{"id":28436,"date":"2023-04-27T15:37:26","date_gmt":"2023-04-27T08:37:26","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28436"},"modified":"2023-04-27T15:37:26","modified_gmt":"2023-04-27T08:37:26","slug":"than-kinh-thi-giac-cach-kham-va-mot-so-ton-thuong-thuong-gap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/27\/than-kinh-thi-giac-cach-kham-va-mot-so-ton-thuong-thuong-gap\/","title":{"rendered":"Th\u1ea7n kinh th\u1ecb gi\u00e1c: C\u00e1ch kh\u00e1m v\u00e0 m\u1ed9t s\u1ed1 t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p"},"content":{"rendered":"

Th\u1ea7n kinh<\/a> th\u1ecb gi\u00e1c ch\u1ecbu tr\u00e1ch nhi\u1ec7m truy\u1ec1n t\u00edn hi\u1ec7u t\u1eeb m\u1eaft \u0111\u1ebfn v\u00f9ng th\u1ecb gi\u00e1c c\u1ee7a n\u00e3o. N\u1ebfu th\u1ea7n kinh th\u1ecb gi\u00e1c b\u1ecb t\u1ed5n th\u01b0\u01a1ng, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1ea5t th\u1ecb l\u1ef1c, nh\u00ecn m\u1edd ho\u1eb7c gi\u1ea3m t\u1ea7m nh\u00ecn, gi\u1ea3m \u0111\u1ed9 nh\u1ea1y c\u1ea3m \u00e1nh s\u00e1ng v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn th\u1ecb gi\u00e1c. C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c c\u00f3 th\u1ec3 l\u00e0 do ch\u1ea5n th\u01b0\u01a1ng, b\u1ec7nh l\u00fd ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 kh\u00e1c nh\u01b0 \u0111\u1ed9t qu\u1ef5, \u0111a x\u01a1 c\u1ee9ng, ung th\u01b0.<\/strong><\/p>\n

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D\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c \u0111\u1ea3m nh\u1eadn ch\u1ee9c n\u0103ng truy\u1ec1n t\u00edn hi\u1ec7u t\u1eeb m\u1eaft t\u1edbi v\u00f9ng th\u1ecb gi\u00e1c<\/figcaption><\/figure>\n

1. Gi\u1ea3i ph\u1eabu c\u1ee7a d\u00e2y th\u1ea7n kinh th\u1ecb gi\u00e1c<\/strong><\/h2>\n

– C\u01a1 quan c\u1ea3m th\u1ee5 (t\u1ebf b\u00e0o th\u1ee9 nh\u1ea5t) c\u1ee7a th\u1ea7n kinh th\u1ecb gi\u00e1c l\u00e0 c\u00e1c t\u1ebf b\u00e0o h\u00ecnh n\u00f3n v\u00e0 g\u1eady \u1edf v\u00f5ng m\u1ea1c.<\/p>\n

    \n
  • T\u1ebf b\u00e0o g\u1eady s\u1ed1 l\u01b0\u1ee3ng nhi\u1ec1u v\u00e0 r\u1ea3i r\u1ea3i r\u00e1c kh\u1eafp v\u00f5ng m\u1ea1c, \u0111\u00e1p \u1ee9ng v\u1edbi \u00e1nh s\u00e1ng y\u1ebfu ph\u1ee5 tr\u00e1ch th\u1ecb tr\u01b0\u01a1ng ngo\u1ea1i bi\u00ean, s\u1ef1 di chuy\u1ec3n c\u1ee7a c\u00e1c \u0111\u1ed3 v\u1eadt v\u00e0 nh\u00ecn ban \u0111\u00eam khi \u00e1nh s\u00e1ng y\u1ebfu.<\/li>\n
  • T\u1ebf b\u00e0o n\u00f3n \u00edt h\u01a1n, \u1edf kh\u1eafp v\u00f5ng m\u1ea1c nh\u01b0ng nhi\u1ec1u nh\u1ea5t \u1edf\u00a0\u0111i\u1ec3m v\u00e0ng v\u00e0 ch\u1ec9 ho\u1ea1t \u0111\u1ed9ng ban ng\u00e0y, ph\u1ee5 tr\u00e1ch v\u1ec1 m\u00e0u s\u1eafc v\u00e0 m\u00e0u \u1ea3nh tinh vi. T\u1ea1i gai th\u1ecb th\u00ec kh\u00f4ng c\u00f3 c\u00e1c t\u1ebf b\u00e0o c\u1ea3m th\u1ee5 \u00e1nh s\u00e1ng.<\/li>\n<\/ul>\n

    – L\u1edbp t\u1ebf b\u00e0o th\u1ee9 hai l\u00e0 l\u1edbp t\u1ebf b\u00e0o l\u01b0\u1ee1ng c\u1ef1c, li\u00ean h\u1ec7 v\u1edbi t\u1ebf b\u00e0o g\u1eady v\u00e0 t\u1eadn c\u00f9ng \u1edf l\u1edbp t\u1ebf b\u00e0o h\u1ea1ch, c\u00e1c s\u1ee3i tr\u1ee5c c\u1ee7a t\u1ebf b\u00e0o h\u1ea1ch \u0111i t\u1edbi gai th\u1ecb v\u00e0 t\u1ea1o th\u00e0nh th\u1ea7n kinh th\u1ecb gi\u00e1c. Nh\u01b0 v\u1eady, th\u1ea7n kinh th\u1ecb gi\u00e1c th\u1ef1c th\u1ee5 n\u1eb1m trong v\u00f5ng m\u1ea1c, c\u00f2n c\u00e1i g\u1ecdi l\u00e0 th\u1ea7n kinh th\u1ecb gi\u00e1c ch\u00ednh l\u00e0 th\u00e0nh ph\u1ea7n c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng.<\/p>\n

    – Th\u1ea7n kinh th\u1ecb gi\u00e1c d\u00e0i 5cm, trong \u0111\u00f3 g\u1ed3m 3,5cm trong h\u1ed1c m\u1eaft v\u00e0 l,5cm ngo\u00e0i h\u1ed1c m\u1eaft bao g\u1ed3m c\u00e1c s\u1ee3i kh\u00f4ng c\u00f3 bao myelin, tuy nhi\u00ean khi ra kh\u1ecfi nh\u00e3n c\u1ea7u th\u00ec c\u1ed1 bao myelin. Hai th\u1ea7n kinh th\u1ecb hai b\u00ean giao nhau t\u1ea1i giao thoa th\u1ecb gi\u00e1c. T\u1ea1i giao th\u1ecb c\u1ed1 s\u1ef1 b\u1eaft ch\u00e9o, c\u00e1c s\u1ee3i ph\u1ee5 tr\u00e1ch th\u1ecb tr\u01b0\u1eddng th\u00e1i d\u01b0\u01a1ng (g\u1ed3m kho\u1ea3ng 2\/3 s\u1ed1 s\u1ee3i) b\u1eaft ch\u00e9o qua b\u00ean \u0111\u1ed1i di\u1ec7n, sau \u0111\u00f3 t\u1ea1o th\u00e0nh d\u1ea3i th\u1ecb v\u00e0 \u0111a s\u1ed1 s\u1ee3i t\u1eadn c\u00f9ng t\u1ea1i th\u1ec3 g\u1ed1i ngo\u00e0i, t\u1ea1i \u0111\u00e2y c\u00f3 m\u1ed9t neuron t\u1ea1o th\u00e0nh tia th\u1ecb v\u00e0 \u0111i \u0111i v\u00f9ng ch\u1ea9m.<\/span><\/p>\n

    – C\u00e1c s\u1ee3i ph\u1ee5 tr\u00e1ch ph\u1ea3n x\u1ea1 \u00e1nh s\u00e1ng c\u00f9ng \u0111i chung \u0111\u01b0\u1eddng v\u1edbi s\u1ee3i d\u1eabn truy\u1ec1n \u00e1nh s\u00e1ng nh\u01b0ng kh\u00f4ng t\u1eadn c\u00f9ng \u1edf th\u1ec3 g\u1ed1i ngo\u00e0i m\u00e0 \u0111i t\u1edbi nh\u00e2n tr\u01b0\u1edbc m\u00e1i, sau \u0111\u00f3 ti\u1ebfp h\u1ee3p v\u1edbi nh\u00e2n th\u1ea7n kinh III. <\/span>V\u00f9ng ti\u1ebfp nh\u1eadn c\u1ea3m gi\u00e1c th\u1ecb gi\u00e1c n\u1eb1m \u1edf th\u00f9y ch\u1ea9m. C\u00e1c s\u1ee3i th\u1ea7n kinh xu\u1ea5t ph\u00e1t t\u1eeb \u0111i\u1ec3m v\u00e0ng c\u00f3 v\u00f9ng ph\u00f3ng chi\u1ebfu r\u1ea5t r\u1ed9ng n\u00ean \u00edt khi v\u00f9ng n\u00e0y b\u1ecb m\u1ea5t th\u1ecb l\u1ef1c trong t\u1ed5n th\u01b0\u01a1ng th\u00f9y ch\u1ea9m.<\/span><\/p>\n

    2. Th\u0103m kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n c\u1ee7a th\u1ea7n kinh th\u1ecb gi\u00e1c<\/strong><\/h2>\n

    Kh\u00e1m c\u00e1c ch\u1ee9c n\u0103ng th\u1ea7n kinh th\u1ecb gi\u00e1c g\u1ed3m c\u00f3 kh\u00e1m th\u1ecb l\u1ef1c, th\u1ecb tr\u01b0\u1eddng, ph\u00e2n bi\u1ec7t m\u00e0u s\u1eafc v\u00e0 soi \u0111\u00e1y m\u1eaft. <\/span>Kh\u00e1m t\u1ed5ng qu\u00e1t t\u00f9ng m\u1eaft m\u1ed9t, quan s\u00e1t k\u00edch th\u01b0\u1edbc \u0111\u1ed3ng t\u1eed, c\u00e1c v\u00f2ng b\u1ea5t th\u01b0\u1eddng nh\u01b0 v\u00f2ng tu\u1ed5i gi\u00e0, v\u00f2ng Kayser-Fleisher.<\/span><\/p>\n

    2.1. Th\u1ecb l\u1ef1c: <\/strong><\/h3>\n

    Kh\u00e1m b\u1eb1ng b\u1ea3ng Snellen thu nh\u1ecf ho\u1eb7c kh\u00e1m b\u1eb1ng t\u1edd b\u00e1o \u0111\u1ec3 tr\u01b0\u1edbc m\u1eaft kho\u1ea3ng 35cm. N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ea5y R\u00d5 th\u00ec s\u1eed d\u1ee5ng k\u00ednh l\u1ed7, n\u1ebfu mang k\u00ednh l\u1ed7 m\u00e0 nh\u00ecn r\u00f5 h\u01a1n th\u00ec l\u00e0 t\u1eadt kh\u00fac x\u1ea1, n\u1ebfu kh\u00f4ng r\u00f5 h\u01a1n th\u00ec l\u00e0 b\u1ec7nh th\u1ea7n kinh th\u1ecb gi\u00e1c. Th\u00f4ng th\u01b0\u1eddng, th\u1ecb l\u1ef1c \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf kho\u1ea3ng 20\/400, sau \u0111\u00f3 t\u0103ng d\u1ea7n v\u00e0 b\u00ecnh th\u01b0\u1eddng v\u00e0o l\u00fac 5 tu\u1ed5i, t\u1edbi 12 tu\u1ed5i th\u1ecb l\u1ef1c t\u1ed1t nh\u1ea5t, sau \u0111\u00f3 s\u1ebd gi\u1ea3m d\u1ea7n.<\/span><\/p>\n

    2.2. Kh\u00e1m m\u00e0u s\u1eafc: <\/strong><\/h3>\n

    D\u00f9ng c\u00e1c b\u0103ng m\u00e0u \u0111\u1ec3 kh\u00e1m, n\u1ebfu kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c m\u00e0u xanh v\u00e0 m\u00e0u \u0111\u1ecf l\u00e0 m\u00f9 m\u00e0u (Achromatopsia). \u0110\u00e2y l\u00e0 m\u1ed9t lo\u1ea1i b\u1ec7nh di truy\u1ec1n, g\u1eb7p <\/span>\u1edf <\/span>3-4% ng\u01b0\u1eddi nam v\u00e0 0,3% n\u1eef.<\/span><\/p>\n

    Th\u1ecb tr\u01b0\u1eddng: c\u1ea7n s\u1ef1 h\u1ee3p t\u00e1c c\u1ee7a b\u1ec7nh nh\u00e2n. C\u00f3 th\u1ec3 kh\u00e1m b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p so s\u00e1nh v\u1edbi th\u1ecb tr\u01b0\u1eddng c\u1ee7a b\u00e1c s\u0129 ho\u1eb7c kh\u00e1m b\u1eb1ng c\u00e1ch \u0111\u00e1nh gi\u00e1 c\u00e1c g\u00f3c nh\u00ecn \u1edf nhi\u1ec1u h\u01b0\u1edbng. Trong tr\u01b0\u1eddng h\u1ee3p mu\u1ed1n k\u1ebft qu\u1ea3 ch\u00ednh x\u00e1c th\u00ec ph\u1ea3i d\u00f9ng m\u00e1y kh\u00e1m th\u1ecb tr\u01b0\u1eddng. Trong tr\u01b0\u1eddng h\u1ee3p tr\u1ebb con hay hysterie, c\u00f3 th\u1ec3 kh\u00e1m m\u1ed9t c\u00e1ch gi\u00e1n ti\u1ebfp b\u1eb1ng c\u00e1ch \u0111\u01b0a m\u1ed9t v\u1eadt t\u1eeb ngo\u00e0i v\u00e0o th\u1ecb tr\u01b0\u1eddng, n\u1ebfu b\u1eaft \u0111\u1ea7u th\u1ea5y b\u1ec7nh nh\u00e2n s\u1ebd li\u1ebfc v\u1ec1 ph\u00eda \u0111\u1ed3 v\u1eadt.<\/span><\/p>\n

    2.3. C\u00e1c thay \u0111\u1ed5i th\u1ecb tr\u01b0\u1eddng<\/strong><\/h3>\n

    – Thu h\u1eb9p \u0111\u1ed3ng t\u00e2m: do teo gai th\u1ecb, b\u1ec7nh tho\u00e1i h\u00f3a v\u00f5ng m\u1ea1c, m\u1ec7t m\u1ecfi, m\u1ea5t t\u1eadp<\/span><\/p>\n

    – Thu h\u1eb9p h\u00ecnh \u1ed1ng: hysterie, m\u1ec7t m\u1ecfi, m\u1ea5t t\u1eadp trung<\/span><\/p>\n

    – B\u00e1n manh: B\u00e1n manh hai th\u00e1i d\u01b0\u01a1ng, do t\u1ed5n th\u01b0\u01a1ng giao thoa th\u1ecb gi\u00e1c, g\u1eb7p trong u tuy\u1ebfn y\u00ean ho\u1eb7c u s\u1ecd h\u1ea7u. B\u00e1n manh \u0111\u1ed3ng \u0111anh: m\u1ea5t n\u1eeda th\u1ecb tr\u01b0\u1eddng c\u00f9ng b\u00ean ph\u1ea3i ho\u1eb7c tr\u00e1i, do t\u1ed5n th\u01b0\u01a1ng d\u1ea3i th\u1ecb hay tia th\u1ecb. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, c\u00f3 th\u1ec3 ph\u00e2n bi\u1ec7t b\u1eb1ng ph\u1ea3n \u1ee9ng b\u00e1n manh Webike: d\u00f9ng \u0111\u00e8n r\u1ecdi t\u1eeb ph\u00eda b\u00e1n manh t\u1edbi, n\u1ebfu c\u1ed1n ph\u1ea3n x\u1ea1 \u00e1nh s\u00e1ng th\u00ec t\u1ed5n th\u01b0\u01a1ng <\/span>\u1edf <\/span>t\u00eda th\u1ecb, n\u1ebfu m\u1ea5t th\u00ec t\u1ed5n th\u01b0\u01a1ng \u1edf d\u1ea3i th\u1ecb; tuy nhi\u00ean ph\u1ea3n \u1ee9ng n\u00e0y kh\u00f4ng ho\u00e0n to\u00e0n ch\u00ednh x\u00e1c do s\u1ef1 khu\u1ebfch t\u00e1n \u00e1nh s\u00e1ng trong m\u00f4i tr\u01b0\u1eddng trong su\u1ed1t c\u1ee7a m\u1eaft. B\u00e1n manh \u0111\u1ed3ng danh th\u01b0\u1eddng g\u1eb7p \u1edf c\u00e1c u n\u00e3o v\u00f9ng th\u00e1i d\u01b0\u01a1ng, \u0111\u1ec9nh, ch\u1ea9m, tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o v\u00f9ng chi ph\u1ed1i \u0111\u1ed9ng m\u1ea1ch n\u00e3o gi\u1eefa hay n\u00e3o<\/span><\/p>\n

    – Altitudinal v\u00e0 horizontal hemianopia: V\u00f9ng m\u1ea5t th\u1ecb tr\u01b0\u1eddng n\u1eb1m tr\u00ean ho\u1eb7c d\u01b0\u1edbi, g\u1eb7p trong t\u1ed5n th\u01b0\u01a1ng v\u00f5ng m\u1ea1c do c\u00e1c b\u1ec7nh v\u1ec1 m\u1eaft.<\/span><\/p>\n

    – Scotoma: \u00e1m \u0111i\u1ec3m, l\u00e0 v\u00f9ng m\u1ea5t th\u1ecb tr\u01b0\u1eddng c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf, kh\u00f3 ph\u00e1t hi\u1ec7n khi kh\u00e1m c\u00f3 c\u00e1c lo\u1ea1i \u00e1m \u0111i\u1ec3m sau:<\/span><\/p>\n

      \n
    • \u00c1m \u0111i\u1ec3m sinh l\u00fd, n\u1eb1m kho\u1ea3ng 15 \u0111\u1ed9 v\u1ec1 ph\u00eda th\u00e1i d\u01b0\u01a1ng, l\u00e0 v\u1ecb tr\u00ed c\u1ee7a \u0111\u1ea7u th\u1ea7n kinh th\u1ecb (gai th\u1ecb).<\/span><\/li>\n
    • Central, paracentral, annular scotoma: \u00e1m \u0111i\u1ec3m n\u1eb1m ngay th\u1ecb tr\u01b0\u1eddng trung \u01b0\u01a1ng do b\u1ec7nh l\u00fd v\u00f5ng m\u1ea1c.<\/span><\/li>\n
    • Cuneate scotoma: \u00e1m \u0111i\u1ec3m h\u00ecnh ch\u00eam, do t\u1ed5n th\u01b0\u01a1ng v\u00f5ng m\u1ea1c.<\/span><\/li>\n
    • Centrocecal scotoma: \u00e1m \u0111i\u1ec3m bao c\u1ea3 \u0111i\u1ec3m v\u00e0ng v\u00e0 \u0111i\u1ec3m m\u00f9.<\/span><\/li>\n
    • Ring scotoma: \u00e1m \u0111i\u1ec3m h\u00ecnh v\u00f2ng bao quanh th\u1ecb tr\u01b0\u1eddng trung \u01b0\u01a1ng, do tho\u00e1i h\u00f3a v\u00f5ng m\u1ea1c.<\/span><\/li>\n<\/ul>\n

      2.4. Soi \u0111\u00e1y m\u1eaft<\/strong><\/h3>\n

      D\u00f9ng \u0111\u00e8n soi \u0111\u00e1y m\u1eaft (ophthalmoscope), khi soi s\u1ebd cho h\u00ecnh \u1ea3nh ph\u00f3ng \u0111\u1ea1i kho\u1ea3ng 14 l\u1ea7n; quan s\u00e1t h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u, gai th\u1ecb, \u0111i\u1ec3m v\u00e0ng.<\/span><\/p>\n

      – M\u1ea1ch m\u00e1u<\/span>: C\u00e1c m\u1ea1ch m\u00e1u quan s\u00e1t \u0111\u01b0\u1ee3c c\u00f3 k\u00edch th\u01b0\u1edbc kho\u1ea3ng 75 – 100 Jim, t\u0129nh m\u1ea1ch m\u00e0u \u0111\u1ecf s\u1eadm v\u00e0 c\u00f3 th\u1ec3 c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng \u0111\u1eadp theo nh\u1ecbp tim t\u1ea1i g\u1ed1c, \u0111\u1ed9ng m\u1ea1ch m\u00e0u \u0111\u1ecf t\u01b0\u01a1i di song song t\u0129nh m\u1ea1ch, b\u00ecnh th\u01b0\u1eddng t\u1ef7 l\u1ec7 \u0111\u1ed9ng m\u1ea1ch\/t\u0129nh m\u1ea1ch l\u00e0 2\/3, t\u1ef7 l\u1ec7 n\u00e0y thay \u0111\u1ed5i khi c\u1ed1 s\u1ef1 d\u1eabn n\u1edf t\u0129nh m\u1ea1ch hay co th\u1eaft \u0111\u1ed9ng m\u1ea1ch (t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd hay cao huy\u1ebft \u00e1p).<\/span><\/p>\n

      – Gai th\u1ecb<\/span>: M\u00e0u h\u1ed3ng v\u00e0ng, c\u00f3 d\u1ea1ng b\u1ea7u d\u1ee5c, b\u1edd gai r\u00f5 ho\u1eb7c h\u01a1i m\u1edd nh\u1eb9 ph\u00eda m\u0169i, chung quanh c\u00f3 th\u1ec3 c\u00f3 m\u1ed9t vi\u1ec1n \u0111en do l\u1edbp h\u1eafc v\u00f5ng m\u1ea1c b\u00ean d\u01b0\u1edbi l\u1ed9 ra, vi\u1ec1n \u0111en n\u00e0y c\u00f3 th\u1ec3 r\u1ea5t r\u00f5 \u1edf ng\u01b0\u1eddi c\u1eadn th\u1ecb. Khi kh\u00e1m th\u01b0\u1eddng gai th\u1ecb \u0111\u01b0\u1ee3c l\u00e0m trung t\u00e2m \u0111\u1ec3 m\u00f4 t\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng v\u00e0 kho\u1ea3ng c\u00e1ch trong \u0111\u00e1y m\u1eaft \u0111\u01b0\u1ee3c t\u00ednh b\u1eb1ng \u0111\u01b0\u1eddng k\u00ednh gai th\u1ecb. Tr\u00ean th\u1ef1c t\u1ebf, gai th\u1ecb c\u00f3 th\u1ec3 c\u00f3 h\u00ecnh \u1ea3nh to h\u01a1n b\u00ecnh th\u01b0\u1eddng trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n c\u1eadn th\u1ecb v\u00e0 nh\u1ecf h\u01a1n b\u00ecnh th\u01b0\u1eddng khi vi\u1ec5n th\u1ecb.<\/span><\/p>\n

        \n
      • Teo gai th\u1ecb nguy\u00ean ph\u00e1t: Gai th\u1ecb tr\u1eafng b\u1ec7nh v\u00e0 b\u1edd r\u1ea5t r\u00f5, m\u1ea1ch m\u00e1u ngh\u00e8o n\u00e0n (gai th\u1ecb m\u00e0u s\u1ee9), g\u1eb7p trong vi\u00eam th\u1ecb th\u1ea7n kinh h\u1eadu nh\u00e3n c\u1ea7u hay c\u00e1c t\u1ed5n th\u01b0\u01a1ng do ch\u00e8n \u00e9p tr\u1ef1c ti\u1ebfp v\u00e0o th\u1ea7n kinh th\u1ecb.<\/span><\/li>\n
      • Teo gai th\u1ee9 ph\u00e1t: B\u1edd gai m\u1edd, nham nh\u1edf, gai th\u1ecb tr\u1eafng, m\u1ea1ch m\u00e1u ngh\u00e8o n\u00e0n, do t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/span><\/li>\n
      • Ph\u00f9 gai th\u1ecb: Gai th\u1ecb v\u00e0 c\u00e1c m\u1ea1ch m\u00e1u trong gai m\u1edd trong khi v\u00f5ng m\u1ea1c v\u00e0 m\u1ea1ch m\u00e1u \u1edf v\u00f5ng m\u1ea1c v\u1eabn r\u1ed3 b\u00ecnh th\u01b0\u1eddng. N\u1ebfu ch\u00fang ta ch\u1ec9nh g\u01b0\u01a1ng v\u1ec1 ph\u00eda \u0111\u1ed9 + th\u00ec s\u1ebd th\u1ea5y l\u00f5m gai th\u1ecb, \u0111\u1ed9 ki\u1ebfng c\u1ea7n ch\u1ec9nh \u0111\u1ec3 nh\u00ecn r\u00f5 gai th\u1ecb \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u0111\u1ed9 ph\u00f9 gai th\u1ecb, c\u1ee9 m\u1ed7i l\u1ea7n ch\u1ec9nh 3 dioptries th\u00ec gai th\u1ecb ph\u00f9 l\u00ean lmm. Hi\u1ec7n t\u01b0\u1ee3ng ph\u00f9 gai g\u1eb7p trong t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd, xu\u1ea5t huy\u1ebft m\u00e0ng n\u00e3o, thuy\u00ean t\u1eafc t\u0129nh m\u1ea1ch n\u00e3o, suy h\u00f4 h\u1ea5p m\u00e3n, H\u1ed9i ch\u1ee9ng Guillain Ba\u00f1\u00e9. Trong tr\u01b0\u1eddng h\u1ee3p vi\u00eam gai th\u1ecb thl gai th\u1ecb c\u0169ng m\u1edd c\u00f3 khi k\u00e8m xu\u1ea5t huy\u1ebft, r\u1ea5t kh\u00f3 ph\u00e2n bi\u1ec7t v\u1edbi t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/span><\/li>\n<\/ul>\n

        3. C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh th\u1ecb gi\u00e1c<\/strong><\/h2>\n

        – Ch\u00e8n \u00e9p th\u1ea7n kinh th\u1ecb <\/span>l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t C\u00e1c nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 c\u1ed1 l\u00e0 ch\u00e8n \u00e9p do ph\u00ecnh m\u1ea1ch c\u1ee7a \u0111\u1ed9ng m\u1ea1ch th\u00f4ng tr\u01b0\u1edbc, u m\u00e0ng n\u00e3o v\u1eebng c\u00e1nh nh\u1ecf x\u01b0\u01a1ng b\u01b0\u1edbm, u c\u1ea1nh xoang hang hay glioma th\u1ea7n kinh th\u1ecb \u1edf tr\u1ebb nh\u1ecf. C\u00e1c tr\u01b0\u1eddng h\u1ee3p ch\u00e8n \u00e9p n\u00e0y \u0111\u1ec1u g\u00e2y teo gai th\u1ecb nguy\u00ean ph\u00e1t v\u00e0 d\u1ec5 l\u1ea7m l\u1eabn v\u1edbi vi\u00eam th\u1ea7n kinh th\u1ecb h\u1eadu nh\u00e3n c\u1ea7u.<\/span><\/p>\n

        – Vi\u00eam th\u1ea9n t\u00ednh th\u1ecb<\/span>: th\u01b0\u01a1ng do x\u01a1 c\u1ee9ng r\u1ea3i r\u00e1c, kh\u1ecfi ph\u00e1t m\u1ed9t b\u00ean v\u1edbi t\u00ecnh tr\u1ea1ng gi\u1ea3m th\u1ecb l\u1ef1c \u0111\u1ed9t ng\u1ed9t trong v\u00e0i ng\u00e0y, sau \u0111\u00f3 h\u1ed3i ph\u1ee5c \u0111i di ch\u1ee9ng \u00e1m \u0111i\u1ec3m trung t\u00e2m. B\u1ec7nh t\u00e1i ph\u00e1t t\u1eebng \u0111\u1ee3t v\u00e0 th\u01b0\u1eddng lan sang hai b\u00ean. Vi\u00eam m\u00e0ng n\u00e3o, vi\u00eam n\u00e3o, giang mai c\u0169ng c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam th\u1ea7n kinh th\u1ecb.<\/span><\/p>\n

        – Ng\u1ed9 \u0111\u1ed9c: <\/span>th\u01b0\u1eddng kh\u1edfi ph\u00e1t hai b\u00ean c\u00f9ng l\u00fac v\u00e0 hay ph\u1ed1i h\u1ee3p c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00e1c c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng. SMON (subacute myelo-optic neuropathy) c\u00f3 th\u1ec3 g\u00e2y ra do nh\u00f3m hydroxyquinoline, vi\u00eam th\u1ea7n kinh th\u1ecb do ng\u1ed9 \u0111\u1ed9c r\u01b0\u1ee3u, thu\u1ed1c l\u00e1, thi\u1ebfu vitamin B12.<\/span><\/p>\n

        – Vi\u00eam th\u1ea7n kinh th\u1ecb do thi\u1ebfu m\u00e2u: <\/span>m\u00f9 \u0111\u1ed9t ng\u1ed9t, th\u01b0\u1eddng do b\u1ec7nh Horton, x\u01a1 m\u01a1 \u0111\u1ed9ng m\u1ea1ch, tr\u1ee5y tim m\u1ea1ch n\u1eb7ng.<\/span><\/p>\n

        – Vi\u00eam th\u1ea7n kinh th\u1ecb gia \u0111\u00ecnh: <\/span>B\u1ec7nh Leber, x\u1ea3y ra tr\u00ean tr\u1ebb trai, th\u01b0\u1eddng b\u1ecb hai b\u00ean v\u00e0 ng\u01b0\u1eddi m\u1eb9 l\u00e0 ng\u01b0\u1eddi mang gen b\u1ec7nh l\u00fd.<\/span><\/p>\n

        – C\u00e1c t\u1ed5n th\u01b0\u01a1ng v\u00f9ng giao th\u1ecb<\/span><\/p>\n

          \n
        • Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng l\u00e0 b\u00e1n manh hai th\u00e1i d\u01b0\u01a1ng, nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p l\u00e0 u tuy\u1ebfn y\u00ean v\u00e0 u s\u1ecd h\u1ea7u<\/span><\/li>\n
        • B\u00e1n manh hai th\u1ecb tr\u01b0\u1eddng m\u0169i r\u1ea5t hi\u1ebfm g\u1eb7p v\u00e0 th\u01b0\u1eddng do ch\u00e8n \u00e9p giao th\u1ecb t\u1eeb hai b\u00ean do m\u1ea1ch m\u00e1u.<\/span><\/li>\n<\/ul>\n

          – T\u1ed5n th\u01b0\u01a1ng sau giao th\u1ecb: <\/span>C\u00e1c t\u1ed5n th\u01b0\u01a1ng v\u00f9ng th\u00f9y th\u00e1i d\u01b0\u01a1ng, th\u00f9y ch\u1ea9m ho\u1eb7c th\u00f9y \u0111\u1ec9nh \u0111\u1ec1u g\u00e2y b\u00e1n manh \u0111\u1ed3ng danh hay g\u00f3c manh ph\u00eda \u0111\u1ed1i di\u1ec7n. Nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p l\u00e0 tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o, u n\u00e3o.<\/span><\/p>\n

           <\/p>\n","protected":false},"excerpt":{"rendered":"

          Th\u1ea7n kinh th\u1ecb gi\u00e1c ch\u1ecbu tr\u00e1ch nhi\u1ec7m truy\u1ec1n t\u00edn hi\u1ec7u t\u1eeb m\u1eaft \u0111\u1ebfn v\u00f9ng th\u1ecb gi\u00e1c c\u1ee7a n\u00e3o. N\u1ebfu th\u1ea7n kinh th\u1ecb gi\u00e1c b\u1ecb t\u1ed5n th\u01b0\u01a1ng, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1ea5t th\u1ecb l\u1ef1c, nh\u00ecn m\u1edd ho\u1eb7c gi\u1ea3m t\u1ea7m nh\u00ecn, gi\u1ea3m \u0111\u1ed9 nh\u1ea1y c\u1ea3m \u00e1nh s\u00e1ng v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nTh\u1ea7n kinh th\u1ecb gi\u00e1c: C\u00e1ch kh\u00e1m v\u00e0 m\u1ed9t s\u1ed1 t\u1ed5n th\u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p<\/title>\n<meta name=\"description\" content=\"Th\u1ea7n kinh th\u1ecb gi\u00e1c ch\u1ecbu tr\u00e1ch nhi\u1ec7m truy\u1ec1n t\u00edn hi\u1ec7u t\u1eeb m\u1eaft \u0111\u1ebfn v\u00f9ng th\u1ecb gi\u00e1c c\u1ee7a n\u00e3o. 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