18-颅脑损伤,王海军的.ppt

颅脑损伤;第一节 头皮损伤;头皮血肿;头皮裂伤应注意有无骨折，脑损伤。 头皮撕脱伤防治失血性或疼痛性休克。 ;第二节 颅骨骨折;线性骨折;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;颅底部的线性骨折－颅底骨折;;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;颅中窝骨折 外耳道流血或脑脊液耳漏（偶见鼻漏） 周围性面瘫，听力下降 眶上裂综合征 外伤性尿崩症 颈内动脉－海绵窦漏 颈内动脉破裂：致命大出血 ;颅后窝骨折 Battle征－迟发性 咽后壁有时可见黏膜下瘀血 后组颅神经损伤 ;诊断 以临床症状及体征为主要依据 辅助检查 颅骨平片－颏顶位（一般不做） CT 处理 着重处理脑损伤、并发症 ;脑脊液漏的处理－预防颅内感染 卧床休息、抬高床头 保持局部清洁，禁止填塞 抗生素 勿行腰穿 避免用力 保守治疗多可治愈 ;颅顶骨凹陷性骨折;凹陷性骨折的手术指征;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;第三节 脑损伤;闭合性脑损伤的机制;原发性脑损伤;脑震荡;弥散性轴索损伤（DAI）;脑挫裂伤;;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;;;;;;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;原发性脑干损伤;CT 脑干点片状高密度影，脑干肿胀， 基底池、环池消失。MRI 可清晰显示伤灶。优于CT。 注意与继发性脑干损伤鉴别 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;下丘脑损伤;继发性脑损伤;颅内血肿;颅内血肿的分类;硬膜外血肿;出血来源 脑膜中动脉 静脉窦 脑膜中静脉 板障静脉 ;临床表现;辅助检查CT：首选；可见双凸透镜形高密度影X线平片：95％见颅骨骨折 骨折线跨脑膜血管沟、静脉窦 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;硬膜下血肿;急性硬膜下血肿;临床特点－临床症状较重，发展迅速－意识障碍：多呈进行性加重－颅高压症状：呕吐和躁动多见－局灶症状较多见－脑疝症状出现较快 辅助检查CT、X线平片