课件：C及MRI断面解剖.pptVIP

Acute Epidural Hematoma 血塊內含較灰區(箭)， 代表正 在出血中，有未凝結的血塊 EDH：紡垂型，高濃度血塊 頭皮腫(箭)，撞擊處 THANK YOU SUCCESS * * 可编辑 Acute Subdural Hematoma Sickle-shape (鐮刀型) or new lunar shape (新月型) of hyperdense lesion over large portion of cerebral hemisphere The hematoma may extending into the subdural space of tentorial region or interhemispheric fissure SDH：新月型(A.B) SDH可能在interhemispheric fissure內(C)。 SDH也可在tentorium下(D) (不要誤為腦內出血) A B C D Acute Subdural Hematoma Chronic Subdural hematoma Shape: Semilunar, Fusiform, Oval shape Density: Hyperdense Isodense Hypodense Mixed density Chronic Subdural Hematoma T1WI T2WI methemoglobin Hyperintense Subdural Hematoma Subdural Effusion Occurred in aged patient or infant Developed several days later after a head injury Often bilateral Spontaneously resorbed Craniotomy, V-P shunt, meningitis also may cause subdural effusion Subdural Effusion 4 days later 10 days later Intracerebral Lesions Brain contusion 腦挫傷(edema, hemorrhage..) Subarachnoid hemorrhage (SAH)蜘蛛網膜下腔出血 Intraventricular hemorrhage (IVH) 腦室內出血 Brain Contusion Brain edema mixed with multiple small hemorrhages 腦水腫合併出血 ：最常見 Solitary hematoma Circumscribed area of brain edema 局部腦水腫：很少見 Diffuse brain edema Diffuse axonal injury 廣泛神經軸受傷 Brain Contusion Punctate hemorrhages and edemas in the subcortical white matter of left frontal lobe (A) and corpus callosum (B,C) A B C Head injury, GCS:3’Diffuse axonal injury (DAI) Traumatic SAH Often associates with other intracerebral or extracerebral lesions CT findings: Linear high density in the subarachnoid spaces (sulci, fissures, cisterns) May cause hydrocephalus Traumatic SAH 1 1 2 3 4 5 5 2 1. SDH 2. EDH 3. Contusion hemorrhage and edema 4. IVH (外傷性腦室內出血) 5. SAH (外傷性蜘蛛網膜下腔出血) SAH：在腦溝、腦裂、腦池內 看到出血 5 Open Cranial Injury Skull fracture Pneumoencephalus 頭部外傷後遺症 廣泛腦萎縮 ( Diffuse brain atrophy ) 腦室積水 ( Hydrocephalus ) 腦組織軟化 ( Encephalomalacia ) 86,5,14 Acute SDH contusion he