Vertebral hlab ntsha tawm ntawm cov hlab ntsha loj subclavian. Cov channel no pub rau qhov chaw ntawm lub hlwb. Hauv particular, occipital lobes, cerebellum, pob tw yog nkag nrog cov ntshav. Tom ntej no, peb yuav tshuaj xyuas kom meej ntxiv seb cov hlab ntsha vertebral yog dab tsi. Kab lus yuav piav qhia txog kev ua haujlwm tsis zoo ntawm cov hlab ntsha, cov duab kho mob thiab cov kev kho mob uas siv los tshem tawm lawv.
cov ntaub ntawv dav dav
ntu ntawm cov hlab ntsha vertebral dhau los ntawm cov kwj dej uas tsim los ntawm cov txheej txheem hloov pauv ntawm cov pob txha hauv tsev menyuam. Rau lawv qhov chaw, cov nkoj tau txais lawv lub npe. Nkag mus rau hauv lub cranial kab noj hniav los ntawm foramen magnum, cov hlab ntsha vertebral sib koom ua ke ntawm lub hlwb qia mus rau hauv kwj dej basilar. Los ntawm cheeb tsam no lawv nce mus. Branching tshwm sim nyob rau hauv lub cerebral hemispheres. Cov hlab ntsha sab xis yog khiav ntawm ib sab thiab sab laug vertebral hlab ntsha nyob rau lwm qhov.
Anatomy
Txhua tus channel tau muab faib ua qee yam. Cov ntu hauv qab no ntawm cov hlab ntsha vertebral yog qhov txawv:
- Intracranial. Ntu no khiav raws cov kab noj hniav mus rau qhov chaw ntawm kev sib tshuam ntawm cov ceg thiab tsim cov kwj dej basilar.
- Ntshai-occipital. Cov ntu no khiav tawm ntawm txoj kev tawm ntawm cov kwj dej ntawm cov txheej txheem ntawm (transverse) vertebrae (cervical) mus rau qhov nkag mus rau hauv cov kab noj hniav cranial.
- caj dab. Tshooj lus no dhau los ntawm cov kwj dej ntawm cov txheej txheem (transverse) ntawm lub ncauj tsev menyuam vertebrae.
- Txhob Cia Siab. Qhov no yog qhov qis tshaj plaws. Cov ntu khiav los ntawm qhov chaw ntawm keeb kwm ntawm lub vertebral hlab ntsha los ntawm subclavian mus rau qhov nkag mus rau hauv lub kwj dej ntawm cov txheej txheem ntawm lub ncauj tsev menyuam vertebrae.
Head blood supply
Lub paj hlwb pub ob lub pas dej: vertebrosobasilar thiab carotid. Cov tom kawg suav nrog cov hlab ntsha carotid (sab hauv). Lawv muab 70 mus rau 85% ntawm tag nrho cov ntshav ntim. Cov hlab ntsha carotid yog lub luag haujlwm rau yuav luag txhua yam kev mob loj ntawm lub hlwb. Ua ntej ntawm tag nrho cov, qhov no siv rau mob strokes. Nyob rau hauv no hais txog, nyob rau hauv tus txheej txheem ntawm kev ntsuam xyuas, lawv cov mob yog muab tshwj xeeb mloog. Lawv cov kab mob atherosclerotic thiab lawv qhov tshwm sim yog qhov txaus siab rau cov kws kho plawv, nrog rau cov kws kho mob hlwb thiab cov kws phais mob vascular. Lub vertebrobasilar phiab suav nrog ob sab xis thiab sab laug vertebral hlab ntsha. Lawv muab li 15-30% ntawm tag nrho cov ntshav ntim. Kev raug mob xws li mob stroke tuaj yeem ua mob hnyav rau tus neeg mob, txawm tias ua rau lawv tsis taus.
Cov hlab ntsha vertebral thiab lawv cov ceg pub lub cerebellum. Nrog tsis muaj ntshav txaus, kiv taub hau yuav tshwm sim. Cov tsos mob ntawm cov hlab ntsha vertebral yog hu ua "vertebrobasilar insufficiency". Los ntawm cov hlab ntsha uas txiav txim siab, lub paj hlwb tau muab. Hauv noqauv concentrated tseem ceeb chaw ntawm kev ua pa thiab ntshav ncig. Hauv qhov no, mob stroke hauv cheeb tsam no yog qhov hnyav heev thiab feem ntau ua rau tuag taus. Cervical osteochondrosis yog qhov txaus ntshai heev. Lub vertebral artery syndrome tshwm sim los ntawm deformation ntawm cov pob txha ntsiab. Lub nkoj ua tortuous, uas ua rau cov ntshav tsis txaus.
Ua txhaum cai
Ua kom muaj kab mob pathological yam tseem ceeb tuaj yeem yog vertebrogenic thiab non-vertebrogenic xwm. Nyob rau hauv rooj plaub tom kawg, peb tab tom tham txog kev raug mob uas tsis muaj kev cuam tshuam nrog tus txha nraub qaum. Lawv tshwm sim los ntawm congenital anomalies nyob rau hauv qhov loj thiab chav kawm ntawm cov hlab ntsha los yog atherosclerosis. Tab sis qhov ua rau tom kawg yog kuaj tsis tau. Cov anomalies no tsis muaj qhov tseem ceeb ntawm kev ywj pheej. Tab sis vim yog qhov sib ntxiv ntawm lwm yam ntawm kev nyem cov hlab ntsha, qhov xwm txheej tsis zoo heev tau tsim.
Vertebrogenic lesions yog tshwm sim los ntawm ntau yam pathologies ntawm tus txha nraub qaum (osteochondrosis - feem ntau). Cov kab mob no tuaj yeem tshwm sim rau lawv tus kheej txawm tias thaum menyuam yaus lossis thaum hluas los ntawm cov keeb kwm ntawm dysplastic los yog tom qab raug mob tsis txaus ntseeg hauv cheeb tsam tsev menyuam. Vim li ntawd, cov hlab ntsha vertebral tuaj yeem deformed.
Cov tsos mob ntawm cov ntshav tsis txaus
Cov yam ntxwv tshwj xeeb tshaj plaws ntawm pathology yog suav tias yog tas mus li, qee zaum paroxysmal intensifying excruciating throbbing mob nyob rau hauv lub taub hau. Raws li txoj cai, nws yog nyob rau hauv cheeb tsam occipital. Thaum muaj kev tawm tsam, qhov mob tuaj yeemkis mus rau lwm qhov chaw. Feem ntau, nws muab rau thaj tsam ntawm lub orbit thiab choj ntawm lub qhov ntswg, mus rau thaj tsam parietal-temporal, rau hauv pliaj lossis pob ntseg. Kev mob tuaj yeem yog ob qho tib si paroxysmal thiab mus tas li. Kev hnov lus feem ntau yog nyob ntawm ib sab.
mob tawv taub hau feem ntau tshwm sim. Qhov kev xav no tshwm sim txawm tias me ntsis kov, combing. Thaum tig los yog qaij lub taub hau, tus yam ntxwv crunch yuav tshwm sim, qee zaum muaj qhov kub hnyiab.
Qee zaus, cov neeg mob uas muaj kab mob vertebral artery mob kiv taub hau, nrog xeev siab lossis ntuav, hnov lus tsis zoo, tinnitus, thiab ntau yam tsis pom kev. Cov yav tas yuav tsum muaj xws li cov tsos mob ntawm daim ntaub thaiv los yog pos huab ua ntej ob lub qhov muag, ob lub qhov muag, clouding, thiab lwm yam. Tsis tshua muaj, cov neeg mob yws ntawm qhov kev xav ntawm lub cev txawv teb chaws hauv caj pas (pharyngeal migraine) thiab nqos nyuaj. Ntawm cov kab mob autonomic, tej zaum yuav muaj kev xav luv luv ntawm kev tshaib kev nqhis, nqhis dej, xav tias kub los yog txias.
Sypathetic plexus lesion
Hauv qhov no, Bernard-Horner syndrome tau sau tseg. Cov mob feem ntau yog nrog los ntawm qhov mob unilateral thiab paresthesia. Cov tsos mob feem ntau yog ntes lub ntsej muag, tawv palate, hniav, tus nplaig. Ib qho tingling, kub hnyiab, ib qho kev xav ntawm lub xub ntiag ntawm ib tug txawv teb chaws lub cev tshwm nyob rau hauv lub caj pas. Ntxiv nrog rau cov tsos mob no, muaj kev ua txhaum ntawm hom vestibular nyob rau hauv daim ntawv ntawm kiv taub hau, staggering thiab ntog. Nrog rau cov teeb meem noxeev siab thiab ringing lossis suab nrov hauv pob ntseg. Thaum lub sij hawm tawm tsam ntawm mob taub hau, ua daus no tshwm sim, efficiency txo, tawm hws nce, qaug zog nce, pom acuity txo, thiab "flies ua ntej ob lub qhov muag" tshwm. Nrog rau txhua qhov kev hloov hauv txoj hauj lwm ntawm lub taub hau, qhov kev siv ntawm qhov mob nce ntau. Tab sis tib lub sijhawm, tus neeg mob tuaj yeem nrhiav txoj haujlwm uas qhov kev xav no tau txo qis lossis ploj tag nrho.
Congenital anomaly
qeb ntawm pathologies suav nrog hypoplasia. Sab laug vertebral hlab ntsha tsis tshua muaj kev cuam tshuam. Cov tsos mob ntawm pathology tsis pom tam sim ntawd. Cov tsos mob zoo sib xws nrog kev cuam tshuam hemodynamic. Qhov no txhais tau hais tias ua ntej congestion thiab tsis txaus cov ntshav los ua kev kho mob tseem ceeb, ib lub sij hawm yuav tsum dhau. Nyob rau tib lub sijhawm, nws yuav tsum nco ntsoov tias cov txheej txheem them nyiaj ua haujlwm hauv tib neeg lub cev, tso cai rau qee lub sijhawm kom muaj kev noj zaub mov zoo.
Cas of anomaly
Vim li cas hypoplasia tshwm sim? Sab laug vertebral hlab ntsha tuaj yeem tsim qhov txawv txav hauv utero rau ntau yam. Cov tseem ceeb suav nrog:
- Bruises, ntog ntawm tus poj niam thaum cev xeeb tub.
- Kev siv cawv ua ntej yug menyuam, tshuaj noj, tshuaj, thiab haus luam yeeb.
- Kab mob kis tau thaum cev xeeb tub.
- Npaj xeeb xeeb.
Tawm tsam keeb kwm ntawm hypoplasia, muaj qhov nqaim ntawm lumen ntawm cov hlab ntsha ntawm qhov chaw ntawm nws nkag mus rau hauv kwj dej ua rau cov kab noj hniav cranial.
Diagnosis
Kev txheeb xyuas cov kab mob cuam tshuam nrog kev siv ntau txoj hauv kev tshawb fawb. Ua ntej tshaj plaws, tus kws kho mob tshwj xeeb hauv nws cov lus xaus yog ua raws li daim duab kho mob. Hauv qhov no, peb tab tom tham txog cov ntaub ntawv tau txais thaum lub sijhawm kuaj mob hlwb, nrog rau cov neeg mob tsis txaus siab. Kev kuaj mob feem ntau qhia qhov nro ntawm cov leeg occipital, nyuaj tig lub taub hau, mob thaum nias rau ntawm cov txheej txheem ntawm 1 thiab thib 2 vertebrae hauv cheeb tsam tsev menyuam. X-ray kuj tseem siv tau thaum kuaj. MRI yog qhov yuav tsum tau ua. Cov txheej txheem no tso cai rau koj los txheeb xyuas qhov tseeb ua rau muaj kev cuam tshuam ntawm cov hlab ntsha, txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhav Ib txoj hauv kev kuaj mob tseem ceeb yog UZDG (ultrasound dopplerography). Thaum kuaj mob, tus kws kho mob tshwj xeeb yuav tsum sib txawv ntawm tus mob migraine.
Kev cuam tshuam kho mob
Yog tias cov ntshav ncig raug cuam tshuam (cov hlab ntsha vertebral yog nqaim lossis deformed), kev kho mob feem ntau yog siv los ua ib qho nyuaj. Kev ntsuas kho yog nyob ntawm lub hnub nyoog ntawm tus neeg mob, qhov hnyav ntawm tus mob, nrog rau tus kheej tus yam ntxwv ntawm tus neeg mob. Vim qhov tseeb tias cov neeg mob no muaj kev pheej hmoo ntawm mob stroke, cov kev kho mob feem ntau yog tsom rau kev tshem tawm cov hlab ntsha thiab cov hlab ntsha hauv cov hlab ntsha. Lub complex siv lub tshuab nqus tsev kho mob, pharmacopuncture. Tsuas yogntawm qhov no, reflexotherapy, noj ntau cov tshuaj tau sau tseg. Ntawm cov tshuaj qhia rau kev siv yog me me antidepressants thiab anti-inflammatory tshuaj. Cov tshuaj pom zoo xws li "Aminophylline", "Cinnarizine", "Cavinton". Rau kiv taub hau, cov tshuaj "Betahistine" yog sau.
Nyob rau hauv rooj plaub ntawm kev kuaj pom ntawm cov hlab ntsha ntawm lub paj hlwb lossis tus txha caj qaum thaum lub sijhawm kuaj, pom zoo rau kev mus pw hauv tsev kho mob ntawm tus neeg mob. Thaum tsis muaj qhov xav tau ceev ceev hauv tsev kho mob, tus kws kho mob tshwj xeeb yuav pom zoo kom hnav ib ntus ntawm Shants dab tshos. Qhov corset no yog siv los txo cov load ntawm lub ncauj tsev menyuam. Tawm tsam keeb kwm yav dhau los ntawm vertebral artery syndrome, phau ntawv kho mob, physio- thiab acupuncture, electrophoresis nrog analgesics, phonophoresis, diadynamic tam sim no feem ntau tau sau tseg.
