闭合性颅脑损伤.pptxVIP

闭合性颅脑损伤

（ClosedBrainInjury）;;;闭合性脑创伤（ClosedBrainInjury）;闭合性脑创伤（ClosedBrainInjury）;闭合性脑创伤（ClosedBrainInjury）;闭合性脑创伤（ClosedBrainInjury）;诊断要点;治疗;诊断要点;脑挫裂伤;脑挫裂伤;脑挫裂伤;处理原则;处理原则(续);脑干损伤;脑干损伤;脑干损伤;特殊表现;特殊表现;特殊表现;脑干损伤的处理原则;颅内血肿（Intracranialhematoma）;颅内血肿（Intracranialhematoma）;颅内出血（Intracranialhematoma）;颅脑外伤急诊室流程;临床表现;临床表现;临床表现;临床表现;临床表现;GCSscore（E+V+M）;诊断;影像学;治疗原则;颞叶血肿;一、硬膜外血肿;与颅骨损伤有密切关系，多为急性。占30%。

形成原因：

硬脑膜动脉破裂，多为脑膜中动脉

静脉窦出血。

板障出血。;Acuteepiduralhematoma;头部外伤病史。

X线提示：骨折经过血管沟或静脉窦。

头颅CT：硬膜与颅骨之间有一呈棱状的高密度阴影。;Epiduralhematoma;Epiduralhematoma;右颞急性硬膜外血肿清除术;右颞急性硬膜外血肿清除术;特急性硬膜外血肿致双侧颞叶钩回疝;野战条件下颅骨钻孔探查部位及顺序;二、硬膜下血肿;Subduralhematoma;出血来源主要为脑皮质血管。根据是否伴有脑挫裂伤分：

复合性血肿:最多见，进展快，脑疝出现早。大多由对冲性脑挫裂伤所致，好发于额极、颞极及其底面。

单纯性血肿:血肿大，有中间清醒期。桥静脉、静脉窦撕裂所致，不伴有脑挫裂伤。;Acutesubduralhematoma;临床特点比较;Acutesubduralhematoma;Acutesubduralhematoma;慢性硬膜下血肿（Chronicsubduralhematoma）;Chronicsubduralhematoma;三、脑内血肿;Intracerebralhematoma;Intracerebralhematoma;颞叶脑内血肿;双额叶脑挫裂伤减压术;思考题;SUMMARY;Headinjuries

scalpinjuries

skullinjuries

braininjuries;Scalpinjuries

Thedirectionandsiteofforceandheadinjury,orwhetherhavingbraininjury.

Skullfractures

Theriskofinfectionorintracranialhemorrhage.

Thefracturesoftheroofofskull:X-ray.

Basicranialfractures:clinicalmanifestationsuchasthesitesofthecerebrospinalfluidleakageorscalppetechia/ecchymosis.;Braininjuries

Closedbraininjuries

Openbraininjuries

;Primarybraindamages:

concussion,contusionandbrainsteminjury.

Secondarybraindamages:

intracranialhematomas.

brainedema,

brainhernia

subrachnoidhemorrhage.;intracranialhematomas

epiduralhematomas

subduralhematomas

intracerebralhematomas;Intracranialhematomas

Classification

Clinicalmanifestations

symptomsorsignsofacuteintracranialhypertension.

threemainsymptoms:headache,vomiting,Papilledema.

cushing’sreaction:bradycardia,bradypnea,andarterialhypertension(mainlyraisedsystolicbloodpressure).;cerebr