Ubongo Angioentsefalopatiya - ndichiyani? Zizindikiro, mankhwala ndi madokotala ananena zawo

Nthawi zina madokotala amati syndromic matenda Mwachitsanzo, ubongo angioentsefalopatiya. Ndi chiyani icho? Matenda ischemic kuukira. Mwa njira, ndithu matenda wamba, anthu wamba konse kulabadira mawu ake. Nthawi zambiri amapezeka mu okalamba, osachepera - wachinyamata ndi okhwima. Matendawa amatenga nthawi yaitali zobisika, ndi zizindikiro kuoneka, izo ndi mochedwa kwambiri kukhwimitsa kwambiri.

EPIDEMIOLOGY

Chifukwa cha kudandaula nonspecific, mawonetseredwe matenda ndi kusintha anafotokozedwa kulingalira ubongo, kusonkhanitsa deta zowerengera zovuta. Kwa ena woweruza mmene angioentsefalopatii kuwanda akhoza kukhala chiwerengero cha mkwapulo. Chaka chilichonse mu Russia pali pafupifupi theka la miliyoni milandu chikhalidwe pachimake.

Akatswiri kutsindika kuti zopindulitsa mu kupeza matenda ubongo dyscirculatory ndi matenda chidziwitso, ntchito chidziwitso ndi pafupipafupi aakulu oziziritsa magazi insufficiency. Koma si kusonyeza chithunzi chenicheni cha kuchuluka kwa matenda.

etiology

Pa zimene angathe ubongo angioentsefalopatiya? Zimayambitsa matenda a magazi mu ubongo aakulu, mwachitsanzo, mu mtima kapena mapapo - chimodzimodzi. Waukulu etiological chinthu - ziwiri;
- atherosclerosis;
- kuwonjezeka magazi.

zidzachitika panthawi imodzi ndipo nthawi zambiri kulimbikitsa wina ndi mzake. Komanso, zotsatira pa oziziritsa magazi ndi kupereka mtima ndi mtima matenda ena, monga dysrhythmia ndi kulephera aakulu mtima. Chofunika kwambiri ndi kukhalapo kwa malformations mtima ku ubongo khosi, kapena ziwiya kwambiri. Iwo akhoza alibe kuonekera kwa nthawi yaitali mpaka kukhala matenda ena zokhudza zonse. udindo Secondary mu zikutha m'mayiko makope ubongo magazi chimagwira psinjika ziwiya lalikulu, komanso kuchepa lakuthwa mu kuthamanga, makamaka anthu okalamba.

matenda yosungirako angakhalenso chifukwa chifukwa cha zomwe osauka ubongo angioentsefalopatiya. Ndi chiyani icho? Izi boma, pamene maselo chifukwa ndondomeko pathological kudziunjikira ena zinthu zenizeni: mapuloteni, mafuta ndi chakudya.

Pankhaniyi okalamba mtima amyloidosis zikachitika, imbaenda kusintha osachiritsika malinga awo. matenda Endocrine komanso ndi kulemera ena. Mwachitsanzo, yaying'ono - ndi makroantiopatii mu shuga chifukwa aakulu oziziritsa ischemia. Pakuti amagawanika kutsogolera dongosolo matenda: enaake ophwanya m'thupi, vasculitis, matenda magazi.

Monga ulamuliro, kusankha iliyonse chinthu chimodzi sizotheka, kotero matenda imatengedwa polyetiological. dokotala anafotokoza kukhalapo kwa zinthu zazikulu, ndi comorbidities ankaona okhulupirika.

pathogenesis

The matenda pamwamba ndi zinthu zoyambitsa kuchepa kwa kufalitsidwa mu minofu ubongo, ndipo, chotero, njala ake (kusowa mpweya ndi shuga). Poyamba, njira pathological (zizindikiro za ubongo angioentsefalopatii) azaonekera yekha mu zotengera yaing'ono. Akutukuka microangiopathy. A ambiri mitsempha anakhudzidwa kuchititsa ischemia kugonjetsedwa kanthu woyera, komanso infarctions angapo lacunar. Kuphatikiza zinthu izi zimabweretsa kusokonezeka kwa nyumba ubongo.

Ngati chimayambitsa atherosclerosis angioentsefalopatii ndiye advantageously anakhudzidwa mtsempha wamagazi thunthu. Zimenezi zimabweretsa chakuti mlingo wa magazi mu ubongo amadalira hemodynamics zokhudza zonse. Pankhani ya wolumikizira oopsa mu malo oyamba, ishemiziruyutsya perforating mtsempha wamagazi ubongo.

Posachedwapa, Madokotala aubongo ndi neurosurgeons wachinsinsi matenda aakulu magazi m'njira ziwiri: chikhalidwe cha kuwonongeka ndi kutanthauzira kwake. Akakufunsani kapena akakufunsani angioentsefalopatiya chidawoneka syndrome oziziritsa, amene lagawidwa leykoentsefalopatichesky ndi binsvangerovsky.

Alipo focal ubongo angioentsefalopatiya. Ndi chiyani icho? Ndi pamaso pa minofu mitsempha kupanga mipata angapo kukha magazi. Mu yochizira matenda, ambiri mitundu wosanganiza, chifukwa n'zosatheka kuonetsetsa wina pathogenetic limagwirira.

chithunzi matenda

Mwatsoka, ogwira ntchito ambiri mwina nthawi yake kupanga matenda monga ubongo angioentsefalopatiya. Zizindikiro si pokha osati kwambiri modetsa nkhawa kapena aluso kapena wodwala. Kotero, kwenikweni, ndi maganizo lability, amene ali chibadidwe anthu okalamba ndipo popanda pathologies aliyense, komanso imfa yokumbukira ndi luso kuphunzira. Pamodzi, zinthu zitatu izi kuyambitsa maladaptation odwala ndi vuto.

Komanso, mutu, chizungulire, kuwonongeka yokumbukira ndi tulo, zotengera malingaliridwe phokoso mutu, kapena kulira m'khutu, utachepa masomphenya, kufooka, ndiponso kutopa akhoza kukhala zizindikiro za osati chakuti munthu akuchita ubongo angioentsefalopatiya. Kodi zingakhale zambiri? Pamaso pa malformations mtima, matenda osiyanasiyana opatsirana, matenda oopsa, syndrome asthenic ndi nosology ena. Komanso, thupi Choncho anatumiza chizindikiro kutopa amphamvu.

Pali malumikizanidwe pakati pa chiwerengero cha madandaulo ndiponso azikhala mtima encephalopathy. Kwakukulu kuvutika kukumbukira chidwi ndi woganiza, kupatula munthu akunena za dokotalayu. Choncho, Zikavuta, wodwala onetsetsani kuti si kusokoneza.

siteji

Pali magawo atatu angioentsefalopatii:

1. madandaulo zotengera malingaliridwe a kuwonongeka yokumbukira ndi chidwi limodzi ndi zizindikiro yaing'ono focal: utachepa pupillary reflex, zikamera wa bongo sanali wangwiro wa automatism m'kamwa. kusintha pang'ono gait, kusadalira, irritability.
2. Mu stepi ino, zizindikiro ubongo ndi ukuwonjezeka crystallizes limodzi lalikulu chizindikiro. Kungakhale matenda extrapyramidal, pseudobulbar manjenje, ataxia, cranial mitsempha kukanika. Wamphamvu akuvutika ntchito chidziwitso, yafupika akatswiri ndi chikhalidwe anatengera.
3. Odwala chogwidwa syndromes angapo. Chidwi akhakula gait chisokonezo, matenda cerebellar, matenda Parkinson, kusokonezeka ziwalo m'chiuno. Pa nthawi imeneyi, ndi kutsutsa kwa chikhalidwe chake m'tali ndi madandaulo sangakhale konse. Odwala kukhala osatetezeka ngati ana, chifukwa iwo kukhala maganizo.

zizindikiro minyewa

Pali zingapo syndromes kuti ayende ubongo angioentsefalopatiya. Ndi chiyani icho? Izi kuwundana zizindikiro zomwe zikuonetsa kuti kugonjetsedwa kwa kapangidwe konkire chapakati mantha dongosolo.

1. Vestibular syndrome. Odwala kusonyeza madandaulo a chizungulire, unsteadiness poyenda, anapeza nystagmus ndi mgwirizano osauka. chipatala zikusonyeza kuwonongeka kapena kugonjetsa thirakiti cerebellum fronto-tsinde chifukwa yafupika magazi mu mtsempha wamagazi mkati carotid.
2. Pyramidal syndrome amasonyeza kuchuluka bongo tendon, komanso zikamera mosiyanasiyana pathological, nthawi zambiri asymmetrical. Pamaso pa paresis anasonyeza kuti mbiri ya munthu sitiroko.
3. matenda Parkinson amakhala ndi kusakwiya kuyenda, kuchepa mu nkhope, chinthu chimodzimodzi minofu pa miyendo. Odwala zambiri kugwa pansi chifukwa sindingathe kuchiletsa mu nthawi chifukwa kuphwanya ayende maulendo. Zonsezi zikuloza kuti akunde cortico-striatal ndi yokhudza kotekisi manyuroni wa brainstem lapansi.
4. Pseudobulbar manjenje kumachitika pamene kugonjetsedwa kwa m'njira cortico-nyukiliya. Wodwala ali ndi bvuto ndi kulankhula ndi kumeza, komanso zinthu zochititsa maganizo "chiwawa".
5. Psihorganichesky matenda, nthawi zambiri limodzi ndi matenda nkhawa kuvutika, chidziwitso kukanika.

diagnostics

Mofanana ndi matenda ena aliwonse, katswiriyu ayenera kusonkhanitsa zonse mbiri moyo ndi matenda kudziwa mlingo wa kupitilira zizindikiro ndi kukhalapo kwa matenda comorbid zachipatala. Ndiye kudzifufuza thupi: kuwerengera kugunda kwa mtima ndi kuyeza magazi, tsatani mtima zikumveka, magazi mu mitsempha lalikulu la theka chapamwamba za thupi. Ndiye nthawi mayesero ubongo.

Gawo lotsatira - zasayansi diagnostics. Izi zimathandiza kuti anthu amvetse chifukwa cha angioentsefalopatii. The wodwala anafunsa kuti akapereke magazi, magazi sayansi ndi kusanthula coagulation magazi, misinkhu shuga. Ndiye kudutsa kulingalira ubongo: yopangidwa tomography (CT), kumveka maginito kulingalira (Kujambula), electroencephalography (akugwirira). Zonsezi zimathandiza kudziwa mlingo wa kufalitsidwa oziziritsa, ndi kuzindikira mbali kudwala. Kodi Komanso perekani electrocardiography (ECG) ndi ultrasound kuti awonetsepo matenda a dongosolo mtima.

Zikuonetsa kuti hospitalization

Palibe protocol ndi matenda silimanena chithandizo ku chipatala cha odwala matenda ndi ubongo angioentsefalopatiya. Chithandizo, madokotala ananena zawo ndi kuteteza matenda, monga ulamuliro, chichitike pa outpatient maziko. Kuchotserapo milandu pamene matenda anali kumva ndi decompensation somatic kudwala kapena kukhala ndi sitiroko.

Madokotala aubongo ndikukhulupirira kuti kuchotsa moumiriza odwala ku zinthu mwachizolowezi zitha aziwonjezereka. Choncho, mu gawo lotsiriza ili makamaka ikuchitika zothandizira mipingo yawo kunyumba osati kunyamula wodwala kuchipatala.

chithandizo

cholinga zimatheka, matenda ubongo angioentsefalopatiya, mankhwala ayenera kuyamba posachedwapa, kuti amachepetsa mphamvu ya ndondomeko pathological. Komanso, kuchititsa kupewa sitiroko ndi mankhwala a matenda somatic.

Chithandizo imatsogoleredwa patsogolo perfusion a minofu ubongo ndi zokhudza dongosolo mtima, komanso malangizo a katundu rheological magazi. Izi zikusonyeza atherosclerosis mankhwala ndi oopsa ngati zinthu zikuluzikulu za chitukuko cha ischemia.

mankhwala wowerengeka

odwala ena achikulire ndikukhulupirira kuti asapembedzere "ululu" mapiritsi, ndipo m'pofunika kufufuza njira zina. Choncho, zodabwitsa maganizo angasonyeze ubongo angioentsefalopatiya. mankhwala chikhalidwe Sali olandilidwa mwa madokotala, chifukwa amakwiya ndi akuchuluka zizindikiro.

Akatswiri amalangiza mankhwala zina aziyenda bwino oziziritsa ntchito mizu ya chinanso chotulutsa ndi hellebore Caucasus, mapesi a chithaphwi cinquefoil, basamu "Magic atatu", tincture wa adyo ndi cranberries ndi zambiri. Mphamvu ya zamdziko izi N'zokayikitsa kwambiri, chotero simuyenera kuchita zinthu zatsopano zimenezi. Ndi bwino kupita kwa dokotala woyenera.