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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,2021/1/30,#,Classification of head injury by clinicopathological correlation,根据临床病理联系的脑损伤分类,Classification of head injury,1,Classification of head injury by neuroradiological and neuropathological features,根据神经放射学和神经病理学特点分类,Classification of head injury,2,Classification of head injury by mechanism of production,根据产生机制分类,Classification of head injury,3,An arrested growing fracture that presented in a woman of 38. When asked about childhood injuries, she remembered that she fallen out of her carriage as a very young child. A. Plain skull X-ray. B. The excised portion of bone.,颅骨骨折,Fissured fracture,线性骨折,Depressed fracture,凹陷型骨折,Penetrated fracture,孔状骨折,Comminuted fracture,粉碎性骨折,Bursting fracture,崩裂性骨折,An arrested growing fracture t,4,冲击点伤和对冲伤,Mechanism of cerebral contusion. Arrows indicate point of application and direction of force; black area indicates location of contusion.,冲击点伤和对冲伤Mechanism of cerebral,5,Small intracortical contusions in typical sites at the base of frontal (A) and temporal lobes (B).,Small intracortical contusions,6,Old contusions on the base of the frontal lobes.,Old contusions on the base of,7,Extradural hemorrhages.,硬膜外出血,EDH,A. A man of 60 received a blow behind his ear. Bruising in the temporails muscle and this linear, right-sided temporal fracture overlay a large extradural hemorrhage, which was the cause of his death 5 hours later. B, Gross appearance of a bifrontal extradural hematoma. C. A classical extradural hematoma situated in the parietotemporal region.,Extradural hemorrhages. 硬膜外出血,8,Acute and subacute subdural hematomas,硬膜下血肿,. SDH,A. Acute subdural hematoma; B. Acute subdural hematoma; C. Subacute subdural hematoma.,Acute and subacute subdural he,9,慢性硬膜下血肿 (脑瘫小儿),慢性硬膜下血肿 (脑瘫小儿),10,11,外伤后大脑中动脉闭塞性血栓栓塞梗死,外伤后大脑中动脉闭塞性血栓栓塞梗死,12,DAI,弥漫性轴索损伤、脑白质弥漫性变化、剪切损伤、弥漫性脑深部损伤,胼胝体以及脑干前段的局灶性出血病变,弥漫性脑损伤,4,类,DAI,弥漫性缺血缺氧损伤,脑水肿,弥漫性血管损伤,DAI弥漫性脑损伤4类,13,Frequency of Principal macroscopic lesion in diffuse axonal injury and their anatomical distribution,好发部位,Frequency of Principal macrosc,14,Two days survival after injury. Damaged axons are easily seen on routine stains.,Two days survival after injur,15,Beta-APP diagnosis axonal damage (2h),Beta-APP diagnosis axonal dama,16,Depressed fracture 凹陷型骨折,Berry aneurysm,Hemorrhagic infarcts 出血性梗死,When asked about childhood injuries, she remembered that she fallen out of her carriage as a very young child.,Two days survival after injury.,Multiple lobe hemorrhages in a patient with leukemia 白血病,Fissured fracture 线性骨折,弥漫性轴索损伤、脑白质弥漫性变化、剪切损伤、弥漫性脑深部损伤,Multiple lobe hemorrhages in a patient with leukemia 白血病,慢性硬膜下血肿 (脑瘫小儿),Extradural hemorrhages.,Classification of head injury by mechanism of production 根据产生机制分类,慢性硬膜下血肿 (脑瘫小儿),Damaged axons are easily seen on routine stains.,Brainstem hemorrhage 脑干出血延髓、中脑罕见,脑桥多见;,车祸后脑外伤死亡,广泛脑出血导致死亡,Comminuted fracture 粉碎性骨折,Depressed fracture 凹陷型骨折,脑梗死原因,Hemorrhagic infarcts 出血性梗死,Depressed fracture 凹陷型骨折,17,Histology in cases where diffuse brain injury is suspected,诊断,DAI,Histology in cases where di,18,Patterns and causes of hypoxic ischemic brain damage after traumatic brain injury,脑外伤后的弥漫性缺血缺氧性损伤原因及类型,好发部位,Hippocampus CA1,Laminar cortical necrosis,Infrction in the bounadry zones of the major cerebral aeteries,Patterns and causes of hypoxic,19,弥漫性血管损伤,车祸后脑外伤死亡,广泛脑出血导致死亡,弥漫性血管损伤车祸后脑外伤死亡,广泛脑出血导致死亡,20,反复脑损伤与痴呆,反复脑损伤与痴呆,21,儿科脑损伤,儿科脑损伤,22,法医学法医CNStraumaPPT优质推荐课件,23,Vascular Pathology,Vascular Pathology,24,Distribution of the blood in the various forms of intracranial hemorrhages,颅内出血原因,Distribution of the blood in t,25,法医学法医CNStraumaPPT优质推荐课件,26,Vascular Pathology,Penetrated fracture 孔状骨折,Multiple lobe hemorrhages in a patient with leukemia 白血病,Hemorrhagic infarcts 出血性梗死,The excised portion of bone.,Extradural hemorrhages.,慢性硬膜下血肿 (脑瘫小儿),根据出血部位判断动脉瘤位置,Classification of head injury by mechanism of production 根据产生机制分类,Classification of head injury by neuroradiological and neuropathological features 根据神经放射学和神经病理学特点分类,Intracerebellar hemorrhage 小脑出血突然头痛、眩晕、呕吐;,Classification of head injury by mechanism of production 根据产生机制分类,Small intracortical contusions in typical sites at the base of frontal (A) and temporal lobes (B).,脑动脉粥样硬化好发部位,外伤后大脑中动脉闭塞性血栓栓塞梗死,A classical extradural hematoma situated in the parietotemporal region.,Multiple lobe hemorrhages in a patient with leukemia 白血病,弥漫性轴索损伤、脑白质弥漫性变化、剪切损伤、弥漫性脑深部损伤,Penetrated fracture 孔状骨折,Fissured fracture 线性骨折,Berry aneurysm,Vascular PathologyBerry aneury,27,法医学法医CNStraumaPPT优质推荐课件,28,法医学法医CNStraumaPPT优质推荐课件,29,30,Diffuse subarachnoid hemorrhage,Diffuse subarachnoid hemorrhag,31,动脉瘤出血部位,动脉瘤出血部位,32,根据出血部位判断动脉瘤位置,根据出血部位判断动脉瘤位置,33,Giant atherosclerotic aneurysmsA. Anterior cerebral artery. B. Basilar artery,Giant atherosclerotic aneurysm,34,高血压与高血压性脑血管病,高血压与高血压性脑血管病,35,法医学法医CNStraumaPPT优质推荐课件,36,Multiple lobe hemorrhages in a patient with leukemia 白血病,Bursting fracture 崩裂性骨折,The risk of temporal herniation,Vascular malformations.,脑梗死原因,Classification of head injury by mechanism of production 根据产生机制分类,慢性硬膜下血肿 (脑瘫小儿),Small intracortical contusions in typical sites at the base of frontal (A) and temporal lobes (B).,Medial frontal cerebral arteriovenous aneurysm.,硬膜外出血 EDHA.,Fissured fracture 线性骨折,脑动脉粥样硬化好发部位,Acute subdural hematoma; C.,根据出血部位判断动脉瘤位置,Damaged axons are easily seen on routine stains.,慢性硬膜下血肿 (脑瘫小儿),弥漫性轴索损伤、脑白质弥漫性变化、剪切损伤、弥漫性脑深部损伤,Vascular malformations.,Multiple lobe hemorrhages in a patient with leukemia 白血病,Damaged axons are easily seen on routine stains.,基底核出血,Multiple lobe hemorrhages in a,37,Intracerebellar hemorrhage,小脑出血,突然头痛、眩晕、呕吐;眼震;昏迷;枕骨大孔疝迅速死亡。,Intracerebellar hemorrhage 小脑出,38,Brainstem hemorrhage,脑干出血,延髓、中脑罕见,脑桥多见;突然发病;眼部症状;呼吸障碍;感觉运动障碍;深昏迷;去脑强直;数小时或,24,小时内死亡。,Brainstem hemorrhage 脑干出血延髓、中,39,法医学法医CNStraumaPPT优质推荐课件,40,法医学法医CNStraumaPPT优质推荐课件,41,脑叶出血、皮质下白质出血,额叶,:精神障碍,智能障碍,近记忆力、计算力、判断力障碍,运动性失语。,颞叶,:破入蛛网膜下腔出现脑膜刺激症,感觉性或命名性失语,精神症状。,顶叶,:下肢较上肢及颜面部重的偏瘫及感觉障碍。,枕叶,:对侧偏盲,皮质盲,瞳孔光反射存在。,脑叶出血、皮质下白质出血,42,Vascular malformations.,A. Medial frontal cerebral arteriovenous aneurysm. B. Vein of Galen aneurysm.,脑血管畸形主要,4,种,动静脉血管畸形,AVM,静脉血管畸形,海绵状血管畸形,毛细血管扩张,Vascular malformations. A. Me,43,Multiple lobe hemorrhages in a patient with leukemia,白血病,Multiple lobe hemorrhages in a,44,贫血性梗死,贫血性梗死,45,Hemorrhagic infarcts,出血性梗死,Hemorrhagic infarcts 出血性梗死,46,Fissured fracture 线性骨折,脑动脉粥样硬化好发部位,A classical extradural hematoma situated in the parietotemporal region.,Small intracortical contusions in typical sites at the base of frontal (A) and temporal lobes (B).,Medial frontal cerebral arteriovenous aneurysm.,Acute and subacute subdural hematomas 硬膜下血肿.,Classification of head injury by clinicopathological correlation根据临床病理联系的脑损伤分类,Classification of head injury by mechanism of production 根据产生机制分类,Classification of head injury by neuroradiological and neuropathological features 根据神经放射学和神经病理学特点分类,枕叶:对侧偏盲,皮质盲,瞳孔光反射存在。,高血压与高血压性脑血管病,注意出血病理动态变化过程,Classification of head injury by mechanism of production 根据产生机制分类,脑叶出血、皮质下白质出血,根据出血部位判断动脉瘤位置,慢性硬膜下血肿 (脑瘫小儿),顶叶:下肢较上肢及颜面部重的偏瘫及感觉障碍。,Brainstem hemorrhage 脑干出血延髓、中脑罕见,脑桥多见;,Depressed fracture 凹陷型骨折,车祸后脑外伤死亡,广泛脑出血导致死亡,注意出血病理动态变化过程,Fissured fracture 线性骨折注意出血病理动,47,法医学法医CNStraumaPPT优质推荐课件,48,脑梗死原因,脑梗死原因,49,脑动脉粥样硬化好发部位,脑动脉粥样硬化好发部位,50,法医学法医CNStraumaPPT优质推荐课件,51,Evolution of lesions caused by atheromatous carotid stenosis,Evolution of lesions caused by,52,判断栓子,判断栓子,53,法医学法医CNStraumaPPT优质推荐课件,54,法医学法医CNStraumaPPT优质推荐课件,55,The risk of temporal herniation,The risk of temporal herniatio,56,A classical extradural hematoma situated in the parietotemporal region.,Hemorrhagic infarcts 出血性梗死,Medial frontal cerebral arteriovenous aneurysm.,Extradural hemorrhages.,Anterior cerebral artery.,枕叶:对侧偏盲,皮质盲,瞳孔光反射存在。,Evolution of lesions caused by atheromatous carotid stenosis,额叶:精神障碍,智能障碍,近记忆力、计算力、判断力障碍,运动性失语。,胼胝体以及脑干前段的局灶性出血病变,Brainstem hemorrhage 脑干出血延髓、中脑罕见,脑桥多见;,Medial frontal cerebral arteriovenous aneurysm.,车祸后脑外伤死亡,广泛脑出血导致死亡,Classification of head injury by neuroradiological and neuropathological features 根据神经放射学和神经病理学特点分类,顶叶:下肢较上肢及颜面部重的偏瘫及感觉障碍。,根据出血部位判断动脉瘤位置,Damaged axons are easily seen on routine stains.,The excised portion of bone.,Acute and subacute subdural hematomas 硬膜下血肿.,Multiple lobe hemorrhages in a patient with leukemia 白血病,Small intracortical contusions in typical sites at the base of frontal (A) and temporal lobes (B).,大脑后动脉梗死,A classical extradural hematom,57,椎基底动脉系统,椎基底动脉系统,58,法医学法医CNStraumaPPT优质推荐课件,59,法医学法医CNStraumaPPT优质推荐课件,60,61,法医学法医CNStraumaPPT优质推荐课件,62,法医学法医CNStraumaPPT优质推荐课件,63,法医学法医CNStraumaPPT优质推荐课件,64,65,法医学法医CNStraumaPPT优质推荐课件,66,小结,小结,67,法医学法医CNStraumaPPT优质推荐课件,68,法医学法医CNStraumaPPT优质推荐课件,69,法医学法医CNStraumaPPT优质推荐课件,70,外伤后大脑中动脉闭塞性血栓栓塞梗死,外伤后大脑中动脉闭塞性血栓栓塞梗死,71,外伤后大脑中动脉闭塞性血栓栓塞梗死,外伤后大脑中动脉闭塞性血栓栓塞梗死,72,高血压与高血压性脑血管病,高血压与高血压性脑血管病,73,高血压与高血压性脑血管病,高血压与高血压性脑血管病,74,Multiple lobe hemorrhages in a patient with leukemia,白血病,Multiple lobe hemorrhages in a,75,Multiple lobe hemorrhages in a patient with leukemia,白血病,Multiple lobe hemorrhages in a,76,弥漫性轴索损伤、脑白质弥漫性变化、剪切损伤、弥漫性脑深部损伤,车祸后脑外伤死亡,广泛脑出血导致死亡,慢性硬膜下血肿 (脑瘫小儿),Multiple lobe hemorrhages in a patient with leukemia 白血病,The excised portion of bone.,Classification of head injury by neuroradiological and neuropathological features 根据神经放射学和神经病理学特点分类,Classification of head injury by mechanism of production 根据产生机制分类,Medial frontal cerebral arteriovenous aneurysm.,车祸后脑外伤死亡,广泛脑出血导致死亡,Small intracortical contusions in typical sites at the base of frontal (A) and temporal lobes (B).,Small intracortical contusions in typical sites at the base of frontal (A) and temporal lobes (B).,Classification of head injury by mechanism of production 根据产生机制分类,Acute subdural hematoma; C.,脑动脉粥样硬化好发部位,Multiple lobe hemorrhages in a patient with leukemia 白血病,Berry aneurysm,The risk of temporal herniation,Brainstem hemorrhage 脑干出血延髓、中脑罕见,脑桥多见;,车祸后脑外伤死亡,广泛脑出血导致死亡,车祸后脑外伤死亡,广泛脑出血导致死亡,弥漫性轴索损伤、脑白质弥漫性变化、剪切损伤、弥漫性脑深部损伤,77,法医学法医CNStraumaPPT优质推荐课件,78,
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