Ubungqina beBongo

Umxholo

• Iindidi zobuchwephesha bobuchwephesha
• Iimpawu zobuchwephesha bobuchopho
• Oonobangela bokuhlanjwa kwengqondo
• Ukunyanga ubuchwephesha bobuchwephesha
• Iingxaki zobuchwephesha bobuchwephesha
• Imbonakalo yobuchwephesha bobuchwephesha

Ushwankathelo

Ingqondo ye-herniation, okanye i-cerebral herniation, yenzeka xa izicwili zobuchopho, igazi, kunye ne-cerebrospinal fluid (CSF) isuka kwindawo yayo yesiqhelo ngaphakathi kolukakayi. Imeko ihlala ibangelwa kukudumba ngenxa yokwenzakala entloko, ukubetha, ukopha, okanye ithumba lobuchopho. Ingqondo yokuhluthwa yingxakeko yonyango kwaye ifuna unyango kwangoko. Ihlala ibulala ukuba ayinyangwa kwangoko.

Iindidi zobuchwephesha bobuchwephesha

Ingqondo yokuhluthwa inokwahlulwa apho izicwili zobuchopho ziye zatshintsha khona. Zintathu iintlobo eziphambili zobuchopho:

• Subfalcine. Izicubu zobuchopho zihamba ngaphantsi kwembrane eyaziwa ngokuba yi-falx cerebri embindini wengqondo. Izicubu zeBongo ziphela zityhalelwa kwelinye icala. Olu lolona hlobo luqhelekileyo lobuchwephesha bobuchwephesha.
• Ukuhlanjululwa kwetranstentorial. Olu hlobo lwe-herniation yengqondo lunokuphinda lwaphulwe lube ziindidi ezimbini:
  • Ukuhla kwetranstentorial okanye uncal. I-uncus, eyinxalenye ye-lobe yexeshana, itshintshelwa ezantsi kwindawo eyaziwa njenge-posterior fossa. Olu lolona hlobo lwesibini luqhelekileyo lobuchwephesha bobuchwephesha.
  • Ukunyuka kwe-transtentorial herniation. I-cerebellum kunye ne-brainstem zihambela phezulu nge-notch kwi-membrane ebizwa ngokuba yi-tentorium cerebelli.
• Iitoniillar zecerebellar. Iitoni ze-cerebellar zihamba ziye ezantsi nge-foramen magnum, ukuvulwa kwendalo emazantsi okhakhayi apho intambo yomqolo inxibelelana nengqondo.

Ingqondo yokuhluthwa kwengqondo inokwenzeka nasemngxunyeni owawenziwe ngaphambili ngexesha lotyando.

Iimpawu zobuchwephesha bobuchopho

Ingqondo yobuchwephesha ithathwa njengengxamisekileyo. Iimpawu kunye neempawu zingabandakanya:

• abafundi abaxubileyo
• intloko ebuhlungu
• ukozela
• ubunzima bokugxila
• igazi elonyukayo
• ukulahleka kwengqondo
• ukuxhuzula
• ukuma ngokungaqhelekanga, ukunyakaza okungqongqo komzimba, kunye nezikhundla ezingaqhelekanga zomzimba
• ukubanjwa kwe-cardiac
• ukulahleka kwengqondo
• ikhoma

Oonobangela bokuhlanjwa kwengqondo

Ingqondo ye-herniation ngesiqhelo sisiphumo sokudumba kwengqondo. Ukudumba kubeka uxinzelelo kwizicubu zobuchopho (ekubhekiswa kuzo njengokonyusa uxinzelelo lwe-intracranial), kubangela ukuba izicwili zinyanzelwe kude ne-positon yesiqhelo.

Ezona zinto zixhaphakileyo zokuchongwa kwengqondo kubandakanya:

• ukulimala entloko okukhokelela kwi-hematoma engaphantsi komhlaba (xa igazi liqokelela kumphezulu wobuchopho phantsi kolukakayi) okanye ukudumba (i-cerebral edema)
• ukubetha
• ukuphuma kwegazi kwingqondo (ukopha kwingqondo)
• ithumba lobuchopho

Ezinye izizathu zokunyuka koxinzelelo kukhakhayi zibandakanya:

• ithumba (ingqokelela yobofu) kwintsholongwane okanye usulelo lomngundo
• ulwandiso lolwelo kwingqondo (i-hydrocephalus)
• utyando lobuchopho
• Isiphene kulwakhiwo lobuchopho olubizwa ngokuba yi-Chiari malformation

Abantu abanezicubu zobuchopho okanye iingxaki zemithambo yegazi, njenge-aneurysm, basemngciphekweni omkhulu wokuba nengqondo yokuhluthwa. Ukongeza, nawuphina umsebenzi okanye ukhetho lwendlela yokuphila olukubeka emngciphekweni wokonzakala entloko kunokwandisa umngcipheko wobuchwephesha bengqondo.

Ukunyanga ubuchwephesha bobuchwephesha

Unyango lujolise ekupheliseni ukudumba kunye noxinzelelo ngaphakathi kwengqondo olubangela ukuba ubuchopho buhluthe ukusuka kwelinye igumbi ukuya kwelinye. Unyango luya kuba yimfuneko ukusindisa ubomi bomntu.

Ukunciphisa ukudumba kunye noxinzelelo, unyango lunokubandakanya:

• utyando lokususa ithumba, ihematoma (igazi elijiyileyo), okanye ithumba
• utyando lokufaka idreyini ebizwa ngokuba yi-ventriculostomy ngomngxunya okhakhayi ukuze kuphume ulwelo
• Unyango lwe-osmotic okanye i-diuretics (amayeza asusa umbane emzimbeni) ukukhupha ulwelo kwizicwili zobuchopho, ezinje ngemannitol okanye i-hypertonic saline
• corticosteroids ukunciphisa ukudumba
• utyando lokususa icandelo lokakayi ukwenza indawo engaphezulu (craniectomy)

Ngelixa unobangela wobuchwephesha bobuchopho kusonjululwa, umntu onyangiweyo unokufumana:

• ioksijini
• ityhubhu ebekwe kwindlela yabo yomoya ukuxhasa ukuphefumla
• ukuthomalalisa
• amayeza okulawula ukuxhuzula
• iyeza lokunyanga ithumba okanye ukuthintela usulelo

Ukongeza, umntu onengqondo yobuchopho uya kufuna ukubekwa esweni ngokusondeleyo kwiimvavanyo ezinje:

• X-reyi yekhakhayi nentamo
• Ukuskena i-CT
• Ukuskena iMRI
• iimvavanyo zegazi

Iingxaki zobuchwephesha bobuchwephesha

Ukuba ayinyangwa kwangoko, ukuhamba kwethishu yobuchopho kunokuphazamisa izakhiwo ezibalulekileyo emzimbeni.

Iingxaki zobuchwephesha bobuchwephesha zibandakanya:

• ukufa kwengqondo
• ukuphefumla okanye ukubanjwa kwentliziyo
• ukulimala kwengqondo okungapheliyo
• ikhoma
• ukufa

Imbonakalo yobuchwephesha bobuchwephesha

Imbonakalo ixhomekeke kuhlobo kunye nobukrakra bokwenzakala okubangele i-herniation kwaye apho kwenzeka khona kwingqondo. Ubuchwephesha bobuchwephesha bunokunqamla ukunikezelwa kwegazi kwingqondo. Ngesi sizathu, iya kubulala ukuba ayinyangwa kwangoko. Nokuba unyango, ubuchwephesha bengqondo bunokukhokelela kwiingxaki ezinzulu, ezingapheliyo kwingqondo, okanye ekufeni.

Ingqondo yokuchithwa kwengqondo ithathwa njengengxamisekileyo yonyango. Kuya kufuneka ubize i-911 okanye uye kwigumbi likaxakeka kwangoko ukuba umntu owenzakele entloko okanye ithumba lobuchopho lingaqapheli okanye lididekile, uxhuzula, okanye akazi nto.