuya elithile kunye nemeko yomsebenzi ebuchotsheni. Saqhuba a ukuzinza umngxuma imixholo ngokuthe ngcembe craniovertebral ezenzeke ngaxeshanye kunye kuqheleke imeko yomsebenzi wobuchopho (ephuculiweyo inkumbulo, imisebenzi yengqondo, umlenze ahambe, kuqheleke ukuchama). Ezi nguqu zenzeke phantsi kwempembelelo semithambo esebenzayo, yokucolwa kunye nonyango degitratatsionnoy.

Xa hydrocephalus evulekileyo babonakala njengoko amaxabiso eqhelekileyo luthambe isiqulatho craniovertebral, kunye neendyebo zalo abalulekileyo okanye ukuncitshiswa kuthelekiswa eqhelekileyo. Ngelo xesha xa hydrocephalus occlusal kwabonwa kuphela amanani aqhelekileyo kunye nokwanda luthambe, ngelixa kuncitshiswa luthambe kuthelekiswa kunye neenqobo eqhelekileyo mbaleko. unyango zoqhaqho obstructive esa hydrocephalus ventriculoperitoneal, triventrikulostomiya endoscopic) kwakhokelela ebalulekileyo, ukuncitshiswa kwezobalo ebalulekileyo luthambe isiqulatho craniovertebral kunye nenkangeleko amaxabiso aphantsi kakhulu luthambe efanayo, njengoko kwezinye izigulane hydrocephalus ezikwekwayo) Ngaloo ndlela uqhaqho hydrocephalus kubangela ukuba ukutshintsha iindlela komzimba, ibangela hydrocephalus occlusive uba ngathi analogu hydrocephalus ukuvula nywa.

Ngelo xesha emva endoscopic triventrikulostomii waphawula ukuhla ngokwamanani luthambe kuphela nesantya yokumpompoza kwegazi lwemithambo, kanti lungenzeki akukho lutshintsho okubonakalayo itanki reserve umxholo craniovertebral. A ukwehla Mani Loyi ebalulekileyo okubuyela kwimo emva triventrikulostomii endoscopic kufuna ingqalelo ekhethekileyo, njengoko xa usebenzisa invasive ukumnika uvavanyo utshintsho luthambe oluthembekileyo nakuye. Nemiphumela emibi ngenxa iimvavanyo ezonakalisayo ukumnika kubonakala ukuba ukusungulwa wetyuwa CSF ngexesha inkqubo ukumnika yahluka iimeko uvavanyo intsebenziswano volume isiqulatho engundoqo craniovertebral (izihlunu ingqondo, igazi kunye likovora), nto leyo enokukhokelela ekubeni iziphumo eziphosakeleyo. Ngenxa yoko, ukufunda non-invasive yengqondo krovobrascheniya lwemithambo, zabafaki kulwelo lwe- cerebrospinal kunye nomlinganiselo umthamo craniovertebral inika invormatsiyu obalulekileyo iindlela patafiziologicheskih gipetenzii intracranial kunye hydrocephalus, kwakunye nokuvavanya ukusebenza unyango pathogenetic.