Tlhaloso ea boko

Brain herniation ke ho sisinyeha hoa lisele tsa boko ho tloha sebakeng se seng bokong ho ea ho se seng ka mameno a fapaneng le likheo.

Bokhopo ba boko bo etsahala ha ho hong ho ka hara lehata ho hlahisa khatello e tsamaisang lisele tsa boko. Hangata hona ke phello ea ho ruruha ha boko kapa ho tsoa mali ho tsoa ho tsoa hlooho, stroke kapa hlahala ea boko.

Tlhaloso ea bokooa e ka ba litla-morao tsa lihlahala bokong, ho kenyelletsa:

• Hlahala ea metastatic bokong
• Hlahala ea mantlha ea boko

Herniation ea boko le eona e ka bakoa ke lintlha tse ling tse lebisang khatellong e eketsehileng kahare ho lehata, ho kenyelletsa:

• Ho bokelloa ha pus le lisebelisoa tse ling bokong, hangata ho tsoa tšoaetsong ea baktheria kapa fungal (abscess)
• Ho tsoa mali bokong (tšollo ea mali)
• Mokelikeli o mongata ka har'a lehata o lebisang ho ruruha ha boko (hydrocephalus)
• Liropo tse bakang ho ruruha ha boko
• Ho ruruha ka mor'a kalafo ea radiation
• E haelloa ke sebopeho sa boko, joalo ka boemo bo bitsoang Arnold-Chiari malformation

Tlhaloso ea bokooa e ka etsahala:

• Ho tloha lehlakoreng le leng ho isa lehlakoreng le leng kapa tlase, ka tlasa, kapa ka mose ho lera le thata joaloka tentorium kapa phakoe
• Ka lesoba la masapo a tlhaho botlaaseng ba lehata le bitsoang foramen magnum
• Ka menyako e entsoeng nakong ea ts'ebetso ea boko

Matšoao a ka kenyelletsa:

• Khatello ea mali e phahameng
• Pelo e sa tloaelehang kapa e liehang
• Ho tšoaroa ke hlooho e bohloko
• Bofokoli
• Ho tšoaroa ha pelo (ha ho na pulse)
• Ho lahleheloa ke kelello, koma
• Ho lahleheloa ke mefuta eohle ea maikutlo a kelello (ho panya, ho qhekella le bana ba arabelang leseling)
• Ho ts'oaroa ka phefumoloho (ha ho phefumolohe)
• Barutoana ba bangata (ba atolositsoeng) mme ha ho motsamao ka leihlong le leng kapa a mabeli

Tlhahlobo ea tsamaiso ea boko le methapo e bontša liphetoho tlhokomelong. Ho ipapisitse le matla a herniation le karolo ea boko e hatelloang, ho tla ba le mathata ka mohopolo o le mong kapa ho feta o amanang le boko le ts'ebetso ea methapo.

Liteko li ka kenyelletsa:

• X-ray ea lehata le molala
• Tlhatlhobo ea hlooho ea CT
• Ho hlahloba hlooho ea MRI
• Ho hlahlojoa mali haeba ho belaelloa lefu la ho tsoa kapa ho tsoa mali

Herniation ea boko ke tšohanyetso ea bongaka. Morero oa kalafo ke ho pholosa bophelo ba motho eo.

Ho thusa ho khutlisa kapa ho thibela herniation ea boko, sehlopha sa bongaka se tla phekola ho ruruha le khatello e eketsehileng bokong. Kalafo e ka kenyelletsa:

• Ho kenya drain bokong ho thusa ho tlosa cerebrospinal fluid (CSF)
• Meriana e fokotsang ho ruruha, haholo haeba ho na le hlahala bokong
• Meriana e fokotsang ho ruruha ha boko, joalo ka mannitol, saline, kapa diuretics tse ling
• Ho beha tube tseleng ea moea (endotracheal intubation) le ho eketsa sekhahla sa ho hema ho fokotsa maemo a carbon dioxide (CO₂) mading
• Ho tlosa mali kapa mali haeba a baka khatello ka har'a lehata mme a baka herniation
• Ho tlosa karolo ea lehata ho fa boko sebaka se seholo

Batho ba nang le bokooa ba boko ba na le kotsi e mpe ea boko. Mohlomong ba se ba ntse ba na le monyetla o tlase oa ho fola ka lebaka la kotsi e bakileng herniation. Ha herniation e hlaha, e theola monyetla oa ho fola.

Ponahalo ea fapana, ho latela hore na herniation e hlaha kae bokong. Ntle le kalafo, lefu le ka ba teng.

Ho ka ba le tšenyo likarolong tsa boko tse laolang ho hema le phallo ea mali. Sena se ka lebisa lefung kapa lefung la boko ka potlako.

Mathata a ka kenyelletsa:

• Lefu la boko
• Mathata a sa feleng le a bohlokoa a methapo ea pelo

Letsetsa 911 kapa nomoro ea maemo a tšohanyetso ea lehae kapa u ise motho eo kamoreng ea maemo a tšohanyetso ea sepetlele haeba a ka fokotseha kapa a ba le matšoao a mang, haholoholo haeba ho bile le kotsi ea hlooho kapa haeba motho a na le hlahala bokong kapa bothata ba methapo ea mali.

Kalafo e potlakileng ea khatello e sa sebetseng ea mathata le mathata a amanang le ona a ka fokotsa menyetla ea ho hloloa ke boko.

Lefu la Herniation; Tlhaloso ea Transtentorial; Phokotso ea Uncal; Hlooho ea Subfalcine; Tlhaloso ea lithane; Herniation - boko

• Kotsi ea boko - ho tsoa

• Boko
• Hernia ea boko

Beaumont A. Physiology ea mokelikeli oa cerebrospinal fluid le khatello e sa sebetseng. Ka: Winn HR, e hlophisitsoeng. Phekolo ea Youmans le Winn Neurological. La 7th. Philadelphia, PA: Elsevier; 2017: khaolo ea 52.

Ntate L, Goldberg SA. Ho sithabela hlooho. Ka: Marako RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Likhopolo le Tloaelo ea Kliniki. La 9th. Philadelphia, PA: Elsevier; 2018: khaolo ea 34.

Tlokotsi ea Stippler M. Craniocerebral. Ka: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, bahlophisi. Neurology ea Bradley ho Tloaelo ea Bongaka. La 7th. Philadelphia, PA: Elsevier; 2016: khaolo ea 62.