(法医学教材）3法医CNS trauma 2014.pptxVIP

CNS Trauma竺可青2014-3-11Classification of head injury by clinicopathological correlation根据临床病理联系的脑损伤分类Classification of head injury by neuroradiological and neuropathological features 根据神经放射学和神经病理学特点分类Classification of head injury by mechanism of production 根据产生机制分类颅骨骨折Fissured fracture 线性骨折Depressed fracture 凹陷型骨折Penetrated fracture 孔状骨折Comminuted fracture 粉碎性骨折Bursting fracture 崩裂性骨折An arrested growing fracture that presented in a woman of 38. When asked about childhood injuries, she remembered that she fallen out of her carriage as a very young child. A. Plain skull X-ray. B. The excised portion of bone.Old contusions on the base of the frontal lobes.Extradural hemorrhages. 硬膜外出血 EDHA. A man of 60 received a blow behind his ear. Bruising in the temporails muscle and this linear, right-sided temporal fracture overlay a large extradural hemorrhage, which was the cause of his death 5 hours later. B, Gross appearance of a bifrontal extradural hematoma. C. A classical extradural hematoma situated in the parietotemporal region.Acute and subacute subdural hematomas 硬膜下血肿. SDHA. Acute subdural hematoma; B. Acute subdural hematoma; C. Subacute subdural hematoma.慢性硬膜下血肿 （脑瘫小儿） 外伤后大脑中动脉闭塞性血栓栓塞梗死 DAI弥漫性轴索损伤、脑白质弥漫性变化、剪切损伤、弥漫性脑深部损伤胼胝体以及脑干前段的局灶性出血病变弥漫性脑损伤4类DAI弥漫性缺血缺氧损伤脑水肿弥漫性血管损伤Frequency of Principal macroscopic lesion in diffuse axonal injury and their anatomical distribution 好发部位Two days’ survival after injury. Damaged axons are easily seen on routine stains.Beta-APP diagnosis axonal damage (2h)Histology in cases where diffuse brain injury is suspected诊断DAIPatterns and causes of hypoxic ischemic brain damage after traumatic brain injury 脑外伤后的弥漫性缺血缺氧性损伤原因及类型好发部位Hippocampus CA1Laminar cortical necrosisInfrction in the bounadry zones of the major cerebral aeteries 弥漫性血管损伤车祸后脑外伤死亡，广泛脑出血导致死亡反复脑损伤与痴呆 儿科脑损伤Vascular PathologyDistribution of the blood in the various forms of intracranial hemorrhages 颅内出血原因Berry aneurysm Diffuse subarachnoid hemorrhage动脉瘤出血部位 根据出血部位判断动脉瘤位置Giant