(外科学课件）01 已翻译Increased Intracranial Pressure.ppt

* * 1. 3) internal decompression 8. Management of increased ICP Resection of part of brain tissue (the non-dominant hemisphere frontal半球额面, temporal pole颞极) to reduce the volume of the cranial contents 4) bypass operation of CSF: including external ventricular drainage脑室外引流, ventriculoperitoneal shunt腹腔分流术 external ventricular drainage脑室外引流 when obstruction of circulation pathway of CSF induced hydrocephalus脑积水. ventriculoperitoneal shunt腹腔分流术 Pre- 5D Post- thalamic hemorrhage丘脑出血 Part 1. Increased Intracranial Pressure Part 2. Acute Brain Herniation急性脑疝 Part 2. Acute Brain Herniation Anatomy relative to brain herniation Definition of brain herniation Classification Transtentorial herniation小脑幕切迹疝 Transforamen magna herniation枕骨大孔疝 outline tentorium cerebelli小脑幕 falx cerebri大脑镰 tentorial notch 小脑幕切迹 1. Anatomy relative to brain herniation ~ is the displacement of part of brain tissue from its original location into anatomic解剖的 defects/incisures 切迹 caused by pressure gradients压力梯度 that develop between craniospinal颅脑 compartments间隔. common diseases: Traumatic brain injury脑外伤, Brain tumor肿瘤, intracranial hemorrhage颅内出血, Brain abscess脑脓肿, etc. # 2. Definition of brain herniation脑疝 # 3. Classification of brain herniation Transtentorial小脑幕切迹 herniation or temporal uncal颞叶钩回 herniation Foramen magnum枕大孔 herniation or cerebellar tonsillar小脑扁桃体 herniation Subfalcine大脑镰下 herniation or gyri脑回 callousus胼胝体 herniation大脑镰下疝 Based on location of herniation and dispalced brain tissue # 4. Transtentorial herniation or temporal uncal herniation medial aspect of temporal lobe through tentorium幕 Pathophysiology midbrain compressed and distorted → compressed aqueduct导管 impairs CSF flow (obstructive hydrocephalus) → haemorrhage in pons and midbrain脑桥和中脑 risk to ----ipsilateral[?ps?l?t?r?l]同侧 3rd nerve ----posterior cerebral artery脑后动脉 ----ipsilateral cerebral peduncle大脑脚 Midbrain haemorrhage and necrosis坏死 following tentorial herniation # Clinical manifestation表现 a. Symptom of in