He aha te Whakahekehere Pūngāwerewere? Tohutohu, Take, me te Maimoatanga

He rōpū o ngā oko toto koretake i roto i tō roro, i tō tūpuna rānei te whakahekehere pūngāwerewere, ā, he rite te ahua ki te hua iti, ki te pūtau popcorn rānei. He angiangi ngā pakitara o ēnei oko toto, ā, kua ki tonu i te toto e ngāwari ana te rere, nō reira ka rerekē atu i ngā oko toto noa i roto i tō tinana.

Whakaarohia he raruraru iti o ngā oko toto iti i kore e hanga tika i te wā o te whanaketanga. Ahakoa ka rongo te ingoa he wehi, he tokomaha ngā tāngata e ora ana i o rātou oranga katoa me ngā whakahekehere pūngāwerewere me te kore e mōhio kei a rātou. Ka kiia hoki ko ngā angiomas pūngāwerewere, ko ngā cavernomas rānei, ā, ka pā ki te 1 i roto i te 200 o ngā tāngata.

He aha ngā tohu o te whakahekehere pūngāwerewere?

He tokomaha ngā whakahekehere pūngāwerewere kaore e puta he tohu, ā, ka kitea noa i te wā o ngā tirotiro roro mō ētahi take. Ki te puta ngā tohu, ka puta nā te whakaheke toto iti o te whakahekehere, i te pēhi rānei ki te kōpū roro e tata ana.

Ko ngā tohu tino noa ka pā atu ki a koe:

• Ngā hopu (te tohu tino noa, e pā ana ki te 40-70% o ngā tāngata e whai tohu ana)
• Ngā mamae o te upoko ka rerekē pea te ahua i ō mamae upoko noa
• Te ngoikore, te mōrearea rānei o ō ringa, o ō waewae, o tō mata rānei
• Ngā raruraru tirohanga, te tirohanga takirua rānei
• Te raruraru ki te taurite, ki te whakahaere rānei
• Ngā raruraru kōrero, te raruraru ki te kimi kupu rānei
• Ngā raruraru mahara, te whakapohehe rānei

I roto i ngā take onge, ka taea e ngā toto nui ake te whakaeke i ngā tohu nui ake penei i te mamae o te upoko nui, te ruaki, te ngaro o te mohio rānei. Heoi, ko te nuinga o ngā whakahekehere pūngāwerewere ka whakaheke toto tino ngāwari, ā, ka puta he huringa tītī, ehara i te ngāwari, i te nui o ngā tohu.

He aha ngā momo whakahekehere pūngāwerewere?

Ka whakarōpūtia e ngā tākuta ngā whakahekehere pūngāwerewere i runga i te wāhi kei reira, me te mea rānei kei roto i ngā whānau. Ko te mārama ki ēnei momo ka āwhina i tō rōpū hauora ki te whakarite i te huarahi pai mō tō āhuatanga motuhake.

Ko ngā momo matua:

• Ngā whakahekehere pūngāwerewere koretake: Ka puta enei i te koretake, ā, ka puta noa i tetahi lesion kotahi
• Ngā whakahekehere pūngāwerewere whānau: Ka rere enei i roto i ngā whānau, ā, ka whai maha ngā lesions puta noa i te roro
• Ngā whakahekehere pūngāwerewere o te roro: Kei ngā wāhi rerekē o te roro (cerebrum, cerebellum, brainstem rānei)
• Ngā whakahekehere pūngāwerewere o te tūpuna: Kaore i te noa, kei te tūpuna

Ko ngā momo whānau e puta mai ana i ngā rerekētanga ira, ā, ko te 20% pea o ngā take katoa. Ki te whai koe i te momo whānau, ka whai hua pea ō whānau ki te tohutohu ira me te tirotiro.

He aha ngā take o te whakahekehere pūngāwerewere?

Ka whānau ngā whakahekehere pūngāwerewere ina kore e hanga tika ngā oko toto i roto i tō roro, i tō tūpuna rānei i te wā o te whanaketanga. Ko te nuinga o te wā, ka puta tenei i te koretake kaore he take mārama ka taea e koe, e ō mātua rānei te aukati.

Ko ngā take matua:

• Ngā huringa whanaketanga koretake: Ko te nuinga o ngā take ka puta noa i te wā o te whanaketanga o te roro
• Ngā rerekētanga ira: E toru ngā ira motuhake (CCM1, CCM2, me te CCM3) ka taea te whakaeke i ngā momo whānau
• Te whakamahinga o te radiation: Ko te onge rawa, ka taea e te maimoatanga radiation o mua ki te upoko te whakaeke i te whanaketanga

He mea nui kia mārama ko ngā whakahekehere pūngāwerewere kaore i puta mai i tetahi mea i mahi koe, i kore rānei e mahi. Kaore e hono atu ki ngā take noho penei i te kai, te whakakori tinana, te ahotea rānei. Āe rawa i roto i ngā take whānau, ko te whai i te ira kaore e whakamana ka whānau koe i ngā tohu.

Nōhea te haere ki te tākuta mō te whakahekehere pūngāwerewere?

Me rapu awhina hauora koe ki te pā atu ki a koe ngā tohu neurology hou, te kino ake rānei, ina koa ngā hopu kaore i whakamāramahia. Ahakoa he maha ngā take o ēnei tohu, he mea nui kia arotake tika.

Whakapa atu ki tō tākuta wawe ki te kite koe:

• Ngā hopu hou, te huringa rānei o ngā tauira hopu o mua
• Ngā mamae o te upoko mau tonu e rerekē ana te ahua i ō mamae noa
• Te ngoikore ohorere, te mōrearea rānei, te wiri rānei o ō waewae
• Ngā huringa tirohanga, te tirohanga takirua rānei
• Te raruraru ki te kōrero, te taurite, te whakahaere rānei
• Ngā raruraru mahara, te whakapohehe rānei

Rapua te tiaki ohorere tonu ki te pā atu ki a koe te mamae o te upoko ohorere, nui, kaore i rite ki tetahi atu i pā atu ki a koe i mua, ina koa ki te haere tahi me te ruaki, te uaua o te kaki, te ngaro o te mohio rānei. Ahakoa he onge ngā toto nui, me whai awhina hauora wawe.

He aha ngā take morearea mō te whakahekehere pūngāwerewere?

Ko te nuinga o ngā whakahekehere pūngāwerewere ka whānau noa, engari ka taea e ētahi take te whakanui ake i tō tūponotanga ki te whai i tetahi. Ko te mārama ki ēnei take morearea ka āwhina i a koe me tō tākuta ki te whakatau whakamārama mō te tirotiro me te aroturuki.

Ko ngā take morearea matua:

• Te hītori whānau: Ko te whai whānau e whai whakahekehere pūngāwerewere ana ka whakanui ake i tō morearea nui
• Te whakatupuranga Hispanic: Ko ētahi rerekētanga ira ka noa ake i roto i ngā taupori Hispanic
• Te radiation o te upoko o mua: Kua hono atu ngā take onge ki te maimoatanga radiation i whiwhi i ngā tau i mua
• Ko te wahine: Ka nui ake pea te tere o te toto o ngā wāhine, ina koa i te wā o ngā huringa homonal

Ko te tau me te ira tangata kaore e whakatau nui ki te tangata ka whānau i ngā whakahekehere pūngāwerewere, i te mea ka kitea i roto i ngā tāngata o ngā tau katoa. Ko te nuinga kei te noho mai i te whānautanga, engari kaore pea e puta he tohu tae noa ki muri i te ora, ki te puta rānei.

He aha ngā raruraru pea o te whakahekehere pūngāwerewere?

Ahakoa he tokomaha ngā whakahekehere pūngāwerewere kaore e puta he raruraru, ka taea e ētahi te arahi ki ngā raruraru e pā ana ki tō oranga o ia rā. Ko te rongo pai ko ngā raruraru nui he onge, ā, he maha ka taea te whakahaere pai me te tiaki hauora tika.

Ko ngā raruraru pea:

• Ngā hopu hoki: Ka hiahia pea ki te whakahaere rongoā roa
• Ngā ngoikore neurology e ahu whakamua ana: Te kino haere o te ngoikore, te kōrero, te mahi hinengaro rānei
• Te whakaheke toto nui: Ka taea e ngā toto nui ake te whakaeke i ngā tohu rite ki te pōkairangi
• Hydrocephalus: Ko te onge, ka taea e te whakaheke toto te aukati i te rere o te wai noa i roto i te roro

Ko te morearea o ia tau o te whakaheke toto tohu he iti, e whakaarohia ana he 0.5-3% ia tau mō te nuinga o ngā whakahekehere pūngāwerewere. Heoi, ka nui ake pea tenei morearea mō ngā lesions i ētahi wāhi o te roro, i ngā mea kua whakaheke toto i mua rānei. Ka āwhina tō tākuta i a koe ki te mārama ki tō morearea motuhake i runga i tō āhuatanga motuhake.

Me pēhea te aukati i te whakahekehere pūngāwerewere?

Aroha mai, kaore he huarahi hei aukati i te whānautanga o ngā whakahekehere pūngāwerewere i te mea kei te noho mai rātou i te whānautanga nā ngā take whanaketanga, ira rānei. Heoi, ka taea e koe te tango i ngā kaupae hei whakaiti i tō morearea o ngā raruraru me te whakahaere i ngā tohu pai.

Ahakoa kaore e taea te aukati, ka taea e koe:

• Whai i ngā tohutohu tohutohu ira: Ki te whai koe i te hītori whānau, ka taea e te whakamātautau ira te arahi i ngā whakatau whakatupuranga whānau
• Aukati i te whara upoko koretake: Ahakoa kaore te whara e whakaeke i ngā whakahekehere pūngāwerewere, ka taea pea te whakaeke i te whakaheke toto i roto i ngā mea o mua
• Whakahaere pai i te toto toto: Ko te whakahaere pai o te toto toto ka taea te whakaiti i te morearea o te whakaheke toto
• Tangohia ngā rongoā hopu penei i te whakahaua: Ko te whakamahinga rongoā mau tonu ka aukati i ngā raruraru e pā ana ki te hopu

Ki te whakatū te whānau, ā, he momo ira e mohiotia ana, ka taea e te tohutohu ira te āwhina i a koe ki te mārama ki ngā morearea me ngā kōwhiringa kei a koe.

Me pēhea te whakatau i te whakahekehere pūngāwerewere?

Ko te whakatau i te whakahekehere pūngāwerewere ka whai wāhi ngā whakaahua roro e taea ai te whakaatu mārama i ēnei rōpū oko toto motuhake. Ka tīmata pea tō tākuta me tō hītori hauora me ngā tohu i mua i te tono i ngā whakamātautau motuhake.

Ko te tukanga whakatau ka whai wāhi:

• MRI (Magnetic Resonance Imaging): Ko te whakamātautau paerewa koura e whakaatu ana i ngā whakahekehere pūngāwerewere hei lesions "popcorn" "berry-like" motuhake
• Te tirotiro CT: Ka taea te mahi tuatahi i roto i ngā āhuatanga ohorere, engari kaore i te tino taipitopito penei i te MRI
• Te MRI gradient echo: He momo MRI motuhake e tino pai ana ki te kite i ngā toto iti
• Te whakamātautau ira: E tūtohutia ana ki te whai koe i ngā lesions maha, i te hītori whānau rānei

Ka tono pea tō tākuta i ētahi atu whakamātautau penei i te EEG (electroencephalogram) ki te whai koe i ngā hopu. Ko te ahua motuhake i runga i te MRI ka maarama te whakatau, ā, he onge te hiahiatia o te biopsy i te mea he motuhake ngā kitenga whakaahua.

He aha te maimoatanga mō te whakahekehere pūngāwerewere?

Ko te maimoatanga mō te whakahekehere pūngāwerewere ka whakawhirinaki ki ō tohu, te wāhi o te lesion, me tō hauora whānui. He tokomaha ngā tāngata e whai whakahekehere pūngāwerewere ana kaore e hiahia ki te maimoatanga i tua atu i te aroturuki noa, ā, ko ētahi ka whai hua mai i te rongoā, i te pokanga rānei.

Ko ngā kōwhiringa maimoatanga:

• Te mataara me ngā tirotiro MRI noa: Mō ngā lesions kaore he tohu, i ngā mea e whakaeke ana i ngā tohu ngāwari rānei
• Ngā rongoā anti-hopu: Ko te maimoatanga tuatahi mō te whakahaere hopu
• Te tango pokanga: E whakaarohia ana mō ngā lesions e whakaeke ana i ngā tohu nui, i te whakaheke toto hoki rānei
• Stereotactic radiosurgery: He kōwhiringa maimoatanga radiation arotahi mō ētahi lesions kaore e taea te tango haumaru

Ko te pokanga e tūtohutia ana i te nuinga o te wā ina whakaeke ngā whakahekehere pūngāwerewere i te whakaheke toto hoki, i ngā hopu kaore e taea te whakahaere, i ngā raruraru neurology e ahu whakamua ana rānei. Ko te whakatau ka whai wāhi te taumaha o ngā morearea o te pokanga ki ngā morearea o te waiho i te lesion kaore i te maimoatia. Ka kōrero tō neurosurgeon i ēnei take ki a koe i te tino taipitopito.

Me pēhea te whakahaere i te whakahekehere pūngāwerewere i te kāinga?

Ko te noho me te whakahekehere pūngāwerewere ka whai wāhi ngā whakarerekētanga noho ngāwari me te aro nui ki ō tohu. Ko te nuinga o ngā tāngata ka taea te pupuri i ngā oranga noa, mahi me ētahi whakatūpato whāinga me te whakawhitiwhiti korero pai me tō rōpū hauora.

Ko ngā rautaki whakahaere kāinga:

• Tangohia ngā rongoā mau tonu: Ki te whakahaua ngā rongoā anti-hopu, tangohia rātou penei i te whakahaua
• Pupuri i te puka tohu: Tuhia ngā tohu hou, ngā mamae o te upoko, te huringa rānei o tō āhuatanga
• Pupuri i te whakahaere pai o te toto toto: Whai i te kai hauora ngākau me te whakakori tinana penei i te tūtohutia
• Aukati i ngā mahi he nui te morearea hinga: Whakamahia te tupato me ngā mahi penei i te piki i ngā arawhata, te kauhoe kotahi rānei
• Noho makuku me te moe pai: Ka taea e ngā mea e rua te āwhina i te aukati i ngā hopu ki te pā atu ki a koe

He mea nui hoki te whakangungu i ngā mema whānau, i ngā hoa tata rānei mō tō āhuatanga me te mea me mahi ki te whai koe i te hopu. Ko te nuinga o ngā tāngata e whai whakahekehere pūngāwerewere ana e ora ana i ngā oranga noa me ngā herenga iti.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite pai mō tō hui ka āwhina i te whakarite ka whiwhi koe i ngā korero tino whai hua, ka whakatau pai rānei mō tō tiaki. Ka hiahia tō tākuta ki te mārama ki ō tohu, ki ō awangawanga, me te āhua o te āhuatanga ki tō oranga o ia rā.

I mua i tō hui:

• Rārangihia ngā tohu katoa: Whai wāhi te wā i tīmata ai rātou, te maha o te puta, me te mea e pai ake ai rātou, te kino ake rānei
• Mau mai ngā hua whakaahua katoa: Kohikohia ngā tārua o ngā tirotiro MRI, ngā tirotiro CT, me ngā ripoata mai i ētahi atu tākuta
• Kohikohia tō hītori hauora: Whai wāhi ētahi atu āhuatanga, ngā pokanga, me ngā rongoā kei te tango koe
• Whakarite i ngā pūrongo: Tuhia te mea e hiahia ana koe ki te mōhio mō ngā kōwhiringa maimoatanga, ngā morearea, me te whakatau
• Whakaarohia te mau mai i te tautoko: Ka taea e te mema whānau, e te hoa rānei te āwhina i a koe ki te mahara ki ngā korero nui

Kaua e whakaroa ki te ui mō tetahi mea kaore koe e mārama. Me whakamārama e tō tākuta tō āhuatanga, ngā kōwhiringa maimoatanga, me ngā morearea i roto i ngā kupu e mārama ana ki a koe.

He aha te mea nui mō te whakahekehere pūngāwerewere?

Ko te mea nui rawa atu ki te mārama mō te whakahekehere pūngāwerewere ko te whai i tetahi kaore e tikanga ka whai koe i ngā raruraru nui. He tokomaha ngā tāngata e ora ana i ngā oranga noa, hauora me ēnei lesions, ā, he maimoatanga whai hua kei te wātea mō te hunga e whānau ana i ngā tohu.

Ko ngā take nui hei mahara:

• Ko te nuinga o ngā whakahekehere pūngāwerewere kaore e puta he tohu
• Ki te puta ngā tohu, ka taea te whakahaere i te nuinga o te wā me te rongoā
• Ko te aroturuki noa ka āwhina i te hopu i ngā huringa wawe
• Ko te pokanga he haumaru, he whai hua hoki ina hiahiatia
• Ka taea e koe te ora i te ora tino, mahi me te tiaki hauora tika

Mahi tata atu ki tō rōpū hauora ki te whakawhanake i te mahere aroturuki me te maimoatanga e tika ana mō tō āhuatanga motuhake. Noho whakamārama, ui pūrongo, ā, mahara kaore koe e noho kotahi ana i te whakahaere i tēnei āhuatanga.

Ngā pūrongo e ui pinepinetia ana mō te whakahekehere pūngāwerewere

P1: Ka taea e ngā whakahekehere pūngāwerewere te tipu, te maha rānei i te wā?

Ko ngā whakahekehere pūngāwerewere takitahi kaore e tipu nui ake, engari ka taea te whānau i ngā wāhi hou o te whakaheke toto ka nui ake pea te ahua i runga i ngā whakaahua. I roto i te momo whānau, ka taea te puta mai i ngā lesions hou i te wā, nō reira he mea nui te aroturuki noa ki te whai koe i te momo ira.

P2: He haumaru te whakakori tinana, te takaro takaro rānei me te whakahekehere pūngāwerewere?

Ko te nuinga o ngā tāngata e whai whakahekehere pūngāwerewere ana ka taea te whakakori tinana noa me te whai wāhi ki ngā takaro. Heoi, ki te whai koe i ngā hopu, ka hiahia pea koe ki te karo i ētahi mahi penei i te kauhoe kotahi, i ngā takaro hono rānei. Kōrerohia tō āhuatanga motuhake ki tō tākuta kia whiwhi koe i ngā tūtohu mahi motuhake.

P3: Ka taea e te hapu te pā ki ngā whakahekehere pūngāwerewere?

Ko te hapu kaore e puta he whakanui nui i te morearea o te whakaheke toto mai i ngā whakahekehere pūngāwerewere, ahakoa ko ētahi rangahau e whakaatu ana he morearea iti ake i te wā o te hapu me te whānautanga. Ki te whakatū koe i te hapu, kōrerohia ngā rautaki aroturuki me tō neurologist me tō obstetrician.

P4: Ka hiahia au ki te pokanga ki te tīmata te whakaheke toto o taku whakahekehere pūngāwerewere?

Kaore pea. Ko ngā toto iti maha ka mutu noa iho kaore he pokanga. Ko te pokanga e whakaarohia ana i te nuinga o te wā ina he whakaheke toto hoki, ngā hopu kaore e taea te whakahaere, i ngā tohu neurology e ahu whakamua ana rānei. Ko te whakatau ka whakawhirinaki ki te wāhi, ki ō tohu, ki ngā morearea pokanga rānei ki ngā painga.

P5: Ka taea te whakaora katoa i ngā whakahekehere pūngāwerewere?

Ki te tangohia katoatia te whakahekehere pūngāwerewere, kua ora tonu, ā, kaore e puta he raruraru i muri mai. Heoi, ko ngā tāngata e whai momo whānau ana ka taea te whānau i ngā lesions hou i ētahi atu wāhi. Ko ngā maimoatanga kore-pokanga e whakahaere ana i ngā tohu pai, engari kaore e whakakore i te lesion anō.