Ubuchopho Angioentsefalopatiya - kuyini? Izimpawu, ukwelashwa kanye Izibikezelo

Ngezinye izikhathi odokotela basikisela uphethwe syndromic, isibonelo, ubuchopho angioentsefalopatiya. Kuyini lokhu? Okungalapheki kuhlasela ischemic. By the way, ngempela isifo ovamile, abantu nje abavamile neze sinake indlela amagama abekwe ngayo yayo. Ngokuvamile kwenzeka kwasebekhulile, okungenani - e abasha abavuthiwe. Lesi sifo sithatha isikhathi eside zifihliwe, nalapho kuvele izimpawu, kudaleke umonakalo ukuthatha izinyathelo ezinqala.

lwezifo

Ngenxa izikhalazo nonspecific, ukubonakaliswa emitholampilo izinguquko zikhonjwe ubuchopho imaging, ukuqoqa idatha kwezibalo kunzima. Ukuze ezinye ijaji ngokwezinga angioentsefalopatii nokudlanga singaba unhlangothi izikhathi eziningana. Njalo ngonyaka eRussia kukhona izimo abangaba isigamu sesigidi yesimo oyingozi.

Ochwepheshe bagcizelela ukuthi yinzuzo uzingela izifo ubuchopho dyscirculatory lezi zinkinga engqondweni yethu, imisebenzi lehlukene ekucabanga kwengcondvo netintfo ukuvama ezingamahlalakhona cerebral esingamahlalakhona kwegazi. Kodwa akusho ukuthi lokhu khombisa isithombe kweqiniso we ukwanda kwalesi sifo.

omsakazo

On ngalokho okungase kwenzeke ubuchopho angioentsefalopatiya? Izimbangela kuphazamiseka ezingamahlalakhona kwegazi ebuchosheni futhi, isibonelo, inhliziyo noma amaphaphu - okufanayo. The main isici etiological - amabili:
- isifo sokuqina kwemithambo yegazi;
- ukwanda wegazi.

zenzeka kanyekanye futhi ngokuvamile baqinise nomunye. Ngaphezu kwalokho, umphumela cerebral kwegazi bawasize nangezinye inhliziyo futhi semithambo izifo, ezifana dysrhythmia futhi ezingalapheki yokumelwa yinhliziyo. Okubaluleke kakhulu kuba khona kombungu semithambo ebuchosheni, intamo, noma izitsha ezinkulu. Abakwazi akusho ukuzibonakalisa isikhathi eside kuze kube ozokhula ezinye izifo letindzala. indima yesibili e Ukuwohloka ubuchopho kwegazi kudlala kokucindezelwa imithambo esikhulu, kanye ukwehla elibukhali ingcindezi, ikakhulukazi abantu abadala.

izifo Isitoreji kungenzeka kube isizathu ngenxa lapho ekuthuthukiseni ingqondo angioentsefalopatiya. Kuyini lokhu? Lokhu isimo, lapho amaseli ngenxa inqubo sokugembula buthelela ezinye izinto ezithile: amaphrotheni, amafutha kanye carbohydrate.

Kulokhu asebekhulile amyloidosis semithambo kwenzeka, okuholela izinguquko esiwohlozayo e izindonga zawo. izifo ze-endocrine futhi abe nesisindo ethile. Ngokwesibonelo, micro - futhi makroantiopatii sikashukela kubangele ezingamahlalakhona ischemia palsy. Ukuze imiphumela efanayo ukuhola uhlelo iziyaluyalu: imfiva ye-rheumatism, vasculitis, izifo igazi.

Njengomthetho, ukhethe noma iyiphi isici esisodwa akunakwenzeka, ukuze isifo kubhekwa polyetiological. Udokotela yabhekisela khona yezinto eziyinhloko, futhi zonke comorbidities kubhekwe ozikhethela.

pathogenesis

Izifo ngenhla nemibandela liyochukuluza Ukwehla lasakazwa izicubu ubuchopho, futhi ngenxa yalokho, ukubulawa indlala yayo (yokushodelwa umoya kanye glucose). Ekuqaleni, izinqubo sokugembula (izimpawu kobuchopho angioentsefalopatii) avele kuphela ezitsheni ezincane. Ukuthuthukisa microangiopathy. Inani elikhulu imithambo abathintekayo okubangela ischemia ukumelana ndaba omhlophe, njengoba multiple lacunar infarctions. Inhlanganisela yalawo izimo kuholela ukuphazamiseka izakhiwo ingqondo.

Uma imbangela atherosclerosis angioentsefalopatii ke advantageously abathintekayo Umthambo isiqu. Lokhu kuholela yokuthi ileveli yegazi ukugeleza ebuchosheni luncike hemodynamics letindzala. Endabeni umfutho wegazi ophakeme emithanjeni kwasekuqaleni, ishemiziruyutsya perforating Umthambo zobuchopho.

Muva nje, neurologists futhi neurosurgeons oluthathwa okungamahlalakhona nokuphazamiseka kwempilo kwegazi ngezindlela ezimbili: ubunjalo umonakalo futhi kwasendaweni yayo. Ekubhebhetselisa noma angioentsefalopatiya ngokukhukhumala kwentamo obonakala njengenhlangano syndrome palsy, okuyinto ihlukaniswe leykoentsefalopatichesky futhi binsvangerovsky.

Isekhona ebalulekile ubuchopho angioentsefalopatiya. Kuyini lokhu? Kuyinto khona nerve izicubu ukwakha izikhala eziningi ukopha. Zokwelapha, ezahlukeneyo kwande yayihlukene phakathi, ngoba akunakwenzeka ukuba ukwaba iyiphi indlela eyodwa pathogenetic.

emitholampilo isithombe

Ngeshwa, ibhuku elisetshenziswa ngokwabelana kungenzeka njalo ngesikhathi esifanele lokwenza ukuxilongwa ezifana ingqondo angioentsefalopatiya. Izimpawu ze-non-ethize hhayi okwethusayo kakhulu noma onekhono noma ukubekezela. Ngakho, kungcono lability ngokomzwelo, okuyinto esivela kubantu yokuguga futhi ngaphandle pathologies, kanye nokulahlekelwa inkumbulo kanye nekhono ukufunda. Zizonke, lezi zici ezintathu kuholele maladaptation iziguli kanye ukukhubazeka kwabo.

Ngaphezu kwalokho, ikhanda, isiyezi, inkumbulo ukungakhuli ngilale ngokuthula, umsindo subjective ekhanda, noma enkeneneza ezindlebeni, kwehle umbono, ubuthakathaka, futhi ukukhathala kungaba izimpawu nje kuphela yokuthi umuntu uyathuthuka ubuchopho angioentsefalopatiya. Kuyini kungaba ngaphezulu? Ukuba khona kombungu semithambo, izifo ezihlukahlukene ezithathelwanayo, umfutho wegazi ophakeme, asthenic syndrome nezinye nosology. Futhi, umzimba sika ngakho sa amasignali ukukhathala eqinile.

Kukhona ukuhlanganisa emkhatsini izibalo zezikhalazo ezifakwe nobukhali semithambo encephalopathy. Kukhula inkumbulo ukuhlupheka, ukunakwa ukucabanga, kancane umuntu akushoyo ngale udokotela. Ngakho-ke, ezimweni ezimbi kakhulu, isiguli ungaqiniseka ukuthi Ungaphazamisi.

esigabeni

Kunezigaba ezintathu angioentsefalopatii:

1. izikhalazo subjective memory ukungakhuli nokunakwa ephelezelwa izimpawu ezincane ebalulekile: kwehle pupillary reflex, ukuvela ikhaliphe non-ngamandla automatism ngomlomo. Iya kancane izinguquko Gait, nokudikibala, ukucasuka.
2. Kulo sinyathelo, izimpawu zokungasebenzi kahle kwemizwa inyuka crystallizes omunye uphawu evelele. Kungenzeka iziyaluyalu extrapyramidal, pseudobulbar palsy, ataxia, cranial emsipheni ukungasebenzi. Stronger ehlupheka umsebenzi engqondweni yethu, encishisiwe lithathelwe professional kanye nomphakathi.
3. Iziguli wabusa syndromes eziningana. Neziphawulekayo anolaka Gait nasiphazamiso, iziyaluyalu cerebellar, isifo i-Parkinson, ukuphazamiseka kwezitho okhalo. Kulesi sigaba, ukugxekwa ukuba isimo sakhe ukwehla kanye nezikhalo akukwazi nhlobo. Iziguli babe olungenakuzisiza njengabantwana, ngoba ukuthuthukisa komqondo.

izimpawu zokungasebenzi kahle kwemizwa

Kunezindlela eziningana syndromes ezihambisana ubuchopho angioentsefalopatiya. Kuyini lokhu? Lokhu umlaza izimpawu ezibonisa kokunqotshwa isakhiwo obuphathekayo isimiso sezinzwa esiyinhloko.

1. syndrome Vestibular. Iziguli ukukhombisa ngezikhalo isiyezi, nedumbe uma uhamba, ayegubha i-nystagmus nokuxhumana okungekuhle. umtholampilo okunjalo kubonisa umonakalo noma anqobe cerebellum Fronto-stem ipheshana ngenxa encishisiwe igazi flow yangaphakathi carotid Umthambo.
2. Pyramidal syndrome sibonisa anda ikhaliphe umsipha, kanye ukuvela ukusabela sokugembula, ngokuvamile engalingani. Ukuba khona paresis kusikisela ukuthi umlando indoda washaywa unhlangothi.
3. Parkinson libhekene yokuhamba ukuhamba, ehle sebuso, rigidity imisipha phezu imilenze. Iziguli ngokuvamile awe phansi ngoba angikwazi ukuyeka ngesikhathi ngenxa yokwephula yokuhamba. Konke lokhu kukhomba anqobe izinzwa cortico-striatal futhi cortical we brainstem.
4. Pseudobulbar palsy kwenzeka uma kokunqotshwa kwe cortico-zenuzi izindlela. Isiguli sinelungelo nobunzima ngenkulumo nokugwinya, kanye iziqephu imizwelo "enobudlova".
5. syndrome Psihorganichesky, ngokuvamile ephelezelwa iziyaluyalu ukukhathazeka-bacindezeleke, ukungasebenzi yobuchopho.

ukuhlola

Njenganoma yimuphi omunye isifo, udokotela wezinzwa kumelwe ukuqoqa umlando ogcwele ukuphila futhi ukugula ukunquma izinga Ukulandelana izimpawu futhi khona zempilo comorbid. Khona-ke behlolwa: ukubala kwenhliziyo kulinganiswa blood pressure, lalela inhliziyo umsindo, ukugeleza kwegazi e imithambo enkulu engxenyeni engaphezulu emzimbeni. Khona-ke bachitha uvivinyo zezinzwa.

Isiwombe sesibili - ukuhlola laboratory. Lokhu kusiza ukucacisa imbangela angioentsefalopatii. Isiguli ucelwa ukuba nginikeze segazi, igazi oyisazi samakhemikhali ezinto eziphilayo futhi ukuhlaziya igazi coagulation, namazinga kashukela egazini. Bese uya ngokusebenzisa ubuchopho imaging: tomography ngekhompyutha (CT), i-magnetic resonance imaging (MRI), electroencephalography (Bheka). Konke lokhu kusivumela kutholakale izinga kwegazi cerebral, futhi uveze izindawo egunjini lokuhlolwa kwezifo. Ingabe ngaphezu kwalokho nika electrocardiography (ECG) kanye ultrasound ukuqinisekisa isifo yisimiso senhliziyo nemithambo yegazi.

Izinkomba ngoba esibhedlela

Akekho protocol emitholampilo akubonisi isidingo sokwelashwa esibhedlela kweziguli ukuthi nginesifo ubuchopho angioentsefalopatiya. Ukwelashwa, Izibikezelo kanye nokuvinjelwa kwalesi sifo, njengoba umthetho, thatha indawo esigulini esingalalisiwe esibhedlela. Okuhlukile izimo lapho isifo kwakunzima ngenxa yezinkinga ngu decompensation zokugula ukuphathwa kwabathintwayo noma ukuthuthukisa unhlangothi.

Neurologists bakholelwa ukuthi ukususwa ngenkani iziguli ezivela isimo evamile kungaba ibhebhetheke. Ngakho-ke, isigaba lokugcina mhlawumbe eyenziwa ukusekelwa ekhaya hhayi ukuthutha isiguli esibhedlela.

ukwelashwa

Umgomo kufinyelelwa, kwatholakala ukuthi nginesifo angioentsefalopatiya ubuchopho, ukwelashwa kufanele kuqale ngokushesha ngangokunokwenzeka, ukuthi lihambe kancane phambili inqubo sokugembula. Ngaphezu kwalokho, ukuqhuba nokwelashwa imivimbo pathologies ukuphathwa kwabathintwayo.

Ukwelashwa sibhekiswe ekuthuthukiseni perfusion ijwabu ubuchopho ngenxa ezithinta esimiso senhliziyo nemithambo yegazi, kanye nokulungiswa izakhiwo rheological yegazi. Lokhu kusikisela yokwelapha isifo sokuqina kwemithambo yegazi nomfutho ophakeme wegazi eziyinhloko yentuthuko ischemia.

amakhambi abantu

Ezinye iziguli esezikhulile bakholelwa ukuthi akufanele ukuthi "ushevu" amaphilisi, futhi kubalulekile ukubheka ezinye izindlela. Ngakho, kuyindida ukucabanga engaveza angioentsefalopatiya ingqondo. zokwelapha ezivamile akuzona wamukelekile phakathi odokotela, ngoba wenza esiya ngokuya siba sibi izimpawu.

Ochwepheshe batusa imithi ehlukile ngokuthuthukisa kwegazi cerebral zisebenzisa izimpande madder futhi hellebore zaseCaucasia, umoba of marsh cinquefoil, ebhalsamu 'Magic Trio ", tincture garlic kanye cranberry nokuningi. Bheka ukuphumelela kwalezi potions kuyangabazeka kakhulu, ngakho-ke akufanele ahileleke ucwaningo anjalo. Kungcono ukuya kudokotela abanekhono.