{"id":27384,"date":"2023-04-24T18:40:17","date_gmt":"2023-04-24T11:40:17","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27384"},"modified":"2023-04-24T18:40:17","modified_gmt":"2023-04-24T11:40:17","slug":"tiep-can-chong-mat-tai-phong-cap-cuu","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/tiep-can-chong-mat-tai-phong-cap-cuu\/","title":{"rendered":"Ti\u1ebfp c\u1eadn ch\u00f3ng m\u1eb7t t\u1ea1i ph\u00f2ng c\u1ea5p c\u1ee9u"},"content":{"rendered":"<p><strong>Ch\u00f3ng m\u1eb7t l\u00e0 c\u1ea3m gi\u00e1c m\u1ea5t th\u0103ng b\u1eb1ng, khi\u1ebfn b\u1ea1n c\u1ea3m th\u1ea5y ch\u00ednh m\u00ecnh ho\u1eb7c m\u00f4i tr\u01b0\u1eddng xung quanh quay cu\u1ed3ng, l\u1eadt nh\u00e0o, xoay tr\u00f2n khi\u1ebfn b\u1ea1n kh\u00f4ng th\u1ec3 gi\u1eef th\u0103ng b\u1eb1ng v\u00e0 t\u00e9 ng\u00e3. C\u01a1 ch\u1ebf sinh b\u1ec7nh c\u1ee7a ch\u00f3ng m\u1eb7t r\u1ea5t ph\u1ee9c t\u1ea1p v\u00e0 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb tu\u1ef3 thu\u1ed9c v\u00e0o nguy\u00ean nh\u00e2n g\u00e2y ch\u00f3ng m\u1eb7t.\u00a0 Sau \u0111\u00e2y l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ti\u1ebfp c\u1eadn \u0111\u1ec3 qu\u1ea3n l\u00fd b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t trong ph\u00f2ng c\u1ea5p c\u1ee9u nh\u1eb1m x\u00e1c \u0111\u1ecbnh c\u00e1c tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd b\u1ecb ch\u00f3ng m\u1eb7t trung \u01b0\u01a1ng c\u1ea7n ch\u1ee5p h\u00ecnh \u1ea3nh th\u1ea7n kinh v\u1edbi s\u1ef1 tr\u00ec ho\u00e3n t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng.<\/strong><\/p>\n<figure id=\"attachment_27411\" aria-describedby=\"caption-attachment-27411\" style=\"width: 490px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-27411\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/th.png\" alt=\"anh-mo-ta-benh-nhan-chong-mat\" width=\"490\" height=\"312\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/th.png 490w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/th-300x191.png 300w\" sizes=\"(max-width: 490px) 100vw, 490px\" \/><figcaption id=\"caption-attachment-27411\" class=\"wp-caption-text\">\u1ea2nh m\u00f4 t\u1ea3 b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t, cho\u00e1ng v\u00e1ng<\/figcaption><\/figure>\n<h2><span style=\"font-weight: 400;\">1. T\u1ed5ng quan<\/span><\/h2>\n<p><em><span style=\"font-weight: 400;\">1.1. Th\u1ef1c tr\u1ea1ng ch\u00f3ng m\u1eb7t t\u1ea1i ph\u00f2ng c\u1ea5p c\u1ee9u<\/span><\/em><\/p>\n<p><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/chong-mat-nguyen-nhan-trieu-chung-dieu-tri\/\">Ch\u00f3ng m\u1eb7t<\/a> chi\u1ebfm 10\u201315% nguy\u00ean nh\u00e2n v\u00e0o khoa c\u1ea5p c\u1ee9u v\u00e0 ph\u00f2ng kh\u00e1m (v\u00e0o n\u0103m 2018, con s\u1ed1 n\u00e0y l\u00e0 8%, CI 6%-10%). Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t c\u00f3 t\u1ea7m quan tr\u1ecdng l\u1edbn trong \u0111\u00e1nh gi\u00e1 t\u1ea1i khoa c\u1ea5p c\u1ee9u: c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng t\u01b0\u01a1ng t\u1ef1 c\u00f3 th\u1ec3 do c\u00e1c nguy\u00ean nh\u00e2n r\u1ea5t kh\u00e1c nhau (b\u1ec7nh tai, th\u1ea7n kinh ho\u1eb7c to\u00e0n th\u00e2n) v\u1edbi ti\u00ean l\u01b0\u1ee3ng r\u1ea5t kh\u00e1c nhau.<\/span><span style=\"font-weight: 400;\"> M\u1eb7t kh\u00e1c, c\u00f9ng m\u1ed9t b\u1ec7nh l\u00fd c\u00f3 th\u1ec3 t\u01b0\u01a1ng \u1ee9ng v\u1edbi c\u00e1c h\u1ed9i ch\u1ee9ng kh\u00e1c nhau.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"> M\u1ed9t trong nh\u1eefng v\u1ea5n \u0111\u1ec1 ch\u00ednh ph\u1ea3i \u0111\u1ed1i m\u1eb7t v\u1edbi b\u1ec7nh nh\u00e2n b\u1ecb ch\u00f3ng m\u1eb7t kh\u1edfi ph\u00e1t g\u1ea7n \u0111\u00e2y (ph\u00fat, gi\u1edd) l\u00e0 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t gi\u1eefa c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nhau c\u1ee7a ch\u00f3ng m\u1eb7t v\u00e0 tr\u00ean h\u1ebft l\u00e0 x\u00e1c \u0111\u1ecbnh xem li\u1ec7u c\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 b\u1eaft ngu\u1ed3n t\u1eeb m\u1ed9t bi\u1ebfn c\u1ed1 thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 ph\u1ea3i \u0111i\u1ec1u tr\u1ecb trong giai \u0111o\u1ea1n c\u1ea5p t\u00ednh hay kh\u00f4ng. V\u1ea5n \u0111\u1ec1 n\u1ea3y sinh khi \u0111\u1ed1i m\u1eb7t v\u1edbi b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t \u0111\u01a1n thu\u1ea7n v\u00ec khi c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u ho\u1eb7c tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh kh\u00e1c, s\u1ebd d\u1ec5 d\u00e0ng nghi ng\u1edd m\u1ed9t r\u1ed1i lo\u1ea1n trung \u01b0\u01a1ng h\u01a1n (c\u00f3 th\u1ec3 l\u00e0 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u1ea5p t\u00ednh).<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><em>1.2. C\u00e1c nghi\u00ean c\u1ee9u li\u00ean quan:<\/em>\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Trong nghi\u00ean c\u1ee9u c\u1ee7a Lee v\u00e0 c\u1ed9ng s\u1ef1, trong s\u1ed1 240 b\u1ec7nh nh\u00e2n li\u00ean ti\u1ebfp b\u1ecb nh\u1ed3i m\u00e1u ti\u1ec3u n\u00e3o \u0111\u01a1n \u0111\u1ed9c trong v\u00f9ng \u0111\u1ed9ng m\u1ea1ch v\u00e0o vi\u1ec7n trong giai \u0111o\u1ea1n c\u1ea5p t\u00ednh v\u1edbi ch\u00f3ng m\u1eb7t \u0111\u01a1n thu\u1ea7n, g\u1ee3i \u00fd vi\u00eam th\u1ea7n kinh ti\u1ec1n \u0111\u00ecnh. V\u00f9ng \u0111\u1ed9ng m\u1ea1ch ti\u1ec3u n\u00e3o sau &#8211; d\u01b0\u1edbi (PICA) l\u00e0 v\u00f9ng th\u01b0\u1eddng xuy\u00ean b\u1ecb \u1ea3nh h\u01b0\u1edfng nh\u1ea5t trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y (24\/25: 96%), ti\u1ebfp theo l\u00e0 v\u00f9ng \u0111\u1ed9ng m\u1ea1ch ti\u1ec3u n\u00e3o tr\u01b0\u1edbc &#8211; d\u01b0\u1edbi (AICA) (1\/25: 4%). Kh\u00f4ng c\u00f3 b\u1ec7nh nh\u00e2n n\u00e0o b\u1ecb nh\u1ed3i m\u00e1u v\u00f9ng \u0111\u1ed9ng m\u1ea1ch ti\u1ec3u n\u00e3o tr\u00ean (SCA). M\u1ed9t nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng vi\u1ec7c ch\u1ee5p MRI \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n v\u00e0o c\u1ea5p c\u1ee9u v\u00ec h\u1ed9i ch\u1ee9ng ti\u1ec1n \u0111\u00ecnh c\u1ea5p t\u00ednh kh\u00f4ng tr\u1ea3 l\u1eddi \u0111\u1ea7y \u0111\u1ee7 c\u00e2u h\u1ecfi, v\u00ec c\u00e1c chu\u1ed7i DWI \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong giai \u0111o\u1ea1n c\u1ea5p t\u00ednh kh\u00f4ng ph\u00e1t hi\u1ec7n c\u00e1c t\u1ed5n th\u01b0\u01a1ng thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 \u1edf h\u1ed1 s\u1ecd sau trong \u0111\u1ebfn 50% tr\u01b0\u1eddng h\u1ee3p.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Th\u1ef1c t\u1ebf l\u00e0 ch\u00f3ng m\u1eb7t trong ph\u00f2ng c\u1ea5p c\u1ee9u l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u1edbn g\u1ea7n \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c nh\u1ea5n m\u1ea1nh b\u1edfi m\u1ed9t nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u th\u1ef1c hi\u1ec7n tr\u00ean h\u01a1n 40.000 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n v\u1edbi ch\u1ea9n \u0111o\u00e1n ch\u00f3ng m\u1eb7t ngo\u1ea1i bi\u00ean. M\u1ed9t t\u1ef7 l\u1ec7 nh\u1ecf trong s\u1ed1 h\u1ecd (0,18%) b\u1ecb \u0111\u1ed9t qu\u1ef5 trong v\u00f2ng 30 ng\u00e0y t\u1eeb khi xu\u1ea5t vi\u1ec7n; m\u1eb7c d\u00f9 th\u1ea5p, nh\u01b0ng t\u1ef7 l\u1ec7 n\u00e0y cao h\u01a1n kho\u1ea3ng b\u1ea3y l\u1ea7n so v\u1edbi nh\u00f3m ch\u1ee9ng. K\u1ebft lu\u1eadn c\u1ee7a c\u00e1c t\u00e1c gi\u1ea3 nh\u1ea5n m\u1ea1nh, ngo\u00e0i t\u1ef7 l\u1ec7 bi\u1ebfn c\u1ed1 th\u1ea5p, th\u1ef1c t\u1ebf l\u00e0 m\u1ed9t s\u1ed1 \u0111\u1ed9t qu\u1ef5 c\u00f3 th\u1ec3 b\u1ecb ch\u1ea9n \u0111o\u00e1n nh\u1ea7m l\u00e0 ch\u00f3ng m\u1eb7t ngo\u1ea1i bi\u00ean ho\u1eb7c c\u00e1c c\u01a1n ch\u00f3ng m\u1eb7t c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ea3nh b\u00e1o \u0111\u1ed9t qu\u1ef5. Nghi\u00ean c\u1ee9u n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00f2a so\u1ea1n c\u00f4ng b\u1ed1, trong \u0111\u00f3 ba \u0111i\u1ec1u sau \u0111\u00e2y \u0111\u01b0\u1ee3c n\u00eau b\u1eadt l\u00ean:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0V\u1ea5n \u0111\u1ec1 <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/dot-quy-nguyen-nhan-dau-hieu-nhan-biet-cach-phong-tranh\/\">\u0111\u1ed9t qu\u1ef5<\/a> b\u1ecb ch\u1ea9n \u0111o\u00e1n nh\u1ea7m \u1edf b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t l\u1edbn nh\u01b0 th\u1ebf n\u00e0o.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Li\u1ec7u c\u00e1c nguy\u00ean nh\u00e2n c\u1ee7a ch\u1ea9n \u0111o\u00e1n sai c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c kh\u1eafc ph\u1ee5c kh\u00f4ng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Li\u1ec7u ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c s\u1edbm h\u01a1n c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 \u0111\u1ed9t qu\u1ef5 hay kh\u00f4ng.<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">2. Ti\u00eau chu\u1ea9n l\u00e2m s\u00e0ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t gi\u1eefa ch\u00f3ng m\u1eb7t c\u00f3 ngu\u1ed3n g\u1ed1c ngo\u1ea1i\u00a0<\/span><span style=\"font-weight: 400;\">bi\u00ean ho\u1eb7c trung \u01b0\u01a1ng<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Trong t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n ti\u1ec1n \u0111\u00ecnh c\u1ea5p t\u00ednh x\u1ea3y ra v\u1edbi ch\u1ee9ng ch\u00f3ng m\u1eb7t \u201c\u0111\u01a1n thu\u1ea7n\u201d (kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh kh\u00e1c), c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 tr\u00ean h\u1ebft\u00a0 l\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh-tai (neuro-otological) c\u00f3 th\u1ec3 ch\u1ec9 ra v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng, cho d\u00f9 n\u00f3 c\u00f3 \u0111ang \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u1ec7 th\u1ed1ng ti\u1ec1n \u0111\u00ecnh ngo\u1ea1i vi ho\u1eb7c trung \u01b0\u01a1ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">M\u1ed9t b\u00e0i b\u00e1o g\u1ea7n \u0111\u00e2y b\u00e1o c\u00e1o s\u1ef1 ph\u1ed5 bi\u1ebfn c\u1ee7a c\u00e1c h\u1ed9i ch\u1ee9ng ch\u00f3ng m\u1eb7t \u1edf 23.915 b\u1ec7nh nh\u00e2n c\u1ee7a Trung t\u00e2m Ch\u00f3ng m\u1eb7t v\u00e0 R\u1ed1i lo\u1ea1n C\u00e2n b\u1eb1ng \u1edf Munich-\u0110\u1ee9c v\u00e0 ch\u1ec9 ra t\u1ef7 l\u1ec7 ch\u00f3ng m\u1eb7t trung \u01b0\u01a1ng l\u00e0 tr\u00ean 50%.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><strong>\u00a0H\u1ed9i ch\u1ee9ng ti\u1ec1n \u0111\u00ecnh ngo\u1ea1i bi\u00ean<\/strong> l\u00e0 do m\u1ed9t t\u1ed5n th\u01b0\u01a1ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u00e0nh ph\u1ea7n ti\u1ec1n \u0111\u00ecnh c\u1ee7a tai trong ho\u1eb7c d\u00e2y th\u1ea7n kinh ti\u1ec1n \u0111\u00ecnh d\u1ecdc theo \u0111\u01b0\u1eddng \u0111i b\u00ean ngo\u00e0i th\u00e2n n\u00e3o. Ch\u00f3ng m\u1eb7t (vertigo), trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, l\u00e0 \u1ea3o gi\u00e1c v\u1ec1 chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a c\u1ea3nh th\u1ecb gi\u00e1c (external vertigo); n\u00f3 r\u1ea5t m\u00e3nh li\u1ec7t, v\u1edbi c\u00e1c hi\u1ec7n t\u01b0\u1ee3ng th\u1ea7n kinh th\u1ef1c v\u1eadt (neurovegetative) li\u00ean quan. C\u00e1c d\u1ea5u hi\u1ec7u ti\u1ec1n \u0111\u00ecnh &#8211; gai (Vestibulo-spinal) v\u1edbi xu h\u01b0\u1edbng c\u00f9ng b\u00ean t\u1ed5n th\u01b0\u01a1ng (fall ipsilesionally) c\u00f3 th\u1ec3 li\u00ean quan. Trong tr\u01b0\u1eddng h\u1ee3p m\u1eafc h\u1ed9i ch\u1ee9ng M\u00e9ni\u00e8re, c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng th\u00ednh gi\u00e1c nh\u01b0 m\u1ea5t th\u00ednh l\u1ef1c, \u00f9 tai nh\u1eb9, ho\u1eb7c ho\u00e0n to\u00e0n.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng trong h\u1ed9i ch\u1ee9ng ti\u1ec1n \u0111\u00ecnh ngo\u1ea1i bi\u00ean (v\u00ed d\u1ee5, t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n \u0111\u00ecnh ph\u1ea3i) \u1edf giai \u0111o\u1ea1n c\u1ea5p t\u00ednh:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rung gi\u1eadt nh\u00e3n c\u1ea7u xo\u00e1y-ngang (h\u01b0\u1edbng pha nhanh) \u0111\u00e1nh sang tr\u00e1i, d\u1eef d\u1ed9i h\u01a1n khi b\u1ec7nh nh\u00e2n nh\u00ecn sang tr\u00e1i v\u00e0 khi kh\u00f4ng nh\u00ecn ch\u0103m ch\u00fa (lu\u00f4n lu\u00f4n hi\u1ec7n di\u1ec7n).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Head impulse test d\u01b0\u01a1ng t\u00ednh khi quay \u0111\u1ea7u sang ph\u1ea3i lu\u00f4n hi\u1ec7n di\u1ec7n.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Head shaking test d\u01b0\u01a1ng t\u00ednh v\u1edbi t\u0103ng c\u01b0\u1eddng rung gi\u1eadt nh\u00e3n c\u1ea7u (th\u01b0\u1eddng g\u1eb7p)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Ph\u1ea3n \u1ee9ng nghi\u00eang nh\u00e3n c\u1ea7u (ocular tilt) sang ph\u1ea3i (kh\u00f4ng th\u01b0\u1eddng g\u1eb7p)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0T\u01b0 th\u1ebf v\u00e0 d\u00e1ng \u0111i kh\u00f4ng v\u1eefng v\u1edbi xu h\u01b0\u1edbng nghi\u00eang v\u1ec1 b\u00ean ph\u1ea3i khi \u0111\u1ee9ng (Romberg test) v\u00e0 nh\u1eafm m\u1eaft \u0111i b\u1ed9 (kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u v\u1ec1 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">N\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u \u0111i t\u1edbi \u0111i lui khi nh\u1eafm m\u1eaft, \u0111\u01b0\u1eddng \u0111i s\u1ebd c\u00f3 h\u00ecnh ng\u00f4i sao; n\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u \u0111i b\u1ed9 t\u1ea1i ch\u1ed7 50 b\u01b0\u1edbc v\u1edbi m\u1eaft nh\u1eafm (Unterberger test), anh ta s\u1ebd quay sang b\u00ean ph\u1ea3i (kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u v\u1ec1 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u v\u00e0 \u0111\u1ed9 nh\u1ea1y).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0H\u1ed9i ch\u1ee9ng ti\u1ec1n \u0111\u00ecnh ngo\u1ea1i bi\u00ean \u0111\u1eb7c tr\u01b0ng b\u1edfi rung gi\u1eadt nh\u00e3n c\u1ea7u h\u01b0\u1edbng v\u1ec1 b\u00ean l\u00e0nh. M\u1ed9t ngo\u1ea1i l\u1ec7 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a tr\u00e0n n\u1ed9i d\u1ecbch (hydrops endolymphatic) trong b\u1ec7nh M\u00e9ni\u00e8re, khi \u0111\u00f3 rung gi\u1eadt nh\u00e3n c\u1ea7u c\u00f3 th\u1ec3 h\u01b0\u1edbng v\u1ec1 ph\u00eda b\u1ecb b\u1ec7nh.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\"><strong>H\u1ed9i ch\u1ee9ng ti\u1ec1n \u0111\u00ecnh trung \u01b0\u01a1ng<\/strong> l\u00e0 do t\u1ed5n th\u01b0\u01a1ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c s\u1ee3i c\u1ee7a d\u00e2y th\u1ea7n kinh ti\u1ec1n \u0111\u00ecnh \u1edf th\u00e2n n\u00e3o, c\u00e1c nh\u00e2n ti\u1ec1n \u0111\u00ecnh, c\u00e1c quy chi\u1ebfu t\u1eeb nh\u00e2n ti\u1ec1n \u0111\u00ecnh v\u00e0 ti\u1ec3u n\u00e3o. Trong tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm hoi, t\u1ed5n th\u01b0\u01a1ng ch\u1ec9 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ea7n n\u1ed9i tr\u1ee5c (intra-axial) c\u1ee7a d\u00e2y th\u1ea7n kinh ti\u1ec1n \u0111\u00ecnh \u1edf v\u00f9ng r\u1ec5 \u0111i v\u00e0o (root entry zone), m\u1eb7c d\u00f9 v\u1ecb tr\u00ed n\u00e0y n\u00ean \u0111\u01b0\u1ee3c coi l\u00e0 trung \u01b0\u01a1ng, nh\u01b0ng c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 d\u1ea5u hi\u1ec7u s\u1ebd \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong tr\u01b0\u1eddng h\u1ee3p ngo\u1ea1i bi\u00ean. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1c, ch\u00f3ng m\u1eb7t h\u1ea7u h\u1ebft \u00edt d\u1eef d\u1ed9i h\u01a1n v\u00e0 c\u00f3 th\u1ec3 l\u00e0 \u1ea3o gi\u00e1c v\u1ec1 s\u1ef1 chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a b\u1ea3n th\u00e2n (Internal vertigo), rung gi\u1eadt nh\u00e3n c\u1ea7u kh\u00f4ng ph\u1ea3i xo\u00e1y-ngang (n\u00f3 c\u00f3 th\u1ec3 \u0111\u01a1n thu\u1ea7n l\u00e0 ngang, xo\u00e1y, d\u1ecdc, l\u1eafc), v\u00e0 h\u01b0\u1edbng c\u1ee7a n\u00f3 c\u00f3 th\u1ec3 thay \u0111\u1ed5i theo h\u01b0\u1edbng nh\u00ecn. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Khi l\u00e0m nghi\u1ec7m ph\u00e1p Romberg, b\u1ec7nh nh\u00e2n c\u00f3 xu h\u01b0\u1edbng ng\u00e3 theo m\u1ed9t h\u01b0\u1edbng; c\u00e1c test d\u00e1ng \u0111i v\u00e0 test indexes c\u00f3 th\u1ec3 c\u00f3 ho\u1eb7c kh\u00f4ng cho th\u1ea5y thay \u0111\u1ed5i theo nhi\u1ec1u h\u01b0\u1edbng v\u00e0 kh\u00f4ng nh\u1ea5t thi\u1ebft ph\u1ea3i theo h\u01b0\u1edbng ng\u01b0\u1ee3c l\u1ea1i v\u1edbi h\u01b0\u1edbng c\u1ee7a rung gi\u1eadt nh\u00e3n c\u1ea7u. C\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa kh\u00e1c, gi\u1ea3m th\u00ednh l\u1ef1c r\u00f5 r\u1ec7t (\u0111\u1ed1i v\u1edbi \u0111\u1ed9t qu\u1ef5 do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 \u1edf v\u00f9ng AICA, n\u01a1i b\u1eaft ngu\u1ed3n c\u1ee7a \u0111\u1ed9ng m\u1ea1ch th\u00ednh gi\u00e1c trong) v\u00e0 \/ ho\u1eb7c \u0111au \u0111\u1ea7u (\u0111\u1ed1i v\u1edbi t\u1ed5n th\u01b0\u01a1ng c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng ho\u1eb7c trong tr\u01b0\u1eddng h\u1ee3p migraine ti\u1ec1n \u0111\u00ecnh).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Th\u1eadt kh\u00f4ng may, kh\u00f4ng c\u00f3 m\u1ed9t d\u1ea5u hi\u1ec7u ho\u1eb7c tri\u1ec7u ch\u1ee9ng \u0111\u01a1n l\u1ebb n\u00e0o cho ph\u00e9p ch\u00fang ta ch\u1ea9n \u0111o\u00e1n ch\u00f3ng m\u1eb7t trung \u01b0\u01a1ng ho\u1eb7c ngo\u1ea1i bi\u00ean m\u1ed9t c\u00e1ch ch\u1eafc ch\u1eafn, m\u00e0 l\u00e0 ba test l\u00e2m s\u00e0ng (test l\u1eafc \u0111\u1ea7u, rung gi\u1eadt nh\u00e3n c\u1ea7u, l\u1ec7ch nghi\u00eang \u2014 HINT c\u00f3 li\u00ean quan ho\u1eb7c kh\u00f4ng v\u1edbi gi\u1ea3m th\u00ednh l\u1ef1c \u2014 HINT plus), khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t h\u1ed9i ch\u1ee9ng ti\u1ec1n \u0111\u00ecnh c\u1ea5p t\u00ednh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 c\u01a1n ch\u00f3ng m\u1eb7t \u0111\u01a1n thu\u1ea7n \u0111\u1ea7u ti\u00ean, \u0111\u00e3 cho th\u1ea5y \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u \u0111\u1ed1i v\u1edbi ch\u00f3ng m\u1eb7t m\u1ea1ch m\u00e1u (vascular vertigo) cao h\u01a1n MRI n\u00e3o trong giai \u0111o\u1ea1n c\u1ea5p t\u00ednh. Th\u1ef1c hi\u1ec7n c\u00e1c test n\u00e0y \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n v\u00e0o c\u1ea5p c\u1ee9u v\u00ec khi\u1ebfm khuy\u1ebft ti\u1ec1n \u0111\u00ecnh c\u1ea5p t\u00ednh \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 c\u1ea3 trong vi\u1ec7c c\u1ea3i thi\u1ec7n \u0111\u1ed9 ch\u00ednh x\u00e1c c\u1ee7a ch\u1ea9n \u0111o\u00e1n v\u00e0 gi\u1ea3m chi ph\u00ed cho ch\u1ee5p h\u00ecnh \u1ea3nh th\u1ea7n kinh.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">3. C\u00e1c d\u1ea1ng ch\u00f3ng m\u1eb7t c\u1ea7n ph\u00e2n bi\u1ec7t\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Khi b\u1ec7nh nh\u00e2n ph\u00e0n n\u00e0n v\u1ec1 m\u1ed9t c\u1ea3m gi\u00e1c chung chung l\u00e0 \u201ccho\u00e1ng v\u00e1ng\u201d, \u201cch\u00f3ng m\u1eb7t\u201d v\u00e0 \u201clo\u1ea1ng cho\u1ea1ng\u201d, ng\u01b0\u1eddi ta n\u00ean ph\u00e2n bi\u1ec7t gi\u1eefa c\u00e1c t\u00ecnh tr\u1ea1ng sau:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vertigo &#8211; ch\u00f3ng m\u1eb7t<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness &#8211; cho\u00e1ng v\u00e1ng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Unsteadiness &#8211; lo\u1ea1ng cho\u1ea1ng<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pre-syncope &#8211; ti\u1ec1n ng\u1ea5t\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vertigo \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 &#8220;c\u1ea3m gi\u00e1c t\u1ef1 chuy\u1ec3n \u0111\u1ed9ng khi kh\u00f4ng c\u00f3 chuy\u1ec3n \u0111\u1ed9ng n\u00e0o x\u1ea3y ra trong th\u1ef1c t\u1ebf ho\u1eb7c c\u1ea3m gi\u00e1c t\u1ef1 chuy\u1ec3n \u0111\u1ed9ng b\u1ecb b\u00f3p m\u00e9o trong m\u1ed9t chuy\u1ec3n \u0111\u1ed9ng \u0111\u1ea7u b\u00ecnh th\u01b0\u1eddng&#8221; . \u0110\u00f3 l\u00e0 m\u1ed9t \u1ea3o t\u01b0\u1edfng v\u1ec1 chuy\u1ec3n \u0111\u1ed9ng, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u1ea3m gi\u00e1c xoay ho\u1eb7c chuy\u1ec3n d\u1ecbch, v\u00e0 c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn b\u1ea3n th\u00e2n (ch\u00f3ng m\u1eb7t b\u00ean trong-internal vertigo) ho\u1eb7c m\u00f4i tr\u01b0\u1eddng xung quanh (ch\u00f3ng m\u1eb7t b\u00ean ngo\u00e0i-external vertigo).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Dizziness \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 \u201cc\u1ea3m gi\u00e1c b\u1ecb x\u00e1o tr\u1ed9n ho\u1eb7c suy gi\u1ea3m \u0111\u1ecbnh h\u01b0\u1edbng kh\u00f4ng gian m\u00e0 kh\u00f4ng c\u00f3 c\u1ea3m gi\u00e1c chuy\u1ec3n \u0111\u1ed9ng sai ho\u1eb7c b\u1ecb b\u00f3p m\u00e9o\u201d . Unsteadiness \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 \u201cc\u1ea3m gi\u00e1c kh\u00f4ng v\u1eefng khi ng\u1ed3i, \u0111\u1ee9ng ho\u1eb7c \u0111i b\u1ed9\u201d.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pre-syncope l\u00e0 c\u1ea3m gi\u00e1c s\u1eafp x\u1ea3y ra m\u1ea5t \u00fd th\u1ee9c th\u01b0\u1eddng do gi\u1ea3m to\u00e0n b\u1ed9 l\u01b0u l\u01b0\u1ee3ng m\u00e1u n\u00e3o. C\u00e1c nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 b\u1ec7nh tim m\u1ea1ch, b\u1ec7nh th\u1ea7n kinh t\u1ef1 ch\u1ee7, t\u0103ng th\u00f4ng kh\u00ed, h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf, v\u00e0 ph\u1ea3n \u1ee9ng th\u1ea7n kinh ph\u1ebf v\u1ecb. Xoang c\u1ea3nh t\u0103ng nh\u1ea1y c\u1ea3m, d\u1eabn \u0111\u1ebfn gi\u00e3n m\u1ea1ch v\u00e0 \u1ee9c ch\u1ebf tim, l\u00e0 nguy\u00ean nh\u00e2n quan tr\u1ecdng nh\u1ea5t c\u1ee7a ti\u1ec1n ng\u1ea5t \u1edf ng\u01b0\u1eddi cao tu\u1ed5i, th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn t\u00e9 ng\u00e3.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">D\u01b0\u1edbi \u0111\u00e2y l\u00e0 c\u00e1c t\u00ecnh tr\u1ea1ng c\u00f3 th\u1ec3 l\u00e0m ph\u00e1t sinh ti\u1ec1n ng\u1ea5t v\u00e0 do \u0111\u00f3 ph\u1ea3i \u0111\u01b0\u1ee3c ki\u1ec3m tra v\u00e0 t\u00ecm ki\u1ebfm.<\/span><\/p>\n<p><em><span style=\"font-weight: 400;\">Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t c\u1ee7a ti\u1ec1n ng\u1ea5t c\u00e1c t\u00ecnh tr\u1ea1ng v\u00e0 b\u1ec7nh l\u00fd nh\u01b0:<\/span><\/em><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.vinmec.com\/vi\/benh\/ha-huyet-ap-tu-the-dung-3639\/\"><span style=\"font-weight: 400;\">H\u1ea1 huy\u1ebft \u00e1p c\u00f3 tri\u1ec7u ch\u1ee9ng<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lo\u1ea1n nh\u1ecbp tim\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Thi\u1ebfu m\u00e1u\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gi\u1ea3m oxy m\u00e1u\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Thay \u0111\u1ed5i chuy\u1ec3n h\u00f3a\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Thay \u0111\u1ed5i \u0111i\u1ec7n gi\u1ea3i<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gi\u1ea3m\/t\u0103ng \u0111\u01b0\u1eddng huy\u1ebft\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.vinmec.com\/vi\/benh\/suy-than-3075\/\"><span style=\"font-weight: 400;\">Suy th\u1eadn<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cac-loai-benh-tam-thuong-gap\/\"><span style=\"font-weight: 400;\">R\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n\u00a0<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">T\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 ng\u1ed9 \u0111\u1ed9c do alcohol ho\u1eb7c thu\u1ed1c (v\u00ed d\u1ee5: ch\u1ed1ng \u0111\u1ed9ng kinh, thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng, baclofen, dantrolene, tizanidine, orphenadrine, v.v..)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">B\u1ec7nh n\u00e3o do m\u1ea1ch m\u00e1u m\u1ea1n t\u00ednh<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">4. Khai th\u00e1c b\u1ec7nh s\u1eed v\u00e0 \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u c\u1ee7a ch\u00f3ng m\u1eb7t<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">V\u1edbi m\u1ed9t b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t, c\u1ea7n ph\u1ea3i c\u00f3 n\u0103m y\u1ebfu t\u1ed1 \u0111\u1ec3 x\u00e2y d\u1ef1ng b\u1ec7nh s\u1eed th\u00f4ng qua \u201cquy tr\u00ecnh\u201d\u00a0 do Belal v\u00e0 Glorig ph\u00e1t tri\u1ec3n :<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Th\u1eddi gian (c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e0 c\u1ea5p t\u00ednh hay m\u1ea1n t\u00ednh)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn ch\u00f3ng m\u1eb7t\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng th\u00ednh gi\u00e1c\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">K\u1ecbch ph\u00e1t, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u1edbi c\u00e1c chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a \u0111\u1ea7u\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Vi\u1ec7c ph\u00e2n t\u00edch c\u00e1c y\u1ebfu t\u1ed1 n\u00e0y g\u00f3p ph\u1ea7n x\u00e2y d\u1ef1ng ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t gi\u1eefa ch\u00f3ng m\u1eb7t ngo\u1ea1i bi\u00ean ho\u1eb7c trung \u01b0\u01a1ng.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">5. Th\u0103m kh\u00e1m th\u1ea7n kinh \u1edf b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">\u1ede t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n ch\u00f3ng m\u1eb7t c\u1ea5p t\u00ednh, c\u1ea7n \u0111\u00e1nh gi\u00e1 s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a m\u1ea5t th\u00ednh l\u1ef1c (\u0111\u1eb7c bi\u1ec7t n\u1ebfu \u0111\u1ed9t ng\u1ed9t v\u00e0 m\u1ed9t b\u00ean), v\u00e0 n\u00ean ti\u1ebfn h\u00e0nh kh\u00e1m th\u1ea7n kinh nh\u01b0 sau:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Khi\u1ebfm khuy\u1ebft v\u1eadn \u0111\u1ed9ng\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Khi\u1ebfm khuy\u1ebft c\u1ea3m gi\u00e1c (nh\u1eadn c\u1ea3m, x\u00fac gi\u00e1c \u0111au, nhi\u1ec7t)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">C\u00e1c d\u1ea5u ti\u1ec3u n\u00e3o: finger tests, lo\u1ea1n v\u1eadn ng\u00f4n, r\u1ed1i lo\u1ea1n t\u01b0 th\u1ebf \u0111\u1ee9ng v\u00e0 d\u00e1ng \u0111i<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0R\u1ed1i lo\u1ea1n ng\u00f4n ng\u1eef (m\u1ea5t ng\u00f4n ng\u1eef)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Khi\u1ebfm khuy\u1ebft v\u1eadn nh\u00e3n (s\u1ef1 c\u00e2n b\u1eb1ng c\u1ee7a nh\u00e3n c\u1ea7u, gi\u1eadt nh\u00e3n c\u1ea7u, v\u00e0 chuy\u1ec3n \u0111\u1ed9ng nh\u00e3n c\u1ea7u nh\u1ecbp nh\u00e0ng<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_27402\" aria-describedby=\"caption-attachment-27402\" style=\"width: 745px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-27402\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-564.png\" alt=\"nguyen-nhan-gay-chong-mat\" width=\"745\" height=\"746\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-564.png 745w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-564-300x300.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-564-150x150.png 150w\" sizes=\"(max-width: 745px) 100vw, 745px\" \/><figcaption id=\"caption-attachment-27402\" class=\"wp-caption-text\">C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y ch\u00f3ng m\u1eb7t c\u1ea5p t\u00ednh, b\u00e1n c\u1ea5p t\u00ednh hay m\u1ea1n t\u00ednh.<\/figcaption><\/figure>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Khi\u1ebfm khuy\u1ebft d\u00e2y th\u1ea7n kinh s\u1ecd (lo\u1ea1n v\u1eadn ng\u00f4n v\u00e0\/ho\u1eb7c nu\u1ed1t kh\u00f3, th\u0103m kh\u00e1m th\u1ea7n kinh s\u1ecd IX)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">H\u1ed9i ch\u1ee9ng Bernard-Horner.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Khi\u1ebfm khuy\u1ebft th\u1ecb tr\u01b0\u1eddng (test \u0111\u1ec3 so s\u00e1nh)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ph\u1ea3n x\u1ea1 gan b\u00e0n ch\u00e2n (Plantar reflex) trong tr\u01b0\u1eddng h\u1ee3p ch\u00f3ng m\u1eb7t c\u1ea5p t\u00ednh, vi\u1ec7c ph\u00e1t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh m\u1edbi kh\u1edfi ph\u00e1t l\u00e0 ch\u1ec9 \u0111i\u1ec3m cho nguy\u00ean nh\u00e2n trung \u01b0\u01a1ng.\u00a0<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_27407\" aria-describedby=\"caption-attachment-27407\" style=\"width: 839px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-27407\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-565.png\" alt=\"dieu-tri-chong-mat\" width=\"839\" height=\"675\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-565.png 839w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-565-300x241.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screenshot-565-768x618.png 768w\" sizes=\"(max-width: 839px) 100vw, 839px\" \/><figcaption id=\"caption-attachment-27407\" class=\"wp-caption-text\">S\u01a1 \u0111\u1ed3 ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n ch\u00f3ng m\u1eb7t t\u1ea1i ph\u00f2ng c\u1ea5p<\/figcaption><\/figure>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong> Decision Algorithms for Emergency Neurology, Giuseppe Micieli, Jonathan A. Edlow.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ch\u00f3ng m\u1eb7t l\u00e0 c\u1ea3m gi\u00e1c m\u1ea5t th\u0103ng b\u1eb1ng, khi\u1ebfn b\u1ea1n c\u1ea3m th\u1ea5y ch\u00ednh m\u00ecnh ho\u1eb7c m\u00f4i tr\u01b0\u1eddng xung quanh quay cu\u1ed3ng, l\u1eadt nh\u00e0o, xoay tr\u00f2n khi\u1ebfn b\u1ea1n kh\u00f4ng th\u1ec3 gi\u1eef th\u0103ng b\u1eb1ng v\u00e0 t\u00e9 ng\u00e3. C\u01a1 ch\u1ebf sinh b\u1ec7nh c\u1ee7a ch\u00f3ng m\u1eb7t r\u1ea5t ph\u1ee9c t\u1ea1p v\u00e0 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb tu\u1ef3 thu\u1ed9c v\u00e0o nguy\u00ean nh\u00e2n g\u00e2y [&hellip;]<\/p>\n","protected":false},"author":17,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ti\u1ebfp c\u1eadn ch\u00f3ng m\u1eb7t t\u1ea1i ph\u00f2ng c\u1ea5p c\u1ee9u - Vinmec<\/title>\n<meta name=\"description\" content=\"Ch\u00f3ng m\u1eb7t l\u00e0 c\u1ea3m gi\u00e1c m\u1ea5t th\u0103ng b\u1eb1ng, khi\u1ebfn b\u1ea1n c\u1ea3m th\u1ea5y ch\u00ednh m\u00ecnh ho\u1eb7c m\u00f4i tr\u01b0\u1eddng xung quanh quay cu\u1ed3ng, l\u1eadt nh\u00e0o, xoay tr\u00f2n.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ti\u1ebfp c\u1eadn ch\u00f3ng m\u1eb7t t\u1ea1i ph\u00f2ng c\u1ea5p c\u1ee9u - 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