神经系统课件：神经系统疾病.pptVIP

小脑天幕疝（海马钩回疝） 小脑天幕以上额叶或颞叶肿大，导致颞叶的海马钩回经小脑天幕孔向下膨出。 小脑扁桃体疝（枕骨大孔疝） 小脑和延髓向枕骨大孔移位。 Acute brain swelling in the closed cranial cavity is serious. Swelling of the left cerebral hemisphere has produced a shift with herniation of the uncus of the hippocampus through the tentorium, leading tothe groove seen at the white arrow. 小脑扁桃体疝 The end result of herniation is compression and Duret hemorrhages, as seen here in the pons. 小脑扁桃体疝 脑积水 脑脊液量增多伴脑室扩张 本课件参考资料： 1,Kumar V, Abbas AK, Aster JC. Robbins and Contran pathologic basis of disease, 9th edition. Philadelphia: Elsevier Sander, 2015. 2,《病理学》,陈杰, 李甘地主编, 第2版, 北京: 人民卫生出版社, 2010 本课件教学图片来源： 1,Kumar V, Abbas AK, Aster JC. Robbins and Contran pathologic basis of disease, 9th edition. Philadelphia: Elsevier Sander, 2015. 2,Strayer DV, Rubin E. Rubins Pathology, Clinicopathologic foundations of medicine. 7th edition. Philadelphia: Wolters Kluwer, 2015 3,/WebPath/GENERAL.html 4,/ 5,张帆，上海交通大学医学院，病理教研室 * * Glioblastoma A highly malignant astrocyte glioma with necrosis and vascular proliferation. (grade IV) Schwannoma 变性疾病 一组原因不明的中枢神经系统疾病 选择性地累及某一部位的神经元并产生特定的临床症状 共同病理特点为神经原萎缩、死亡和星形胶质细胞增生 阿尔茨海默病（Alzheimer disease) Alois Alzheimer 1864-1915 1901 first case 1906 first report 阿尔茨海默病（Alzheimer disease) 老年性痴呆 临床表现：进行性痴呆 病因和发病机制 Normal cortex Dementia cortex Atrophy: loss of the neurons 病变特点 部位：大脑额叶、顶叶及颞叶 肉眼：萎缩性改变 Alzheimer病 海马区 大脑皮质区 Alzheimer Hemisphere Normal Hemisphere The cerebral atrophy seen here mainly in the frontal and parietal regions is characterized by narrowed gyri and widened sulci. The atrophy seen here was due to senile dementia of the Alzheimers type (Alzheimers disease). In this case of Alzheimers disease, there is more marked atrophy seen superiorly and laterally, with sparing of the occipital region. 病变特点 镜下 神经斑(老年斑) 神经原纤维缠结 颗粒空泡变性 hirano小体 A? Congo red stain Neuritic plaques Neurofibrillary tangles of Alzheimers disease are also seen best with a silver stain, as shown here. Microscopic lesions: ?, ? Amyloid-? (