中枢外伤医学知识讲座专家讲座.pptxVIP

CentralNervousSystem12/10/20241中枢外伤医学知识讲座第1页

ClassificationofHeadInjuryExtracerebrallesions:SubduralhematomaSubduraleffusionEpiduralhematomaIntracerebrallesions:Braincontusion(edema,

hemorrhage..)Subarachnoidhemorrhage

(SAH)Intraventricularhemorrhage

(IVH)Opencranialinjury.SkullfracturePneumoencephalus12/10/20242中枢外伤医学知识讲座第2页

颅脑外伤braintrauma硬膜外血肿(epiduralhematoma)硬膜下血肿（subduralhematoma）脑挫裂伤（lacerationandcontusionofbrain）蛛网膜下腔出血Subarachnoidhaemorrhage12/10/20243中枢外伤医学知识讲座第3页

硬膜外血肿

(extraduralhematoma)Thesearisebetweentheinnertableoftheskullandthedura.Theyusuallydevelopfrominjurytothemiddlemeningealarteryoroneofitsbranches,andthereforeareusuallytemporoparietalinlocation.Atemporalbonefractureisoftenthecause,butisnotessential.Theexpandinghaematomastripsthedurafromtheskull;thisattachmentisquitestrongsuchthatthehaematomaisconfined,givingrisetoitscharacteristicbiconvexshape,withawelldefinedmargin.12/10/20244中枢外伤医学知识讲座第4页

CT征象：颅板内侧梭形(双凸透镜)高密度影(与脑实质比)，CT值50~90Hu；(范围小而厚)密度普通较均匀边缘清楚、光滑锐利局部常见脑水肿征局部蛛网膜下腔常见出血征局部有颅骨骨折征含有占位征：局部脑回受压内移，中线结构向对侧移位12/10/20245中枢外伤医学知识讲座第5页

biconvexshape,withawelldefinedmargin.12/10/20246中枢外伤医学知识讲座第6页

12/10/20247中枢外伤医学知识讲座第7页

血块内含较灰区(箭)，代表正在出血中，有未凝结血块EDH：纺垂型，高浓度血块头皮肿(箭)，撞击处12/10/20248中枢外伤医学知识讲座第8页

硬膜外血肿MRI平扫、Gd-DTPA增强12/10/20249中枢外伤医学知识讲座第9页

硬膜下血肿

（subduralhematoma）Thesearisebetweentheduraandarachnoid,oftenfromrupturedveinscrossingthispotentialspace.Thespaceenlargesasthebrainatrophiesandsosubduralhaematomasaremorecommonintheelderly.12/10/202410中枢外伤医学知识讲座第10页

CT征象颅内板内侧新月状(或带状)高密度影(与脑实质比)，CT值50~90Hu，范围广而薄密度普通较均匀边界清楚，但不光滑锐利局部可有或无脑水肿局部可有或无蛛网膜下腔出血局部普通无颅骨骨折，常为对冲伤出血较多时含有占位效应，局部脑实质受压内移，中线结构向对侧移位12/10/202411中枢外伤医学知识讲座第11页

thecrescentichighdensitycollectiontypicalofaacutesubduralhaematoma,withassociatedmidlineshift.12/10/202412中枢外伤医学知识讲座第12页

急性硬膜下血肿（SDH）SDH：新月型(A.B)