Istaroog waa dhimashada unugyada maskaxda, badanaa waxaa soo saarey joojinta dhiig socodka qayb ka mid ah maskaxda. Dhibaatooyinka dhexdhexaadinta ee caadiga ah ee keeni kara madax-dhiigfuranka waxaa ka mid ah xinjirowga dhiigga ee xuubka dhiigga ee maskaxda, embolus (xinjir dhiig oo u socdaalaya maskaxda oo ku hoyda), iyo dhibaatooyinka maxalliga ah ee ku lug leh xididdada dhiigga ee maskaxda, sida aneurysm ama barar
Kadib markii qof uu istaroog ku dhacay, dhakhtarku wuxuu isku dayi doonaa inuu go'aamiyo sababaha gaarka ah, sababtoo ah sababaha asaasiga ah ee istaroogga ayaa inta badan go'aaminaya daaweynta ugu fiican. Si kastaba ha noqotee, ilaa 40 boqolkiiba kiisaska, si kastaba ha ahaatee, lama sheegi karo sabab gaar ah. Xanuunka aan la aqoon waxaa loo yaqaan 'stroke cryptogenic'. (Ereyga "cryptogenic" ayaa si fudud u caddaynaya in sababta keentay uu yahay macquul, ama diiqad.)
Goorma Ayaad Walaacsan Tahay Cryptogenic?
Kadib markii uu istaroog ku dhaco, mararka qaarkood way adkaan kartaa in la ogaado haddii jahawareerka dhiigga ee soo saarey istaroogga ayaa sababay xinjir dhiig oo abuuray meel (trombus), xinjir dhiig oo maskaxda ka socda meelo kale ( embolus ), ama qaar ka mid ah dhibaatooyinka kale ee ku dhaca xididada dhiigga
Istaroog waa in aan loo yeedhin cryptogenic ilaa qiimeyn buuxa la sameeyo iyada oo aan keenin sabab gaar ah. Guud ahaan, qiimeynta noocan oo kale ah waa in ay ku jirto sawiridda maskaxda (oo leh baaritaanka CT ama MRI scan ), sawiridda xididdada dhiigga ee bixiya maskaxda (carotid duplex ama daraasadaha Doppler ), iyo suurtogal ahaan angiography .
Intaa waxa u dheer, daraasad dhamaystiran ee baaritaanka wadnaha ee wadnaha waa in la sameeyaa, raadinta ilaha wadnaha ee embolus. Qalabka wadnaha ee suurto galka ah waxaa ka mid ah xinjiro dhiig oo ku jira wadnaha (badanaa ku yaala bidixda bidix), Patent foramen ovale (PFO) , aneurysm oo ah septum atrial , fibrillation atrial , ama prolapse valve (MVP) .
Haddii aan la ogaanin ka dib qiimeyntan dhamaystiran, istaroogga ayaa loo arkaa inuu yahay cryptogenic.
Sababaha dhabta ah ee istiraatiijiyadaha cryptogenic (haddii la aqoonsan karo) waa kuwo badan, iyo dadka loo calaamadiyay inay yihiin qufac quustin-ku-dhac ah waa koox heterogeysan leh. Maadaama sayniska caafimaadku uu wanaajin karo awooda uu ku garan karo sababaha kufsiga ee bukaanka shakhsiyaadka, tirada dadka loo sheegay inay ku dhacaan faalig (cryptogenic stroke) ayaa dhici doona.
Yaa Heli Kara Cadaadiska Cryptogenic?
Faahfaahinta bukaannada ka soo gaaray masiiboyinka cryptogenic ayaa guud ahaan la mid ah kuwa bukaanka qaba jimicsi loo garto sababo la garan karo. Waxay u muuqdaan inay yihiin dad waayeel ah oo leh calaamadaha halista ah ee cudurrada wadnaha.
Isticmaalka Cryptogenic ayaa si siman uga muuqda ragga iyo dumarka. Waxaa laga yaabaa inay ku badan yihiin madow iyo Hispanics. Inkasta oo ay kudhacdo cryptogenic ee dadka da 'yarta ah (ka yar 50 jir) waxay dareen badan ka helaan dhakhaatiirta iyo suugaanta caafimaadka, daraasaduhu waxay soo jeedinayaan in da'da dhabta ah ee da'da cryptogenic ay la mid tahay kuwa aan lahayn cryptogenic. Taasi waa, awoodda lagu aqoonsan karo sababaha istaroogga ee dadka dhalinta yar waa wax la mid ah sida dadka waayeelka ah.
Waa maxay Muuqaalka Kadib Marka Aad Qaadato Cudurka Qaaxada?
Guud ahaan, qiyaasta bukaan-socodka ee ku dhacay jiritaanka maskax-wareerka (cryptogenic stroke) waxay u muuqataa inay ka fiicantahay marka laga hadlayo stroke-ka aan ahayn cryptogenic.
Hase yeeshee, heerka 2-sanno ee qanjidh-ka-celinta celcelis ahaan celcelis ahaan 15 - 20 boqolkiiba.
Sababta oo ah daaweyn si looga hortago istaroog ku soo noqoshada waxay kuxirantahay sababta keenta istaroogga (xinjirowga lidka ku ah miyir-beelka dabaysha ka dib amberlatelet therapy with aspirin ama clopidogrel ka dib istaroogta thrombotic), daaweynta ugu fiican ka dib istiraatiijiga cryptogenic. Si kastaba ha ahaatee, waafaqsanaanta khabiirada ka dhexaysa khilaafkan, si kastaba ha ahaatee, waxay ku tiirsan yihiin isticmaalka daaweynta caabbinta.
Dhexdhexaadinta PFO
Mid ka mid ah dhinacyada muranka badan ee murugada cryptogenic ayaa ah su'aasha ah inta jeer ee ay sababaan Patent Foramen Ovale (PFOs), oo loo yaqaanno daloolka wadnaha.
Waxaa hubaal ah in qaar ka mid ah istaroogyada cryptogenic ay soo saaraan xinjiro dhiig oo ka gudbo PFO, galaan wareegga, iyo u safraan maskaxda. Si kastaba ha ahaatee, dhacdadani waa mid aad u yar, halka PFOs ay aad u badan yihiin. (PFOs waxaa lagu ogaan karaa illaa 25% dhammaan shakhsiyaadka echocardiography.)
Waxaa macquul ah, sababtan darted, daraasado qiimeynaya faa'iidooyinka faa'idada leh ee isticmaalka aaladaha xirmada PFO ee bukaanka kuwaas oo ku dhacay qufac nuxur-darro ah ayaa niyad jabay - wax yar laguma sheegin istaroog ku-xigta. Isla mar ahaantaana, hababka loo isticmaalo in la xiro PFOs waxay soo bandhigaan bukaanka si ay u saameyn ugu yeeshaan waxyeelada halista ah.
Weli waxay u badan tahay in bukaanno gaar ah, xidhitaanka PFOs laga yaabo inay faa'iido u yeeshaan. Laakiin marxaladdan, ma jiro wax la xaqiijiyay oo lagu ogaanayo bukaanka qaba istaroogga qufaca iyo PFO inay ka faa'iidaystaan xiritaanka PFO.
Si kastaba ha ahaatee, daraasad dhowaan soo bandhigtay ayaa muujinaysa in loo shaqeeynayo doppler daraasad ku salaysan, iyada oo la socota daraasad xajmi ah, dhakhaatiirtu waxay bilaabi karaan inay ogaadaan bukaano gaar ah kuwaas oo cirridka cryptogenic ay sababeen PFO. Daraasado dheeraad ah ayaa loo baahan doonaa si loo qiimeeyo haddii xiritaanka PFO uu yareeynayo istaroog ku xiga qaybta bukaan-socodka.
Qeybta hoose, inkastoo, waa in xiritaanka joogtada ah ee PFOs ee bukaanka qaba qulqulka cryptogenic aan la aqbali karin maanta. Akadamiyadda Mareykanka ee Nuurolojiga ee sannadka 2016 ayaa ka digay in ay si joogta ah u bixiyaan xidhitaanka PFO dadka qaba dhibaatooyinka cryptogenic.
Xakameynta Atriyadeed iyo Qufac-darro
Fayras-ka-dillaaca ayaa ah arrin si fiican loo garan karo ee istaraatiijiga Embolic, dadka bukaanka qaba fibrillada atrial-ka guud ahaan waxay u baahanyihiin in lagu daaweeyo xinjirowga.
Caddaynta dhowaan waxay soo jeedinaysaa in tiro yar oo bukaan ah oo qaba qallalka "cryptogenic stroke" laga yaabo inay qabaan "qanjirro" atrial fibrillation - taas oo ah, dhacdooyinka fibrillada atrial oo aan sababin calaamado muhiim ah, sidaas darteedna aan la aqoonsan. Dheeraad ah, waxaa jira xog soo jeedinaysa in in kormeerka wadnaha dheer ee ba'an ay ku habboon tahay in la ogaado qallafsanaanta hoose ee qalliinka ee bukaanada kuwaas oo yeeshay qallal-celin. Bukaannadan, malaha, sida bukaannada kale ee qaba fibrillada atrial, daawada xinjirowga lidka ku ah waxay u badan tahay inay yareeyaan khatarta istaroogga.
Ilaha:
> Cujec B, Polasek P, Voll C, Shuaib A. Baaritaanka Echocardiography ee Transesophageal Echocardiography ee lagu ogaado Qalbka Isku-kalsoon ee Iska Ilaha Embolism ee Bukaanka Stroke. Stroke 1991; 22: 727.
> Lansberg MG, O'Donnell MJ, Khatri P, et al. Antithrombotic iyo Thrombolytic Therapy for Therapeutic Stroke: Daaweynta Antithrombotic-ka iyo Ka Hortagga Trombos, 9th ed: Kuliyada American College of Chest Physicians Tilmaamaha Tababarka Dhaqanka ee Calaamadaha Ku Salaysan. Nabadgelyada 2012; 141: e601S.
> Messe SR, Gronseth G, Kent DM, Et al. La-talin Tababarka: Dib-usocodka Dib-u-dhiska ee 'Patent Foramen Ovale' (Soo-celinta Xirfad-Dhaqameedka Warbixinta Horumarinta Tilmaamaha, Qeybinta, iyo Guddi-hoosaadka ee Agaasinka Aqoonta Mareykanka.
Mohr, JP, Choi, WC, Grotta, JC, et al. Stroke: Pathophysiology, Diagnosis, iyo Maareynta, Qaybta 4aad, Churchill Livingstone, New York 2004.