Cudurka 'pituitary apoplexy'

Pituitary apoplexy waa xaalad naadir ah, laakiin xaalad halis ah qanjirka 'pituitary gland'.

Pituitary waa qanjir yar oo kuyaala salka maskaxda. Pituitary wuxuu soo saaraa hoormoono badan oo xakameeya habsami u socodka jirka.

Pituitary apoplexy waxaa sababi kara dhiigbax ku dhaca pituitary ama socodka dhiigga oo xirmay pituitary. Apoplexy macnaheedu waa dhiigbax xubin ama luminta socodka dhiigga ee xubin.

Cudurka 'pituitary apoplexy' waxaa caadi ahaan sababa dhiig bax gudaha burooyinka aan caadiga ahayn (benign) ee pituitary. Burooyinkani waa kuwo aad u badan oo inta badan lama baadho. Pituitary-ga ayaa waxyeellooba marka burooyinka si lama filaan ah u weynaadaan. Waxay ku dhiig baxdaa pituitary-ga ama waxay xannibtaa bixinta dhiigga ee pituitary-ga. Markay sii weynaato burada, waxay sare u sii qaadeysaa halista apoplexy pituitary apoplexy ee mustaqbalka.

Marka dhiig baxa pituitary uu ku dhaco haweeney inta lagu gudajiro ama saxda ah dhalmada ka dib, waxaa loogu yeeraa Sheehan syndrome. Tani waa xaalad aad u dhif ah.

Waxyaabaha halista ah ee loo yaqaan 'pituitary apoplexy' ee dadka aan uurka lahayn ee aan lahayn buro waxaa ka mid ah:

• Ciladaha dhiig-baxa
• Sonkorowga
• Dhaawac madaxa ah
• Shucaac ku dhaca qanjirka 'pituitary gland'
• Adeegsiga mashiinka neefsashada

Pituitary apoplexy xaaladahan waa mid aad u yar.

Pituitary apoplexy badanaa waxay leedahay muddo gaaban oo astaamo ah (daran), taas oo nafta halis gelin karta. Calaamadaha badanaa waxaa ka mid ah:

• Madax xanuun daran (noloshaada ugu xun)
• Curyaannimo oo muruqyada isha, oo keenta aragti laba-laab ah (ophthalmoplegia) ama dhibaatooyin furitaanka baalalka indhaha
• Lumidda aragga durugsan ama luminta dhammaan aragtida hal ama labada indhood
• Cadaadiska dhiigga oo hooseeya, lallabbo, rabitaanka cuntada oo yaraada, iyo matag ka timaadda yaraanshaha adrenal
• Shakhsiyadda ayaa is beddeleysa sababtoo ah cidhiidhi lama filaan ah oo ka mid ah halbowlayaasha maskaxda (antery cerebral artery)

Caadi ahaan, cilladda pituitary waxay u muuqan kartaa si tartiib tartiib ah. Sheehan syndrome, tusaale ahaan, astaamaha ugu horreeya waxay noqon karaan guuldarro soo saarista caano ay sababtay la'aanta hormoonka prolactin.

Waqti ka dib, dhibaatooyinka hormoonnada kale ee 'pituitary' ayaa laga yaabaa inay soo baxaan, iyagoo keenaya calaamadaha xaaladaha soo socda:

• Kobaca hormoon la'aanta
• Ku filnaansho la'aanta adrenal (haddii aan hore loo soo bandhigin ama aan la daaweyn)
• Hypogonadism (qanjidhada jidhka ee jidhka ayaa soo saara wax yar ama aan lahayn hoormoonno)
• Hypothyroidism (qanjirka 'thyroid' ma sameeyo hormoon tayroodh ku filan)

Marar dhif ah, marka qeybta dambe ee dambe ee pituitary uu ku lug yeesho, astaamaha waxaa ka mid noqon kara:

• Ku guuldarraysiga ilmo-galeenka inuu qandaraas yeesho si uu ilmo u dhasho (dumarka)
• Ku guuldareysiga soo saarida caanaha naaska (haweenka)
• Kaadi soo noqnoqda iyo harraad daran (sonkorowga insipidus)

Bixiyaha xanaanada caafimaadka ayaa sameyn doona baaritaan jireed wuxuuna weydiin doonaa astaamahaaga.

Tijaabooyinka la dalban karo waxaa ka mid ah:

• Baaritaanka indhaha
• MRI ama CT scan

Tijaabooyin dhiig ayaa la qaadi doonaa si loo hubiyo heerarka:

• ACTH (hormoonka adrenocorticotropic)
• Cortisol
• FSH (hoormoonka kiciya follicle)
• Hormoonka koritaanka
• LH (hormoonka luteinizing)
• Prolactin
• TSH (hormoon tayroodh kiciya)
• Cunsurka sida insulin-u eg-1 (IGF-1)
• Sodium
• Dhiig bax iyo kaadi

Cudurka 'apoplexy Acute' wuxuu u baahan karaa qalliin si looga yareeyo cadaadiska saaran pituitary loona hagaajiyo astaamaha aragga. Xaaladaha daran waxay u baahan yihiin qalliin degdeg ah. Haddii aragga uusan saameyn, qalliin badanaa looma baahna.

Daaweyn deg-deg ah oo lala yeesho hormoonnada beddela adrenal (glucocorticoids) ayaa loo baahan karaa. Hormoonadan waxaa badanaa lagu bixiyaa xididka (IV). Hormoonnada kale ayaa ugu dambeyn la beddeli karaa, oo ay ku jiraan:

• Hormoonka koritaanka
• Hormoonnada galmada (estrogen / testosterone)
• Hormoonka tayroodhka
• Vasopressin (ADH)

Cudurka 'pituitary apoplexy' ee daran wuxuu halis gelin karaa nolosha. Aragtida ayaa ufiican dadka qaba cillada pituitary ee muddada dheer (daba dheeraatay) ee la ogaado lana daweeyo.

Dhibaatooyinka ku dhaca apoplexy pituitary apoplexy waxaa ka mid noqon kara:

• Dhibaatada adrenal (xaalad dhacda marka la waayo cortisol ku filan, hormoon ay soo saaraan qanjidhada adrenal)
• Aragtida oo lumisa

Haddii hormoonnada kale ee maqan aan la beddelin, astaamaha hypothyroidism iyo hypogonadism ayaa soo bixi kara, oo ay ku jiraan madhalaysnimo.

Wac daryeel bixiyahaaga haddii aad isku aragto wax calaamado ah oo ku filan oo ah yaraanshaha cudurka pituitary.

Aad qolka gargaarka deg-degga ah ama wac nambarka deg-degga ah ee deegaanka (sida 911) haddii aad leedahay astaamo xasaasiyad daran oo pituitary apoplexy, oo ay ku jiraan:

• Muruqyada indhaha oo daciifa ama araga oo daciifa
• Madax xanuun lama filaan ah
• Cadaadis dhiig oo hooseeya (oo keeni kara suuxdin)
• Lallabbo
• Matagid

Haddii aad isku aragto astaamahan oo mar hore lagaa helay burooyinka 'pituitary buro', raadso caawimaad dhakhso leh.

Cudurka 'Pituitary infarction'; Cudurka 'pituitary buro apoplexy'

• Qanjirada 'Endocrine'

Hannoush ZC, Weiss RE. Cudurka 'pituitary apoplexy'. Gudaha: Feingold KR, Anawalt B, Boyce A, et al, eds. Endotext [Internetka]. South Dartmouth, MA: MDText.com. 2000-. www.ncbi.nlm.nih.gov/books/NBK279125. La cusbooneysiiyay Abriil 22, 2018. La helay May 20, 2019.

Melmed S, Kleinberg D. Cudurka Pituitary iyo burooyinka. Gudaha: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Buugga Buugga Endocrinology. 13aad. Philadelphia, PA: Elsevier; 2016: cutubka 9.