顱內(nèi)壓增高八年制臨床醫(yī)學(xué)ppt課件

1、Craniocerebral injury has high incidence whether in peacetime or war times. But Increased ICP is the essential and the knotty problem passing through neurosurgical clinical and teaching which the teaching programme demands to hold.Importance Significance Necessity Intracranial pressure , ICP： is the

2、 pressure in cranial cavity,namely brain pressure, which is expressed in pressure of CSF.Range of normal value: 0.7-2 kPa (70-200mmH2O), children:0.5-1.0kPa. 2kPa Intracranial hypertension， 0.7kPa Intracranial hypotension1. PathophysiologyD E F I N I T I O NCSFCSF10%10%bloodblood10%10%brainbrain80%8

3、0%brainCSFbloodIts general volume is constant1400ml ICP的調(diào)節(jié)與代償Generation of CSFtotal amount:130ml V=0.35ml/minAbsorptionOf CSFExcessive CSF：hydrocephalusCBF ： AVM、aneurysmsBrain tissue volume :cerebral edema (brain injury, inflammation, hypoxia,poisoning)Space-occupying lesion： hematoma ,tumor , absc

4、ess , granuloma Basilar invagination and large depressed fracture of skullcontentscranial cavity1. Influence of cerebral blood flowDiagnosisLumbar vertebrae punctureAccessory examination.Accessory examination. CT & MRI Accessory examination. Cerebral Vascular Angiographydigital subtraction Angiograp

5、hy , DSA3D-DSASphenoidal meningioma1. Etiological treatmentSpace-occupying focus: removalIntraoperationEtiological treatmentEtiological treatment2.Hydrocephalus:by-pass operation of CSFeg. Ventriculoperitoneal shunt 3. Dehydration therapy Mannitol 20% Glucosi 50% Furosemide (Lasix) Glycerin fructose

6、 Hydrochlorothiazide Dimox 4. Hormonotherapy Improve function of Blood brain Barrier, BBB ， lower permeability of capillary Desamethasone Methylprednisolone Hydrocortisone Prednisone5.Subhypothermia therapyLower cerebral metabolism, Reduce cerebral oxygen consumption Prevent development of hydroceph

7、alus(Schematic diagram) Cause of formation ICP caused bycaused by different reasonsdifferent reasonsbrain tissue pass down the position brain tissue pass down the position where pressure is lowwhere pressure is lowgive rise to a series give rise to a series of clinic syndromesof clinic syndromesname

8、ly brain hernianamely brain herniaMultiple choice questionsReview1. Regulation of CSF only makes the volume of cranial cavity reduce by:A. Draw off a lot of CSF on lumbar punctureB. Intracranial diffusive cerebral edemaC. Velocity of fluid infusion is too fastD. Pressure of each branch cranial cavity is unbalanced2. Which is the most basic condition of hernia formation? A Auto-regulation of Cerebral vessel dont workB Cerebral edema, Herniation of brainC Gastrointestinal dysfunctionD Pulmon