He aha te Dural Arteriovenous Fistula? Tohutohu, Take, me te Maimoatanga

Ko te dural arteriovenous fistula (DAVF) tētahi hononga koretake i waenga i ngā ātiretā me ngā uaua i te āhuatanga o waho o tō roro e kiia nei ko te dura mater. Whakaarohia he huarahi poto kore e hiahiatia, kei reira te toto e rere tika ana i ngā ātiretā teitei-peihana ki ngā uaua iti-peihana, kāore e pā ana ki te whatunga capillary noa e tika ana kia whakaiti i ngā mea.

Ko tēnei āhuatanga e pā ana ki te 10-15% o ngā ngoikoretanga o te roro, no reira he mea onge, engari he mea nui kia mārama. Ko te nuinga o te iwi ka whanake i ngā DAVFs i muri i te ora, i te nuinga i muri i te 50 tau, ahakoa ka puta i tetahi tau.

He aha ngā tohu o te dural arteriovenous fistula?

Ko ngā tohu o te DAVF e whakawhirinaki ana ki te waahi o te hononga koretake me te pehea te rere o te toto i reira. Ko te nuinga o te iwi me ngā take ngawari kaore e kite i ngā tohu, engari ko ētahi atu pea ka kite i ngā huringa e whanake ana i te wa roa i roto i ngā marama, tau rānei.

Ko ēnei ngā tohu tino noa ka kite koe:

• Tinnitus pupuhi - He oro pupuhi pupuhi ranei i roto i tō taringa e rite ana ki tō ngākau
• Ngā mamae o te upoko - I te nuinga o te wā ka whakaahuatia he rerekē i ngā mamae o tō upoko, i etahi wā he pupuhi
• Ngā raruraru tirohanga - Te tirohanga māre, te tirohanga takirua, te ngaro rānei o te tirohanga taha
• Ngā tohu e pā ana ki te kanohi - Ngā kanohi pupuhi, ngā kanohi whero, pupuhi rānei, te pehanga nui rānei i muri i ngā kanohi
• Ngā huringa hinengaro - Te uaua ki te aro, ngā raruraru mahara, te whakapohehe rānei
• Ngā raruraru toenga - Te wiri, te kore toenga, ngā raruraru whakarite rānei

Ka puta mai ngā tohu nui ake ina puta he tauira rere toto kino i te fistula. Kei roto i ēnei ngā mamae o te upoko nui, ngā hopu, te ngoikore i tetahi taha o te tinana, te uaua rānei ki te kōrero.

I roto i ngā take onge, ka taea e ngā DAVFs te whakaputa i ngā raruraru kino penei i te toto o te roro, te pēhanga roro rānei, koia te take he mea nui te arotake hauora tere mena ka kite koe i ngā tohu neurological nui, ohorere.

He aha ngā momo dural arteriovenous fistula?

Ka whakarōpū ngā tākuta i ngā DAVFs i runga i tō rātou wāhi me te pehea te rere o te toto i reira. Ko tēnei pūnaha whakarōpū, e kiia nei ko te whakarōpū Cognard, hei awhina i te whakatau i te tere o te maimoatanga me te huarahi.

Ko ngā momo matua kei roto:

• Momo I (Te tūponotanga iti) - Ka rere tika ki ngā sinuses uaua kāore e whakaputa i te rere whakamuri
• Momo II (Te tūponotanga waenga) - Ka whakaputa i tetahi rere whakamuri ki ngā uaua o te roro engari ka noho tonu te whakahaere
• Momo III (Te tūponotanga teitei) - Ka rere tika ki ngā uaua o te roro, ka hanga i ngā huringa pehanga nui
• Momo IV (Te tūponotanga teitei) - Ka rere ki ngā uaua o te roro me ētahi atu raruraru penei i ngā putea uaua
• Momo V (Te tūponotanga teitei rawa) - Ka rere tika ki ngā uaua o te tuaiwi, e pā ana ki te mahi o te tuaiwi

Ka whakatau tō tākuta ko tēhea momo kei a koe mā ngā rangahau whakaahua motuhake. Ko ngā DAVFs teitei-tohu i te nuinga o te wā e hiahia ana ki te maimoatanga tere na te mea he nui ake te tūponotanga o te toto, te pēhanga roro rānei.

He aha ngā take o te dural arteriovenous fistula?

Ko te nuinga o ngā dural arteriovenous fistulas ka whanake hei āhuatanga whiwhi, arā, ka hangaia i roto i tō oranga kāore i te noho mai i te whānau. Ko te take tika i te nuinga o te wā kaore i te mārama, engari he maha ngā take ka taea te whakaputa i tō rātou whanaketanga.

Ko ngā take whakauru noa kei roto:

• Te thrombosis uaua - Ngā toto i roto i ngā uaua o te roro e aki ana i te toto ki te kimi i ngā huarahi rere rerekē
• Te whara o te upoko - Ngā whara o te upoko o mua e pakaru ana i ngā oko toto, te whakarereke rānei i ngā tauira rere toto
• Te pokanga roro - Ngā mahi pokanga neuro o mua ka taea te whakaputa i te hanga oko koretake
• Ngā mate - Ngā mate taringa, ngā manga rānei e horapa ana ki ngā kiko tata
• Ngā huringa homoni - Te hapu, te rereketanga homoni rānei e pā ana ki te whanaketanga o ngā oko toto

I roto i ngā take onge, ka taea e ngā take ira te whai wāhi, ina koa ki te iwi me te hereditary hemorrhagic telangiectasia (HHT), tētahi āhuatanga e pā ana ki te hanga oko toto puta noa i te tinana.

I etahi wā ka whanake ngā DAVFs kāore he take e taea te tautuhi, e kiia ana e ngā tākuta he hanga "ohorere". Ko te whakautu whakaora noa o tō tinana ki ngā whara oko iti pea ka hanga i ēnei hononga koretake i a ia e ngana ana ki te whakahoki i te rere toto.

Nōhea te haere ki te tākuta mō te dural arteriovenous fistula?

Me rapu koe i te tiaki hauora mena ka kite koe i ngā tohu neurological roa, kino ake rānei, ina koa mena ka whanake haere i roto i ngā wiki, ngā marama rānei. Ko te aromatawai wawe ka taea te aukati i ngā raruraru nui me te whakapai ake i ngā hua maimoatanga.

Whakaritea he hui ki tō tākuta mena ka kite koe:

• Tinnitus pupuhi kaore e ngaro, ka kino ake rānei
• Ngā momo mamae o te upoko hou, rerekē rānei
• Ngā huringa i tō tirohanga kanohi rānei
• Te wiri roa, ngā raruraru toenga rānei
• Ngā raruraru mahara, aro rānei

Rapua te tiaki hauora ohorere tonu mena ka kite koe i te mamae o te upoko nui, ohorere, ngā hopu, te ngoikore i tetahi taha o tō tinana, te uaua ki te kōrero, te ngaro ohorere rānei o te tirohanga. Ka taea e ēnei tohu te tohu i tetahi raruraru kino e hiahia ana ki te maimoatanga ohorere.

Kaua e whakaroa ki te karanga i te 111, te haere rānei ki te ruma ohorere tata ki a koe mena kaore koe e tino mohio ki te kino o ō tohu. I te wā e pā ana ki ngā āhuatanga e pā ana ki te roro, he pai tonu te mahi i runga i te taha tupato.

He aha ngā take tūponotanga mō te dural arteriovenous fistula?

He maha ngā take ka taea te whakapiki i tō tūponotanga ki te whanake i te DAVF, ahakoa te whai i ngā take tūponotanga kaore e whakamana ka whanake koe i tēnei āhuatanga. Ko te mārama ki ēnei take ka taea te awhina i a koe me tō tākuta ki te noho mataara ki ngā tohu pea.

Ko ngā take tūponotanga tino nui kei roto:

• Te pakeke neke atu i te 50 - Ko te nuinga o ngā DAVFs ka puta i ngā pakeke o te tau waenga me ngā pakeke
• Te wahine - Ko ngā wāhine ka whanake i ētahi momo DAVFs i te nuinga atu i ngā tāne
• Te hītori o ngā toto - Te thrombosis uaua o mua i tetahi wāhi o te tinana
• Te whara o te upoko, o te kaki rānei - Ngā whara iti rawa atu i ngā tau kua hipa
• Te pokanga roro o mua - Tetahi mahi pokanga neuro e pā ana ki ngā oko toto
• Ngā mate taringa roa - Ngā mate maha, kino rānei e pā ana ki ngā kiko tata

Ko ngā take tūponotanga iti ake kei roto te hapu, ētahi āhuatanga autoimmune, me ngā mate ira e pā ana ki ngā oko toto. Ko ētahi rongoā e pā ana ki te toto pea ka whai wāhi, ahakoa kaore i te tino mārama tēnei hononga.

Mena he maha ngā take tūponotanga kei a koe, kōrerohia ki tō kaiwhakarato hauora i ngā haerenga noa. Ka taea e rātou te awhina i a koe ki te mārama ki tō taumata tūponotanga takitahi me ngā tohu hei titiro atu.

He aha ngā raruraru pea o te dural arteriovenous fistula?

Ahakoa ko te nuinga o ngā DAVFs ka noho pumau me te whakaputa i ngā tohu iti anake, ko ētahi ka taea te arahi ki ngā raruraru nui mena kaore i te maimoatia. Ko te taumata tūponotanga e whakawhirinaki ana ki te momo me te wāhi o tō fistula motuhake.

Ko ngā raruraru pea kei roto:

• Te toto o te roro - Te toto ki roto i te kiko o te roro ina pakaru ngā oko toto i te pehanga koretake
• Te pēhanga roro - Mai i te toto, te iti rānei o te rere toto ki ngā wāhi o te roro
• Ngā hopu - Te mahi hiko koretake e whakaputahia ana e te rere toto rerekē, te pehanga rānei
• Te hekenga hinengaro haere tonu - Te kino haere tonu o te mahi hinengaro, te mahi motuka rānei
• Te ngaro o te tirohanga - Te pakaru tonu o te uaua tirohanga mai i te pehanga nui
• Te toto nui uaua - Te piki kino o te pehanga i roto i ngā uaua o te roro

I roto i ngā take onge, ka taea e ngā DAVFs o te tuaiwi te whakaputa i te ngoikore haere tonu, te ngenge, ngā raruraru pūnaha rānei mena ka pā ki te rere toto o te tuaiwi. Ko ēnei raruraru i te nuinga o te wā ka whanake haere tonu engari ka taea te noho tonu mena kaore i te maimoatia.

Ko te rongo pai ko te tirotiro tika me te maimoatanga, ka taea te aukati i te nuinga o ngā raruraru, te whakahaere rānei. Ka aromatawai tō rōpū hauora i tō taumata tūponotanga motuhake ka tūtohutia ngā whakauru tika.

Me pēhea te aukati i te dural arteriovenous fistula?

Na te mea ko te nuinga o ngā DAVFs ka whanake hei āhuatanga whiwhi mai i ngā take maha, kaore i te taea te aukati katoa. Engari, ka taea e koe te mahi i ngā mahi hei whakaiti i tō tūponotanga me te whakaputa i te hauora oko katoa.

Ko ngā rautaki aukati kei roto:

• Tīakina tō upoko - Kakahu i ngā taputapu haumaru tika i ngā wā hapū me ngā mahi
• Whakahaere i te tūponotanga toto - Whai i ngā tohutohu a tō tākuta mo ngā kaiwhakaiti toto mena ka tohua
• Maimoatia ngā mate tonu - Kaua e waiho ngā mate taringa, ngā manga rānei kia kore e maimoatia
• Whakahaere i te pehanga toto - Kia pai te whakahaere i te toto teitei mā te oranga me ngā rongoā
• Whakahaere i te hauora oko - Mahi haere tonu, kai i te kai hauora ngākau, kaua hoki e pā te paowa

Mena he mate ira kei a koe penei i te HHT e whakapiki ana i te tūponotanga DAVF, mahi tata ki ngā tohunga e mārama ana ki ēnei mate. Ka taea e rātou te whakarato i ngā rautaki tirotiro me te aukati whakarite.

Ahakoa kaore e taea e koe te aukati i ia take, ko te pupuri i te hauora pai me te rapu i te maimoatanga tere mō ngā tohu āwangawanga tonu te tiaki pai rawa atu mōu i ngā raruraru.

Me pēhea te whakatau i te dural arteriovenous fistula?

Ko te whakatau i te DAVF e hiahia ana ki ngā rangahau whakaahua motuhake ka taea te kite i ngā tauira rere toto i roto i ngā kōrero. Ko tō tākuta pea ka tīmata me te whakamātautau neurological tino pai me te arotake i ō tohu i mua i te tono i ngā whakamātautau motuhake.

Ko te tukanga whakatau i te nuinga o te wā kei roto:

1. Te tātaritanga CT, MRI rānei - Te whakaahua tuatahi hei titiro mo ngā ngoikoretanga hanganga, ngā tohu toto rānei
2. Te angiography CT (CTA) - Ngā whakaahua taipitopito o ngā oko toto mā te whakamahi i te tae whakakā
3. Te angiography pūmanawa (MRA) - Te whakaahua oko toto i runga i te MRI kāore he radiation
4. Te angiography whakakore digital (DSA) - Ko te whakamātautau paerewa koura e whakaatu ana i ngā tauira rere toto tika

Ko te DSA kei roto te whakauru i tetahi catheter iti ki roto i ō oko toto me te whakauru i te tae whakakā i te wā e tango ana i ngā whakaahua X-ray. Ka whakarato tēnei tukanga i te tirohanga tino taipitopito o tō DAVF ka awhina i ngā tākuta ki te whakarite i te maimoatanga.

Pea ka mahi tō rōpū hauora i ētahi atu whakamātautau penei i te lumbar puncture, ngā whakamātautau kanohi motuhake rānei i runga i ō tohu. Ko te tukanga whakatau katoa i te nuinga o te wā e toru ki ngā wiki, i runga i te whakarite me te wātea o te whakamātautau.

He aha te maimoatanga mō te dural arteriovenous fistula?

Ko te maimoatanga mō te DAVF e whakawhirinaki ana ki ō tohu, te wāhi me te momo o te fistula, me tō hauora katoa. Kaore i te hiahia ia DAVF ki te maimoatanga tere, ka taea te tirotiro haumaru i ētahi i te wa roa.

Ko ngā kōwhiringa maimoatanga kei roto:

• Te tirotiro me te tirotiro - Ngā rangahau whakaahua noa mō ngā DAVFs iti-tūponotanga, kore-tohu
• Te embolization endovascular - Te tukanga iti-whakauru hei aukati i te rere toto koretake mā te whakamahi i ngā kōiwi, te whakapiri rānei
• Te maimoatanga pokanga - Te whakatikatika pokanga tika, te tango rānei i te hononga koretake
• Te radiosurgery stereotactic - Te rongoā radiation arotahi hei kati i te fistula i te wa roa
• Ngā huarahi whakakotahi - Te whakamahi i ngā huarahi maimoatanga maha mō ngā take uaua

Ko te embolization endovascular i te nuinga o te wā ko te kōwhiringa tuatahi na te mea he iti ake te whakauru i te pokanga, he pai hoki ngā reiti angitu mō ngā momo DAVF maha. I roto i tēnei tukanga, ka whakauru ngā tākuta i ngā kōiwi iti, te whakapiri rongoā rānei mā te catheter hei aukati i te hononga koretake.

Ka kōrero tō rōpū neurovascular i te huarahi pai rawa atu mō tō āhuatanga motuhake, mā te whakaaro ki ngā take penei i tō tau, ō tohu, me te uaua hangarau o te maimoatanga i tō wāhi DAVF motuhake.

Me pēhea te whakahaere i ngā tohu i te kāinga i te wā o te dural arteriovenous fistula?

I te wā e tatari ana koe mō te maimoatanga, mena kei te tirotirohia koe rānei, he maha ngā rautaki ka taea te awhina i a koe ki te whakahaere i ngā tohu me te pupuri i tō kounga ora. Ko ēnei huarahi ka pai te mahi me ngā tūtohu a tō rōpū hauora.

Ko ngā rautaki whakahaere kāinga kei roto:

• Te whakaora mamae o te upoko - Whakamahia ngā kaiwhakaora mamae-i-te-kaute-i runga i ngā tohutohu, tonohia ngā kāpeka makariri, mahana rānei
• Te whakahaere tinnitus - Whakamahia ngā mīhini haruru ma, karohia te caffeine, mahi i ngā tikanga whakaiti ahotea
• Te tū moe - Whakaarahia tō upoko iti hei whakaiti i ngā tohu pehanga
• Te whakaiti ahotea - Mahi i ngā tikanga whakamahinga, te whakakori ngawari, te whakaaroaro rānei
• Te whakarereke mahi - Kaua e mahi i ngā nekehanga upoko ohorere, ngā mahi rānei e whakaiti ana i ngā tohu

Pupurihia he tātai tohu hei aroturuki i ngā huringa i te wa roa. Tuhia he aha te mea e pai ake ai, te kino ake rānei o ngā tohu, na te mea ko ēnei kōrero hei awhina i tō rōpū hauora ki te mahi i ngā whakatau maimoatanga.

Whakapa atu ki tō kaiwhakarato hauora mena ka kino ohorere ngā tohu, mena ka whanake koe i ngā tohu neurological hou rānei. Kaua e ngana ki te whakahaere i ngā tohu nui ma tō ake, ina koa mena ka āwangawanga ki ngā mahi o ia rā, te moe rānei.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite mō tō hui hei whakarite kia whiwhi koe i te nuinga mai i tō wā me te rōpū hauora. Kawe mai ngā kōrero tika, kia rite ki te kōrero taipitopito i ō tohu.

I mua i tō hui:

• Rārangihia ngā tohu katoa - Kei roto te wā i tīmata ai rātou, te maha o te puta, me ngā mea e whakaputa ana i a rātou
• Kohikohia ngā rēkōta hauora - Kawe mai ngā rangahau whakaahua o mua, ngā hua whakamātautau, me ngā rārangi rongoā
• Whakaritea ngā pātai - Tuhia ngā āwangawanga mo ngā kōwhiringa maimoatanga, ngā tūponotanga, me ngā hua e tumanakohia ana
• Kawe mai te tautoko - Whakaarohia te whai i te mema whānau, te hoa rānei hei haere tahi me koe
• Ngā kōrero inihua - Manatokohia te uhi mō ngā tukanga motuhake me ngā rangahau whakaahua

Kia rite ki te kōrero taipitopito i tō hītori hauora, tae atu ki tetahi whara o te upoko, ngā pokanga, ngā raruraru toto rānei. E hiahia ana tō tākuta ki ēnei kōrero hei mārama ki ō take tūponotanga motuhake me ngā hiahia maimoatanga.

Kaua e whakaroa ki te tono i te whakamārama mena kaore ngā kupu hauora, ngā kōwhiringa maimoatanga rānei e mārama ana. E hiahia ana tō rōpū hauora kia pai te whakamārama me te ngāwari ki tō mahere tiaki.

He aha te mea nui mō te dural arteriovenous fistula?

Ko ngā dural arteriovenous fistulas he āhuatanga e taea te maimoatanga, ahakoa he mea kino pea, ka taea te whakahaere pai me te tiaki hauora tika. Ko te mea nui ko te mohio wawe ki ngā tohu me te mahi tahi me ngā tohunga neurovascular wheako e mārama ana ki ēnei āhuatanga uaua.

Kia mahara kaore i te hiahia ia DAVF ki te maimoatanga tere, a he maha ngā tāngata e ora ana i te oranga noa me te tirotiro tika, te maimoatanga angitu rānei. He pai ngā reiti angitu o ngā tikanga maimoatanga hou me ngā reiti raruraru iti rawa atu ina mahihia e ngā rōpū wheako.

Noho hono atu ki ō kaiwhakarato hauora, whai i ngā kaupapa tirotiro e tūtohuhia ana, kaua hoki e whakaroa ki te whakapa atu mena ka kite koe i ngā huringa i ō tohu. Me te tiaki tika me te aro, ka taea e koe te pupuri i te kounga ora pai i te wā e whakahaere ana i tēnei āhuatanga.

Ngā pātai maha e ui ana mō te dural arteriovenous fistula

Ka taea te ngaro ake te dural arteriovenous fistula?

Ka taea e ētahi DAVFs iti te kati ohorere, engari he mea onge, he kore whakatau. Ko te nuinga o ngā DAVFs ka noho pumau, ka kino ake rānei i te wa roa mena kaore i te maimoatia. Ka tirotirohia e tō tākuta tō keehi motuhake mā te tirotiro noa hei whakatau mena ka puta te kati ohorere, mena ka hiahiatia te whakauru rānei.

He mate ira te dural arteriovenous fistula?

Ko te nuinga o ngā DAVFs he āhuatanga whiwhi e whanake ana i roto i tō oranga kāore i ngā mate ira. Engari, ko te iwi me ētahi mate ira penei i te hereditary hemorrhagic telangiectasia (HHT) he nui ake te tūponotanga ki te whanake i ngā ngoikoretanga oko toto, tae atu ki ngā DAVFs. Mena he hītori whānau kei a koe mo ngā ngoikoretanga oko toto, kōrerohia ki tō tākuta.

E hia te roa o te ora i muri i te maimoatanga DAVF?

Ko te wā ora e rerekē ana i runga i te tikanga maimoatanga i whakamahia me tō āhuatanga motuhake. Ko ngā tukanga endovascular i te nuinga o te wā e hiahia ana ki te 1-2 rā i te hōhipera me te hoki haere tonu ki ngā mahi noa i roto i te 1-2 wiki. Ko te maimoatanga pokanga pea ka hiahia ki ngā noho roa atu i te hōhipera me ngā wiki maha o te ora. Ka whakarato tō rōpū hauora i ngā aratohu ora motuhake i runga i tō maimoatanga.

Ka taea e au te rere, te haere rānei me te dural arteriovenous fistula?

Ko te nuinga o te iwi me ngā DAVFs ka taea te haere haumaru, engari me kōrero koe ki tō tākuta i mua i ngā mahere haere. Pea ka tūtohu rātou kia karo i ngā mahi e pā ana ki ngā huringa teitei nui, te ahotea tinana rānei, i runga i tō āhuatanga motuhake me ngā tohu. Kawe tonu i ō kōrero hauora me ngā whakapā ohorere i te wā e haere ana.

Me tango rongoā roa ahau i muri i te maimoatanga DAVF?

Ko ngā hiahia rongoā e rerekē ana i runga i tō maimoatanga me ngā āhuatanga motuhake. Ko ētahi pea ka hiahia ki ngā kaiwhakaiti toto i te wa poto i muri i ētahi tukanga, ko ētahi atu pea ka hiahia ki ngā rongoā hei whakahaere i ngā tohu penei i ngā hopu, ngā mamae o te upoko rānei. Ka hanga e tō tākuta tētahi mahere rongoā whakaritea, ka arotake tonu i ō hiahia i te wa roa.