orka miya churralari (spina bifida)

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poroki razvitiya tsentralnoy nervnoy sistemi markaziy nerv sistemasi rivojlanish nuksonlari prof.kariev g.m. asosiy nozologik turlari orka miya churralari bosh miya churralari kraniostenoz dendi-uokera sindromi arnold-kiari sindromi orka miya churralari (spina bifida) tulik eki notulik raxishiz spina bifida complicata : - meningotsele - meningoradikulotsele - meningomielotsele spina bifida occulta spina bifida anterior statistika xar 1000 mingta chakalokdan 1 tasida kuzatilishi mumkin lokalizatsiyasi buyicha: 60% - bel umurtkalari soxasida 22,5% - dumgaza soxasida 10% - kukrak umurtkalari soxasida 7.5% - buyin umurtkalari soxasida diagnostika maxalliy uzgarishlar nevrologik tekshirishlar rentgenografiya, uzd, kt eki mrt genetik tekshirishlar meningotsele klinikasi yumshok elastik konsistentsiyali usmasimon xosila bulishi shish kuzatilgan soxa terisini yupkalashganligi va yalliglanish belgilari kuzatilishi orka miya va orka miya ildizchalarining zararlanish belgilari bulmasligi meningoradikulotsele klinikasi meningotseledagi barcha uzgarishlar + bitta, ikkita eki birnecha ildizchalar zararlanish belgilari bulishi chanok a'zolari faoliyatini buzilish belgilari bulishi meningomieloradikulotsele xuddi yukoridagidagidek + zararlangan soxadan pastida orka miya faoliyatini tulik …

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kura - sagital kraniostenoz - koronar kraniostenoz - umumiy kraniostenoz kompensatsiya darajasiga kura - kompensatsiyalashgan - subkompensatsiyalashgan - dekompensatsiyalashgan diagnostikasi kalla suyagi obzor rentgenografiyasi 2 ta proektsiyada oftalmologik tekshirishlar nevrologik tekshirishlar klinikasi tashki kurinish: trigonotsefaliya, dolixotsefaliya, braxotsefaliya ekzoftalm psixomotor rivojlanishdan ortda kolish kalla suyagi ichi bosimini ortish belgilari davosi chultokli kraniotomiya tsirkulyar kraniotomiya malformatsiya arnold-kiari (arnold-chiari malformation) nepravilnoe formirovanie struktur zadney cherepnoy yamki i opushenie mindalin mozjechka v bolshoe zatilochnoe otverstie, so sdavleniem stvola mozga i narusheniem likvorotsirkulyatsii klassifikatsiya arnold-kiari 1 – opushenie mindalin mozjechka nije urovnya foramen magnum, i razvitiem siringomielii klassifikatsiya arnold-kiari 2 – virajennoe opushenie mindalin mozjechka v foramen magnum, i kaudalnaya dislokatsiya stvola mozga. kaudalnie nervi imeyut vosxodyashee napravlenie (v norme nisxodyashee). chasto (90%) soprovojdaetsya razvitiem meningotsele. klassifikatsiya arnold-kiari 3 – naibolee tyajelaya forma i obichno nesovmestima s jiznyu, t.k. soprovojdaetsya entsefalomeningotsele klinika arnold-kiari mak 1 : sheyno-zatilochnie golovnie boli, mozjechkovie rasstroystva, pri siringomielii - dissotsiirovannie …

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stikoy obolochki mak 3 - neoperabelni isxodi pri mak 1 – uluchshenie - 87%, stabilizatsiya sostoyaniya 13% pri mak 2 – uluchshenie – 80%. odnako u 20% neobxodimo provodit 2 etap operatsii. ploxie rezultati u detey do 1 goda, i osnovnaya prichina ostanovka dixaniya anomaliya dendi-uokera (dandy-walker) ageneziya (otsutstvie) chervya mozjechka s formirovaniem bolshoy kisti zchya, soobshayusheysya s 4-m jeludochkom, v rezultate atrezii otverstiy majandi i lyushka. klinika i diagnostika gidrotsefaliya nablyudaetsya u >90% bolnix s anomaliey dendi-uokera i, poetomu osnovnimi simptomami v rannem detskom vozraste budut simptomi progressiruyushey gidrotsefalii. diagnoz podtverjdaetsya putem provedeniya kt ili mrt (predpochtitelnee) golovnogo mozga. mrt rezultati pri adu lechenie tolko likvoroshuntiruyushie operatsii - v kistu (schitaetsya predpochtitelnim tolko pri ochen bolshix kistax zchya) - v bokovoy jeludochek (naibolee standartnaya taktika) - v kistu i bokovoy jeludochek (v sluchae soputstvuyushey okklyuzii silvievogo vodoprovoda) isxodi vijivaemost novorojdennix v bolshinstve sovremennix seriy sostavlyaet >80%. odnako, funktsionalniy nevrologicheskiy …

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"orka miya churralari (spina bifida)" haqida

poroki razvitiya tsentralnoy nervnoy sistemi markaziy nerv sistemasi rivojlanish nuksonlari prof.kariev g.m. asosiy nozologik turlari orka miya churralari bosh miya churralari kraniostenoz dendi-uokera sindromi arnold-kiari sindromi orka miya churralari (spina bifida) tulik eki notulik raxishiz spina bifida complicata : - meningotsele - meningoradikulotsele - meningomielotsele spina bifida occulta spina bifida anterior statistika xar 1000 mingta chakalokdan 1 tasida kuzatilishi mumkin lokalizatsiyasi buyicha: 60% - bel umurtkalari soxasida 22,5% - dumgaza soxasida 10% - kukrak umurtkalari soxasida 7.5% - buyin umurtkalari soxasida diagnostika maxalliy uzgarishlar nevrologik tekshirishlar rentgenografiya, uzd, kt eki mrt genetik tekshirishlar meningotsele klinikasi yumshok elastik konsisten...

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