{"id":27565,"date":"2023-04-25T15:43:16","date_gmt":"2023-04-25T08:43:16","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27565"},"modified":"2023-04-25T15:43:16","modified_gmt":"2023-04-25T08:43:16","slug":"gioi-thieu-va-phan-loai-di-dang-chiari","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/gioi-thieu-va-phan-loai-di-dang-chiari\/","title":{"rendered":"Gi\u1edbi thi\u1ec7u v\u00e0 ph\u00e2n lo\u1ea1i d\u1ecb d\u1ea1ng Chiari"},"content":{"rendered":"

D\u1ecb d\u1ea1ng Chiari (Chiari Malformation) \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t t\u1eadt b\u1ea9m sinh, m\u1eb7c d\u00f9 c\u00e1c b\u1ec7nh m\u1eafc ph\u1ea3i c\u1ee7a t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n. Gi\u00e1o s\u01b0 gi\u1ea3i ph\u1eabu b\u1ec7nh ng\u01b0\u1eddi \u0110\u1ee9c, Hans Chiari, \u0111\u00e3 \u0111\u1ea7u ti\u00ean m\u00f4 t\u1ea3 nh\u1eefng b\u1ea5t th\u01b0\u1eddng c\u1ee7a n\u00e3o b\u1ed9 \u1edf v\u1ecb tr\u00ed ch\u1ea9m c\u1ed5 v\u00e0o nh\u1eefng n\u0103m 1890. \u00d4ng ph\u00e2n lo\u1ea1i th\u1ee9 t\u1ef1 theo m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng: lo\u1ea1i I, II, III v\u00e0 IV. Thu\u1eadt ng\u1eef \u201cArnold – Chiari\u201d sau \u0111\u00f3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho d\u1ecb d\u1ea1ng Chiari lo\u1ea1i II. Nh\u1eefng d\u1ecb d\u1ea1ng n\u00e0y c\u00f9ng v\u1edbi r\u1ed7ng t\u1ee7y s\u1ed1ng hay t\u1ee7y s\u1ed1ng \u1ee9 n\u01b0\u1edbc (syringomyelia \/ hydromyelia) l\u00e0 hai t\u1eadt th\u01b0\u1eddng k\u1ebft h\u1ee3p ch\u1eb7t ch\u1ebd v\u1edbi nhau, s\u1ebd \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 d\u01b0\u1edbi \u0111\u00e2y.<\/strong><\/p>\n

1. Nh\u1eafc l\u1ea1i gi\u1ea3i ph\u1eabu<\/h2>\n

Ti\u1ec3u n\u00e3o \u0111i\u1ec1u khi\u1ec3n s\u1ef1 ph\u1ed1i h\u1ee3p c\u1ee7a v\u1eadn \u0111\u1ed9ng, v\u00e0 c\u00f3 v\u1ecb tr\u00ed b\u00ecnh th\u01b0\u1eddng \u1edf trong h\u1ed1 sau. Th\u00f4ng th\u01b0\u1eddng, ti\u1ec3u n\u00e3o bao g\u1ed3m hai n\u1eeda b\u00e1n c\u1ea7u v\u00e0 m\u1ed9t ph\u1ea7n nh\u1ecf gi\u1eefa hai b\u00e1n c\u1ea7u, \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 th\u00f9y nh\u1ed9ng ti\u1ec3u n\u00e3o (c\u00f2n g\u1ecdi l\u00e0 th\u00f9y giun \u2013 vermis). \u1ede m\u1eb7t d\u01b0\u1edbi c\u1ee7a hai b\u00e1n c\u1ea7u ti\u1ec3u n\u00e3o, c\u00f3 hai ch\u1ed7 l\u1ed3i nh\u1ecf \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 h\u1ea1nh nh\u00e2n ti\u1ec3u n\u00e3o (tonsil hay amidan ho\u1eb7c amygdale). N\u00e3o th\u1ea5t t\u01b0 l\u00e0 khoang ch\u1ee9a d\u1ecbch n\u00e3o t\u1ee7y n\u1eb1m \u1edf ph\u00eda tr\u01b0\u1edbc c\u1ee7a ti\u1ec3u n\u00e3o v\u00e0 ph\u00eda sau th\u00e2n n\u00e3o. T\u1ea5t c\u1ea3 c\u00e1c c\u1ea5u tr\u00fac n\u00e0y \u1edf ph\u00eda tr\u00ean l\u1ed7 ch\u1ea9m (hay c\u00f2n g\u1ecdi l\u00e0 l\u1ed7 l\u1edbn \u2013 magnum). \u0110\u00e2y l\u00e0 l\u1ed7 l\u1edbn nh\u1ea5t t\u1ea1i n\u1ec1n s\u1ecd m\u00e0 t\u1ee7y s\u1ed1ng \u0111i v\u00e0o v\u00e0 n\u1ed1i v\u1edbi th\u00e2n n\u00e3o.<\/p>\n

\"Nh\u1eafc
Nh\u1eafc l\u1ea1i gi\u1ea3i ph\u1eabu v\u00f9ng ti\u1ec3u n\u00e3o<\/figcaption><\/figure>\n

2. T\u1ea7n su\u1ea5t l\u01b0u h\u00e0nh<\/h2>\n

T\u1ea7n su\u1ea5t l\u01b0u h\u00e0nh trong d\u00e2n s\u1ed1 n\u00f3i chung \u0111\u00e3 \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh th\u1ea5p h\u01a1n m\u1ed9t ch\u00fat so v\u1edbi 1 \/ 1000. \u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng. D\u1ecb d\u1ea1ng Chiari th\u01b0\u1eddng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd nh\u1edd ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nh\u1eefng l\u00fd do kh\u00f4ng li\u00ean quan.<\/p>\n

3. Ph\u00e2n lo\u1ea1i d\u1ecb d\u1ea1ng Chiari<\/span><\/h2>\n

3.1. D\u1ecb d\u1ea1ng Chiari lo\u1ea1i I<\/span><\/h3>\n

D\u1ecb d\u1ea1ng n\u00e0y x\u1ea3y ra trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a thai nhi<\/strong>\u00a0v\u00e0 \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi v\u1ecb tr\u00ed h\u1ea1nh nh\u00e2n ti\u1ec3u n\u00e3o di chuy\u1ec3n xu\u1ed1ng d\u01b0\u1edbi l\u1ed7 ch\u1ea9m h\u01a1n 4 mm v\u00e0o trong \u1ed1ng s\u1ed1ng c\u1ed5. S\u1ef1 di chuy\u1ec3n n\u00e0y c\u00f3 th\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 l\u01b0u th\u00f4ng b\u00ecnh th\u01b0\u1eddng c\u1ee7a d\u1ecbch n\u00e3o t\u1ee7y gi\u1eefa \u1ed1ng t\u1ee7y s\u1ed1ng v\u00e0 kh\u00f4ng gian n\u1ed9i s\u1ecd. D\u1ecb d\u1ea1ng Chiari c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p v\u1edbi r\u1ed7ng t\u1ee7y s\u1ed1ng. N\u00f3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf thanh thi\u1ebfu ni\u00ean ho\u1eb7c ng\u01b0\u1eddi l\u1edbn.<\/p>\n

Nh\u1eefng b\u1ea5t th\u01b0\u1eddng c\u1ee7a n\u1ec1n s\u1ecd v\u00e0 c\u1ed9t s\u1ed1ng \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y trong 30-50 % b\u1ec7nh nh\u00e2n b\u1ecb d\u1ecb d\u1ea1ng Chiari lo\u1ea1i I. Ch\u00fang bao g\u1ed3m:<\/p>\n

    \n
  • Ch\u00e8n \u00e9p c\u1ee7a ph\u1ea7n tr\u00ean c\u1ee7a c\u1ed9t s\u1ed1ng v\u00e0o n\u1ec1n s\u1ecd g\u00e2y ch\u00e8n \u00e9p th\u00e2n n\u00e3o.<\/li>\n
  • D\u00ednh th\u00e2n \u0111\u1ed1t s\u1ed1ng c\u1ed5 th\u1ee9 nh\u1ea5t (C1) v\u1edbi n\u1ec1n s\u1ecd.<\/li>\n
  • D\u00ednh m\u1ed9t ph\u1ea7n \u0111\u1ed1t s\u1ed1ng c\u1ed5 th\u1ee9 nh\u1ea5t v\u00e0 th\u1ee9 hai (C1 k\u1ebft h\u1ee3p v\u1edbi C2).<\/li>\n
  • Bi\u1ebfn d\u1ea1ng Klippel \u2013 Feil (d\u00ednh b\u1ea9m sinh c\u1ee7a c\u00e1c \u0111\u1ed1t s\u1ed1ng c\u1ed5).<\/li>\n
  • T\u1eadt n\u1ee9t \u0111\u1ed1t s\u1ed1ng \u1ea9n (Spina bifida occulta)\u00a0<\/strong>.<\/li>\n
  • V\u1eb9o c\u1ed9t s\u1ed1ng \u2013 c\u00f3 trong 16-80 % b\u1ec7nh nh\u00e2n r\u1ed7ng t\u1ee7y, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf tr\u1ebb em v\u00ec c\u1ed9t s\u1ed1ng ch\u01b0a tr\u01b0\u1edfng th\u00e0nh.<\/li>\n<\/ul>\n
    \"H\u00ecnh
    H\u00ecnh \u1ea3nh tho\u00e1t v\u1ecb h\u1ea1nh nh\u00e2n ti\u1ec3u n\u00e3o xu\u1ed1ng d\u01b0\u1edbi l\u1ed7 ch\u1ea9m trong d\u1ecb d\u1ea1ng Chiari lo\u1ea1i I<\/figcaption><\/figure>\n

    Tri\u1ec7u ch\u1ee9ng c\u1ee7a d\u1ecb d\u1ea1ng Chiari lo\u1ea1i I<\/span><\/h4>\n

    Nhi\u1ec1u ng\u01b0\u1eddi b\u1ecb d\u1ecb d\u1ea1ng Chiari lo\u1ea1i I kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng. Tuy nhi\u00ean, b\u1ea5t c\u1ee9 tri\u1ec7u ch\u1ee9ng n\u00e0o sau \u0111\u00e2y \u0111\u1ec1u c\u00f3 th\u1ec3 x\u1ea3y ra, \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi nhau. M\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a \u1ed1ng t\u1ee7y (khoang d\u1ecbch n\u00e3o t\u1ee7y trong t\u1ee7y s\u1ed1ng).<\/p>\n

      \n
    • \u0110au \u0111\u1ea7u v\u00e0 c\u1ed5 n\u1eb7ng<\/li>\n
    • \u0110au \u0111\u1ea7u v\u00f9ng ch\u1ea9m v\u00e0 c\u1ea3m th\u1ea5y t\u1ed3i t\u1ec7 h\u01a1n khi ho, h\u1eaft h\u01a1i, ho\u1eb7c c\u0103ng th\u1eb3ng.<\/li>\n
    • M\u1ea5t c\u1ea3m gi\u00e1c \u0111au v\u00e0 c\u1ea3m gi\u00e1c nhi\u1ec7t \u0111\u1ed9 c\u1ee7a th\u00e2n tr\u00ean v\u00e0 c\u00e1nh tay (do r\u1ed7ng t\u1ee7y).<\/li>\n
    • Y\u1ebfu tay v\u00e0 c\u00e1nh tay (do r\u1ed7ng t\u1ee7y).<\/li>\n
    • Ng\u00e3 qu\u1ef5 do y\u1ebfu c\u01a1.<\/li>\n
    • Li\u1ec7t c\u1ee9ng.<\/li>\n
    • Ch\u00f3ng m\u1eb7t.<\/li>\n
    • V\u1ea5n \u0111\u1ec1 th\u0103ng b\u1eb1ng.<\/li>\n
    • Nh\u00ecn \u0111\u00f4i ho\u1eb7c nh\u00ecn th\u1ea5y m\u1edd.<\/li>\n
    • Qu\u00e1 m\u1eabn v\u1edbi \u00e1nh s\u00e1ng ch\u00f3i.<\/li>\n<\/ul>\n

      3.2. D\u1ecb d\u1ea1ng Chiari lo\u1ea1i II<\/span><\/h3>\n

      D\u1ecb d\u1ea1ng n\u00e0y \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 di chuy\u1ec3n xu\u1ed1ng c\u1ee7a h\u00e0nh t\u1ee7y, n\u00e3o th\u1ea5t th\u1ee9 t\u01b0 v\u00e0 ti\u1ec3u n\u00e3o v\u00e0o trong \u1ed1ng s\u1ed1ng c\u1ed5, c\u0169ng nh\u01b0 k\u00e9o d\u00e0i c\u1ee7a c\u1ea7u n\u00e3o v\u00e0 n\u00e3o th\u1ea5t t\u01b0. Lo\u1ea1i n\u00e0y\u00a0x\u1ea3y ra h\u1ea7u nh\u01b0 ch\u1ec9 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 tho\u00e1t v\u1ecb t\u1ee7y \u2013 m\u00e0ng t\u1ee7y (myelomeningocele)<\/strong>. Tho\u00e1t v\u1ecb t\u1ee7y \u2013 m\u00e0ng t\u1ee7y l\u00e0 m\u1ed9t khuy\u1ebft t\u1eadt b\u1ea9m sinh trong \u0111\u00f3 t\u1ee7y s\u1ed1ng v\u00e0 c\u1ed9t s\u1ed1ng kh\u00f4ng \u0111\u00f3ng \u0111\u00fang c\u00e1ch trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a thai nhi, k\u1ebft qu\u1ea3 l\u00e0 \u0111\u1ee9a tr\u1ebb \u0111\u01b0\u1ee3c sinh ra v\u1edbi m\u1ed9t ph\u1ea7n c\u1ee7a t\u1ee7y s\u1ed1ng b\u1ecb h\u1edf \u1edf m\u1eb7t sau. B\u1ea5t th\u01b0\u1eddng kh\u00e1c li\u00ean quan \u0111\u1ebfn tho\u00e1t v\u1ecb t\u1ee7y \u2013 m\u00e0ng t\u1ee7y bao g\u1ed3m n\u00e3o \u00fang th\u1ee7y, b\u1ea5t th\u01b0\u1eddng v\u1ec1 tim m\u1ea1ch, d\u1ecb t\u1eadt kh\u00f4ng l\u1ed7 h\u1eadu m\u00f4n c\u0169ng nh\u01b0 b\u1ea5t th\u01b0\u1eddng ti\u00eau h\u00f3a kh\u00e1c, v\u00e0 c\u00e1c b\u1ea5t th\u01b0\u1eddng sinh d\u1ee5c.<\/p>\n

      Tri\u1ec7u ch\u1ee9ng c\u1ee7a d\u1ecb d\u1ea1ng Chiari lo\u1ea1i II<\/span><\/h4>\n

      C\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn d\u1ecb d\u1ea1ng Chiari lo\u1ea1i II c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi tho\u00e1t v\u1ecb t\u1ee7y \u2013 m\u00e0ng t\u1ee7y v\u00e0\u00a0n\u00e3o \u00fang th\u1ee7y.<\/strong>\u00a0Nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u00e0y bao g\u1ed3m:<\/p>\n

        \n
      • Thay \u0111\u1ed5i nh\u1ecbp th\u1edf, bao g\u1ed3m c\u1ea3 giai \u0111o\u1ea1n ng\u01b0ng th\u1edf (m\u1ed9t th\u1eddi gian ng\u1eafn ng\u1eebng th\u1edf).<\/li>\n
      • N\u00f4n.<\/li>\n
      • Chuy\u1ec3n \u0111\u1ed9ng xu\u1ed1ng c\u1ee7a m\u1eaft, nhanh ch\u00f3ng, kh\u00f4ng t\u1ef1 \u00fd.<\/li>\n
      • Y\u1ebfu c\u00e1nh tay.<\/li>\n<\/ul>\n
        \"H\u00ecnh
        H\u00ecnh v\u1ebd minh h\u1ecda v\u00e0 h\u00ecnh MRI c\u1ee7a b\u1ec7nh nh\u00e2n b\u1ecb d\u1ecb d\u1ea1ng Chiari lo\u1ea1i II cho th\u1ea5y (1) bi\u1ebfn d\u1ea1ng h\u00ecnh tam gi\u00e1c \u0111i\u1ec3n h\u00ecnh c\u1ee7a c\u1ee7 n\u00e3o sinh t\u01b0, (2) xoang t\u0129nh m\u1ea1ch th\u1eb3ng d\u1ef1ng \u0111\u1ee9ng, (3) h\u1ed9i l\u01b0u t\u0129nh m\u1ea1ch c\u00f3 v\u1ecb tr\u00ed th\u1ea5p, (4) c\u1ea7u n\u00e3o v\u00e0 n\u00e3o th\u1ea5t t\u01b0 k\u00e9o d\u00e0i, (5) gai t\u1ee7y, (6) t\u1ee7y b\u00e1m th\u1ea5p, (7) tho\u00e1t v\u1ecb t\u1ee7y \u2013 m\u00e0ng t\u1ee7y th\u1eaft l\u01b0ng.<\/figcaption><\/figure>\n

        3.3. D\u1ecb d\u1ea1ng Chiari lo\u1ea1i III<\/span><\/h3>\n

        D\u1ecb d\u1ea1ng n\u00e0y bao g\u1ed3m h\u1ed9i ch\u1ee9ng d\u1ecb t\u1eadt b\u1ea9m sinh c\u1ed9t s\u1ed1ng (dysraphism)<\/strong> v\u1edbi tho\u00e1t v\u1ecb m\u1ed9t ph\u1ea7n c\u1ee7a ti\u1ec3u n\u00e3o<\/strong> v\u00e0\/ho\u1eb7c n\u00e3o \u1edf m\u1eb7t sau c\u1ee7a \u0111\u1ea7u ho\u1eb7c c\u1ed5. Nh\u1eefng d\u1ecb d\u1ea1ng n\u00e0y r\u1ea5t hi\u1ebfm v\u00e0 c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong s\u1edbm r\u1ea5t cao, ho\u1eb7c lo\u1ea1n th\u1ea7n kinh n\u1eb7ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n s\u1ed1ng s\u00f3t. N\u1ebfu \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c, c\u1ea7n s\u1eeda ch\u1eefa l\u1ea1i s\u1edbm c\u00e1c khi\u1ebfm khuy\u1ebft. N\u1ebfu c\u00f3 n\u00e3o \u00fang th\u1ee7y, th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u0111i k\u00e8m, c\u0169ng ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u1eb7t m\u1ed9t thi\u1ebft b\u1ecb \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 m\u1ed9t \u1ed1ng th\u00f4ng (shunt).<\/p>\n

        D\u1ecb d\u1ea1ng b\u1ea9m sinh nghi\u00eam tr\u1ecdng th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n k\u00e8m theo, c\u00f3 th\u1ec3 c\u1ea7n \u0111i\u1ec1u tr\u1ecb t\u1ed5ng qu\u00e1t. Tr\u1ebb s\u01a1 sinh c\u00f3 d\u1ecb d\u1ea1ng Chiari lo\u1ea1i III c\u00f3 th\u1ec3 c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng.<\/p>\n

        \"H\u00ecnh
        H\u00ecnh MRI c\u1ee7a hai b\u1ec7nh nh\u00e2n kh\u00e1c nhau b\u1ecb d\u1ecb d\u1ea1ng Chiari lo\u1ea1i III cho th\u1ea5y (1) n\u00e3o \u00fang th\u1ee7y, (2) s\u1ef1 di chuy\u1ec3n xu\u1ed1ng d\u01b0\u1edbi c\u1ee7a h\u00e0nh t\u1ee7y, n\u00e3o th\u1ea5t th\u1ee9 t\u01b0 v\u00e0 ti\u1ec3u n\u00e3o, (3) r\u1ed7ng t\u1ee7y s\u1ed1ng, (4) tho\u00e1t v\u1ecb t\u1ee7y \u2013 m\u00e0ng t\u1ee7y ng\u1ef1c \u2013 th\u1eaft l\u01b0ng, (5) b\u00e0ng quang th\u1ea7n kinh, (6) tho\u00e1t v\u1ecb ti\u1ec3u n\u00e3o v\u00f9ng ch\u1ea9m.<\/figcaption><\/figure>\n

        3.4. D\u1ecb d\u1ea1ng Chiari lo\u1ea1i IV<\/span><\/h3>\n

        D\u1ecb d\u1ea1ng n\u00e0y l\u00e0 lo\u1ea1i nghi\u00eam tr\u1ecdng nh\u1ea5t v\u00e0 hi\u1ebfm nh\u1ea5t. Ti\u1ec3u n\u00e3o kh\u00f4ng ph\u00e1t tri\u1ec3n b\u00ecnh th\u01b0\u1eddng. C\u00f3 th\u1ec3 c\u00f3 d\u1ecb d\u1ea1ng c\u00f3 li\u00ean quan kh\u00e1c c\u1ee7a b\u1ed9 n\u00e3o v\u00e0 th\u00e2n n\u00e3o. H\u1ea7u h\u1ebft c\u00e1c em b\u00e9 sinh ra v\u1edbi d\u1ecb d\u1ea1ng n\u00e0y kh\u00f4ng t\u1ed3n t\u1ea1i t\u1eeb giai \u0111o\u1ea1n th\u01a1 \u1ea5u.<\/p>\n

        R\u1ed7ng t\u1ee7y s\u1ed1ng hay t\u1ee7y s\u1ed1ng \u1ee9 n\u01b0\u1edbc (Syringomyelia \/ Hydromyelia)<\/strong><\/p>\n

        Khi d\u1ecbch n\u00e3o t\u1ee7y t\u1ea1o th\u00e0nh khoang ho\u1eb7c nang trong t\u1ee7y s\u1ed1ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 r\u1ed7ng t\u1ee7y s\u1ed1ng hay t\u1ee7y s\u1ed1ng \u1ee9 n\u01b0\u1edbc (syringomyelia \/ hydromyelia). \u0110\u00e2y l\u00e0 nh\u1eefng r\u1ed1i lo\u1ea1n m\u00e3n t\u00ednh ph\u00e1t tri\u1ec3n trong t\u1ee7y s\u1ed1ng, m\u1edf r\u1ed9ng ho\u1eb7c lan r\u1ed9ng theo th\u1eddi gian. Khi khoang d\u1ecbch m\u1edf r\u1ed9ng, n\u00f3 c\u00f3 th\u1ec3 thay th\u1ebf ho\u1eb7c l\u00e0m t\u1ed5n th\u01b0\u01a1ng c\u00e1c s\u1ee3i th\u1ea7n kinh trong t\u1ee7y s\u1ed1ng. M\u1ed9t lo\u1ea1t c\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra, t\u00f9y thu\u1ed9c v\u00e0o k\u00edch th\u01b0\u1edbc v\u00e0 v\u1ecb tr\u00ed c\u1ee7a r\u1ed7ng t\u1ee7y s\u1ed1ng. M\u1ea5t c\u1ea3m gi\u00e1c m\u1ed9t v\u00f9ng chi ph\u1ed1i c\u1ee7a m\u1ed9t s\u1ed1 r\u1ec5 th\u1ea7n kinh l\u00e0 m\u1ed9t trong nh\u1eefng tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh v\u00e0 v\u1eb9o c\u1ed9t s\u1ed1ng s\u1ebd ph\u00e1t tri\u1ec3n.<\/p>\n

        R\u1ed7ng t\u1ee7y s\u1ed1ng (Syringomyelia)<\/strong>\u00a0c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n. D\u1ecb d\u1ea1ng Chiari l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u, m\u1eb7c d\u00f9 nguy\u00ean nh\u00e2n tr\u1ef1c ti\u1ebfp ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5. N\u00f3 \u0111\u01b0\u1ee3c cho l\u00e0 li\u00ean quan \u0111\u1ebfn s\u1ef1 c\u1ea3n tr\u1edf s\u1ef1 l\u01b0u th\u00f4ng c\u1ee7a d\u00f2ng ch\u1ea3y d\u1ecbch n\u00e3o t\u1ee7y b\u00ecnh th\u01b0\u1eddng do ti\u1ec3u n\u00e3o l\u00e0m t\u1eafc ngh\u1ebdn \u1edf l\u1ed7 ch\u1ea9m.<\/p>\n

        T\u00ecnh tr\u1ea1ng n\u00e0y c\u0169ng c\u00f3 th\u1ec3 l\u00e0 bi\u1ebfn ch\u1ee9ng c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng, vi\u00eam m\u00e0ng n\u00e3o, kh\u1ed1i u, vi\u00eam m\u00e0ng nh\u1ec7n, ho\u1eb7c t\u1ee7y s\u1ed1ng b\u00e1m th\u1ea5p. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, r\u1ed7ng t\u1ee7y h\u00ecnh th\u00e0nh trong ph\u1ea7n c\u1ee7a t\u1ee7y s\u1ed1ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng. C\u00e0ng nhi\u1ec1u b\u1ec7nh nh\u00e2n c\u00f2n s\u1ed1ng s\u00f3t sau t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng th\u00ec r\u1ed7ng t\u1ee7y s\u1ed1ng sau ch\u1ea5n th\u01b0\u01a1ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u0103ng l\u00ean.<\/p>\n

        T\u1ee7y s\u1ed1ng \u1ee9 n\u01b0\u1edbc (Hydromyelia) t<\/strong>h\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ef1 gi\u00e3n r\u1ed9ng b\u1ea5t th\u01b0\u1eddng \u1ed1ng trung t\u00e2m c\u1ee7a tu\u1ef7 s\u1ed1ng. \u1ed0ng trung t\u00e2m l\u00e0 m\u1ed9t khoang d\u1ecbch r\u1ea5t m\u1ecfng \u1edf gi\u1eefa t\u1ee7y s\u1ed1ng v\u00e0 l\u00e0 d\u1ea5u t\u00edch c\u1ee7a s\u1ef1 ph\u00e1t tri\u1ec3n b\u00ecnh th\u01b0\u1eddng.<\/p>\n

        Tri\u1ec7u ch\u1ee9ng c\u1ee7a d\u1ecb d\u1ea1ng Chiari lo\u1ea1i IV<\/span><\/h4>\n
          \n
        • V\u1eb9o c\u1ed9t s\u1ed1ng.<\/li>\n
        • M\u1ea5t c\u1ea3m gi\u00e1c, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u1ea3m gi\u00e1c n\u00f3ng v\u00e0 l\u1ea1nh.<\/li>\n
        • Y\u1ebfu v\u00e0 co c\u1ee9ng c\u01a1.<\/li>\n
        • M\u1ea5t ki\u1ec3m so\u00e1t ru\u1ed9t v\u00e0 b\u00e0ng quang.<\/li>\n
        • Suy gi\u1ea3m v\u1eadn \u0111\u1ed9ng.<\/li>\n
        • \u0110au m\u00e3n t\u00ednh.<\/li>\n
        • Nh\u1ee9c \u0111\u1ea7u (th\u01b0\u1eddng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c d\u1ecb d\u1ea1ng Chiari).<\/li>\n<\/ul>\n

          Ngu\u1ed3n:<\/p>\n

            \n
          1. BS. L\u00e2m Xu\u00e2n Nh\u00e3 – Y h\u1ecdc c\u1ed9ng \u0111\u1ed3ng<\/li>\n
          2. American Association of Neurological surgeons.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

            D\u1ecb d\u1ea1ng Chiari (Chiari Malformation) \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t t\u1eadt b\u1ea9m sinh, m\u1eb7c d\u00f9 c\u00e1c b\u1ec7nh m\u1eafc ph\u1ea3i c\u1ee7a t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n. Gi\u00e1o s\u01b0 gi\u1ea3i ph\u1eabu b\u1ec7nh ng\u01b0\u1eddi \u0110\u1ee9c, Hans Chiari, \u0111\u00e3 \u0111\u1ea7u ti\u00ean m\u00f4 t\u1ea3 nh\u1eefng b\u1ea5t th\u01b0\u1eddng c\u1ee7a n\u00e3o b\u1ed9 \u1edf v\u1ecb tr\u00ed ch\u1ea9m c\u1ed5 v\u00e0o nh\u1eefng n\u0103m 1890. […]<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nGi\u1edbi thi\u1ec7u v\u00e0 ph\u00e2n lo\u1ea1i d\u1ecb d\u1ea1ng Chiari - Vinmec<\/title>\n<meta name=\"description\" content=\"D\u1ecb d\u1ea1ng Chiari (Chiari Malformation) \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t t\u1eadt b\u1ea9m sinh, \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u1ee9 t\u1ef1 theo m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng: lo\u1ea1i I, II, III v\u00e0 IV\" \/>\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=\"Gi\u1edbi thi\u1ec7u v\u00e0 ph\u00e2n lo\u1ea1i d\u1ecb d\u1ea1ng Chiari - Vinmec\" \/>\n<meta property=\"og:description\" content=\"D\u1ecb d\u1ea1ng Chiari (Chiari Malformation) \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t t\u1eadt b\u1ea9m sinh, \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u1ee9 t\u1ef1 theo m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng: lo\u1ea1i I, II, III v\u00e0 IV\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/gioi-thieu-va-phan-loai-di-dang-chiari\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-25T08:43:16+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-23-at-22.32.34-300x155.png\" \/>\n<meta name=\"author\" content=\"Tu Cam\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tu Cam\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/gioi-thieu-va-phan-loai-di-dang-chiari\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/gioi-thieu-va-phan-loai-di-dang-chiari\/\",\"name\":\"Gi\u1edbi thi\u1ec7u v\u00e0 ph\u00e2n lo\u1ea1i d\u1ecb d\u1ea1ng Chiari - 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