中枢神经系统影像.ppt

3EpiduralHematoma硬膜下血肿ScoureofbloodLaceration（撕裂）ofCortical（脑皮层血管）AA.andVV.(Direct:penetratinginjury)(直接穿透伤)Bridging(Cortical)Veins（桥静脉）Duralsinus（静脉窦）LargeContusions(Direct/indirect:PulpedBrain硬膜下血肿（SDH）：

颅内出血积聚于硬脑膜和蛛网膜下腔之间SubduralHematoma硬膜下血肿

PresentationSignificantheadtrauma,butchronicsubdural-onlyminororremotehistoryoftraumaBilateralin20%adults(commoninelderly),80-85%bilateralininfantsExtensionintointerhemisphericfissure（纵裂），tentorial（小脑幕）marginsBraininjuryin50%;ComplexInjury(DAI)Skullfractureinonly1%SubduralHematoma-CT1.Sickle-shape(镰刀型)ornewlunarshape(新月型)2.Extendspastthesutures3.AcuteSDH-HyperdenseSubacuteSDH-Isodense(1-2weeks)ChronicSDH–Hypordense4.Braininjuryin50%;ComplexInjury(DAI);5.Skullfractureinonly1%Thehematomamayextendingintothesubduralspaceoftentorialregion.血肿可以延伸到小脑幕区.AcuteSubduralHematoma急性硬膜下血肿Thehematomamayextendingintotheinterhemisphericfissure血肿延伸至大脑镰部.AcuteSubduralHematomaShape：Semilunar，fusiform，Ovalshape外形：半月形、纺锤形、椭圆形.Density：HyperdenseIsodenseHypodenseMixeddensity密度：高密度、等密度、低密度、混杂密度ChronicSubduralHematoma

慢性硬膜下血肿等密度慢性硬膜下血肿.IsodenseChronicsubduralhematomaHyperintensityofchronicsubduralhematoma高密度慢性硬膜下血肿

（T1/T2均为高信号）等密度硬膜下血肿双侧脑室对称变小，体部呈长条状两侧侧脑室前角内聚，夹角变小，呈“兔耳征”脑白质变窄塌陷皮层脑沟消失MembraneHematomaEpiduralAcuteBiconvexUnilateralSkullFracture90%LimitedbysuturesDirecttraumatocraniumLaceration（撕裂）ofMeningealArterylucidinterval（中间清醒期40%pts）SubduralAcutetoChronicNewlunarshapeBilateralFracture+/-1%CrosssuturesContrecoupInjury对冲伤Laceration（撕裂）ofBridgingVeins（桥静脉）4.SubduralEffusion硬膜下积液SubduralEffusion硬膜下积液

Occurredinagedpatientorinfant发生在老人及幼儿.Developedseveraldayslaterafteraheadinjury外伤几天后形成Oftenbilateral常双侧