神经系统疾病影像学_.ppt

137 对于一个怀疑脑卒中的患者，首选影像学检查方法是什么，为什么？ 一个急性脑卒中的患者[8小时]，左侧肢体中枢性瘫，右侧中枢性面瘫，CT 报告：右侧颞叶脑梗塞。请问[梗塞]的诊断有问题吗？需要进一步检查吗？WHY? 一个身体健康20岁男性，晨起发现双下肢瘫，大小便失禁，请问首选影像学检查方法是什么，为什么？ 谢 谢 Recent cerebral Infarct horizontal section of the brain at the level of the upper third ventricle showing a recent infarct in the middle cerebral artery distribution manifested by discoloration and disintegration (cracking) of the tissue of part of one hemisphere. Note the marked swelling of the affected hemisphere with herniation of structures across the midline. 昉ale infarcts such as this are usually due to thrombi. Middle Cerebral Artery Infarct coronal section through the brain at the level of the thalamus and lenticular nuclei. The arrow points to a very old middle cerebral artery infarct in which most of the affected cerebralcortex, white matter, lenticular nucleus, and part of the thalamus has been destroyed by loss of blood supply to the region. After the infarct occurred, macrophages picked up the dead tissue and disposed of it leaving alarge cavity. Infarcts of cerebral hemispheres Coronal section of the brain through the level of the midbrain showing two small cystic infarcts, one in the lateral midbrain and one in the lateral white matter close to the optic radiations. due to ischemia or loss of blood supply to these regions. Intracerebral Hemorrhage coronal section of brain through the thalamus showing a large intracerebral hemorrhage。 Note the shift of structures toward the opposite side including the cingulate gyrus, lateral and thirdventricles and thalamus There is blood in the ventricles as well Cerebral Aneurysm The view of the base of the brain at the level of the optic chiasm showing a giant aneurysm (arrow)that was found incidently at autopsy. It had not ruptured but compressed cranial nerves Subarachnoid Hemorrhage Two coronal sections of brain one their side. Note the dark reddish color of the leptomeninges. This represents subarachnoid hemorrhage from a ruptured berry aneurysm