Cavernous sinus thrombosis: zviratidzo, nechirwere, kurapwa

Cavernous sinus thrombosis chiri occlusion thrombus cavernous sinus, riri mujinga dehenya kumativi maviri ari sella turcica.

Zvaiitwa cavernous sinus chinhu venous water drainage kubva munzvimbo ziso zvigadziko uye pfungwa, uyewo mutemo cerebral riparadzirwe.

zvokurwara Izvi zvisinganyanyi kuitika, asi zvinogona kukonzera zvakakomba. Uyewo kashoma kuwana thrombosis pamusoro sigmoid uye transverse sinus.

Zvinokonzera chirwere

Cavernous sinus thrombosis kunogona kuitika nezvikonzero zvakasiyana-siyana. Kwaari predispose:

• zvirwere izvo zvaitika rikwanise muchimiro ari maxillary sinuses, nzeve, mazino, mhuno uye pahuro;
• kuvapo cranial mupfungwa;
• autoimmune zvirwere (chinonzi systemic lupus erythematosus, dzinonzi rheumatoid arthritis);
• pathological hemostasis pezvakaitwa ayo pamwe zvakawedzera paumbwe thrombi (kuvapo politsetemii);
• vascular uye cardiac chirwere (ischemic kukuvara mwoyo, mwoyo mutinhimira nyonganyonga, et him.);
• chirwere cheshuga mellitus;
• kupfupfudzika;
• kubva kuberekwa kwemwana.

clots Ropa rwarisa uye noninfectious hunhu. Pari, zvakawanda akacherekedza non-rwarisa mavambo. Izvi nokuda kakawanda kushandisa mishonga inorwisa mabhakitiriya kuti kudzivirira kwazvo matambudziko. Muchiitiko ichi itsika kutaura idiopathic chimiro venous thrombosis.

symptomatology chirwere

Ndezvipi zviratidzo zvirwere zvakadai cavernous sinus thrombosis? Clinic zviri zvikuru kunzwisisa. Dzimwe nguva chirwere Zvakaoma kuziva mukutanga mumatanho, nekuti zviratidzo kazhinji kumbopfeka muzvinhu zvakasikwa uye akafanana zviratidzo zvimwe zvirwere.

Pakati huru zviratidzi chirwere zvinofanira pachena:

• kuvapo kwakanyanya nomusoro;
• svoto uye kurutsa;
• kurasikirwa uye kuvhiringidzika;
• chaanoziva;
• panowanikwa pfari.
• marwadzo ari muhuro ari flexion ari mberi akananga;
• fivhiri;
• kuvapo exophthalmos (protrusion yeziso mberi uchiteverwa misha nenzira).
• budiriro ophthalmoplegia (kuoma ziso tsandanyama vari kukundwa tsinga inodzora kufamba kwemaziso);
• panowanikwa edema ari optic etsinga uye kukotsira;
• ungaderedza zvakaratidzwa;
• diplopia;
• marwadzo uye cyanosis nezvigadziko, huma uye mumhino nechimwe;
• kurasikirwa aikanganiswa of chiso etsinga;
• thrombophlebitis chiso mutsinga.

Cavernous sinus thrombosis kunoratidzwa yakaderera tembiricha giredhi, asthenia, ndichinzwa kurwadza tsandanyama uye mapfundo. Kana ropa clots zvinotapukira hunhu zviratidzo zvakadaro zvingasava.

Cerebral zviratidzo kuonekwa meningeal zviratidzo. With kukura chirwere anowedzera kufenda pachikumbaridzo. In Muzviitiko zvakaipisisa, murwere anogona vanowira pakoma.

The pakuonekwa yaivhuvhuta zviratidzo makatsamwisa CSF water drainage, ikawanda intracranial kumanikidzwa, nokuwedzera chepfungwa edema, izvo zvingaita anonamata rufu nomurwere.

diagnosing

Rinotaurwa cavernous sinus thrombosis? Chirwere pazvikanganiso siyana nzira bvunzo. Also kufungwa zvichemo murwere uye nhoroondo zvokurapa.

Migraine Somuenzaniso, ane nhamba zvinhu:

• Kunotanga acutely uye zvishoma nezvishoma anova refu. Marwadzo anova husingakwanisi kurwadziwa.
• Marwadzo kuwedzerwa kurovedza muviri uye supine chinzvimbo. kuratidzwa uku nemusoro kunoratidza kuti munhu sinus thrombosis feathery.
• Kana Vakamanikidza pfungwa Greenstein murwere anonyunyuta marwadzo. Pane ari kuzvimba uye ziso nezvigadziko bulging yeziso.

Varwere zvose chetsinga zviratidzo zvakafanana hunhu zvaida kushanya kuhofisi ophthalmologist wacho.

Ari fundus inogona kuchengetwa kuvapo tortuosity midziyo, kuzvimba optic Disc.

Kubva Murabhoritari zvidzidzo nzira inoshandiswa kuongorora chirwere:

• kwakakwana count ropa.
• muunganidzwa ropa tsika kuti kusabereka.
• achiitisa coagulation,
• Pakusarudza chakarurama D-dimer
• Kuongororwa cerebrospinal mvura.

kuongorora kwakadaro zvinopa mukana kuziva kutapuriranwa lesion, uyewo hemostatic zvirwere.

Kubva paku nzira zvinofanira kucherechedzwa:

• opacification kubudikidza CT;
• rinobva resonance kuri;
• chepfungwa angiography.

kurapa Basics

Cavernous sinus thrombosis, uyewo sigmoid uye transverse, zvakajairika nzira zvinoda kurapwa. Mushonga inogona kuchinja uye zvomusejari. Zvapedzisira chiyero kunoratidzwa nokuda ndasiya zvirwere.

Nzira yokurapwa

Sezvo yacho cavernous sinus thrombosis? Treatment kuchinja nzira anodzingana dzinoverengeka zvinangwa:

• detoxification;
• pakurwisana paumbwe ropa clots;
• kubviswa pfungwa edema;
• nokusunga chirwere muitiro;
• neuroprotective kurapa.

Detoxification uye inorwisa mabhakitiriya kurapa rinoshandiswa kana paine thrombosis nezvirwere mavambo. Detoxification inopa mukana kubvisa muuye zvine chepfu. Nokuti chinangwa ichi anoshandiswa aizomupa isotonic yavaibvisa chloride mhinduro, "reopoligljukin" "gemodez".

Pashure muunganidzwa ropa tsika yakatarwa inorwisa mabhakitiriya. Maererano nenyaya prescribers ane chakarondedzera chiito. In zvakafanana, mishonga kungadiwa kuti zvakazorodza anaerobic zvirwere ( "Metronidazole").

Kudzorera chakaipa krovobrascheniya vanofanira kubvisa clot. Kwaizvozvi, mumwe heparin kurapa. Uyezve vakagadzwa yakananga anticoagulants, izvo wabatwa kwemwedzi mitatu.

Mushure inotikurudzira kuti varwere kugamuchira antiplatelet yomuchipatara akadai "asipurini", "Dipyridamole" "Clopidogrel".

In Muzviitiko zvakaipisisa, kuvandudzwa chepfungwa edema chirwere muitiro panobviswa ne diuretics.

Neuroprotective kurapa chinotarisirwa ari kupora nguva. Zvinonzi inoitwa pachishandiswa nevamiririri iyo pave vasodilatation uye neurometabolic nzira.

kushanda kupindira

The kuvhiya kuvhiyiwa unoratidzwa panyaya umo kuchinja nzira havana kubereka zvakakodzera mugumisiro. Pakazosvika cavernous sinus zvakaoma chaizvo kusvika nokuda kwayo anatomical nzvimbo. Saka, anoita kunosanganisira hwomukova sinuses uye kutsvinda chepuraimari rwarisa kukoshesa.

zvinogoneka yematambudziko

Cavernous sinus thrombosis (mufananidzo varwere vanenge chirwere ichi chiri munyaya iyi) kungaita kuti dzakakomba matambudziko. Kwokutanga chirwere maitirwo ezvinhu uye akatanga kurapa rwaiitwa, shoma mukana yematambudziko.

Matambudziko ari rakakamurwa mangwanani uye kunonoka.

Vachangobva zvinofanira kucherechedzwa:

• kurasikirwa chinooneka acuity;
• paresis pamusoro abducens ;
• kuvapo ptosis (vachirembedza remakore);
• Kugadzirwa arachnoiditis;
• hypopituitarism;
• anisocoria.

Early:

• pfungwa edema;
• kukwana pfari;
• chepfungwa infarction.

Kazhinji, cavernous sinus thrombosis kunotungamirira murwere:

• zvachose upofu.
• Kurohwa (chenjera kweropa chirwere muuropi, izvo kazhinji chinokurwadzai urema uye rufu);
• nokuvhiringidzirwa functionality pamusoro pineal shwanu kuti anokonzera chinovhiringidza kuwedzera kemikari kusunungurwa;
• tava kuderera bundu kukura kwacho;
• Zvirwere zvepabonde pakukura uye maitiro.

yematambudziko vakadaro akacherechedza munenge chetatu Muzviitiko.

matanho

Kuitira kudzivisa zvirwere akaita chirwere vanofanira kutevera vamwe matanho chokudzivirira kubatsira kudzivirira kukura chirwere:

• nenguva Mabatirwo anogumbura pezvakaitwa mumuviri;
• kuomerera mararamiro utano;
• panguva yakafanira kuwana munhu anoshingaira nezvirwere izvo rwakavapo chisingaperi uye pamwe STRUCTURAL rokuchinja mudziyo madziro uye chitarisiko hyperviscosity.

fungidziro

Fungidziro chirwere chiri zvakananga novimba nenguva zvokuongorora uye kurapwa. The kwokutanga akasimbisa kuvapo kwezvirwere, uye kurapwa ari atanga, nani mikana nokupora.

Nzira yokurapa, ari zvaisanganisira mushonga ano zvinoita kuderedza zvikuru vanourayiswa kubva ichi chirwere pachikumbaridzo. Figure ndiyo 20%. Around 10% kubva Muzviitiko thrombosis dzokororo mukati gore rimwe pashure kurapwa.

mhedziso

Cavernous sinus thrombosis, zviratidzo izvo dzave zvinotsanangurwa munyaya ino, chirwere chakakomba zvikuru. The chirwere chinonetsa kurapa.

Kazhinji, kuti zvokurwara kukonzera urema murwere, uye kazhinji kunoguma murufu. Naizvozvo, zvakakosha kuti nenguva chirwere maitirwo ezvinhu uye kurapwa.