Topic: Maradhi ya kiharusi (stroke)

Maana ya Kiharusi











Kiharusi ni hali inayotokea pale mishipa inayosambaza damu kwenye ubongo inapopatwa na misukosuko kiasi cha kushindwa kupeleka damu kwenye ubongo na hivyo kuathiri ufanyaji kazi wa ubongo kwa zaidi ya masaa 24.


Kulingana na shirika la afya duniani kiharusi ni nakisi katika neva ambayo hutokana na tatizo katika mishipa ya damu ya ubongo na ambalo huendelea zaidi ya masaa 24 au kukoma ndani ya masaa 24. Muda wa masaa 24 umechukuliwa ili kutofautisha kiharusi na kiharusi cha kukosa oksijeni katika ubongo (ischemia) ambacho hutokea na kudumu kwa muda mfupi yaani (transient ischemic attack).


Kwa kawaida dalili za TIA hupotea na mtu kurudia hali yake ya kawaida ndani ya masaa 24.





Aina za kiharusi


Kiharusi kimegawanyika katika aina kuu mbili kulingana na jinsi kinavyotokea (visababishi vyake). Aina hizo ni


1. Kiharusi cha kukosa hewa kwenye Ubongo (Ischemic stroke)


Aina hii ya kiharusi hutokea iwapo usambazaji wa damu katika sehemu ya ubongo hupungua na kupelekea tishu za ubongo za eneo liliathirika kushindwa kufanya kazi zake vizuri.


Aina hii ya kiharusi husababishwa na nini?


Aina hii ya kiharusi husababishwa na


Damu iliyoganda kuziba mishipa midogo ndani ya ubongo (cerebral thrombosis) au
Kipande cha damu kumeguka na kwenda kuziba mshipa wa damu kwenye ubongo(cerebral embolism)
Kupungua kwa usambazaji wa damu kwa ujumla kwa mfano shock.
Vena thrombosis
2. Kiharusi cha kuvuja damu ndani ya Ubongo (Haemorrhagic Stroke)


Aina hii ya kiharusi hutokea pale ambapo mishipa midogo ya damu ndani ya ubongo hupasuka na kusababisha kusambaa kwa damu ubongoni (cerebral hemorrhage). Mara nyingi aina hii ya kiharusi hutanguliwa na dalili za kichwa kuuma, au kuwepo kwa historia ya ajali ya kichwa.


Visababishi vya Kiharusi (kwa ujumla)


Wakati fulani, mishipa ya damu huzungukwa na aina fulani za mafuta yasiyofaa mwili, hali inayoitwa kitaalamu kama atherosclerotic plaque. Hali hii husababisha kuganda kwa damu katika mishipa (thrombosis) hiyo. Kuganda huku kwa damu kunaweza kutokea kwenye mishipa mikubwa au midogo inayopeleka damu kwenye ubongo. Baadhi ya mishipa mikubwa ya damu inayoweza kuathirika na tatizo hili ni pamoja na arteri za common carotid na interior carotid arteries, na arteri za vertebral. Nyingine ni mishipa midogo inayounda eneo linaloitwa circle of willis lililo katika ubongo.
Kuganda kwa chembe nyekundu za damu za mgojwa wa sickle cell kunaweza pia kusababisha kuziba mishipa ya damu hivyo kusababisha Kiharusi.
Kuganda kwa damu (embolus) kwenye mishipa ya damu ya sehemu nyingine za mwili au (hewa, mafuta, kusanyiko la vijimelea kama bakteria waletao ugonjwa wa endocarditis) huweza kusababisha kuziba kwa mishipa inayosambaza damu kwenye ubongo na hivyo kusababisha kiharusi.
Upungufu wa usafirishaji damu mwilini (systemic hypoperfusion) - Wakati fulani moyo hushindwa kusukuma damu vizuri kwenda sehemu mbalimbali za mwili ikiwemo ubongo kutokana na kufa kwa sehemu za nyama ya moyo kwa kukosa damu ya kutosha (Ischaemic Heart Diseases) au kutokana na kujaa kwa maji kwenye gamba lake la nje (pericardial effusion) au kupungua kwa damu mwilini, kunakoweza kusababishwa na mambo kadhaa. Hali hii husababisha sehemu kubwa ya mwili ikiwemo ubongo kukosa oksijeni ya kutosha na kusababisha kuathiriwa kwa sehemu ya ubongo.
Shinikizo la damu la muda mrefu lisilothibitiwa linaweza kusababisha kupasuka kwa mishipa midogo inayosambaza damu kwenye ubongo na hivyo damu kujaa kwenye ubongo (Intracerebral hemorrhage).
Dalili za kiharusi


Dalili za kiharusi hutegemea na eneo la ubongo liliathiriwa.


Iwapo sehemu ya ubongo mkubwa ( Cerebellum) itaadhirika, mgonjwa atakuwa na dalili kama kushindwa kutembea vizuri, hivyo kuathiri mwendo wake, kujihisi kizunguzungu na pia kutapika.
Iwapo sehemu ya ubongo wa kati (cerebral cortex) itakuwa imeathirika, mgonjwa atakuwa na dalili za kushindwa kuongea,kushindwa kuelewa lugha inayozungumzwa, kushindwa kuona vizuri, kuwa na ukosefu wa kumbukumbu, kuwa na mvurugiko wa mpangilio wakw wa kufikiri, kuchanganyikiwa, na kubadilika kwa mwendo wa harakati za hiari.
Iwapo mgonjwa ataadhirika sehemu ya ubongo kwenye shingo kuelekea kwenye uti wa mgongo (brain stem), mgonjwa anaweza kuwa na dalili za kuhisi mabadiliko ya harufu, ladha, kusikia na kuona; kulegea kwa misuli ya macho (ptosis); kupungua kwa ufahamu na kulegea kwa misuli ya uso; Ulegevu wa Ulimi (kushindwa kutoa nje au kusogeza upande upande); kupungua uwezo wa kumeza; ulegevu wa misuli ya shingo na kushindwa kugeuza shingo upande mmoja; kushindwa kusimama sawasawa na kuona vitu kwa hali ya utofauti; mabadiliko ya upumuaji na kiwango cha moyo kudunda.
Iwapo sehemu mojawapo ya mfumo mkuu wa neva (central nervous system) imeathirika, mgonjwa atakuwa na dalili za kupoteza ufahamu kwa upande mmoja wa mwili na kulegea kwa misuli ya uso, kuhisi ganzi mwilini, na kupungua kwa ufahamu wa hisia na hisia mtetemo.
Aidha bila kujalisha eneo lililoathiriwa, mgonjwa pia anaweza kuwa na dalili za kupoteza fahamu, maumivu makali ya kichwa na kutapika. Dalili hizi za kuumwa kichwa na kutapika kwa kawaida hutokea kwa mgonjwa mwenye kiharusi cha kuvuja damu (hemorrhagic stroke) ambacho husababisha ongezeko la shinikizo na mgandamizo wa ubongo ndani ya fuvu kutokana na kuvuja kwa damu.


Vipimo


Mionzi
CT-scan
MRI
PET
SPECT
Vipimo vingine ni;


ECG, ECHOCARDIOGRAM huwezesha kutambua hitilafu katika mapigo ya moyo (arrhythmia) na kama kuna damu iliyoganda kwenye moyo ambayo inaweza kufika kwenye ubongo
Holter monitor husaidia kutambua hitilafu katika mapigo ya moyo (arrhythmia) zinazotokea kwa vipindi
Angiogram huwezesha kugundua matatizo kwenye mishipa ya damu, na ni mishipa ipi ya damu iliyoziba.
Vipimo vya damu huwezesha kutambua uwepo wa lijamu mwilini (hypercholesterolemia) na mabadiliko mengine katika damu
Vihatarishi vya kiharusi


Vitu vinavyoweza kumuweka mtu katika hatari ya kupata kiharusi ni pamoja na


Shinikizo la damu lisilothibitiwa
Kisukari
Uvutaji sigara
Unywaji pombe kupita kiasi
Kutofanya mazoezi kabisa
Fetma (obesity)
Kuwa na cholesterol nyingi kwenye damu
Atrial fibrillation
Matibabu


Matibabu ya kiharusi hutegemea pia aina na visababishi vyake .


1. Matibabu ya kiharusi kinachotokana na ubongo kukosa hewa (Ischemic stroke)


Mgonjwa hutibiwa kwa kutumia dawa za kuyeyusha damu iliyoganda (thrombolytics) au kwa kuondoa damu iliyoganda kwa njia mbalimbali (thrombectomy). Dawa nyingine kama vile junior Aspirin na Clopidogrel hutolewa kwa ajili ya kuzuia chembe sahani kukusanyika na kuganda.


2. Matibabu ya kiharusi kinachotokana na damu kuvujia kwenye ubongo (Hemorrhagic stroke)


Aina hii ya kiharusi huitaji tathmini ya upasuaji wa neva ili kuchunguza na kutibu sababu ya damu kuvuja. Angalizo: ni hatari kumpa mgonjwa wa aina hii ya kiharusi dawa za kuyeyusha damu iliyoganda au za kuzuia kuganda maana uhatarisha maisha ya mgonjwa badal ya kumsaidia. Kwahiyo ni vizuri kwa wataalamu kufanya ufanya uchunguzi wa kutosha ili kuwa na uhakika na tatizo.


Huduma na Matunzo kwa mgonjwa wa Kiharusi


Mojawapo ya mambo muhimu ya kufanya kwa mgonjwa aliyepata kiharusi ni kumuongoza na kumuelimisha ili arudishe ujuzi wake wa maisha ya kila siku. Hapa uhitaji ushirikiano wa wauguzi, wataalamu wa viungo, wataalamu wa ushauri wa kazi na daktari. Kuna umuhimu pia wa kuwaelimisha ndugu kuhusu hali ya mgonjwa ili waweze kumsaidia katika matunzo yake nyumbani na kwenye jamii inayomzunguka.


Matarajio (prognosis)


Asilimia 75 ya wagonjwa wa kiharusi wanaonusurika kifo huwa walemavu na kusababisha kuathirika kwa ufanyaji kazi wao na kuajiriwa. Ulemavu unaweza kuwa wa kimwili au kiakili au vyote kwa pamoja.


Ulemavu wa kimwili ni pamoja na


Ulegevu wa misuli
Kujihisi ganzi sehemu mbalimbali za mwili hususani zilizoathirika
Kujikojolea
Kutoona vizuri
Kushindwa kuendelea na shughuli za kila siku
Vichomi
Vidonda shinikizo
Kukosa hamu ya chakula.
Ulemavu wa akili hujumuisha vitu kama


Mgonjwa kuwa na wasiwasi
Hofu ya mashambulizi, na
Unyongovu.
Jinsi ya kuzuia kiharusi


Zuia au tibu shinikizo la damu
Dhibiti kisukari
Fanya mazoezi
Acha kuvuta sigara
Punguza uzito
Acha kunywa pombe kupita kiasi
Tumia Junior Aspirin
Kula chakula kisichokuwa na mengi na kisicho na chumvi nyingi.
Tumia dawa za kupunguza mafuta mwilini (statins)kwa mfano Simvastatin
http://www.tanzmed.com/index.php/mag...iharusi-stroke

Asante; je chance ya kupona kwa watu waliopata stroke ikoje. Kupona nikiwa na maana ya kutokufa, hata kama atakuwa mlemavu?

By nyumba kubwa

Asante; je chance ya kupona kwa watu waliopata stroke ikoje. Kupona nikiwa na maana ya kutokufa, hata kama atakuwa mlemavu?

ipo chance ya kupona ikiwa kama atawahi kutumia dawa za tiba mbadala.

Asilimia 75 ya wagonjwa wa kiharusi wanaonusurika kifo huwa walemavu na kusababisha kuathirika kwa ufanyaji kazi wao na kuajiriwa. Ulemavu unaweza kuwa wa kimwili au kiakili au vyote kwa pamoja.




Ulemavu wa kimwili ni pamoja na




Ulegevu wa misuli
Kujihisi ganzi sehemu mbalimbali za mwili hususani zilizoathirika
Kujikojolea
Kutoona vizuri
Kushindwa kuendelea na shughuli za kila siku
Vichomi
Vidonda shinikizo
Kukosa hamu ya chakula.
Ulemavu wa akili hujumuisha vitu kama




Mgonjwa kuwa na wasiwasi
Hofu ya mashambulizi, na
Unyongovu nyumba kubwa

binafsi nashukuru sana naleo nirudie for the second time kukushukuru MziziMkavu u played your role on ma moms treatment and now she walks and talk as normal. Hakuna tena kutetemeka wala kushindwa kutumia sehem za mwili wake and hata uso umerudi to its normal position.

Mkuu ktika watu ambao huwa najiskia kuwaombea kwa Mungu ni wewe you said it nikajaribu now mma ni mzima kabisa. Umeshiri katika kuisimamia furaha yangu duniani MziziMkavu.

nawashauri wana jf doctors wawe wanatilia maanani ushauri wanaopewa na madatari hapa huwa unasadia sana.

By gfsonwin

binafsi nashukuru sana naleo nirudie for the second time kukushukuru MziziMkavu u played your role on ma moms treatment and now she walks and talk as normal. Hakuna tena kutetemeka wala kushindwa kutumia sehem za mwili wake and hata uso umerudi to its normal position.

Mkuu ktika watu ambao huwa najiskia kuwaombea kwa Mungu ni wewe you said it nikajaribu now mma ni mzima kabisa. Umeshiri katika kuisimamia furaha yangu duniani MziziMkavu.

nawashauri wana jf doctors wawe wanatilia maanani ushauri wanaopewa na madatari hapa huwa unasadia sana.

Asante na wewe Mama yetu Mwenyeezi Mungu atampa afaya njema inshallah. gfsonwin

Unajua nimekuwa interested na hii thread kwa kuwa my dady amepatwa na stroke recently ya upande mmoja, yeye ni aged kiasi 73 years na naweza sema ni over weight. Yani nimetoka ku google kuhusu stroke tu naingia JF doctor nakuta huu uzi.

Napenda baba yangu apone hata kama atakuwa na ulemavu that's why nimeuliza chance ya kupona. Yeye aligunduliwa kuwa ana pressure hata mwaka haujaisha amepata stroke. Mimi niko mbali lakini najua yuko na madaktari bingwa ingawa these days naamini kuwa tunapaswa kutafuta additional medical information whenever possible, hasa katika ulimwengu wa sasa wa IT.

Nashukuru sana kwa kunipa moyo kuwa anaweza kuishi au hata kupona.

mkuu mzizi big up sana. pale umesema ni vizuri kuwa makini kutoa dawa za kuyeyusha damu ni kweli kabisa kama vile asprin au clopidogrel sababu utaifanya damu kuwa nyepesi zaidi na hivyo kuvuja kirahisi kwenye ubongo.

What Is a Stroke?

Stroke is a medical emergency and a leading cause of death in the U.S. It occurs when a blood vessel in the brain bursts or, more commonly, when a blockage develops. Without treatment, cells in the brain quickly begin to die. The result can be serious disability or death. If a loved one is having stroke symptoms, seek emergency medical attention without delay.




Stroke Symptoms

Signs of a stroke may include:

• Sudden numbness or weakness of the body, especially on one side.
• Sudden vision changes in one or both eyes, or difficulty swallowing.
• Sudden, severe headache with unknown cause.
• Sudden problems with dizziness, walking

Stroke Test: Talk, Wave, Smile

The F.A.S.T. test helps spot symptoms. It stands for:
Face. Ask for a smile. Does one side droop?
Arms. When raised, does one side drift down?
Speech. Can the person repeat a simple sentence? Does he or she have trouble or slur words?
Time. Time is critical. Call 911 immediately if any symptoms are present.


Stroke: Time = Brain Damage

Every second counts when seeking treatment for a stroke. When deprived of oxygen, brain cells begin dying within minutes. There are clot-busting drugs that can curb brain damage, but they have to be used within three hours of the initial stroke symptoms. Once brain tissue has died, the body parts controlled by that area won't work properly. This is why stroke is a top cause of long-term disability.

Diagnosing a Stroke

When someone with stroke symptoms arrives in the ER, the first step is to determine which type of stroke is occurring. There are two main types, and they are not treated the same way. A CT scan can help doctors determine whether the symptoms are coming from a blocked blood vessel or a bleeding one. Additional tests may also be used to find the location of a blood clot or bleeding within the brain



Ischemic Stroke

The most common type of stroke is known as an ischemic stroke. Nearly nine out of 10 strokes fall into this category. The culprit is a blood clot that obstructs a blood vessel inside the brain. The clot may develop on the spot or travel through the blood from elsewhere in the body.


Hemorrhagic Stroke

Hemorrhagic strokes are less common but far more likely to be fatal. They occur when a weakened blood vessel in the brain bursts. The result is bleeding inside the brain that can be difficult to stop.

'Mini-Stroke' (TIA)

A transient ischemic attack, often called a "mini-stroke," is more like a close call. Blood flow is temporarily impaired to part of the brain, causing symptoms similar to an actual stroke. When the blood flows again, the symptoms disappear. A TIA is a warning sign that a stroke may happen soon. It's critical to see your doctor if you think you've had a TIA. There are therapies to reduce the risk of stroke.


What Causes a Stroke

A common cause of stroke is atherosclerosis -- hardening of the arteries. Plaque made of fat, cholesterol, calcium, and other substances builds up in the arteries, leaving less space for blood to flow. A blood clot may lodge in this narrow space and cause an ischemic stroke. Atherosclerosis also makes it easier for a clot to form. Hemorrhagic strokes often result from uncontrolled high blood pressure that causes a weakened artery to burst.


Risk Factors: Chronic Conditions

Certain chronic conditions increase your risk of stroke. These include:

• High blood pressure
• High cholesterol
• Diabetes
• Obesity

Taking steps to control these conditions may reduce your risk.

Risk Factors: Behaviors

Certain behaviors also increase the risk of stroke:

• Smoking
• Getting too little exercise
• Heavy use of alcohol

Risk Factors: Diet

A poor diet may increase the risk for stroke in a few significant ways. Eating too much fat and cholesterol can lead to arteries that are narrowed by plaque. Too much salt may contribute to high blood pressure. And too many calories can lead to obesity. A diet high in fruits, vegetables, whole grains, and fish may help lower stroke risk.



Risk Factors You Can't Control

Some stroke risk factors are beyond your control, such as getting older or having a family history of strokes. Gender plays a role, too, with men being more likely to have a stroke. However, more stroke deaths occur in women. Finally, race is an important risk factor. African-Americans, Native Americans, and Alaskan Natives are at greater risk compared to people of other ethnicities.

Stroke: Emergency Treatment

For an ischemic stroke, emergency treatment focuses on medicine to restore blood flow. A clot-busting medication is highly effective at dissolving clots and minimizing long-term damage, but it must be given within three hours of the onset of symptoms. Hemorrhagic strokes are more difficult to manage. Treatment usually involves attempting to control high blood pressure, bleeding, and brain swelling.


Stroke: Long-Term Damage

Whether a stroke causes long-term damage depends on its severity and how quickly treatment stabilizes the brain. The type of damage depends on where in the brain the stroke occurs. Common problems after a stroke include numbness in the arms or legs, difficulty walking, vision problems, trouble swallowing, and problems with speech and comprehension. These problems can be permanent, but many people regain most of their abilities.


Stroke Rehab: Speech Therapy

Rehabilitation is the centerpiece of the stroke recovery process. It helps patients regain lost skills and learn to compensate for damage that can't be undone. The goal is to help restore as much independence as possible. For people who have trouble speaking, speech and language therapy is essential. A speech therapist can also help patients who have trouble swallowing.

Stroke Rehab: Physical Therapy

Muscle weakness, as well as balance problems, are very common after a stroke. This can interfere with walking and other daily activities. Physical therapy is an effective way to regain strength, balance, and coordination. For fine motor skills, such as using a knife and fork, writing, and buttoning a shirt, occupational therapy can help.


Stroke Rehab: Talk Therapy

It's common for stroke survivors and their loved ones to experience a wide range of intense emotions, such as fear, anger, worry, and grief. A psychologist or mental health counselor can provide strategies for coping with these emotions. A therapist can also watch for signs of depression, which frequently strikes people who are recovering from a stroke



Stroke Prevention: Lifestyle

People who have had a stroke or TIA can take steps to prevent a recurrence:

• Quit smoking.
• Exercise and maintain a healthy weight.
• Limit alcohol and salt intake.
• Eat a healthier diet with more veggies, fish, and whole grains.

Stroke Prevention: Medications

For people with a high risk of stroke, doctors often recommend medications to lower this risk. Anti-platelet medicines, including aspirin, keep platelets in the blood from sticking together and forming clots. Anti-clotting drugs, such as warfarin, may be needed to help ward off stroke in some patients. Finally, if you have high blood pressure, your doctor will prescribe medication to lower it.

Stroke Prevention: Surgery

In some cases, a stroke results from a narrowed carotid artery -- the blood vessels that travel up each side of the neck to bring blood to the brain. People who have had a mild stroke or TIA due to this problem may benefit from surgery known as carotid endarterectomy. This procedure removes plaque from the lining of the carotid arteries and can prevent additional strokes.




Stroke Prevention: Balloon and Stent

Doctors can also treat a clogged carotid artery without major surgery in some cases. The procedure, called angioplasty, involves temporarily inserting a catheter into the artery and inflating a tiny balloon to widen the area that is narrowed by plaque. A metal tube, called a stent, can be inserted and left in place to keep the artery open.





Life After a Stroke

More than half of people who have a stroke regain the ability to take care of themselves. Those who get clot-busting drugs soon enough may recover completely. And those who experience disability can often learn to function independently through therapy. While the risk of a second stroke is higher at first, this risk drops off over time.