颅内和椎管内血管性疾病_哈医大《外科学》(神经外科)课件.PPT

颅内和椎管内血管性疾病 intracranial and intraspinal vascular disease Abstract The incidence and mortality rate of cerebrovascular disease are high.these disease seriously threaten the health of human and are called three main diseases which kill the man with coronary heart disease and malignant tumor. The operation is the most important therapeutic method.There are some vascular malformations, such as arteriovenous Malformation, moyamoya Abstract disease, intracranial aneurysm, et al, need opreate, the other neednot. Diagnosis is as important as therapy.CT and MRI are very important assistant examination for the diagnosis of vascular malformation.But the gold standard for this kind of disease is DSA. We can know the size, the part, single or multiple et al through it, and this will help us to decide how to deal with the vascular malformation. vocabulary Subarachnoid adj　 蛛网膜下腔的 Hemorrhage adj 出血 Moyamoya disease n 烟雾病 Intracranial adj 颅内的 Aneurysm n 动脉瘤 Vascular malformation n 血管畸形 vocabulary Arteriovenous adj 动静脉的 Hemangioma n 血管瘤 Cavernous adj 海绵状的 Venous adj 静脉的 Varices n 静脉曲张 人类死亡的三大杀手 癌 症 cancer 冠 心 病coronary heart disease 脑血管病cerebrovascular disease 第一节 自发性蛛网膜下腔出血spontaneous subarachnoid hemorrhage 指脑血管破裂，血液流至蛛网膜下 腔的统称。 外伤性蛛网膜下腔出血—脑挫裂伤。 自发性蛛网膜下腔出血---70-80%- 颅内动脉瘤、AVM---外科处理。 病 因 pathogeny 1、颅内动脉瘤 2、颅内血管畸形 3、动脉硬化症 4、烟雾病 5、肿瘤卒中 6、血液病 7、其他：动脉炎，脑炎，抗凝治疗后 临床表现clinic presentation 1、出血症状：血压升高因素剧烈头痛，恶 心，呕吐，面色苍白，全身冷汗 精神症状：烦躁，意识障碍 昏迷---脑疝---死亡 2、脑神经损害：一侧动眼神经麻痹 后交通动脉瘤 3、偏瘫：20%，累及运动区，传导束， 血管痉挛 4、视力视野障碍： SAH 视N鞘 玻璃体膜下片 状出血