最新脑疝分类及影像学表现图解学习课件.pptVIP

Superior vermian herniation ( ascending transtentorial herniation ) 由于后颅凹的占位效应，小脑蚓和小脑半球通过小脑幕切迹向上移动 临床表现 影像所见 并发症 恶心 呕吐 意识障碍 中脑外观呈陀螺状 双侧环池变窄 四叠体池充满 因小脑上动脉受压引起梗塞 Galen静脉移位 脑积水 意识障碍迅速出现，并可能死亡 .. 陀螺状外观 .. 双侧环池变窄 .. 四叠体池充满 .. 不露齿的微笑 .. 类型 脑疝部位命名 别名 疝入脑组织命名 1．大脑镰下疝 扣带回疝 2．小脑天幕疝 前疝 后疝 小脑幕切迹疝、小脑幕下降疝 脚间池疝 环池疝，四叠体疝 颞叶钩回疝 海马回疝 3．小脑幕孔中心疝 间脑 4．小脑幕孔上疝 小脑幕上疝 小脑蚓部疝 5．枕骨大孔疝 小脑扁桃体疝 .. 示意图 .. 解剖关系 .. 解剖关系 F Qc Mb 3v T O Sy CC lv F P O Sp CC lv s s .. 解剖关系 F T Ce s P d 4th V F T Mb Ce s .. The suprasellar cistern the quadrigeminal cistern The left and center images show the suprasellar cistern. Its anterior borders are formed by the frontal lobes (F). Its lateral borders are formed by the uncus (U) of the temporal lobes. The left image shows the 5-pointed star appearance of the suprasellar cistern where the posterior border is formed by the pons (Po). The black arrow points to the fourth ventricle. The center image shows a higher cut where the suprasellar cistern has a 6-pointed star appearance since the posterior border is formed by the cerebral peduncles (P) which have a central cleft. The right image shows the quadrigeminal cistern (black arrow). Note the babys bottom appearance of its anterior border. When ICP is increased, the quadrigeminal cistern space is compressed or obliterated. .. The suprasellar cistern the quadrigeminal cistern. The midline sagittal MRI scan shows the levels of the axial diagrams. The quadrigeminal cistern is located above (anterior to) the Q in the highest cut shown (number 9). The anterior border of the quadrigeminal cistern is formed by the superior colliculi (c). Image 8 (lower cut) also shows the quadrigeminal cistern. In this case, its anterior border is formed by the inferior colliculi (c). This gives the anterior border of the quadrigeminal cistern the appearance of a babys bottom. The quadrigeminal plate is comprised of the superior and inferior colliculi. The quadrigeminal cistern is posterior to this quadrigemina