Idiopathic Intracranial Hypertension: Izimpawu, Izimbangela kanye Nokwelashwa

I-Idiopathic intracranial hypertension (IIH) yisimo esingajwayelekile esithinta ukucindezela ngaphakathi kogebhezi, okubangela uhla lwezimpawu ezinzima. Ukuphila ne-idiopathic intracranial hypertension kungaba inselele, kodwa ukuqonda lesi simo nokwazi ukusiphatha kungenza umehluko omkhulu ekuphileni kwansuku zonke. Ake sihlole ukuthi odokotela basixilonga futhi basiphathe kanjani lesi simo uma befuna usizo lwezokwelapha, nezindlela zokusivimbela. 

Iyini i-Idiopathic Intracranial Hypertension?

I-Idiopathic intracranial hypertension (IIH) yisimo esibonakala ngomfutho omkhulu ozungeze ubuchopho. Le ngcindezi eyengeziwe ithinta izici ezihlukahlukene zempilo yomuntu, ikakhulukazi umbono wakhe nokunethezeka. Igama elithi "idiopathic" ngokwalo lisho ukuthi imbangela ayaziwa, "intracranial" ibhekisela endaweni engaphakathi kogebhezi lwekhanda, futhi "nomfutho wegazi ophezulu" ikhombisa umfutho ophezulu.

Izinhlobo ze-Intracranial Hypertension

I-IIH yisimo esiyinkimbinkimbi esingahlukaniswa ngezinhlobo ezahlukene ngokuya ngesethulo saso kanye nezici eziyisisekelo: 

• I-IIH eyinhloko: Kwenzeka lapho kungekho sizathu esiqondile esingabonakala sokwanda kwengcindezi ebuchosheni. Leli fomu livame kakhulu futhi livame ukuhlotshaniswa nalo ukukhuluphala, ikakhulukazi kwabesifazane abaseminyakeni yokuzala.
• I-Acute Intracranial Hypertension: Iqala ngokuzumayo, ngokuvamile ngenxa yezingozi noma imivimbo. 
• I-Chronic Intracranial Hypertension: Yakha ngokuhamba kwesikhathi futhi ingase ibangele izinkinga zempilo ezifana namahlule egazi, izimila zobuchopho, noma imithi ethile.

Izimbangela ze-Idiopathic Intracranial Hypertension

Isizathu esiqondile se-IIH asaziwa, yingakho igama elithi "idiopathic". Kodwa-ke, abacwaningi baye bahlonza izici eziningana zobungozi kanye nezinto ezingaba nomthelela kulesi simo. Lokhu kubandakanya:

• Ukukhuluphala: Ingenye yezinto eziyingozi kakhulu ze-IIH, ikakhulukazi kwabesifazane abaneminyaka yobudala yokubeletha. 
• Ubulili: Izigameko ze-IIH zenzeka kakhulu kwabesifazane. 
• Izimo Zezokwelapha: Iziyaluyalu ze-Endocrine, njengesifo sika-Addison kanye ne-hypoparathyroidism, ukudakwa kwe-vitamin A, noma i-hypervitaminosis A, kuhlotshaniswe nomfutho wegazi ophezulu we-intracranial.
• Imithi: Ama-antibiotic e-Tetracycline, i-nitrofurantoin, i-lithium, kanye nokwelashwa kwe-thyroid esikhundleni sezingane ze-hypothyroid nakho kuye kwaxhunyaniswa nalesi simo.

Izimpawu ze-Idiopathic Intracranial Hypertension

I-IIH inohlu lwezimpawu ezingaba nomthelela empilweni yansuku zonke, okuhlanganisa:

• Kunzima, njalo ikhanda elibuhlungu
• Ikhanda elibuhlungu livame ukuba libi kakhulu ekuseni noma lapho ukhwehlela futhi udonsa kanzima, kodwa lingase libe ngcono lapho usukuma. 
• Abanye abantu baphathwa yikhanda elibuhlungu kangangokuthi bavuswa ebuthongweni.
• Izinkinga zokubona njengokulahlekelwa umbono okwesikhashana, umbono kabili, noma izindawo eziyimpumputhe ngokuzumayo. 
• Ezimweni ezibucayi ze-IIH, kungase kube nokulahlekelwa umbono we-peripheral (uhlangothi) noma ngisho nobumpumputhe besikhashana.

Ezinye izimpawu ze-intracranial hypertension zihlanganisa: 

• Ukuzizwa nokugula
• Ukukhathala
• Ukuthukuthela
• Ubunzima noma ubuhlungu lapho ubheka izibani ezikhanyayo, isimo esaziwa ngokuthi i-photophobia
• I-Pulsatile tinnitus (umsindo oshayayo onesigqi ezindlebeni)
• Izinkinga zokusebenzisana nokulinganisela, ukudideka kwengqondo, ukulahlekelwa umuzwa noma ubuthakathaka ezingxenyeni zomzimba
• Ubuhlungu behlombe nentamo

Sifo

Inqubo yokuxilonga ngokuvamile ihilela ukubona kokubili i-neurologist kanye ne-ophthalmologist. 

• The nodokotela wezinzwa izohlola umzimba ukuze ihlole imisebenzi efana namandla emisipha, ama-reflexes, nokulinganisela. 
• An ophthalmologist yenza ukuhlolwa kwamehlo okunwetshiwe ukuze kuhlolwe ingemuva leso kanye nokuhlolwa kwenkundla yokubuka ukuze kuhlolwe ukubona kwendawo ezungezile. Lokhu kuhlola kubalulekile ukuze kutholwe izimpawu ze-IIH, njenge-papilloedema (ukuvuvukala kwemizwa yamehlo).
• Ukuthwebula ubuchopho, okufana ne-CT noma i-MRI imaging, kungakhipha ezinye izimbangela ezingaba khona ze-intracranial hypertension, njengezimila zobuchopho noma amahlule egazi. Lezi zikena kufanele zibonakale zijwayelekile ezimeni ze-IIH.
• Ukubhoboza i-lumbar (impompi yomgogodla) iyithuluzi elibalulekile lokuxilonga. Le nqubo ikala ingcindezi ye-cerebrospinal fluid (CSF) ezungeze ubuchopho nomgogodla. 
• Ukuqinisekisa ukuxilongwa kwe-IIH, odokotela babheka izindlela ezinhlanu eziqondile: 
  • I-Papilloedema 
  • Ukuhlolwa kwe-neurological evamile (ngaphandle kokubona okungaba kabili) 
  • I-imaging yobuchopho evamile 
  • Ukuhlaziywa kwe-CSF evamile
  • Ingcindezi yokuvula i-lumbar puncture ephakanyisiwe

Ukuxilongwa kwe-IIH kungaqinisekiswa uma zonke lezi zindlela zifinyelelwa futhi kungekho esinye isizathu esitholakalayo.

Ukwelashwa kwe-Idiopathic Intracranial Hypertension

• Ukulahlekelwa kwesisindo: Ucwaningo luye lwabonisa ukuthi ukwehla okukhulu kwesisindo somzimba kunganciphisa ukucindezela kwe-intracranial, kuthuthukise izimpawu, futhi kufake i-IIH ekuxolelweni.
• Ukwelashwa Kwezokwelapha: Kuhlanganisa ukusetshenziswa kwe-acetazolamide, i-diuretic eyehlisa ukukhiqizwa koketshezi lwe-cerebrospinal futhi ithuthukise umsebenzi obonakalayo.
• Ukuhlinzwa:  Uma ukwelashwa kwe-conservative idiopathic intracranial hypertension kungaphumeleli, odokotela bangase batuse lokhu kuhlinzwa okulandelayo.
• I-Shunt Surgery: Uketshezi lwe-cerebrospinal oludlulele luphambukiselwa kwenye ingxenye yomzimba.
• I-Optic Nerve Sheath Fenestration: Kubandakanya ukudala iwindi elincane emgodleni ozungeze inzwa ye-optic ukukhulula ingcindezi.
• I-Venus Sinus Stenting: Le nqubo ihlanganisa ukubeka i-stent ukuze kwandiswe ukona kwe-venous emincane, okungenzeka kunciphise umfutho we-intracranial.

Uzoyibona Nini Udokotela

Funa usizo oluphuthumayo uma une:

• Ikhanda elibuhlungu ngokungazelelwe
• Izinguquko embonweni
• Ukudideka
• Ukungabi namandla
• Ukulimala ekhanda ngezinga lokushisa eliphezulu

Prevention

Nakuba i-idiopathic intracranial hypertension ayikwazi ukuvinjelwa ngokuphelele, kunezinyathelo umuntu angazithatha ukuze ehlise ubungozi bazo. Lokhu kubandakanya:

• Ukuphatha Isisindo: Indlela ephumelela kakhulu yokuvikela ukugcina isisindo esinempilo. 
• Ukwamukela Ukudla Okunempilo Nokuzivocavoca Okuvamile: Lezi zinguquko zendlela yokuphila azisizi nje kuphela ukuvimbela umfutho wegazi ophakeme we-idiopathic intracranial hypertension kodwa futhi zinikeza izinzuzo zezempilo ezibanzi, ezingase zehlise ukuthinteka komuntu Isifo senhliziyo, unhlangothi, nesifo sikashukela.
• Ukuphatha Ezinye Izinto Zobungozi: Uma unezimo ezandisa ingozi ye-hypertension ye-intracranial, njenge ukuntula insimbi i-anemia, kubalulekile ukuzilawula ngokuphumelelayo. 

Isiphetho

Ukuphila ne-idiopathic intracranial hypertension kungaba inselele. Nokho, ukuqonda lesi simo nokwazi ukuthi singasiphatha kanjani kungenza umehluko omkhulu ekuphileni kwansuku zonke. Kusukela ekulondolozeni isisindo esinempilo ukuya ekufuneni usizo lwezokwelapha ngokushesha lapho izimpawu zivela, kunezindlela eziningana zokubhekana nalesi simo ngqo. Ukuhlolwa njalo nodokotela kanye nokuhlala phezulu kwezinhlelo zokwelapha kuyisihluthulelo sokulawula izimpawu nokugcina ukubona.

Imibuzo Evame Ukubuzwa

1. Ubani ongathola i-idiopathic intracranial hypertension?

I-Idiopathic intracranial hypertension (IIH) ihlasela kakhulu abesifazane abaseminyakeni yokuzala, ngokuvamile ephakathi kweminyaka engama-20 nengama-30 ubudala. 

2. Ingabe i-IIH iyisimo esibucayi?

Nakuba i-idiopathic intracranial hypertension ngokuvamile ingasongela ukuphila, ingaba inkinga yempilo yonke enemiphumela emibi kakhulu. Okukhathaza kakhulu umthelela ongaba khona embonweni. I-IIH ingabangela ubuhlungu bekhanda obukhubaza okungapheli kanye nokuphazamiseka kokubuka. Ezimweni ezimbi kakhulu, kunengozi yokulahlekelwa ukubona unomphela, okwenzeka engxenyeni eyodwa kwezine yeziguli. Ukuqapha njalo kanye nokwelashwa okufanele kubalulekile ukulawula izimpawu nokugcina umbono.

3. Yini okungafanele uyidle nge-IIH?

Kubantu abane-IIH, imikhawulo ethile yokudla ingase ibe yinzuzo:

• Nciphisa amafutha kanye nokudla kukasawoti, njengoba lokhu kungaba nomthelela ekugcineni amanzi futhi kuvimbele ukuncipha kwesisindo.
• Nciphisa ukudla okunovithamini A, okufana nesibindi senyama yenkomo, ubhatata, izaqathi, utamatisi, nemifino enamahlamvu.
• Nciphisa ukudla okune-tyramine ephezulu, okuhlanganisa noshizi asebekhulile, inyama eselashiwe, ukudla okufakwe emanzini anosawoti, ubhiya, newayini.
• Gwema ukudla ngokweqile imikhiqizo yesoya ebilile, i-sauerkraut, iminqumo, nobhontshisi obanzi.