Hydrocephalus thiab nws cov kev kho mob

Hydrocephalus yog yus muaj los ntawm qhov kev nce rau hauv CSF qhov chaw, feem zuj zus lawm volume ntawm lub paj hlwb cov ntaub so ntswg. Yog vim li cas rau koj ntxiv kom lub ventricles ntau thiab tsawg pab tej zaum yuav occlusion cawv ntws nyob rau hauv lub ventricular system (occlusive hydrocephalus) los yog lus outflow (resorption) cawv subarachnoid qhov chaw los ntawm cov arachnoid villi rau hauv dural kab noj hniav hlwb, uas yog lub ntsiab paths ntawm outflow ntawm lub venous ntshav los ntawm lub paj hlwb (qhib hydrocephalus.) Rau rau cov kev kho mob ntawm hydrocephalus tau tsis tshua muaj neeg vam meej nyob rau hauv koj khom lub tsheb tawm hauv lub mechanisms ntawm nws tshwm sim. Rau cov kev kho mob ntawm hydrocephalus siv ob qho tib si conservative thiab phais txoj kev. Cov kev phais kho mob ntawm hydrocephalus feem ntau txhim kho ventriculoperitoneal shunt endoscopic perforation hauv qab III zheludochka- endoscopic triventrikulostomiya. Tu siab, cov ua hauj lwm tsis yog ib txwm zoo thiab nyob rau tib lub sij hawm yuav ua rau txoj kev loj hlob ntawm cov teeb meem (Syndrome giperdrenirovaniya, tsim subdural hematomas, kab mob ntawm lub shunt system, thiab hais txog. D.). Yog li ntawd, cov nqe lus nug ntawm kev xaiv kom tsim nyog tshaj txoj kev kho mob ntawm hydrocephalus conservative phais yog qho tseem ceeb heev. Attendance tseem ceeb yog qhov teeb meem ntawm lub hauj lwm ntawm lub ntsia bypass system thiab nws cov adequacy. Raws li ib tug tshwm sim ntawm kev soj ntsuam ua nyob rau hauv qhov chaw ntawm kev kawm txoj tib neeg lub hlwb qhia ib tug ncaj tseeb lub sij hawm ntawm lub qhib thiab obstructive hydrocephalus. Nyob rau hauv ib qho qhib hydrocephalus muaj cai raws li ib txwm qhov tseem ceeb ntawm elasticity craniovertebral cov ntsiab lus, thiab nws tseem ceeb nce nyob rau hauv ib tug tseem ceeb txo nyob rau hauv kev sib piv nrog rau cov cai. Nyob rau tib lub sij hawm, obstructive hydrocephalus tshwm sim xwb ib txwm qhov tseem ceeb thiab muaj zog elasticity. Nyob rau hauv no phais kho mob ntawm hydrocephalus (ventrikuloperitonalnoe bypass, endoscopic triventrikulostomiya) coj mus rau ntau yam pauv loj thiab tseem ceeb kev hloov cerebral ntshav txaus thiab venous craniovertebral volumetric ratios. Tus thawj nyob rau hauv lub elasticity ntawm lub cai piv rau ua ntej phais tau kuaj xwb nyob rau hauv cov neeg mob nrog rau kev qhib hydrocephalus. Txawm li cas los, thaum occlusive hydrocephalus txo elasticity dua li ib txwm ua ntej phais twb tsis cai. Nyob rau tib lub sij hawm tom qab lub lag luam nyob rau hauv lub tsev kho mob nrog obstructive hydrocephalus elasticity ho poob nyob rau hauv kev sib piv nrog rau cov kev tshwm sim ntawm lub preoperative kev tshawb fawb. Qhib hydrocephalus yuav tshwm sim los ntawm ntau yam etiological yam. Nws yuav tsum tau borne nyob rau hauv lub siab hais tias nyob rau hauv kev noj qab nyob cov neeg nyob rau hauv txoj kev laus yog lossi yuav mus nyob rau qhov kev tuag ntawm neurons, uas ua rau yus Atrophy ntawm lub paj hlwb tshuaj thiab thiaj li mus rau ib qho kev nce rau hauv lub zeem cia rau tej qhov chaw craniovertebral kab noj hniav. Qhov no ntuj cov txheej txheem no hu ua kev puas ntsoog. Thaum tus kab mob Alzheimer yog ceev laus nrog txawv txav intracellular txuam ntawm kev puas tsuaj ntawm intracellular lug thiab thaum kawg neuronal tuag. Ntawm cov feem ntau cov kev soj ntsuam daim ntawv qhib hydrocephalus faib qub siab hydrocephalus, uas yog ib tug tseem ceeb feem ntawm cov tsos mob Hakima- Adams (1965) (Hakim S, Adams R). Rau no syndrome yog yus muaj los ntawm ib qho kev nce nyob rau hauv lub hlwb ventricles ntawm tej intracranial siab. Nyob rau hauv tas li ntawd tus yam ntxwv nta ntawm lub syndrome Hakima- Adams yog txoj kev loj hlob ntawm dementia, unsteadiness thiab urinary incontinence. Tus mob ntawm ntau cov neeg mob nrog rau cov syndrome Hakim -Adamsa ho txhim kho tom qab shunting hauj lwm. Txawm li cas los, nyob rau hauv tej rooj plaub, cov operatsii ices. Txawm li cas los shunt hauj lwm nquag ua rau mob (nyob rau hauv 13-50% raws li nyias kev soj ntsuam). Yog li ntawd, cov kev xaiv ntawm cov neeg mob nrog Hakim syndrome - Adams rau kev phais kho mob yog ib qho tseem ceeb heev. Tam sim no, rau lub hom phiaj no, nws yog dav siv ntau yam tus txoj kev (Txoj kev lis ntshav ntawm saline mus rau hauv lub CSF qhov chaw mus kawm kev hloov uas tshwm sim thaum lub intracranial siab, kua cawv nrog lub kwv yees ntawm kev hloov nyob rau hauv lub neurological raws li txoj cai, thiab thiaj li nyob. D.). Ivazivnost cov kev ntsuam xyuas ho txwv lawv siv nyob rau hauv lub tsev kho mob . Qhov siab tshaj plaws nqi ntawm ntau cov kev tshawb fawb craniovertebral ntim piv yog nyob rau hauv cov me nyuam nrog hydrocephalus, raws li zoo raws li nyob rau hauv cov neeg laus nrog ua ventriculomegaly (nce nyob rau hauv loj ntawm lub paj hlwb ventricles) thiab txawv variants ntawm lub syndrome Hakima- Adams (nco puas, moj yam, zais zis). Nyob rau hauv peb cov kev tshawb fawb, thaum Hakim syndrome - Adams resilience yog feem ntau ib txwm los yog ntau heev txo, thiab nyob rau hauv cov neeg mob uas lub txim ntawm craniocerebral travmy- thiab mob puas siab puas ntsws elasticity yog ib txwm los yog muaj zog, thiab qhov txawv ntawm cov ob pab neeg ntawm cov neeg mob mus txog statistical tseem ceeb. Ua ntawm dementia nyob rau hauv cov neeg laus tej zaum yuav disintegration ntawm cov ntaub ntawv dab nyob rau hauv lub hlwb tshwm sim los ntawm ntau mechanisms (degenerative, vascular, metabolic dab). Ib tug yog vim li cas rau mob nyob rau hauv cov neeg laus muaj peev xwm yuav cov kev loj hlob ntawm tus kab mob Alzheimer. Nyob rau hauv cov ntaub ntawv no, muaj yog ib tug ntseeg uas txawv nyob rau hauv lub hauv paus ntawm kev soj ntsuam cov ntaub ntawv tsuas vascular dementia thiab tsis nco qab tus kab mob no tsis tshua muaj yooj yim. Txawm li cas los, nws tsim muaj uas nyob rau hauv Alzheimer tus kab mob ntshav khiav tsis zoo hauv extracranial thiab intracranial hlab ntsha nyob rau hauv significantly txo piv nrog noj qab nyob zoo neeg. Alzheimer tus kab mob no yog yus muaj los ntawm ib tug txo nyob rau hauv intracranial siab thiab ib tug txo nyob rau hauv cov nqi ntawm cov dej cawv.

Elasticity craniovertebral cov ntsiab lus, yog ib tug cov neeg kho tshuab cov yam ntxwv ntawm lub cev, txawm li cas los, correlates mus rau ib tug tej yam twg thiab tej yam kev mob ntawm lub paj hlwb. Peb pom gradual normalization kab noj hniav craniovertebral txheem uas tshwm sim ib txhij nrog lub normalization ntawm tej lub xeev ntawm lub paj hlwb (zoo nco, kev txawj ntse zog, moj yam, normalization tso zis). Cov kev hloov no tshwm sim nyob rau hauv tus ntawm active vascular, metabolic thiab degitratatsionnoy txoj kev kho.

Nyob rau hauv ib qho qhib hydrocephalus muaj cai raws li ib txwm qhov tseem ceeb ntawm elasticity craniovertebral cov ntsiab lus, thiab nws tseem ceeb nce los yog tseem ceeb tsawg dua qub nyob rau hauv kev sib piv nrog rau cov cai. Nyob rau tib lub sij hawm thaum occlusal hydrocephalus cai tsuas yog tus qub qhov tseem ceeb thiab muaj zog elasticity, thaum uas txo lub elasticity piv nrog rau tej qhov tseem ceeb muaj cai. Phais kho mob ntawm obstructive hydrocephalus ventriculoperitoneal bypass, endoscopic triventrikulostomiya) coj mus rau ib tug tseem ceeb, cov lus tseem ceeb yuav txo tau nyob rau hauv elasticity craniovertebral cov ntsiab lus thiab cov tsos ntawm heev tsawg qhov tseem ceeb ntawm lub elasticity ntawm tib yam, raws li nyob rau hauv ib co cov neeg mob uas overt hydrocephalus) Yog li phais hydrocephalus ua rau nws hloov physiological mechanisms, ua occlusive hydrocephalus ua zoo li analogue ary qhib hydrocephalus.

Nyob rau tib lub sij hawm tom qab endoscopic triventrikulostomii pom cov lus tseem ceeb txo tsuas elasticity thiab ceev ntawm venous ntshav txaus, whereas tsis muaj teeb meem loj cov kev hloov nyob rau hauv lub zeem cia tank craniovertebral cov ntsiab lus tsis tshwm sim. A lus tseem ceeb txo nyob rau hauv elasticity tom qab endoscopic triventrikulostomii tsim nyog tshwj xeeb xim, raws li thaum uas siv cov tus Txoj kev lis ntshav kuaj txhim khu kev qha elasticity hloov yog ices. Zoo li no tsis tau vim tus kev ntsuam xyuas Txoj kev lis ntshav zoo nkaus li tias cov kev taw qhia ntawm saline mus rau hauv lub CSF thaum lub sij hawm Txoj kev lis ntshav system txawv xeem tej yam kev mob sis ntim craniovertebral ntsiab ntsiab lus (lub hlwb cov ntaub so ntswg, cov ntshav thiab likovora), uas tej zaum yuav ua rau erroneous tau. Yog li, tsis yog-tus txoj kev tshawb no ntawm venous krovobrascheniya hlwb, hlwb txha nqaj qaum kua puab thiab craniovertebral ntim piv qhia ib qho tseem ceeb invormatsiyu ntawm patafiziologicheskih mechanisms intracranial gipetenzii thiab hydrocephalus, raws li zoo raws li ntsuam xyuas cov hauj lwm zoo ntawm pathogenetic txoj kev kho.