Ubungqina beBongo

I-Brain herniation kukushenxiswa kwethishu yobuchopho ukusuka kwindawo enye ukuya kwingqondo iye kwenye ngokuhamba ngeendlela kunye nokuvuleka.

I-Brain herniation yenzeka xa into ethile ngaphakathi kukakayi ivelisa uxinzelelo oluhambisa izicwili zobuchopho. Oku kuhlala kunjalo sisiphumo sokudumba kwengqondo okanye ukopha kwingozi yentloko, ukubetha, okanye ithumba lobuchopho.

I-Brain herniation inokuba sisiphumo esecaleni samathumba kwingqondo, kubandakanya:

• Ithumba lobuchopho bemetastatic
• Ithumba lobuchopho eliphambili

Ukuhluthwa kwengqondo kunokubangelwa zezinye izinto ezikhokelela kukonyuka koxinzelelo ngaphakathi kolukakayi, kubandakanya:

• Ukuqokelelwa kobofu kunye nezinye izinto ebuchotsheni, zihlala zivela kusuleleko lwebhaktiriya okanye lokungunda (ithumba)
• Ukopha ebuchotsheni (ukopha)
• Ukwakhiwa kolwelo ngaphakathi kolukakayi olukhokelela kukudumba kwengqondo (i-hydrocephalus)
• Imivumbo ebangela ukudumba kwengqondo
• Ukudumba emva konyango lwemitha
• Isiphene kulwakhiwo lobuchopho, njengemeko ebizwa ngokuba yi-Arnold-Chiari malformation

I-Brain herniation inokwenzeka:

• Ukusuka ngapha nangapha okanye ezantsi, phantsi, okanye ngapha kolwelwesi oluqinileyo njenge-tentorium okanye i-falx
• Ngokuvula amathambo endalo kwisiseko solukakayi esibizwa ngokuba yi-foramen magnum
• Ngokuvuleka okwenziwe ngexesha lotyando lobuchopho

Iimpawu kunye neempawu zingabandakanya:

• Igazi elonyukayo
• Ukubetha okungaqhelekanga okanye okucothayo
• Intloko ebuhlungu
• Ubuthathaka
• Ukubanjwa kwe-Cardiac (akukho pulse)
• Ukuphulukana nokuqonda, isiqaqa
• Ukuphulukana nazo zonke i-brainstem reflexes (blinking, gagging, kunye nabafundi abasabela ekukhanyeni)
• Ukubanjwa ngokuphefumla (akukho kuphefumla)
• Banzi (banzi) abafundi kwaye akukho ntshukumo kwiliso elinye okanye omabini amehlo

Uvavanyo lwengqondo kunye neenkqubo zovalo lubonisa utshintsho kulumkiso. Kuxhomekeke kubukrakra be-herniation kunye nenxalenye yengqondo ecinezelweyo, kuya kubakho iingxaki ngengqondo enye okanye nangaphezulu enxulumene nengqondo kunye nemisebenzi ye-nerve.

Uvavanyo lunokubandakanya:

• X-ray yokakayi nentamo
• Ukuvavanywa kwentloko kwe-CT
• Ukuvavanywa kwentloko ye-MRI
• Uvavanyo lwegazi ukuba ikrokrela ithumba okanye isifo sokopha

Ubunzima beBongo ngxamisekileyo kwezonyango. Injongo yonyango kukusindisa ubomi bomntu.

Ukunceda ukubuyisela umva okanye ukuthintela ubuchwephesha bobuchwephesha, iqela lezonyango liya kunyanga ukwanda kokudumba kunye noxinzelelo kwingqondo. Unyango lunokubandakanya:

• Ukubeka idreyini kwingqondo ukunceda ukususa i-cerebrospinal fluid (CSF)
• Amayeza okunciphisa ukudumba, ngakumbi ukuba kukho ithumba ebuchotsheni
• Amayeza anciphisa ukudumba kwengqondo, njenge-mannitol, i-saline, okanye ezinye i-diuretics
• Ukubeka ityhubhu kwindlela yomoya (i-endotracheal intubation) kunye nokunyusa izinga lokuphefumla ukunciphisa amanqanaba ecarbon dioxide (CO₂) egazini
• Ukususa igazi okanye amahlwili egazi ukuba anyusa uxinzelelo ngaphakathi kokakayi kwaye abangela i-herniation
• Ukususa inxalenye yokakayi ukunika ubuchopho igumbi elingaphezulu

Abantu abane-herniation yengqondo banokwenzakala okukhulu kwengqondo. Banokuba sele benethuba eliphantsi lokufumana kwakhona ngenxa yokwenzakala okubangele ukuba i-herniation. Xa kwenzeka i-herniation, iqhubeka ithoba ithuba lokubuyela kwimeko yesiqhelo.

Imbonakalo iyahluka, kuxhomekeka ekubeni ubuchwephesha kwenzeka phi kwingqondo. Ngaphandle konyango, ukufa kunokwenzeka.

Kunokubakho umonakalo kumalungu engqondo alawula ukuphefumla nokuhamba kwegazi. Oku kunokukhokelela ngokukhawuleza ekufeni okanye ekufeni kwengqondo.

Iingxaki zinokubandakanya:

• Ukufa kwengqondo
• Iingxaki ezisisigxina nezibalulekileyo ze-neurologic

Fowunela u-911 okanye inombolo yongxamiseko yendawo okanye umse kwigumbi likaxakeka esibhedlele ukuba bayakhula bephaphile okanye ezinye iimpawu, ngakumbi ukuba kukho ukulimala entloko okanye ukuba umntu unethumba ebuchotsheni okanye ingxaki yegazi.

Unyango olukhawulezileyo lokunyuka koxinzelelo lwangaphakathi kunye nokuphazamiseka okunxulumene nawo kunokunciphisa umngcipheko wobuchwephesha bobuchwephesha.

Isifo seHerniation; Ukuhlanjululwa kwetranstentorial; Uncal herniation; I-Subfalcine herniation; Ukuhlanjululwa kweetoni; Herniation - ingqondo

• Ukulimala kwengqondo-ukukhutshwa

• Ingqondo
• Ingqondo yobuchopho

I-Beaumont A. I-Physiology ye-cerebrospinal fluid kunye noxinzelelo lwangaphakathi. Ku: Winn HR, ed. Ugqirha we-Youmans kunye no-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 52.

UPapa L, Goldberg SA. Ukonzakala kwentloko. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: Iikhonsepthi kunye nokuziqhelanisa neKlinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2018: isahluko 34.

I-Stippler M. Craniocerebral trauma. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 62.