{"id":28063,"date":"2023-04-25T15:42:06","date_gmt":"2023-04-25T08:42:06","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28063"},"modified":"2023-04-25T15:42:06","modified_gmt":"2023-04-25T08:42:06","slug":"chan-doan-va-dieu-tri-di-dang-chiari","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/chan-doan-va-dieu-tri-di-dang-chiari\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb d\u1ecb d\u1ea1ng Chiari"},"content":{"rendered":"<p><strong><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/phan-loai-di-dang-chiari\/\">D\u1ecb d\u1ea1ng Chiari<\/a> (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. B\u1ec7nh kh\u00e1 hi\u1ebfm g\u1eb7p, t\u1ef7 l\u1ec7 l\u01b0u h\u00e0nh b\u1ec7nh th\u1ea5p h\u01a1n 1\/1000 d\u00e2n s\u1ed1. \u0110a s\u1ed1 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, b\u1ec7nh \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd khi th\u1ef1c hi\u1ec7n c\u00e1c k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh khi \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh kh\u00e1c. D\u01b0\u1edbi \u0111\u00e2y tr\u00ecnh b\u00e0y c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb d\u1ecb d\u1ea1ng Chiari<\/strong><\/p>\n<h2><strong>1. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n<p>C\u00f3 m\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m c\u00f3 th\u1ec3 gi\u00fap ch\u1ea9n \u0111o\u00e1n v\u00e0 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 d\u1ecb d\u1ea1ng v\u00e0 r\u1ed7ng t\u1ee7y s\u1ed1ng.<\/p>\n<ul>\n<li><strong><em>Ph\u01b0\u01a1ng ph\u00e1p ghi \u0111i\u1ec7n th\u1ebf g\u1ee3i th\u00ednh gi\u00e1c th\u00e2n n\u00e3o (Brainstem auditory evoked potential \u2013 BAER):<\/em><\/strong> Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y gi\u00fap ch\u00fang ta ki\u1ec3m tra t\u00ednh to\u00e0n v\u1eb9n c\u1ee7a h\u1ec7 th\u1ed1ng d\u1eabn truy\u1ec1n th\u00ednh gi\u00e1c v\u00e0 s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh xem th\u00e2n n\u00e3o ho\u1ea1t \u0111\u1ed9ng t\u1ed1t hay kh\u00f4ng.<\/li>\n<\/ul>\n<ul>\n<li><strong><em>Ch\u1ee5p c\u1eaft l\u1edbp \u0111i\u1ec7n to\u00e1n (CT hay CAT scan):<\/em><\/strong> L\u00e0 k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh \u0111\u1eb7c bi\u1ec7t c\u00f3 s\u1eed d\u1ee5ng tia X, gi\u00fap x\u00e1c \u0111\u1ecbnh t\u1ed1t k\u00edch th\u01b0\u1edbc c\u1ee7a n\u00e3o th\u1ea5t v\u00e0 hi\u1ec3n th\u1ecb m\u1ed9t t\u1eafc ngh\u1ebdn r\u00f5 r\u00e0ng. K\u1ef9 thu\u1eadt n\u00e0y k\u00e9m hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ph\u00e2n t\u00edch c\u1ee7a h\u1ed1 sau ho\u1eb7c t\u1ee7y s\u1ed1ng.<\/li>\n<\/ul>\n<ul>\n<li><strong><em>Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI):<\/em><\/strong> L\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh c\u00f3 th\u1ec3 t\u1ea1o th\u00e0nh h\u00ecnh ba chi\u1ec1u (3-D) c\u1ee7a c\u1ea5u tr\u00fac c\u01a1 th\u1ec3 nh\u1edd s\u1eed d\u1ee5ng t\u1eeb tr\u01b0\u1eddng m\u1ea1nh v\u00e0 c\u00f4ng ngh\u1ec7 m\u00e1y t\u00ednh. K\u1ef9 thu\u1eadt n\u00e0y c\u00f3 th\u1ec3 cung c\u1ea5p h\u00ecnh \u1ea3nh ch\u00ednh x\u00e1c c\u1ee7a n\u00e3o, ti\u1ec3u n\u00e3o v\u00e0 t\u1ee7y s\u1ed1ng, gi\u00fap x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 d\u1ecb d\u1ea1ng v\u00e0 ph\u00e2n bi\u1ec7t s\u1ef1 ti\u1ebfn tri\u1ec3n r\u1ea5t t\u1ed1t. MRI cung c\u1ea5p nhi\u1ec1u th\u00f4ng tin h\u01a1n CT scan \u1edf ph\u1ea7n sau c\u1ee7a n\u00e3o v\u00e0 t\u1ee7y s\u1ed1ng, v\u00e0 th\u01b0\u1eddng l\u00e0 k\u1ef9 thu\u1eadt \u0111\u01b0\u1ee3c \u01b0a th\u00edch.<\/li>\n<\/ul>\n<ul>\n<li><strong><em>Ch\u1ee5p t\u1ee7y \u0111\u1ed3 (Myleogram): <\/em><\/strong>L\u00e0 k\u1ef9 thu\u1eadt ch\u1ee5p X quang c\u1ee7a \u1ed1ng t\u1ee7y s\u1ed1ng sau khi ti\u00eam thu\u1ed1c c\u1ea3n quang v\u00e0o khoang d\u1ecbch n\u00e3o t\u1ee7y, c\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh ch\u00e8n \u00e9p l\u00ean t\u1ee7y s\u1ed1ng ho\u1eb7c d\u00e2y th\u1ea7n kinh do d\u1ecb d\u1ea1ng. K\u1ef9 thu\u1eadt n\u00e0y b\u00e2y gi\u1edd \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u00edt h\u01a1n tr\u01b0\u1edbc \u0111\u00e2y.<\/li>\n<\/ul>\n<ul>\n<li><strong><em>Ph\u01b0\u01a1ng ph\u00e1p ghi \u0111i\u1ec7n th\u1ebf g\u1ee3i c\u1ea3m gi\u00e1c th\u00e2n th\u1ec3 (SSEP):<\/em><\/strong> L\u00e0 ph\u01b0\u01a1ng ph\u00e1p ghi l\u1ea1i ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n c\u1ee7a c\u00e1c d\u00e2y th\u1ea7n kinh li\u00ean quan \u0111\u1ebfn c\u1ea3m gi\u00e1c, trong \u0111\u00f3 cung c\u1ea5p m\u1ed9t s\u1ed1 th\u00f4ng tin v\u1ec1 th\u1ea7n kinh ngo\u1ea1i vi, t\u1ee7y s\u1ed1ng, v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a n\u00e3o.<\/li>\n<\/ul>\n<h2><strong>2. \u0110i\u1ec1u tr\u1ecb d\u1ecb d\u1ea1ng Chiari<\/strong><\/h2>\n<p><strong>\u0110i\u1ec1u tr\u1ecb c\u00e1c d\u1ecb d\u1ea1ng v\u00e0 r\u1ed7ng t\u1ee7y s\u1ed1ng ph\u1ee5 thu\u1ed9c v\u00e0o lo\u1ea1i d\u1ecb d\u1ea1ng, c\u0169ng nh\u01b0 s\u1ef1 ti\u1ebfn tri\u1ec3n trong thay \u0111\u1ed5i gi\u1ea3i ph\u1eabu ho\u1eb7c tri\u1ec7u ch\u1ee9ng.<\/strong><\/p>\n<p>D\u1ecb d\u1ea1ng Chiari lo\u1ea1i I m\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng n\u00ean \u0111\u01b0\u1ee3c b\u1ea3o t\u1ed3n. Kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh cho ph\u1eabu thu\u1eadt \u201cd\u1ef1 ph\u00f2ng\u201d. N\u1ebfu d\u1ecb d\u1ea1ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 c\u00f3 tri\u1ec7u ch\u1ee9ng, ho\u1eb7c g\u00e2y ra r\u1ed7ng t\u1ee7y s\u1ed1ng, \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/p>\n<p>D\u1ecb d\u1ea1ng Chiari lo\u1ea1i II \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng, v\u00e0 c\u00e1c b\u00e1c s\u0129 \u0111\u00e3 x\u00e1c \u0111\u1ecbnh r\u1eb1ng kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng n\u00e3o \u00fang th\u1ee7y. Trong m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, t\u1ee7y b\u00e1m th\u1ea5p c\u0169ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n th\u1ea5y. Nhi\u1ec1u tr\u1ebb tr\u1edf n\u00ean c\u00f3 tri\u1ec7u ch\u1ee9ng t\u1eeb d\u1ecb d\u1ea1ng Chiari II, tri\u1ec7u ch\u1ee9ng kh\u1edfi ph\u00e1t, ti\u1ebfn tri\u1ec3n n\u1eb7ng v\u00e0 nhanh ch\u00f3ng, v\u00e0 \u0111i\u1ec1u n\u00e0y \u0111\u00f2i h\u1ecfi m\u1ed9t c\u00e1ch ti\u1ebfp c\u1eadn kh\u1ea9n c\u1ea5p.<\/p>\n<h3><strong>2.1. Ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb d\u1ecb d\u1ea1ng Chiari<\/strong><\/h3>\n<p>\u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt c\u00e1c d\u1ecb d\u1ea1ng t\u00f9y thu\u1ed9c v\u00e0o lo\u1ea1i d\u1ecb d\u1ea1ng. M\u1ee5c \u0111\u00edch c\u1ee7a ph\u1eabu thu\u1eadt l\u00e0 \u0111\u1ec3 l\u00e0m gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng, ho\u1eb7c ng\u0103n ch\u1eb7n s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a r\u1ed7ng t\u1ee7y s\u1ed1ng.<\/p>\n<p>D\u1ecb d\u1ea1ng lo\u1ea1i I c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ph\u1eabu thu\u1eadt gi\u1ea3i \u00e9p khu tr\u00fa b\u1eb1ng c\u00e1ch ch\u1ec9 c\u1eaft b\u1ecf x\u01b0\u01a1ng ho\u1eb7c c\u1eaft b\u1ecf x\u01b0\u01a1ng v\u00e0 m\u00e0ng c\u1ee9ng, ho\u1eb7c c\u1eaft b\u1ecf x\u01b0\u01a1ng, m\u00e0ng c\u1ee9ng v\u00e0 m\u1ed9t s\u1ed1 m\u00f4 ti\u1ec3u n\u00e3o.<\/p>\n<p>Gi\u1ea3i \u00e9p \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n d\u01b0\u1edbi g\u00e2y m\u00ea to\u00e0n th\u00e2n. N\u00f3 bao g\u1ed3m vi\u1ec7c c\u1eaft b\u1ecf m\u1eb7t sau c\u1ee7a l\u1ed7 ch\u1ea9m v\u00e0 ph\u1ea7n sau c\u1ee7a v\u00e0i \u0111\u1ed1t s\u1ed1ng c\u1ed5 \u0111\u1ea7u ti\u00ean ngang m\u1ee9c h\u1ea1nh nh\u00e2n ti\u1ec3u n\u00e3o xu\u1ed1ng th\u1ea5p. \u0110i\u1ec1u n\u00e0y cung c\u1ea5p nhi\u1ec1u kh\u00f4ng gian h\u01a1n cho n\u00e3o, t\u1ee7y s\u1ed1ng v\u00e0 c\u00e1c th\u00e0nh ph\u1ea7n ti\u1ec3u n\u00e3o. V\u00e1 l\u1ea1i ch\u1ed7 h\u1edf b\u1eb1ng m\u00f4 gh\u00e9p \u0111\u1ec3 kh\u00f4ng c\u1ea3n tr\u1edf d\u00f2ng d\u1ecbch n\u00e3o t\u1ee7y. \u0110\u00f4i khi, khoang t\u1ee7y s\u1ed1ng \u1ee9 n\u01b0\u1edbc c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u1eabn l\u01b0u b\u1eb1ng m\u1ed9t \u1ed1ng th\u00f4ng (shunt). \u1ed0ng th\u00f4ng n\u00e0y c\u00f3 th\u1ec3 chuy\u1ec3n d\u1ecbch t\u1eeb b\u00ean trong t\u1ee7y s\u1ed1ng ra b\u00ean ngo\u00e0i, ho\u1eb7c \u0111\u1ebfn ng\u1ef1c ho\u1eb7c \u1ed5 b\u1ee5ng. C\u00e1c th\u1ee7 thu\u1eadt n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n c\u00f9ng nhau ho\u1eb7c ri\u00eang r\u1ebd.<\/p>\n<p>Vi\u1ec7c gi\u1ea3i \u00e9p d\u1ecb d\u1ea1ng Chiari lo\u1ea1i II \u0111\u01b0\u1ee3c x\u1eed l\u00fd t\u01b0\u01a1ng t\u1ef1, nh\u01b0ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c gi\u1edbi h\u1ea1n trong vi\u1ec7c gi\u1ea3i \u00e9p c\u00e1c m\u00f4 trong \u1ed1ng s\u1ed1ng v\u00e0 b\u1ea3o t\u1ed3n ph\u00eda sau c\u1ee7a h\u1ed9p s\u1ecd.<\/p>\n<figure id=\"attachment_28045\" aria-describedby=\"caption-attachment-28045\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-28045\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-24-at-19.43.34-300x225.png\" alt=\"Ph\u1eabu thu\u1eadt gi\u1ea3i \u00e9p l\u1ed7 ch\u1ea9m, t\u1ea1o h\u00ecnh m\u00e0ng c\u1ee9ng\" width=\"300\" height=\"225\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-24-at-19.43.34-300x225.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Screen-Shot-2023-04-24-at-19.43.34.png 473w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-28045\" class=\"wp-caption-text\">Ph\u1eabu thu\u1eadt gi\u1ea3i \u00e9p l\u1ed7 ch\u1ea9m, t\u1ea1o h\u00ecnh m\u00e0ng c\u1ee9ng trong \u0111i\u1ec1u tr\u1ecb d\u1ecb d\u1ea1ng Chiari<\/figcaption><\/figure>\n<p><strong>2.1.1. M\u1ee5c \u0111\u00edch c\u1ee7a ph\u1eabu thu\u1eadt<\/strong><\/p>\n<ul>\n<li>Gi\u1ea3i \u00e9p t\u1ed1i \u01b0u m\u00f4 th\u1ea7n kinh.<\/li>\n<li>T\u00e1i t\u1ea1o d\u00f2ng ch\u1ea3y d\u1ecbch n\u00e3o t\u1ee7y b\u00ecnh th\u01b0\u1eddng xung quanh v\u00e0 ph\u00eda sau ti\u1ec3u n\u00e3o.<\/li>\n<\/ul>\n<p><strong>2.1.2. Chu\u1ea9n b\u1ecb tr\u01b0\u1edbc m\u1ed5<\/strong><\/p>\n<ul>\n<li>C\u0169ng nh\u01b0 nh\u1eefng ph\u1eabu thu\u1eadt th\u00f4ng th\u01b0\u1eddng kh\u00e1c, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n nh\u1eefng x\u00e9t nghi\u1ec7m t\u1ed5ng qu\u00e1t, \u0111o \u0111i\u1ec7n tim, ch\u1ee5p ph\u1ed5i\u2026.nh\u1eb1m ph\u00e1t hi\u1ec7n nh\u1eefng b\u1ec7nh l\u00fd ti\u1ec1m \u1ea9n \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1eabu thu\u1eadt.<\/li>\n<li>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c nh\u1ecbn \u0103n t\u1eeb t\u1ed1i tr\u01b0\u1edbc m\u1ed5, kh\u00e1ng sinh Cephalosporin th\u1ebf h\u1ec7 th\u1ee9 3 v\u00e0 Vancomycin \u0111\u01b0\u1ee3c ti\u00eam tr\u01b0\u1edbc khi r\u1ea1ch da 1 gi\u1edd, Dexamethasone c\u0169ng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 tr\u00e1nh ph\u00f9 n\u00e3o.<\/li>\n<\/ul>\n<p><strong>2.1.3. Theo d\u00f5i sau m\u1ed5<\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c theo d\u00f5i s\u00e1t trong v\u00f2ng 24 gi\u1edd sau m\u1ed5 t\u1ea1i khoa h\u1ed3i s\u1ee9c th\u1ea7n kinh, nh\u1eb1m ph\u00e1t hi\u1ec7n b\u1ea5t c\u1ee9 bi\u1ebfn ch\u1ee9ng n\u00e0o li\u00ean quan \u0111\u1ebfn ph\u1eabu thu\u1eadt, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u th\u00e2n n\u00e3o.<\/li>\n<li>V\u1eadn \u0111\u1ed9ng tr\u1edf l\u1ea1i s\u1edbm ng\u00e0y th\u1ee9 2 sau m\u1ed5 nh\u1eb1m tr\u00e1nh bi\u1ebfn ch\u1ee9ng do n\u1eb1m l\u00e2u.<\/li>\n<li>C\u00f3 th\u1ec3 mang n\u1eb9p c\u1ed5 m\u1ec1m v\u00e0i tu\u1ea7n sau m\u1ed5.<\/li>\n<\/ul>\n<h2><strong>3. Bi\u1ebfn ch\u1ee9ng<\/strong><\/h2>\n<ul>\n<li>H\u00ecnh th\u00e0nh <em>Pseudomeningocele<\/em>.<\/li>\n<li>D\u00f2 d\u1ecbch n\u00e3o t\u1ee7y.<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng v\u1ebft m\u1ed5, vi\u00eam m\u00e0ng n\u00e3o.<\/li>\n<li>C\u00e1c lo\u1ea1i m\u00e1u t\u1ee5 do ph\u1eabu thu\u1eadt.<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u, t\u1ed5n th\u01b0\u01a1ng th\u00e2n n\u00e3o.<\/li>\n<\/ul>\n<p><strong>*K\u1ebft qu\u1ea3<\/strong><\/p>\n<p>Nh\u1eefng l\u1ee3i \u00edch c\u1ee7a ph\u1eabu thu\u1eadt lu\u00f4n lu\u00f4n ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc v\u1edbi nguy c\u01a1 c\u1ee7a n\u00f3 mang l\u1ea1i. M\u1eb7c d\u00f9 m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n gi\u1ea3m tri\u1ec7u ch\u1ee9ng, kh\u00f4ng c\u00f3 s\u1ef1 \u0111\u1ea3m b\u1ea3o r\u1eb1ng ph\u1eabu thu\u1eadt s\u1ebd gi\u00fap \u00edch cho m\u1ed7i c\u00e1 nh\u00e2n. T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh m\u00e0 \u0111\u00e3 x\u1ea3y ra th\u01b0\u1eddng kh\u00f4ng th\u1ec3 h\u1ed3i ph\u1ee5c l\u1ea1i \u0111\u01b0\u1ee3c. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u00e3 ph\u1eabu thu\u1eadt c\u1ea7n ph\u1ea3i ph\u1eabu thu\u1eadt l\u1ea1i, trong khi nh\u1eefng ng\u01b0\u1eddi kh\u00e1c c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng.<\/p>\n<h2><strong>4. Ti\u00ean l\u01b0\u1ee3ng\u00a0<\/strong><\/h2>\n<p>D\u1ef1 h\u1eadu\u00a0<strong>sau m\u1ed5 d\u1ecb d\u1ea1ng Chiari lo\u1ea1i I th\u01b0\u1eddng t\u1ed1t<\/strong>, t\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh c\u1ee7a b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, nh\u1eefng tr\u01b0\u1eddng h\u1ee3p tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh tr\u01b0\u1edbc m\u1ed5 \u00edt, ho\u1eb7c ch\u1ec9 c\u00f3 \u0111au, sau m\u1ed5 th\u01b0\u1eddng h\u1ed3i ph\u1ee5c t\u1ed1t. V\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh tr\u01b0\u1edbc m\u1ed5 n\u1eb7ng, y\u1ebfu c\u01a1 ho\u1eb7c teo c\u01a1 k\u00e9o d\u00e0i, d\u1ef1 h\u1eadu sau m\u1ed5 th\u01b0\u1eddng kh\u00f4ng kh\u1ea3 quan.<\/p>\n<p>Ngu\u1ed3n:<\/p>\n<ol>\n<li>BS. L\u00e2m Xu\u00e2n Nh\u00e3 &#8211; Y h\u1ecdc c\u1ed9ng \u0111\u1ed3ng<\/li>\n<li>American Association of Neurological surgeons.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>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. B\u1ec7nh kh\u00e1 hi\u1ebfm g\u1eb7p, t\u1ef7 l\u1ec7 l\u01b0u h\u00e0nh b\u1ec7nh th\u1ea5p h\u01a1n 1\/1000 d\u00e2n s\u1ed1. \u0110a s\u1ed1 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, b\u1ec7nh \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd khi [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb d\u1ecb d\u1ea1ng Chiari - Vinmec<\/title>\n<meta name=\"description\" content=\"D\u1ecb d\u1ea1ng Chiari \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t t\u1eadt b\u1ea9m sinh. \u0110i\u1ec1u tr\u1ecb c\u00e1c d\u1ecb d\u1ea1ng Chiari v\u00e0 r\u1ed7ng t\u1ee7y s\u1ed1ng ph\u1ee5 thu\u1ed9c v\u00e0o lo\u1ea1i d\u1ecb d\u1ea1ng.\" \/>\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=\"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb d\u1ecb d\u1ea1ng Chiari - 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