{"id":35738,"date":"2023-06-27T22:58:10","date_gmt":"2023-06-27T15:58:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35738"},"modified":"2023-06-27T22:59:08","modified_gmt":"2023-06-27T15:59:08","slug":"cac-phuong-phap-dieu-tri-hieu-qua-cho-benh-nhoi-mau-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/27\/cac-phuong-phap-dieu-tri-hieu-qua-cho-benh-nhoi-mau-nao\/","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 cho b\u1ec7nh nh\u1ed3i m\u00e1u n\u00e3o"},"content":{"rendered":"<p><strong>Nh\u1ed3i m\u00e1u n\u00e3o l\u00e0 b\u1ec7nh l\u00fd do t\u1ed5n th\u01b0\u01a1ng c\u1ee5c b\u1ed9 c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng (h\u01a1n l\u00e0 t\u1ed5n th\u01b0\u01a1ng to\u00e0n th\u1ec3), do t\u1ed5n th\u01b0\u01a1ng h\u1ec7 th\u1ed1ng tu\u1ea7n ho\u00e0n n\u00e3o m\u1ed9t c\u00e1ch t\u1ef1 ph\u00e1t , Bi\u1ec3u hi\u1ec7n b\u1eb1ng c\u00e1c khi\u1ebfm khuy\u1ebft th\u1ea7n kinh x\u1ea3y ra m\u1ed9t c\u00e1ch \u0111\u1ed9t ng\u1ed9t, t\u1ed3n t\u1ea1i k\u00e9o d\u00e0i \u00edt nh\u1ea5t 24 gi\u1edd, ho\u1eb7c t\u1eed vong tr\u01b0\u1edbc 24 gi\u1edd (WHO). \u0110\u1ed9t qu\u1ef5 n\u00e3o l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y t\u1eed vong \u0111\u1ee9ng h\u00e0ng th\u1ee9 3. L\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u00e0n ph\u1ebf.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35739 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c075b78-a36e-4453-8ba3-039fd37136bd-300x300.jpg\" alt=\"nhoi-mau-nao\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c075b78-a36e-4453-8ba3-039fd37136bd-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c075b78-a36e-4453-8ba3-039fd37136bd-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c075b78-a36e-4453-8ba3-039fd37136bd-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/5c075b78-a36e-4453-8ba3-039fd37136bd.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2><strong>1. L\u00e2m s\u00e0ng nh\u1ed3i m\u00e1u n\u00e3o<\/strong><\/h2>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><strong>B\u1ec7nh s\u1eed:<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t<\/p>\n<p>Y\u1ebfu li\u1ec7t n\u1eeda ng\u01b0\u1eddi<\/p>\n<p>N\u00f3i \u0111\u1edb, mi\u1ec7ng m\u00e9o<\/p>\n<ul>\n<li><strong>Kh\u00e1m l\u00e2m s\u00e0ng<\/strong><\/li>\n<\/ul>\n<ul>\n<li>H\u1ed9i ch\u1ee9ng li\u1ec7t n\u1eeda ng\u01b0\u1eddi<\/li>\n<li>Li\u1ec7t VII trung \u01b0\u01a1ng, n\u00f3i kh\u00f3<\/li>\n<li>T\u00ea tay, d\u1ecb c\u1ea3m tay v\u00e0 ch\u00e2n c\u00f9ng b\u00ean<\/li>\n<li>R\u1ed1i lo\u1ea1n ng\u00f4n ng\u1eef: M\u1ea4t ng\u00f4n ng\u1eef Broca, m\u1ea5t ng\u00f4n ng\u1eef Wernicke<\/li>\n<li>R\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c: M\u1ea5t th\u1ecb l\u1ef1c m\u1ed9t ho\u1eb7c hai b\u00ean, b\u00e1n manh, g\u00f3c manh<\/li>\n<li>\u0110au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t<\/li>\n<li>R\u1ed1i lo\u1ea1n tri gi\u00e1c: Ng\u1ee7 g\u00e0, l\u01a1 m\u01a1, h\u00f4n m\u00ea<\/li>\n<\/ul>\n<p><strong><u>B\u1ea3ng ph\u00e2n bi\u1ec7t nh\u1ed3i m\u00e1u n\u00e3o v\u00e0 xu\u1ea5t huy\u1ebft n\u00e3o tr\u00ean l\u00e2m s\u00e0ng:<\/u><\/strong><\/p>\n<p><strong><u>\u00a0<\/u><\/strong><\/p>\n<table width=\"857\">\n<tbody>\n<tr>\n<td width=\"263\"><\/td>\n<td width=\"297\">Nh\u1ed3i m\u00e1u n\u00e3o<\/td>\n<td width=\"297\">\u00a0Xu\u1ea5t huy\u1ebft n\u00e3o<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">1.\u00a0\u00a0\u00a0\u00a0 Ho\u00e0n c\u1ea3nh kh\u1edfi ph\u00e1t<\/td>\n<td width=\"297\">Th\u01b0\u1eddng l\u00fac ng\u1ee7, l\u00fac ngh\u1ec9 ng\u01a1i<\/td>\n<td width=\"297\">Th\u01b0\u1eddng l\u00fac th\u1ee9c, +\/- g\u1eb5ng s\u1ee9c x\u00fac \u0111\u1ed9ng<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">2.\u00a0\u00a0\u00a0\u00a0 Ki\u1ec3u c\u00e1ch di\u1ec5n ti\u1ebfn tri\u1ec7u ch\u1ee9ng<\/td>\n<td width=\"297\">T\u0103ng d\u1ea7n trong nhi\u1ec1u gi\u1edd ho\u1eb7c t\u1eebng n\u1ea5c<\/p>\n<p>L\u1ea5p m\u1ea1ch: \u0110\u1ea1t \u0111\u1ec9nh ngay t\u1ee9c th\u00ec<\/td>\n<td width=\"297\">Ti\u1ebfn tri\u1ec3n n\u1eb7ng nhanh ch\u00f3ng trong \u00a0gi\u1edd \u0111\u1ea7u<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">3.\u00a0\u00a0\u00a0\u00a0 \u0110au \u0111\u1ea7u<\/td>\n<td width=\"297\">Hi\u1ebfm g\u1eb7p<\/td>\n<td width=\"297\">Th\u01b0\u1eddng g\u1eb7p<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">4.\u00a0\u00a0\u00a0\u00a0 N\u00f4n \u00f3i<\/td>\n<td width=\"297\">Hi\u1ebfm g\u1eb7p<\/td>\n<td width=\"297\">Th\u01b0\u1eddng g\u1eb7p<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">5.\u00a0\u00a0\u00a0\u00a0 R\u1ed1i lo\u1ea1n \u00fd th\u1ee9c<\/td>\n<td width=\"297\">\u00cdt g\u0103p, mu\u1ed9n<\/td>\n<td width=\"297\">Hay g\u1eb7p h\u01a1n v\u00e0 s\u1edbm h\u01a1n<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">6.\u00a0\u00a0\u00a0\u00a0 D\u1ea5u m\u00e0ng n\u00e3o<\/td>\n<td width=\"297\">Kh\u00f4ng c\u00f3<\/td>\n<td width=\"297\">C\u00f3 th\u1ec3 c\u00f3<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">7.\u00a0\u00a0\u00a0\u00a0 Ti\u1ec1n c\u0103n c\u01a1n tho\u00e1ng TMN<\/td>\n<td width=\"297\">C\u00f3 th\u1ec3 c\u00f3<\/td>\n<td width=\"297\">Th\u01b0\u1eddng kh\u00f4ng c\u00f3<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">8.\u00a0\u00a0\u00a0\u00a0 T\u0103ng huy\u1ebft \u00e1p<\/td>\n<td width=\"297\">C\u00f3 th\u1ec3 t\u0103ng<\/td>\n<td width=\"297\">Th\u01b0\u1eddng g\u1eb7p, t\u0103ng cao h\u01a1n 190mmHg<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">9.\u00a0\u00a0\u00a0\u00a0 G\u00f2ng c\u1ee9ng m\u1ea5t v\u1ecf, du\u1ed7i c\u1ee9ng m\u1ea5t n\u00e3o<\/td>\n<td width=\"297\">Hi\u1ebfm g\u1eb7p<\/td>\n<td width=\"297\">Th\u01b0\u1eddng g\u1eb7p<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">10.\u00a0 Co gi\u1eadt<\/td>\n<td width=\"297\">Hi\u1ebfm g\u1eb7p<\/td>\n<td width=\"297\">Th\u01b0\u1eddng g\u1eb7p<\/td>\n<\/tr>\n<tr>\n<td width=\"263\">T\u1ed4NG K\u1ebeT<\/td>\n<td width=\"297\"><\/td>\n<td width=\"297\">C\u00f3 \u2265 2 m\u1ee5c tr\u00ean l\u00e0 ch\u1ea9n \u0111o\u00e1n xu\u1ea5t huy\u1ebft n\u00e3o (\u0110\u1ed9 nh\u1ea1y \u2265 95%)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Tri\u1ec7u ch\u1ee9ng theo v\u1ecb tr\u00ed nh\u1ed3i m\u00e1u:<\/strong><\/li>\n<\/ul>\n<ul>\n<li><strong>Nh\u1ed3i m\u00e1u khu v\u1ef1c thu\u1ed1c \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh trong:<\/strong><\/li>\n<\/ul>\n<p><strong>\u0110\u1ed9ng m\u1ea1ch n\u00e3o gi\u1eefa:<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nh\u00e1nh n\u00f4ng:<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>Li\u1ec7t n\u1eeda ng\u01b0\u1eddi n\u1eb7ng \u1edf tay ho\u1eb7c m\u1eb7t n\u1eeda ng\u01b0\u1eddi \u0111\u1ed1i b\u00ean( t\u1ed5n th\u01b0\u01a1ng h\u1ed3i tr\u00e1n l\u00ean)<br \/>\nR\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c n\u1eeda ng\u01b0\u1eddi \u0111\u1ed1i b\u00ean (t\u1ed5n th\u01b0\u01a1ng th\u00f9y \u0111\u1ec9nh)<\/p>\n<p>\u01afu th\u1ebf \u1edf c\u1ea3m gi\u00e1c tinh vi<\/p>\n<p>B\u00e1n manh hay g\u00f3c manh \u0111\u1ed3ng danh<\/p>\n<p><u>N\u1ebfu t\u1ed5n th\u01b0\u01a1ng b\u00e1n c\u1ea7u \u01b0u th\u1ebf:<\/u><\/p>\n<p>R\u1ed1i lo\u1ea1n ng\u00f4n ng\u1eef ki\u1ec3u Broca, Wernick<br \/>\nH\u1ed9i ch\u1ee9ng Gerstmann<\/p>\n<p><u>N\u1ebfu t\u1ed5n th\u01b0\u01a1ng b\u00e1n c\u1ea7u kh\u00f4ng \u01b0u th\u1ebf:<\/u><\/p>\n<p>M\u1ea5t nh\u1eadn th\u1ee9c c\u01a1 th\u1ec3<\/p>\n<p>M\u1ea5t ph\u00e2n bi\u1ec7t n\u1eeda ng\u01b0\u1eddi<br \/>\nH\u1ed9i ch\u1ee9ng Anton-Babinski<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nh\u00e1nh s\u00e2u:<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>Li\u1ec7t n\u1eeda ng\u01b0\u1eddi to\u00e0n b\u1ed9 v\u00e0 \u0111\u1ed3ng \u0111\u1ec1u (m\u1eb7t, tay, ch\u00e2n)<\/p>\n<p>Kh\u00f4ng r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c<br \/>\nR\u1ed1i lo\u1ea1n ng\u00f4n ng\u1eef c\u00f3 th\u1ec3 x\u1ea3y ra n\u1ebfu t\u1ed5n th\u01b0\u01a1ng b\u00e1n c\u1ea7u \u01b0u th\u1ebf<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 To\u00e0n b\u1ed9:<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>Li\u1ec7t n\u1eeda ng\u01b0\u1eddi to\u00e0n b\u1ed9 v\u00e0 \u0111\u1ed3ng \u0111\u1ec1u<\/p>\n<p>M\u1ea5t c\u1ea3m gi\u00e1c n\u1eeda ng\u01b0\u1eddi<\/p>\n<p>M\u1ea5t ng\u00f4n ng\u1eef ki\u1ec3u to\u00e0n th\u1ec3 (t\u1ed5n th\u01b0\u01a1ng b\u00e1n c\u1ea7u \u01b0u th\u1ebf)<\/p>\n<p>B\u00e1n manh \u0111\u1ed3ng danh<\/p>\n<p>Quay \u0111\u1ea7u quay m\u1eaft v\u1ec1 b\u00ean t\u1ed5n th\u01b0\u01a1ng<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>M\u1ea5t nh\u1eadn th\u1ee9c n\u1eeda ng\u01b0\u1eddi<br \/>\nR\u1ed1i lo\u1ea1n tri gi\u00e1c, h\u00f4n m\u00ea<\/p>\n<p><strong>\u0110\u1ed9ng m\u1ea1ch n\u00e3o tr\u01b0\u1edbc:<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>Li\u1ec7t 1 ch\u00e2n ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng lan r\u1ed9ng g\u00e2y li\u1ec7t n\u1eeda ng\u01b0\u1eddi nh\u01b0ng v\u1eabn n\u1eb7ng \u1edf ch\u00e2n h\u01a1n<\/p>\n<p>Gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c c\u01a1, xu\u1ea5t hi\u1ec7n ph\u1ea3n x\u1ea1 c\u1ea7m n\u1eafm<\/p>\n<p>H\u1ed9i ch\u1ee9ng th\u00f9y tr\u00e1n<\/p>\n<p>Ch\u1ee9ng l\u1eb7ng thinh (b\u00eanh c\u1ea3nh b\u1ea5t \u0111\u1ed9ng)<\/p>\n<ul>\n<li><strong>Nh\u1ed3i m\u00e1u \u0111\u1ed9ng m\u1ea1ch c\u1ea1nh \u0111\u1ed1t s\u1ed1ng-th\u00e2n n\u1ec1n:<\/strong><\/li>\n<\/ul>\n<p><strong>\u0110\u1ed9ng m\u1ea1ch n\u00e3o sau:<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>B\u00e1n manh \u0111\u1ed3ng danh (b\u00e1n manh b\u00ean c\u00f9ng t\u00ean)<\/p>\n<p>M\u1ea5t kh\u1ea3 n\u0103ng \u0111\u1ecdc khi nh\u1ed3i m\u00e1u b\u00e1n c\u1ea7u \u01b0u th\u1ebf<\/p>\n<p>T\u00e2m th\u1ea7n l\u00fa l\u1eabn, qu\u00ean (h\u1ed9i ch\u1ee9ng Korsakoff)<\/p>\n<p>M\u1ea5t nh\u1eadn d\u1ea1ng (kh\u00f4ng nh\u1eadn \u0111\u01b0\u1ee3c m\u1eb7t ng\u01b0\u1eddi) khi nh\u1ed3i m\u00e1u n\u00e3o 2 b\u00ean: m\u00f9 v\u1ecf n\u00e3o nh\u01b0ng c\u00f2n ph\u1ea3n x\u1ea1 \u00e1nh s\u00e1ng ho\u1eb7c b\u00e1n manh \u0111\u1ed3ng danh<\/p>\n<p>C\u00f3 th\u1ec3 m\u1ea5t c\u1ea3m gi\u00e1c n\u1eeda ng\u01b0\u1eddi kh\u00e1c b\u00ean c\u00e1c lo\u1ea1i c\u1ea3m gi\u00e1c ( do t\u1ed5n th\u01b0\u01a1ng b\u00f3 \u0111\u1ed3i th\u1ecb-g\u1ed1i), t\u01b0\u01a1ng t\u1ef1 h\u1ed9i ch\u1ee9ng Dejerine-Roussy<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u0110\u1ed9ng m\u1ea1ch th\u00e2n n\u1ec1n:<\/strong><\/p>\n<p>N\u1ebfu nh\u1ed3i m\u00e1u l\u1edbn b\u1ec7nh nh\u00e2n th\u01b0\u1eddng l\u00e0 t\u1eed vong. Trong tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng nh\u1ecf th\u00ec c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng sau: h\u1ed9i ch\u1ee9ng th\u00e1p 2 b\u00ean, h\u1ed9i ch\u01b0ng kh\u00f3a trong (li\u1ec7t t\u1ee9 chi, li\u1ec7t VI, li\u1ec7t VII 2 b\u00ean, ch\u1ec9 c\u00f2n \u0111\u1ed9ng t\u00e1c nh\u00ecn l\u00ean)<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 N\u1ebfu nh\u1ed3i m\u00e1u c\u00e1c nh\u00e1nh nu\u00f4i cho th\u00e2n n\u00e3o xu\u1ea5t ph\u00e1t t\u1eeb \u0111\u1ed9ng m\u1ea1ch th\u00e2n n\u1ec1n:<\/strong><\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cu\u1ed1ng n\u00e3o: <\/strong>H\u1ed9i ch\u1ee9ng Weber hay h\u1ed9i ch\u1ee9ng Claude (li\u1ec7t d\u00e2y s\u1ecd III b\u00ean t\u1ed5n th\u01b0\u01a1ng, h\u1ed9i ch\u1ee9ng ti\u1ec3u n\u00e3o \u0111\u1ed1i b\u00ean)<\/p>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C\u1ea7u n\u00e3o: <\/strong>h\u1ed9i ch\u1ee9ng Millard-Gubler, h\u1ed9i ch\u1ee9ng Foville (li\u1ec7t d\u00e2y s\u1ecd VI, li\u1ec7t nh\u00ecn ngang v\u1ec1 b\u00ean li\u1ec7t, li\u1ec7t n\u1eeda ng\u01b0\u1eddi \u0111\u1ed1i b\u00ean).<\/p>\n<h2><strong>2. C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h2>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng th\u01b0\u1eddng quy<\/strong><br \/>\nC\u00f4ng th\u1ee9c m\u00e1u, \u0111\u00f4ng m\u00e1u to\u00e0n b\u1ed9, \u0111\u01b0\u1eddng huy\u1ebft, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, ch\u1ee9c n\u0103ng th\u1eadn, men gan, men tim<br \/>\nBilan lipid m\u00e1u, t\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u, \u0111i\u1ec7n t\u00e2m \u0111\u1ed3, Xquang ng\u1ef1c th\u1eb3ng<\/li>\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><strong>CT scan s\u1ecd n\u00e3okh\u00f4ng c\u1ea3n quang<\/strong> (C\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n nhanh, ph\u00e2n bi\u1ec7t r\u00f5 gi\u1eefa xu\u1ea5t huy\u1ebft n\u00e3o v\u1edbi \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o)<\/li>\n<\/ul>\n<p><strong><u>Ch\u1ec9 \u0111\u1ecbnh:<\/u><\/strong><\/p>\n<p>Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u1ed9t qu\u1ef5 nh\u1eadp v\u00e0o c\u1ea5p c\u1ee9u<br \/>\nKhi mu\u1ed1n \u0111\u00e1nh gi\u00e1 ti\u1ebfn tri\u1ec3n t\u1ed5n th\u01b0\u01a1ng n\u00e3o ho\u1eb7c phim CT-scan \u0111\u1ea7u ti\u00ean kh\u00f4ng ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng n\u00e3o trong giai \u0111o\u1ea1n s\u1edbm<\/p>\n<ul>\n<li><strong>CT-scan m\u1ea1ch m\u00e1u n\u00e3o v\u1edbi thu\u1ed1c c\u1ea3n quang (CTA<\/strong>): Gi\u00fap kh\u1ea3o s\u00e1t to\u00e0n b\u1ed9 \u0111\u1ed9ng m\u1ea1ch n\u00e3o nh\u1eb1m ph\u00e1t hi\u1ec7n c\u00e1c b\u1ea5t th\u01b0\u1eddng nh\u01b0: h\u1eb9p, ph\u00ecnh m\u1ea1ch hay b\u00f3c t\u00e1ch m\u1ea1ch n\u1ed9i s\u1ecd v\u00e0 ngo\u00e0i s\u1ecd<br \/>\n<strong><u>Ch\u1ec9 \u0111\u1ecbnh:<br \/>\n<\/u><\/strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Khi nghi ng\u1edd t\u00ecnh tr\u1ea1ng b\u1ea5t th\u01b0\u1eddng t\u1ea1i c\u00e1c \u0111\u1ed9ng m\u1ea1ch l\u1edbn trong s\u1ecd hay ngo\u00e0i s\u1ecd<br \/>\nCh\u1ed1ng ch\u1ec9 \u0111\u1ecbnh tuy\u1ec7t \u0111\u1ed1i:<br \/>\nNg\u01b0\u1eddi b\u1ec7nh suy th\u1eadn v\u00e0 c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng v\u1edbi thu\u1ed1c c\u1ea3n quang<\/li>\n<li><strong>MRI n\u00e3o:<\/strong> MRI n\u00e3o kh\u00f4ng ti\u00eam thu\u1ed1c c\u1ea3n t\u1eeb (c\u00e1c chu\u1ed7i xung T1, T2, T2 Flair, T2 Diffusion, T2 GRE + TOF 3D MRA)<br \/>\n<strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <u>Ch\u1ec9 \u0111\u1ecbnh:<\/u><\/strong><br \/>\nKhi CT-scan kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c t\u00ecnh tr\u1ea1ng t\u1ed5n th\u01b0\u01a1ng kh\u00f4ng t\u01b0\u01a1ng x\u1ee9ng v\u1edbi l\u00e2m s\u00e0ng<br \/>\nNghi ng\u1edd nh\u1ed3i m\u00e1u n\u00e3o tu\u1ea7n ho\u00e0n sau<\/li>\n<li><strong>Si\u00eau \u00e2m Doppler xuy\u00ean s\u1ecd (TCD):<\/strong><br \/>\nX\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng h\u1eb9p, t\u1eafc m\u1ea1ch m\u00e1u ho\u1eb7c t\u00e1i th\u00f4ng t\u1ea1i c\u00e1c m\u1ea1ch m\u00e1u trong s\u1ecd, v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho t\u1ea5c c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh b\u1ecb \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o<\/li>\n<li><strong>Si\u00eau \u00e2m Doppler \u0111\u1ed9ng m\u1ea1ch v\u00f9ng c\u1ed5:<\/strong><br \/>\nX\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng h\u1eb9p, t\u1eafc \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh v\u00e0 c\u1ed9t s\u1ed1ng \u0111o\u1ea1n ngo\u00e0i s\u1ecd<\/li>\n<li><strong>Si\u00eau \u00e2m tim:<\/strong><br \/>\nX\u00e1c \u0111\u1ecbnh c\u00e1c b\u1ea5t th\u01b0\u1eddng t\u1ea1i tim c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra \u0111\u1ed9t qu\u1ef5<\/p>\n<ul>\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng ch\u1ecdn l\u1ecdc kh\u00e1c<\/strong><br \/>\nS\u00e0ng l\u1ecdc \u0111\u1ed9c ch\u1ea5t<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>N\u1ed3ng \u0111\u1ed9 c\u1ed3n trong m\u00e1u<\/p>\n<p>C\u00e1c x\u00e9t nghi\u1ec7m v\u1ec1 tai ngh\u00e9n<\/p>\n<p>Kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch (n\u1ebfu nghi ng\u1edd gi\u1ea3m oxy m\u00e1u)<\/p>\n<p>Ch\u1ecdc d\u1ecbch n\u00e3o t\u1ee7y (n\u1ebfu nghi ng\u1edd xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n m\u00e0 kh\u00f4ng th\u1ea5y xu\u1ea5t huy\u1ebft tr\u00ean CT)<\/p>\n<p>\u0110i\u1ec7n n\u00e3o \u0111\u1ed3 (n\u1ebfu nghi ng\u1edd \u0111\u1ed9ng kinh)<\/p>\n<h2><strong>3. Ch\u1ea9n \u0111o\u00e1n:<\/strong><\/h2>\n<p><strong>3.1 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/strong><\/p>\n<p>L\u00e2m s\u00e0ng: B\u1ec7nh c\u1ea3nh \u0111\u1ed9t ng\u1ed9t, khi\u1ebfm khuy\u1ebft th\u1ea7n kinh c\u1ee5c b\u1ed9<\/p>\n<p>H\u00ecnh \u1ea3nh h\u1ecdc: CT scan s\u1ecd n\u00e3o, MRI n\u00e3o<\/p>\n<ul>\n<li><strong>3.2 Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/strong><br \/>\n\u0110\u1ed9ng kinh<\/li>\n<li>\u0110au \u0111\u1ea7u Migrain<\/li>\n<li>Ng\u1ea5t<\/li>\n<li>H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft<\/li>\n<li>B\u1ec7nh n\u00e3o do r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a<\/li>\n<li>Kh\u1ed1i u th\u1ea7n kinh trung \u01b0\u01a1ng<\/li>\n<li>M\u00e1u t\u1ee5 d\u01b0\u1edbi m\u00e0ng c\u1ee9ng<\/li>\n<li>Vi\u00eam n\u00e3o Herpes<\/li>\n<li>B\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean<\/li>\n<li>Li\u1ec7t Bell<\/li>\n<li>R\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n<\/li>\n<\/ul>\n<h2><strong>4. \u0110i\u1ec1u tr\u1ecb nh\u1ed3i m\u00e1u n\u00e3o<\/strong><\/h2>\n<p>G\u1ed3m \u0111i\u1ec1u tr\u1ecb gian \u0111o\u1ea1n c\u1ea5p, x\u1eed tr\u00ed nh\u1ed3i m\u00e1u n\u00e3o tr\u1edf n\u1eb7ng v\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u00f2ng ng\u1eeba t\u00e1i ph\u00e1t<\/p>\n<p><strong>4.1 \u0110i\u1ec1u tr\u1ecb giai \u0111o\u1ea1n c\u1ea5p<\/strong><\/p>\n<ul>\n<li><strong>M\u1ee5c \u0111\u00edch:<\/strong> T\u00e1i th\u00f4ng m\u1ea1ch v\u00e0 thi\u1ebft l\u1eadp l\u1ea1i tu\u1ea7n ho\u00e0n<\/li>\n<li><strong>\u0110i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u:<\/strong>\n<ul>\n<li><strong><u>D\u00f9ng thu\u1ed1c ti\u00eau s\u1ee3i huy\u1ebft t\u0129nh m\u1ea1ch<\/u><\/strong><\/li>\n<\/ul>\n<\/li>\n<li><strong>Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/li>\n<li>Tu\u1ed5i \u2265 18. Kh\u00f4ng c\u00f3 h\u01b0\u1edbng d\u1eabn d\u00f9ng ti\u00eau s\u1ee3i hu\u00fdet cho tr\u1ebb em, tuy nhi\u00ean tr\u1ebb l\u1edbn s\u1eed d\u1ee5ng ti\u00eau s\u1ee3i huy\u1ebft nh\u01b0 ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh.<\/li>\n<li>Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o g\u00e2y ra khi\u1ebfm khuy\u1ebft th\u1ea7n kinh<\/li>\n<li>Nh\u1eadp vi\u1ec7n t\u1eeb 0-4.5 gi\u1edd \u0111\u1ea7u t\u00ednh t\u1eeb l\u00fac kh\u1edfi ph\u00e1t \u0111\u1ed9t quy<\/li>\n<li><strong>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><br \/>\n<strong>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh tuy\u1ec7t \u0111\u1ed1i:<\/strong><\/li>\n<li>Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p tri\u1ec7u ch\u1ee9ng nh\u1eb9 v\u00e0 c\u1ea3i thi\u1ec7n nhanh ch\u00f3ng.<\/li>\n<li>Nguy c\u01a1 xu\u1ea5t huy\u1ebft cao:<\/li>\n<\/ul>\n<p>HATT &gt; 185mmHg ho\u1eb7c HATr &gt;110 mmHg kh\u00f4ng kh\u1ed1ng ch\u1ebf \u0111\u01b0\u1ee3c<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb heparin trong 48 gi\u1edd, PTT t\u0103ng cao<\/p>\n<p>INR &gt;1.7<\/p>\n<p>Ti\u1ec3u c\u1ea7u &lt;100.000\/mm3<\/p>\n<p>Ti\u1ec1n c\u0103n ph\u1eabu thu\u1eadt l\u1edbn, xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a ho\u1eb7c xu\u1ea5t huy\u1ebft ni\u1ec7u g\u1ea7n \u0111\u00e2y ( trong v\u00f2ng 21 ng\u00e0y)<\/p>\n<ul>\n<li>Ti\u1ec1n s\u1eed c\u00f3 xu\u1ea5t huy\u1ebft n\u1ed9i s\u1ecd, tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd c\u00f3 xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n, tr\u00ean phim CT c\u00f3 b\u1ea5t k\u00ec b\u1eb1ng ch\u1ee9ng xu\u1ea5t huy\u1ebft n\u00e3o.<\/li>\n<li>Kh\u1ea3o s\u00e1t h\u00ecnh \u1ea3nh CT-scan n\u00e3o c\u00f3:<\/li>\n<\/ul>\n<p>Hi\u1ec7u \u1ee9ng cho\u00e1n ch\u1ed7 ( kh\u1ed1i u n\u1ed9i s\u1ecd, xu\u1ea5t huy\u1ebft n\u00e3o, xu\u1ea5t huy\u1ebft d\u01b0\u1edbi m\u00e0ng c\u1ee9ng\u2026)<\/p>\n<p>B\u1ea5t th\u01b0\u1eddng \u0111\u1ed9ng t\u0129nh m\u1ea1ch n\u00e3o ( d\u1ecb d\u1ea1ng, ph\u00ecnh b\u00f3c t\u00e1ch\u2026)<\/p>\n<p><strong>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i:<\/strong><\/p>\n<ul>\n<li>\u0110\u1ed9ng kinh khi kh\u1edfi ph\u00e1t \u0111\u1ed9t qu\u1ef5<\/li>\n<li>\u0110\u01b0\u1eddng huy\u1ebft d\u01b0\u1edbi 50 mg\/dL ho\u1eb7c tr\u00ean 400 mg\/dL<\/li>\n<li>C\u00e1c r\u1ed1i lo\u1ea1n xu\u1ea5t huy\u1ebft \u1edf m\u1eaft ho\u1eb7c c\u00e1c khuy\u1ebft t\u1eadt c\u00f3 th\u1ec3 x\u1ea3y ra do xu\u1ea5t huy\u1ebft.<\/li>\n<li>Nh\u1ed3i m\u00e1u c\u01a1 tim trong 6 tu\u1ea7n g\u1ea7n \u0111\u00e2y<\/li>\n<li>Nghi ng\u1edd t\u1eafc m\u1ea1ch nhi\u1ec5m khu\u1ea9n ho\u1eb7c vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n.\n<ul>\n<li><strong><u>\u0110i\u1ec1u tr\u1ecb can thi\u1ec7p n\u1ed9i m\u1ea1ch<\/u><\/strong><\/li>\n<\/ul>\n<\/li>\n<li><strong>Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/li>\n<li>Ng\u01b0\u1eddi b\u1ec7nh nh\u1eadp vi\u1ec7n trong c\u1eeda s\u1ed5 t\u1eeb 0-4.5 gi\u1edd:\n<ul>\n<li>C\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi ti\u00eau s\u1ee3i huy\u1ebft t\u0129nh m\u1ea1ch<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb ti\u00eau s\u1ee3i huy\u1ebft t\u0129nh m\u1ea1ch th\u1ea5t b\u1ea1i<\/li>\n<\/ul>\n<\/li>\n<li>Ng\u01b0\u1eddi b\u1ec7nh nh\u1eadp vi\u1ec7n trong c\u1eeda s\u1edf t\u1eeb 4.5-6 gi\u1edd k\u1ec3 t\u1eeb l\u00fac kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng<\/li>\n<li><strong>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong>\n<ul>\n<li>NIHSS \u2265 30 ho\u1eb7c h\u00f4n m\u00ea<\/li>\n<li>Tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh c\u1ea3i thi\u1ec7n nhanh ch\u00f3ng tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb<\/li>\n<li>Ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa<\/li>\n<li>Ti\u1ec1n s\u1eed d\u1ecb \u1ee9ng thu\u1ed1c c\u1ea3n quang<\/li>\n<li>T\u0103ng huy\u1ebft \u00e1p HATT &gt; 180mmHg ho\u1eb7c HATTr &gt;105 mmHg ch\u01b0a \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t<\/li>\n<li>\u0110ang d\u00f9ng thu\u1ed1c kh\u00e1ng \u0111\u00f4ng v\u1edbi INR \u2265 30<\/li>\n<li>Ti\u1ec3u c\u1ea7u \u2264 30.000<\/li>\n<li>\u0110\u01b0\u1eddng huy\u1ebft \u2264 50mg\/dL<\/li>\n<li>Gi\u1ea3i ph\u1eabu m\u1ea1ch m\u00e1u kh\u00f4ng thu\u1eadn l\u1ee3i cho can thi\u1ec7p n\u1ed9i m\u1ea1ch<\/li>\n<li>CT-scan ho\u1eb7c MRI n\u00e3o c\u00f3 h\u00ecnh \u1ea3nh xu\u1ea5t huy\u1ebft n\u00e3o, hi\u1ec7u \u1ee9ng kh\u1ed1i cho\u00e1n ch\u1ed7 ho\u1eb7c u n\u1ed9i s\u1ecd<\/li>\n<li>Ch\u1ee5p h\u00ecnh m\u1ea1ch m\u00e1u n\u00e3o c\u00f3 b\u1eb1ng ch\u1ee9ng th\u1ea5y b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh ho\u1eb7c t\u1eafc m\u1ea1n t\u00ednh ho\u00e0n to\u00e0n \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh \u0111o\u1ea1n c\u1ed5<\/li>\n<li>Th\u1eddi gian s\u1ed1ng c\u00f2n \u01b0\u1edbc t\u00ednh \u2264 90 ng\u00e0y ( do b\u1ec7nh l\u00fd m\u00e3n t\u00ednh n\u1eb7ng hay \u00e1c t\u00ednh)<\/li>\n<\/ul>\n<\/li>\n<li><strong>Ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb:<\/strong>\n<ul>\n<li>Can thi\u1ec7p l\u1ea5y huy\u1ebft kh\u1ed1i<\/li>\n<li>Sau can thi\u1ec7p b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o \u0111\u01a1n v\u1ecb ch\u0103m s\u00f3c t\u00edch c\u1ef1c, theo d\u00f5i th\u1ea7n kinh, tim m\u1ea1ch, kh\u00f4ng d\u00f9ng c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng, ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u ho\u1eb7c thu\u1ed1c ti\u00eau s\u1ee3i huy\u1ebft kh\u00e1c trong th\u1eddi gian 24 gi\u1edd sau \u0111i\u1ec1u tr\u1ecb<\/li>\n<li>Ch\u1ee5p CT Scan n\u1ebfu t\u00ecnh tr\u1ea1n g l\u00e2m s\u00e0ng di\u1ec5n ti\u1ebfn x\u1ea5u.<\/li>\n<li>Sau 24 h \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng th\u00f4ng m\u1ea1ch m\u00e1u n\u00e3o b\u1eb1ng MRI n\u00e3o, MRA, CTA, si\u00eau \u00e2m xuy\u00ean s\u1ecd. \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng th\u1ea7n kinh, m\u1ee9c \u0111\u1ed9 ph\u1ee5c h\u1ed3i v\u1eadn \u0111\u1ed9ng. sau khi lo\u1ea1i tr\u1eeb xu\u1ea5t huy\u1ebft n\u00e3o s\u1ebd \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1ng \u0111\u00f4ng hay ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>4.2 \u0110i\u1ec1u tr\u1ecb t\u1ed5ng qu\u00e1t:<\/strong><\/p>\n<ul>\n<li><strong>ABCs:<\/strong>\n<ul>\n<li>\u0110\u1ea3m b\u1ea3o \u0111\u01b0\u1eddng th\u1edf th\u00f4ng tho\u00e1ng- A, th\u00f4ng kh\u00ed \u0111\u1ea7y \u0111\u1ee7 &#8211; B, tu\u1ea7n ho\u00e0n \u1ed5n \u0111\u1ecbnh- C.<\/li>\n<li>Th\u1edf oxy khi sPO2 &lt;92% m\u1ee5c ti\u00eau gi\u1eef sPO2 t\u1eeb 95- 100%<\/li>\n<\/ul>\n<\/li>\n<li><strong>Ch\u1ec9 \u0111\u1ecbnh n\u1ed9i kh\u00ed qu\u1ea3n:<\/strong>\n<ul>\n<li>Thi\u1ebfu oxy, suy h\u00f4 h\u1ea5p, r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1edf<\/li>\n<li>H\u00f4n m\u00ea, nguy c\u01a1 h\u00edt s\u1eb7c cao<\/li>\n<\/ul>\n<\/li>\n<li><strong>\u0110i\u1ec1u ch\u1ec9nh HA:<\/strong> kh\u00f4ng \u0111i\u1ec1u ch\u1ec9nh h\u1ea1 HA trong giai \u0111o\u1ea1n c\u1ea5p (trong 24 gi\u1edd \u0111\u1ea7u t\u1eeb khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng) tr\u1eeb khi:<\/li>\n<li><strong>Ch\u1ed1ng t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd<\/strong>\n<ul>\n<li>Th\u00f4ng kh\u00ed \u0111\u1ea7u \u0111\u1ee7<\/li>\n<li>Xem x\u00e9t ph\u1eabu thu\u1eadt gi\u1ea3i \u00e1p n\u1ebfu \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o di\u1ec7n r\u1ed9ng<\/li>\n<li>Li\u1ec7u ph\u00e1p th\u1ea9m th\u1ea5u: manitol<\/li>\n<\/ul>\n<\/li>\n<li><strong>Ch\u1ed1ng nhi\u1ec5m tr\u00f9ng:<\/strong>\n<ul>\n<li>Xoay tr\u1edf, tr\u00e1nh h\u00edt s\u1eb7c, \u1ee9 \u0111\u00e0m, v\u1eadt l\u00fd tr\u1ecb li\u1ec7u<\/li>\n<li>Cho ng\u1ed3i s\u1edbm<\/li>\n<li>Ch\u1ec9 \u0111\u1eb7t sonde ti\u1ec3u khi c\u1ea7n thi\u1ebft<\/li>\n<li>D\u00f9ng kh\u00e1ng sinh ph\u00f9 h\u1ee3p.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Ch\u1ed1ng huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 thuy\u00ean t\u1eafc ph\u1ed5i:<\/strong>\n<ul>\n<li>Xoay tr\u1edf, xoa b\u00f3p, v\u1eadn \u0111\u1ed9ng s\u1edbm<\/li>\n<li>D\u00f9ng v\u1edb \u0111\u00e0n h\u1ed3i<\/li>\n<li>Sau 48 gi\u1edd xem x\u00e9t d\u00f9ng kh\u00e1ng \u0111\u00f4ng cho c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng nguy c\u01a1 cao<\/li>\n<li>Ph\u00e1t hi\u1ec7n s\u1edbm huy\u1ebft kh\u1ed1i TM v\u00e0 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng \u0111\u00f4ng<\/li>\n<li>Ph\u00e1t hi\u1ec7n s\u1edbm thuy\u00ean t\u1eafc ph\u1ed5i v\u00e0 \u0111i\u1ec1u tr\u1ecb<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Xem th\u00eam: <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/xuat-huyet-nao-do-vo-mach-nao-dau-hieu-nhan-biet\/\">Xu\u1ea5t huy\u1ebft n\u00e3o do v\u1ee1 m\u1ea1ch n\u00e3o: D\u1ea5u hi\u1ec7u nh\u1eadn bi\u1ebft<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nh\u1ed3i m\u00e1u n\u00e3o l\u00e0 b\u1ec7nh l\u00fd do t\u1ed5n th\u01b0\u01a1ng c\u1ee5c b\u1ed9 c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng (h\u01a1n l\u00e0 t\u1ed5n th\u01b0\u01a1ng to\u00e0n th\u1ec3), do t\u1ed5n th\u01b0\u01a1ng h\u1ec7 th\u1ed1ng tu\u1ea7n ho\u00e0n n\u00e3o m\u1ed9t c\u00e1ch t\u1ef1 ph\u00e1t , Bi\u1ec3u hi\u1ec7n b\u1eb1ng c\u00e1c khi\u1ebfm khuy\u1ebft th\u1ea7n kinh x\u1ea3y ra m\u1ed9t c\u00e1ch \u0111\u1ed9t ng\u1ed9t, t\u1ed3n t\u1ea1i k\u00e9o d\u00e0i \u00edt [&hellip;]<\/p>\n","protected":false},"author":16,"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>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 cho b\u1ec7nh nh\u1ed3i m\u00e1u n\u00e3o -<\/title>\n<meta name=\"description\" content=\"Nh\u1ed3i m\u00e1u n\u00e3o l\u00e0 b\u1ec7nh l\u00fd do t\u1ed5n th\u01b0\u01a1ng c\u1ee5c b\u1ed9 c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng do t\u1ed5n th\u01b0\u01a1ng h\u1ec7 th\u1ed1ng tu\u1ea7n ho\u00e0n n\u00e3o m\u1ed9t c\u00e1ch t\u1ef1 ph\u00e1t.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, 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