Ese Kuvura Amaraso mu Bwonko (Subarachnoid Hemorrhage)? Ibimenyetso, Intandaro, n’Uko Bavura

Ese kuvura amaraso mu bwonko (subarachnoid hemorrhage) ni ukubura amaraso mu gice kiri hagati y’ubwonko bwawe n’imikaya myiza ikingira. Iki gice, kitwa subarachnoid space, gisanzwe kirimo amazi yo mu bwonko (cerebrospinal fluid) akurinda kandi agakomeza ubwonko bwawe.

Iyo amaraso yinjiye muri iki gice kingira, ashobora gukanda cyane ku mubiri w’ubwonko. Nubwo iyi ndwara ikomeye kandi isaba ubuvuzi bwihuse, gusobanukirwa ibyabaye bishobora kugufasha kumenya ibimenyetso by’uburwayi no gushaka ubuvuzi bwihuse.

Ese kuvura amaraso mu bwonko ni iki?

Kuvura amaraso mu bwonko bibaho iyo umusemburo uri hafi y’ubwonko buvunitse ukavira amaraso mu gice cya subarachnoid. Tekereza nk’aho hari ikibazo mu muyoboro w’amazi ukikingira ubwonko.

Aya maraso abangamira imikorere isanzwe y’amazi yo mu bwonko kandi ashobora kongera umuvuduko mu mutwe. Iyi ndwara igera ku bantu 10 kugeza kuri 15 kuri buri 100.000 buri mwaka, bituma iba idakunze kugaragara ariko isaba ubuvuzi bwihuse iyo ibaye.

Hari ubwoko bubiri nyamukuru: kuvura amaraso mu bwonko bitewe n’imvune mu mutwe, no kuvura amaraso mu bwonko ku bwamahirwe bidakomoka ku mvune. Ibyinshi mu biturika ku bwamahirwe biterwa no gucika kw’imitsi y’amaraso mu bwonko.

Ibimenyetso byo kuvura amaraso mu bwonko ni ibihe?

Ikimenyetso gikomeye ni ububabare bukabije bw’umutwe butunguranye. Abantu bakunze kubivuga ko ari “ububabare bukomeye bw’umutwe mu buzima bwanjye” cyangwa nk’aho “bakubise inkuba”.

Ubu bubabare bukabije bw’umutwe busanzwe bugera ku rwego rwo hejuru mu kanya gato, bitandukanye n’ubundi bubabare bw’umutwe buzamuka buhoro buhoro. Ububabare busanzwe bukwirakwira mu ijosi kandi bushobora guherekejwe n’iseseme no kuruka.

Ibindi bimenyetso ushobora kugira birimo:

• Ijosi rikomera cyane kandi rigakomeretsa
• Kugira ubwoba bw’umucyo
• Iseseme no kuruka
• Ubwenge buhindagurika cyangwa butaboneka
• Uburwayi cyangwa kubura ubwenge
• Imirire
• Ubusembwa cyangwa kubabara mu bice bimwe na bimwe by’umubiri

Bamwe mu bantu bagira ibimenyetso by’uburwayi iminsi cyangwa ibyumweru mbere y’ukuvura amaraso menshi. Ibi bimenyetso by’uburwayi, bitwa sentinel headaches, bishobora kuba ububabare butunguranye bw’umutwe, ububabare bw’ijosi, cyangwa igihe gito cy’ubwenge butaboneka.

Mu bihe bitoroshye, ushobora kugira ibibazo by’ububone, kugira ikibazo cyo kuvuga, cyangwa guhindura imyitwarire bitunguranye. Ibi bimenyetso bishobora guhinduka bitewe n’igice cy’ubwonko cyakozweho n’amaraso.

Ese iki giterwa niki?

Intandaro isanzwe yo kuvura amaraso mu bwonko ku bwamahirwe ni ukubura kw’imitsi y’amaraso mu bwonko. Aneurysm ni ahantu hacye kandi habyimba ku rukuta rw’umusemburo ushobora kuvunika munsi y’umuvuduko.

Ibi bivuze ko 85% byo kuvura amaraso mu bwonko ku bwamahirwe biterwa no gucika kw’imitsi y’amaraso mu bwonko. Aya mitsi y’amaraso akenshi itera ahantu imitsi y’amaraso itandukana, cyane cyane mu gice cya Willis kiri hasi y’ubwonko.

Ibindi bintu bishobora gutera ubwoko bwo kuvura amaraso birimo:

• Arteriovenous malformations (imiterere idasanzwe y’imitsi y’amaraso)
• Kubabara cyangwa kwandura kw’imitsi y’amaraso
• Indwara z’amaraso cyangwa imiti igabanya amaraso
• Ubundi bwoko bwa kanseri y’ubwonko
• Kunywa ibiyobyabwenge nk’ikoka
• Imvune ikomeye mu mutwe yaturutse impanuka cyangwa kugwa

Mu bihe bitoroshye, kuvura amaraso bishobora guterwa na reversible cerebral vasoconstriction syndrome, aho imitsi y’amaraso mu bwonko ihindagurika cyane hanyuma igakira. Rimwe na rimwe, nubwo hakozwe iperereza ryimbitse, abaganga ntibashobora kumenya intandaro yihariye.

Ni ryari ukwiye kubona muganga kubera kuvura amaraso mu bwonko?

Ugomba gushaka ubuvuzi bwihuse bw’ubuvuzi byihuse niba ufite ububabare bukabije bw’umutwe butari bumenyerewe. Ibi ni ngombwa cyane niba ububabare bw’umutwe bugera ku rwego rwo hejuru mu kanya gato.

Hamagara 911 byihuse niba wowe cyangwa undi muntu afite ububabare bukabije bw’umutwe hamwe no gukomera kw’ijosi, kuruka, guhindagurika kw’ubwenge, cyangwa kubura ubwenge. Ibi bimenyetso bisaba isuzuma ryihuse.

Ntugatege amatwi cyangwa ugerageze “kubihanganira” niba ufite ibimenyetso by’uburwayi nk’ububabare butunguranye bw’umutwe, igihe gito cy’ubwenge butaboneka, cyangwa guhindura ububone cyangwa kuvuga bitunguranye. Nubwo ibimenyetso bisa nkaho byakira, bishobora kugaragaza kuvura amaraso make bishobora gutera kuvura amaraso menshi.

Ese ibyago byo kuvura amaraso mu bwonko ni ibihe?

Ibintu byinshi bishobora kongera amahirwe yo kurwara iyi ndwara. Imyaka ikinjiramo, aho abenshi barwara iyi ndwara bafite imyaka iri hagati ya 40 na 60, nubwo bishobora kubaho mu myaka yose.

Abagore bafite ibyago byinshi kuruta abagabo, cyane cyane nyuma y’igihe cyo kubura imihango. Ibi bishobora kuba bifitanye isano n’impinduka z’imisemburo zigira ingaruka ku rukuta rw’imitsi y’amaraso mu gihe.

Ubuzima n’ibintu by’ubuvuzi byongera ibyago birimo:

• Umuvuduko ukabije w’amaraso
• Kunywesha itabi
• Kunywesha inzoga nyinshi
• Amateka y’umuryango w’imitsi y’amaraso mu bwonko
• Indwara zimwe na zimwe z’impyiko nk’indwara ya polycystic kidney
• Imvune mu mutwe mbere
• Kunywa ibiyobyabwenge nk’ikoka

Indwara zimwe na zimwe z’impyiko zishobora kongera ibyago, harimo Ehlers-Danlos syndrome, Marfan syndrome, na neurofibromatosis type 1. Kugira umuntu wo mu muryango ufite aneurysm mu bwonko bishobora gusaba ibiganiro byo gusuzuma n’umuganga wawe.

Ese ingaruka zishoboka zo kuvura amaraso mu bwonko ni izihe?

Kuvura amaraso mu bwonko bishobora gutera ingaruka zikomeye zisaba gukurikiranwa n’ubuvuzi. Ikibazo cya mbere ni umuvuduko ukabije mu mutwe ukomoka ku maraso.

Kuvura amaraso ukundi ni imwe mu ngaruka zikomeye za mbere, igera kuri 20% by’abantu mu byumweru bibiri bya mbere niba aneurysm itabonywe. Uku kuvura amaraso kwa kabiri akenshi kuba kibi kurusha ubwambere.

Ingaruka zisanzwe ushobora guhura nazo harimo:

• Vasospasm (kugabanya imitsi y’amaraso mu bwonko bigatera stroke)
• Hydrocephalus (amazi menshi mu bwonko)
• Imirire
• Amaraso akabana mu bindi bice by’umubiri
• Ibibazo by’umutima
• Ibibazo by’ibihaha
• Kubura ubushobozi bw’umubiri

Vasospasm isanzwe iba nyuma y’iminsi 3 kugeza kuri 14 nyuma yo kuvura amaraso bwa mbere kandi ishobora gutera ibimenyetso nk’ibya stroke. Hydrocephalus ishobora kubaho iyo amaraso abangamiye imikorere isanzwe y’amazi yo mu bwonko.

Ingaruka z’igihe kirekire zishobora kuba guhinduka kw’ubwenge, ibibazo byo kwibuka, kugira ikibazo cyo kwibanda, guhindura imyifatire, no mu bihe bimwe na bimwe, guhomba burundu ubushobozi bw’imikorere y’ubwonko. Ariko kandi, abantu benshi barakira neza bafite ubuvuzi bukwiye n’ubuvuzi bwo gusubiza ubuzima.

Ese kuvura amaraso mu bwonko bipimwa bite?

Isuzuma risanzwe ritangira hakoreshejwe CT scan y’umutwe, ishobora kubona amaraso mu gihe cya 95% iyo yakozwe mu masaha 24 nyuma y’ibimenyetso by’uburwayi. Iyi CT scan ihuta ifasha abaganga kwemeza ko hari amaraso mu gice cya subarachnoid.

Niba CT scan itabonye amaraso ariko ibimenyetso byawe bigaragaza kuvura amaraso mu bwonko, umuganga wawe ashobora gukora lumbar puncture (spinal tap). Ibi bikubiyemo gufata igice gito cy’amazi yo mu bwonko kugira ngo harebwe ko hari uturemangingo tw’amaraso.

Iyo amaraso yemewe, ibizamini byongeyeho bifasha kumenya intandaro:

• CT angiography kugira ngo harebwe imitsi y’amaraso
• MRI na MRA (magnetic resonance angiography)
• Cerebral angiography (uburyo bwiza bwo kureba imitsi y’amaraso)
• Digital subtraction angiography

Itsinda ryawe ry’abaganga rizakora kandi isuzuma ry’ubwonko kugira ngo barebe uko utekereza, imikorere y’imitsi, n’imikorere y’umubiri. Bazakurikirana ibimenyetso byawe by’ubuzima hafi kandi bashobora gukoresha ibipimo nk’ibya Glasgow Coma Scale kugira ngo bakurikirane uko uhagaze.

Ese kuvura amaraso mu bwonko bivurwa bite?

Ubuvuzi butangira byihuse hagamijwe gukomeza ubuzima bwawe no gukumira ingaruka. Ushobora kwakirwa mu ishami ry’ubuvuzi bw’ubwonko kugira ngo ukurikiwe hafi kandi uhabwe ubuvuzi bwihariye.

Intego nyamukuru ni ukubuza amaraso no gukumira kuvura amaraso ukundi. Kubera aneurysm, ibi bisanzwe bikubiyemo guca imitsi cyangwa endovascular coiling, byombi bifunga aneurysm kugira ngo birinde kuvura amaraso.

Uburyo bwawe bwo kuvurwa bushobora kuba:

• Imiti yo gukumira vasospasm
• Gucunga umuvuduko w’amaraso
• Gufata imiti igabanya ububabare
• Imiti yo kurwanya indwara z’imiti niba ari ngombwa
• Ubuvuzi bwa hydrocephalus hamwe n’uburyo bwo gukura amazi
• Ubuvuzi bwo gushyigikira umutima n’ibihaha

Guca imitsi bikubiyemo gushyira igice gito cy’icyuma ku ijosi rya aneurysm mu gihe cy’ubuganga bw’ubwonko. Endovascular coiling ikoresha catheter gushyira ibice bito mu aneurysm, bituma amaraso akabana kandi agafunga.

Itsinda ryawe ry’abaganga rizibanda kandi ku gukumira no kuvura ingaruka nk’vasospasm hamwe n’imiti nk’nimodipine, ifasha kugumisha imitsi y’amaraso mu bwonko ifunguye kandi ikagumisha amaraso atembera.

Uko wakwitwara mu gihe cyo gukira

Gukira kuvura amaraso mu bwonko akenshi biterwa n’igihe kandi bisaba kwihangana n’ubuvuzi burambuye. Itsinda ryawe ry’abaganga rizategura gahunda y’ubuvuzi bw’ubuzima bwiza hashingiwe ku byo ukeneye n’ingaruka zose.

Ubuvuzi bw’umubiri bushobora kugufasha gusubiza imbaraga n’ubwumvikane niba ufite ubusembwa cyangwa ibibazo byo kugendera. Ubuvuzi bw’akazi bwibanda ku gusubira kwiga ibikorwa bya buri munsi no guhuza impinduka zihoraho mu mikorere.

Mu gihe cyo gukira, ushobora gushyigikira gukira kwawe uko:

• Ukurikira gahunda y’imiti yose uko yategetswe
• Kwitabira inama zose zo gukurikirana
• Kwitabira gahunda z’ubuvuzi bw’ubuzima bwiza
• Kuryama bihagije no gusinzira
• Kurya indyo yuzuye kandi nzima
• Kwirinda kunywesha itabi n’inzoga nyinshi
• Gucunga umunaniro ukoresheje uburyo bwo kuruhuka

Abantu benshi bagira umunaniro, ububabare bw’umutwe, cyangwa kugira ikibazo cyo kwibanda mu gihe cyo gukira. Ibi bimenyetso bikunze kuba byiza uko igihe gihita, ariko ni ngombwa kuvugana n’itsinda ryawe ry’abaganga ku bijyanye n’ikibazo icyo ari cyo cyose.

Ubufasha bwo mu mutwe ni ingenzi mu gihe cyo gukira. Tekereza kujya mu matsinda y’ubufasha cyangwa gukorana n’abajyanama basobanukiwe ibibazo byo gukira ibikomere by’ubwonko.

Uko wakwitegura inama yawe na muganga

Niba uteganya inama yo gukurikirana nyuma y’ubuvuzi, kwitegura bishobora kugufasha gukoresha neza igihe cyawe n’umuganga wawe. Andika ibimenyetso byose wabonye kuva ku ruzinduko rwawe rwa nyuma, harimo ububabare bw’umutwe, guhindura uburyo bwo gutekereza, cyangwa ibimenyetso by’umubiri.

Zana urutonde rwuzuye rw’imiti yose ufata, harimo umunaniro n’uko uyifata. Harimo imiti yo kuvura, ibinyobwa, n’imiti y’ibimera.

Tekereza kuzana umuntu wo mu muryango cyangwa inshuti kugira ngo aguhe ubufasha kwibuka amakuru no kubaza ibibazo. Bashobora kandi gutanga ibitekerezo by’agaciro ku guhindura uko uhagaze cyangwa imyitwarire.

Tegura ibibazo byihariye ku bijyanye n’iterambere ryawe, ibikorwa byabuze, ibimenyetso by’uburwayi ugomba kwitondera, n’igihe ushobora gusubira mu kazi cyangwa mu bikorwa bisanzwe. Ntukabe ikibazo cyo kubaza icyo ari cyo cyose gikubangamiye.

Icyingenzi ku bijyanye no kuvura amaraso mu bwonko

Kuvura amaraso mu bwonko ni ubuvuzi bukomeye bukeneye ubuvuzi bwihuse, ariko hamwe no kwitabwaho vuba, abantu benshi barakira neza. Ikintu nyamukuru ni ukumenya ibimenyetso by’uburwayi no gushaka ubufasha vuba.

Wibuke ko ububabare butunguranye bw’umutwe butari bumenyerewe buhora butuma ukeneye ubuvuzi bwihuse. Ubuvuzi bwihuse butera imbere cyane kandi bugabanya ibyago by’ingaruka.

Nubwo iyi ndwara ishobora gutera ubwoba, iterambere mu buvuzi ryongereye umubare w’abarokoka n’uburyo bwo gukira. Itsinda ryawe ry’abaganga rizakorana nawe kugira ngo baguhe ubuvuzi bwiza kandi bagushyigikire mu rugendo rwawe rwo gukira.

Ibanda ku gukurikiza gahunda yawe yo kuvurwa, kwitabira ubuvuzi bw’ubuzima bwiza, no kugumana itumanaho ryiza n’itsinda ryawe ry’abaganga. Hamwe no kwitabwaho neza n’igihe, abantu benshi bakomeza kubaho ubuzima buhamye nyuma yo kuvura amaraso mu bwonko.

Ibibazo bikunze kubaho ku bijyanye no kuvura amaraso mu bwonko

Ese ushobora gukira neza kuvura amaraso mu bwonko?

Abantu benshi barakira neza kuvura amaraso mu bwonko, cyane cyane iyo bahabwa ubuvuzi bwihuse. Gukira biterwa n’ibintu nk’uburemere bw’amaraso, imyaka, ubuzima rusange, n’uburyo ubuvuzi bwatangiye vuba. Bamwe mu bantu basubira mu bikorwa byabo bisanzwe, abandi bashobora kugira ingaruka zimwe na zimwe zihoraho zishobora kuvurwa hamwe n’ubuvuzi bw’ubuzima bwiza n’ubufasha.

Ese gukira kuvura amaraso mu bwonko bimamara igihe kingana iki?

Igihe cyo gukira gitandukanye cyane ukurikije umuntu ku wundi. Igihe cyo kwakirwa mu bitaro gisanzwe kiba ibyumweru 1-3, ariko gukira burundu bishobora kumara amezi kugeza ku myaka. Iterambere rikomeye riba mu mezi atandatu ya mbere, nubwo bamwe mu bantu bakomeza kubona iterambere kugeza ku myaka ibiri. Itsinda ryawe ry’abaganga rizaguha uko byagenda hashingiwe ku mimerere yawe.

Ese ububabare bw’umutwe bwo kuvura amaraso mu bwonko bumva bumeze gute?

Ububabare bw’umutwe bwo kuvura amaraso mu bwonko busanzwe buvugwa ko butunguranye, bukabije, kandi butandukanye n’ububabare bw’umutwe wari ufite mbere. Abantu bakunze kuvuga ko bumva nk’aho “bakubise inkuba” cyangwa “bakubise igiti.” Bugera ku rwego rwo hejuru mu kanya gato kandi akenshi buherekejwe no gukomera kw’ijosi, iseseme, no kugira ubwoba bw’umucyo.

Ese hari ibimenyetso by’uburwayi mbere yo kuvura amaraso mu bwonko?

Bamwe mu bantu bagira ibimenyetso by’uburwayi iminsi cyangwa ibyumweru mbere y’ukuvura amaraso menshi, bitwa sentinel headaches. Ibi bishobora kuba ububabare butunguranye bw’umutwe butandukanye n’uburyo bwawe busanzwe, ububabare bw’ijosi, igihe gito cy’ubwenge butaboneka, cyangwa guhindura ububone bitunguranye. Ariko kandi, kuvura amaraso mu bwonko byinshi bibaho nta bimenyetso by’uburwayi.

Ese impinduka mu mibereho ukwiye gukora nyuma yo kuvura amaraso mu bwonko ni izihe?

Impinduka z’ingenzi mu mibereho harimo kureka kunywesha itabi burundu, kugabanya kunywesha inzoga, gucunga umuvuduko w’amaraso binyuze mu mirire n’imiti, gukora imyitozo nk’uko umuganga wawe yabitegetse, gucunga umunaniro, no gufata imiti yose yategetswe uko yategetswe. Gukurikirana neza no gukurikirana ni ingenzi mu gukumira ingaruka zizakurikira.