Nā hōʻino ʻana i ke aʻa (AVM)

Nā hōʻino ʻana i ke aʻa (AVM)

Welina mai i ka pūnaewele neurosurgery o APCC, kahi a mākou e wehewehe aku ai iā ʻoe i nā arteriovenous malformations (AVMs)—he ʻano maʻi vascular paʻakikī e koi ana i ka ʻike loea, ka pololei, a me kahi ala i kau ʻia ma ke kikowaena o ka mea maʻi. Ke noiʻi nei mākou i ko lākou mau ʻano, ka hōʻailona, ​​a me nā hoʻolālā lapaʻau o kēia wā.

Ke hoʻomaopopo nei i nā maʻi ʻino o ka lolo arteriovenous (AVMs): ʻO nā AVM o ka lolo he mau hiʻohiʻona ʻē o nā kīʻaha koko i loko o ka lolo, e hoʻopili pololei ana i nā aʻa i nā veins me ka ʻole o ka pūnaewele capillary maʻamau. Hiki i kēia ʻano ʻē o ke ʻano ke alakaʻi i ke kahe koko kūpono ʻole, e hoʻonāukiuki ana i nā ʻiʻo o ka lolo a puni a hoʻonui i ka pilikia o ke kahe koko.

Nā ʻano a me nā kumu pilikia: Hōʻike nā AVM o ka lolo i nā ʻano like ʻole:

• Size: Hiki i nā AVM ke ʻokoʻa ka nui, mai ka mea liʻiliʻi a maikaʻi ʻole i ka nui a paʻakikī.
• Location: Hiki iā lākou ke ulu aʻe ma nā wahi like ʻole o ka lolo, e hoʻopilikia ana i nā hana neurological like ʻole.
• Ka pilikia o ke kahe koko: Loaʻa i nā AVM kahi pilikia nui o ke kahe ʻana o ke koko i loko o ka lolo, hiki ke alakaʻi i nā hopena hoʻoweliweli i ke ola.
• Epilepsy: Hiki i kekahi mau AVM kokoke i nā wahi e kaohi ana i nā neʻe ʻana, nā manaʻo, a me ka ʻōlelo ke hana i nā maʻi epileptic e hoʻomaka ana i ka wā ʻōpiopio.

ʻIke a me ka loiloi: He mea nui ka ʻike pololei ʻana i nā AVM o ka lolo no ka hoʻokele pono ʻana. ʻO nā ʻano hana diagnostic:

• Nā scan MRI a me CT: Hāʻawi kēia mau ʻano hana kiʻi i ka ʻike e pili ana i ka nui, kahi, a me nā ʻano o ka AVM, me ka nānā ʻole inā ua kahe ke koko i ka wā ma mua.
• angiography: Hāʻawi kēia kaʻina hana kiʻi i nā kiʻi kikoʻī o nā kīʻaha koko, e kōkua ana i ka ʻike ʻana i nā pilina ʻano ʻē i nā AVM, nā aʻa e hānai ana i ka AVM a me nā aʻa e hoʻokahe iā lākou.

Nā Hoʻolālā Lapaʻau o Kēia Manawa: Hoʻopilikino ʻia nā hoʻolālā lapaʻau no nā AVM lolo i ke kūlana a me nā pono kūikawā o kēlā me kēia maʻi:

• ʻAla: Hiki ke hana ʻia ke wehe ʻana (resection) o ka AVM ma ke ʻoki kino, akā pili kona hiki ke hana ʻia i ka nui, kahi, a me ke olakino holoʻokoʻa o ka mea maʻi.
• Lapaʻau Radiation: ʻO nā ʻano hana e like me ke radiosurgery stereotactic e kuhikuhi ana i ka AVM me nā dosis kiʻekiʻe o ka radiation, e hana ana i nā kīʻaha koko ʻē i ka thrombosis a i ʻole ke kāpili ʻana a i ka hopena e pani ʻia i ka hala ʻana o ka manawa a hiki i 3 mau makahiki. Pono e hoʻomanaʻo ʻia i loko o kēia wā kali, e mau ana nā pilikia o ke kahe koko a i ʻole ke kahe koko a hiki i ka nalowale loa ʻana o ka AVM.
• Embolization: ʻO ke komo ʻana i ke kola i loko o nā aʻa hānai e hoʻopau i ka nidus o ka AVM e ho'ōla i ka mea maʻi i kekahi manawa, ʻoi aku hoʻi i nā AVM liʻiliʻi.
• Lapaʻau mālama: Ua ʻike ʻia ʻaʻole maikaʻi ka hana ʻana o nā maʻi me nā AVM nui loa, ʻoi aku ka nui ma mua o 4-6 cm ka nui, aia pinepine ma nā wahi weliweli o ka lolo, me kekahi ʻano hana ikaika. Loaʻa pinepine i kēia mau maʻi nā hopu wale nō, hana maikaʻi lākou a he haʻahaʻa ka pilikia o ke kahe ʻana o ke koko i loko o ke poʻo. No laila, ʻo ka waiho wale ʻana iā lākou a me ka mālama ʻana i ko lākou mau ʻeha epileptic me nā lāʻau lapaʻau me ka ʻole o ke ʻoki ʻana a i ʻole ka radiation paha ke ala maikaʻi loa.

Ka mālama ʻana i nā ʻano like ʻole: Pono ka mālama ʻana i nā AVM o ka lolo i kahi ala multidisciplinary:

• Nā kauka ʻokiʻoki lolo: He akamai i ka resection ʻoki kino a me ka hoʻonohonoho ʻana i nā hoʻolālā lapaʻau.
• Nā Neuroradiologists Interventional: Nā loea i nā kaʻina hana minimally invasive e like me ka embolization.
• ʻO ka Radiation Oncologists: E kūkākūkā e pili ana i ka radiation therapy no ka pani ʻana o AVM.
• Nūnūnū: E hoʻolako i ka loiloi neurological piha a me ka hoʻokele.