Abun bugun jini shine mutuwar kwakwalwar kwakwalwa, yawanci ana samar da shi ta hanyar katse jini zuwa ɓangare na kwakwalwa. Hanyoyin da ke cikin kwakwalwa da zasu iya haifar da fashewar sun hada da thrombosis (clotting) na jini a cikin kwakwalwa, ƙwallon jini (jini wanda yake tafiya zuwa kwakwalwa da kwari a can), da kuma matsalolin gida da suka shafi tasoshin jini a cikin kwakwalwa, irin su anerism ko ƙonewa.
Bayan wani ya kamu da bugun jini, likita zai yi ƙoƙari ya ƙayyade ainihin abin da ya faru, tun da dalilin da ya haifar da bugun jini yakan ƙayyade mafi kyau maganin. Amma har zuwa kashi 40 na lokuta, duk da haka, babu wani dalili da za'a iya gano. Wani fashewa da ba'a sani ba an kira shi da bugun jini na cryptogenic. (Kalmar "cryptogenic" kawai tana nuna cewa dalilin shine cryptic, ko damuwa.)
Yaushe ne ake kira Strokes Cryptogenic?
Bayan bugun jini, wani lokaci zai iya zama da wuya a ƙayyade ko katsewar jini wanda ya haifar da bugun jini ya haifar da jini wanda aka kafa a wuri (thrombus), jini wanda yake tafiya zuwa kwakwalwa daga wasu wurare ( embolus ), ko kuma wasu matsalolin kwakwalwa.
Ba za a kira wani bugun kira cryptogenic ba har sai an kammala cikakken kimantawa ba tare da bada wani dalili ba. Gaba ɗaya, irin wannan kimantawa ya kamata hada da ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa (tare da CT scan ko MRI scan ), ɗaukar hoto na jini wanda ke ba da kwakwalwa (binciken carotid duplex ko ɗakunan Doppler na tsakiya ), kuma mai yiwuwa angiography .
Bugu da ƙari, dole ne a yi cikakken nazarin rubutun ƙirar zuciya na zuciya, neman magunguna na asali. Wadannan magunguna masu dauke da kwayar cutar suna dauke da jini a cikin zuciya (yawanci a cikin hagu na hagu), Oval breed oval (PFO) , wani motsa jiki na mahimmancin kwayar cutar , magungunan ƙwayar cuta , ko ɓarna na kwakwalwa (MVP) .
Idan babu wani dalili da aka gano bayan wannan kyakkyawan bincike, ana ganin cewa an yi amfani da bugun jini kamar cryptogenic.
Dalili na ainihi na annobar cryptogenic (idan za'a iya gano su) suna da yawa, kuma mutanen da aka lakafta su suna ciwon fashewar cryptogenic su ne rukuni daban-daban. Yayin da kimiyyar likita ta inganta ikonta na gano mawuyacin cututtuka a cikin marasa lafiya, yawan mutanen da aka ce suna da kullun cryptogenic zasu fada.
Wane ne yake samun Cryptogenic ciwo?
Maganar marasa lafiya da suka sha wahala shawoɗun cryptogenic su ne kamar marasa lafiya waɗanda suka sha wahala sakamakon annobar cutar. Sun fi zama tsofaffi waɗanda ke da ƙananan cututtuka na cutar cututtukan zuciya.
Ana ganin kullun cryptogenic daidai a cikin maza da mata. Suna iya zama mafi yawan su a cikin baƙi da yan asalin sa. Yayin da ƙwayar cututtuka na ƙananan yara (a cikin shekaru 50) suna da hankali daga likitoci da kuma cikin littattafai na likita, nazarin ya nuna cewa yawancin shekarun da aka yi wa cututtuka na cryptogenic daidai yake da cututtukan da ba na cryptogenic. Wato, ikon gano ainihin cututtuka a cikin ƙananan yara shine kamar yadda yake a cikin tsofaffi.
Mene ne Outlook Bayan Cryptogenic Stroke?
Gaba ɗaya, bayyanar da wani mai haƙuri da ya sha wahala bugun ƙwayar cututtuka ya bayyana ya zama mafi kyau fiye da ƙwaƙwalwar cututtuka ba cryptogenic.
Duk da haka, shekarun shekaru 2 na ciwon fashewar raguwar kashi 15 - 20 bisa dari.
Tun da magani don hana ciwon bugun jini ya dogara ne da dalilin fashewar (anticoagulation tare da warfarin bayan bugun jini, maganin antiplatelet tare da aspirin ko clopidogrel bayan bugun jini), mafi kyawun farfadowa bayan kullun cryptogenic ba shi da tabbas. Har ila yau, yarjejeniya tsakanin masana a wannan lokaci, duk da haka, yana kokarin yin amfani da maganin rigakafi.
Harkokin PFO
Daya daga cikin batutuwa masu rikice-rikice na bugun ƙwayar cryptogenic shine tambaya akan sau da yawa ne daga Patent Foramen Ovale (PFO), wanda aka sani da rami a zuciya.
Babu shakka wasu ƙwaƙwalwar ƙwayoyin cuta suna haifar da yatsun jini wanda ke biye da PFO, shigar da wurare dabam-dabam, kuma tafiya zuwa kwakwalwa. Duk da haka, wannan abu ne mai wuya, yayin da PFO na da yawa. (Ana iya gano PFO har zuwa kashi 25% na kowane mutum ta hanyar echocardiography.)
Wata kila, saboda wannan dalili, nazarin da suka kimanta amfanin amfani da na'urorin ƙwayar PFO a marasa lafiya waɗanda suka yi fama da ƙwaƙwalwar cryptogenic sun kasance m - ba a rage yawan shanyewa ba. A lokaci guda kuma, hanyoyin da ake amfani da su don rufe PFO sun nuna marasa lafiya ga yiwuwar mummunar tasiri.
Har ila yau akwai yiwuwar cewa a wasu marasa lafiya, rufe PFO zai zama mai amfani. Amma a wannan batu, babu wata hanyar da aka tabbatar don gano wanda marasa lafiya da cututtukan cryptogenic da PFO zasu amfana daga rufewar PFO.
Duk da haka, binciken da aka yi kwanan nan ya nuna cewa ta hanyar yin amfani da nazarin Doppler mai zurfi , tare da bincike mai tsafta, likitoci za su iya fara gano wadanda marasa lafiya a cikin wanda shawoɗun cryptogenic zai iya haifar da PFO. Za a buƙaci ƙarin nazarin don tantance ko rufe PFO zai rage yawan ciwon shanyewa a cikin wannan ɓangaren marasa lafiya.
Amma, asalin ƙasa, ko da yake, shi ne cewa rufewar PFO a cikin marasa lafiya tare da bugun ƙwayar cryptogenic ba za a iya barata a yau ba. Cibiyar Nazarin Kasuwancin Amirka a shekarar 2016 ta gargadi kan ƙaddamar da kullun PFO ga mutanen da suka sha wahala a cikin bugun jini na cryptogenic.
Atrial Fibrillation da Cryptogenic Stroke
Atrial fibrillation ne sanannun dalilai na bugun jini, kuma marasa lafiya tare da filastillation mai tsanani a kullum suna buƙata su zama masu tsauri.
Shaidu na yanzu suna nuna cewa ƙananan marasa lafiya marasa lafiya da ƙwayar cuta na ƙwayar cuta na iya samun "tsaka-tsakin" ƙari - wanda shine, abubuwan da ke tattare da fibrillation wanda bazai haifar da bayyanar cututtuka ba, don haka ba a gane shi ba. Bugu da ari, akwai bayanai da ke nuna cewa tsarin kulawa na kwakwalwa na dogon lokaci na iya zama da amfani a gano magungunan da ke tattare da kwayar cutar a cikin marasa lafiya wadanda suka sami bugun zuciya cryptogenic. A cikin waɗannan marasa lafiya, mai yiwuwa, kamar yadda a cikin wasu marasa lafiya da ke da alaƙa da magungunan kwayar cutar, za su iya rage haɗarin fashewa.
Sources:
> Cujec B, Polasek P, Voll C, Shuaib A. Hanyoyin Halitta na Harkokin Tsarin Harkokin Cikin Gida a cikin Sano Hanyoyin Kyau na Cardiac na Harkokin Embolism a Cutar Cutar. Rushewar 1991; 22: 727.
> Lansberg MG, O'Donnell MJ, Khatri P, et al. Antithrombotic da Thrombolytic Farfesa na Ischemic Stroke: Antithrombotic Far da Rigakafin Thrombosis, 9th ed: Kwalejin Kwalejin Kwalejin Na Amirka Kwararrun Sharuɗɗayar Nazarin Harkokin Clinical Practice. Chest 2012; 141: e601S.
> Messe SR, Gronseth G, Kent DM, Et al. Gudanar da Shawarwari: Saukewa tare da Patent Foramen Ovale (Update of Practice Parameter Report of the Guidance Development, Dissemination, da kuma aiwatar da Subcommittee of the American Academy of Neurology.
Mohr, JP, Choi, WC, Grotta, JC, et al. Buga: Pathophysiology, Fahimtarwa, da Gudanarwa, Edition na 4th, Churchill Livingstone, New York 2004.