病变疾病脱髓鞘疾病精神病了解最少先天畸形发ppt课件.pptVIP

Chapter 16：Disease of Central Nervous System Cerebral Vascular Disorders;Hemodynamic Derangement Cerebral Vascular Disorders 406;Cerebral injury caused by hypertension, cardiac arrest, hemorrhage and shock. Predisposing factors： higher metabolic rate：more susceptible NeuronAsOligoEndo Gray MatterWhite Matter 3rd、5th、6th layers of cortex are most vulnerable;Focal ischemic insults;Persistence and severity of ischemia mild ischemia: no remarkable change severe ischemia, survive few hours before death: not remarkable moderate ischemia, survive more than 12 hours：typical changes Architecture of cerebral arteries the location at the border zone of cerebral arteries is much more vulnerable. ;Changes: 1. laminar cortical necrosis : neurons in 3rd, 5th, 6th layers of cortex involved 2. hippocampal sclerosis ：pyramidal neuron death 3. border zone infarction ： early stage： “C” shaped infarct later stage: astrogliosis (granular atrophy) cardiopetal development→global necrosis(respirator brain) CPC：weakness sensation abnormalities →coma, vegetable status→ death;Cause： thrombosis, embolism, space occupying lesion, local vessels compressed by hernia Types: 1. thrombotic: on the sites of atherosclerosis the symptoms: from weakness of muscles to semiplegia or coma 2. embolic: the emboli often are cardiogenic , or from atherosclerotic plaque, with sudden onset and poor prognosis.;Types: white infarct red infarct: incomplete occlusion or frangible emboli going further to small vessels, resulting in blood escape from injured vascular wall. Morphology changes: first 4~12h: normal then: ischemic neuronal changes 36-48h: swollen and soft; demarcation between gray and white matter becomes blurred due to edema the third day: macrophage, progressive marked