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OC PHIM CT

CHAN THNG SO NAO

CA SO NHU MO-CA SO XNG

GIAI PHAU HNH ANH

VAI IEM GIAI PHAU CAN THIET


Tren leu, di leu (ho sau)
Giai phau cat ngang cau truc nao Nao that (IV, III, ben) Be nao (tren yen, quanh cu nao sinh t) Ranh va khe nao

ng gia

Nao that IV

Nao that III

Giai phau

6 6

1
5 5

2 1 2

3 3

4 4

(1): Bao trong (2): au nhan uoi (3): Nhan beo (4): oi th

(5): Nao that III (6): Sng tran nao that ben

Than nao that ben

Tren nao that

Ranh-khe nao

ng gia

Ton thng CTSN tren CT

PHAN LOAI
Trong truc>< ngoai truc

Nguyen phat >< th phat


Khu tru><lan toa

Kn><H

Cau truc lien quan so-mang nao-nhu mo nao

TON THNG CHAN THNG SO NAO


Trong truc Nhu mo nao Mang mem Mang nhen Ngoai truc Mang cng Hop so

Xuat huyet khoang di nhen

Tu mau ngoai mang cng

Tu mau di mang cng

TON THNG NGUYEN PHAT


V hop so

Ton thng ngoai truc (extra-axial)


-Tu mau ngoai mang cng
-Tu mau di mang cng

-Xuat huyet khoang di nhen

Ton thng trong truc (intra-axial)


-Dap nao

-Xuat huyet trong nao


-Ton thng truc lan toa -Ton thng chat xam sau -Ton thng cuong nao -Xuat huyet trong nao that

TON THNG TH PHAT


Thoat v nao
Nhoi-thieu mau nao do chan thng

Phu nao
Ton thng do thieu oxy nao

TON THNG HOP SO Ton thng phan mem Ton thng xng

TON THNG PHAN MEM

Dap
Rach

Tu mau

TON THNG XNG

Nt so dang ng
Lun so

Dan khp so

V lun so (depressed fracture)

Dan khp so Dap xuat huyet nao vung tran

Nam, 25t, mu mat (T), CTSN V xng tran, thanh trong hoc mat, lo th giac (Bo sot CT thng qui)

TU MAU NGOAI MANG CNG


(Epidural hematoma) Tre Thai dng-nh (95%) ong mach mang nao gia (90%), tnh mach tuy so, xoang mang cng (10%) Nt so cung ben va tu mau di mang cng oi ben (90%)

ng mch mng no gia

TU MAU NGOAI MANG CNG


(Epidural hematoma)

Hnh hai mat loi


Khong vt qua khp so

Chay qua nep mang nao

TU MAU DI MANG CNG


(Subdural hematoma)

Gia Tien lng kem t cac tnh mach cau noi

TU MAU DI MANG CNG


Hnh liem Chay qua cac khp so

Khong vt qua cac nep mang cng

TU MAU DI MANG CNG


Cap
Man
*Tu

(0-7ngay)
(>22 ngay)

am o cao
ong am o am o thap

Ban cap (7-22 ngay)

dch (hygroma)

CHAY MAU TAI PHAT

XUAT HUYET KHOANG DI NHEN

Tang am o cac khe, ranh, be nao

EDH

XUAT HUYET TRONG NAO THAT


(Intraventricular hemorrhage)

XUAT HUYET TRONG NAO THAT


(Intraventricular hemorrhage)

DAP NAO (Contusion)


Va ap vao mat trong hop so, liem-leu nao V mach mau nho, thoat mach

Mau+ nhu mo nao

DAP NAO
Cung ben (coup)
oi ben (contre-coup)

DAP NAO
Giam am o (dapphu)
Tang am o (chay mau)

TON THNG TRUC LAN TOA


(Diffuse axonal injure/ Shear injury)

Ton thng sau Chan thng toc o cao Lc tang,giam toc, xoay ot ngot Cang xe si truc, mach mau nho

TON THNG TRUC LAN TOA


Thng hnh anh CT bnh thng
Not chay mau nho, rai rac

MRI co gia tr trong chan oan

TON THNG TRUC LAN TOA


Ranh gii chat trang-xam The chai Cuong nao (sau ben) Hach nen/bao trong

Chat trang ban cau

TON THNG XUYEN THAU


ng i cua tac nhan Mc o lan rong (manh xng, manh an) V tr manh an

Lien quan mach mau

THOAT V NAO
-Thoat v di liem (Subfalcial H.) -Thoat v qua leu (Transtentorial H.) +Hng len +Hng xuong

-Thoat v hanh nhan tieu nao (Tonsilar H.)

Thoat v nao

THOAT V DI LIEM NAO


-Thoat v di liem: hoi ai qua di b t do liem nao ng gia lech. -Ep nao that cung ben -Co the rong nao that oi ben -Nhoi mau ong mach nao trc

THOAT V QUA LEU HNG XUONG -Mom moc cua hoi canh hai ma thoat v qua khe leu tieu nao xuong di
+Xoa be tren yen

+Rong be goc cau tieu nao cung ben

THOAT V QUA LEU HNG LEN -Thoat v qua leu t di len tren: do khoi choan cho ho sau ay tieu nao len cao qua khe leu tieu nao
+Xoa - bien dang be quanh cuong nao

PHU NAO
-Do nhieu nguyen nhan -Hnh anh +Xoa cac ranh nao-be nao, nao that +Mat ranh gii chat trangxam

DO ONG MACH CANH-XOANG HANG

-Ln xoang hang -Dan tnh mach mat tren

DI CHNG CHAN THNG SO NAO


Nhuyen nao (encephalomalacia) Teo nao Tu kh noi so Do dch nao tuy Ton thng than kinh mat ai thao nhat

Hnh anh nhuyen nao va teo nao vung cham (T) sau dap xuat huyet nao 3 thang trc

Tom lai: Ton thng hay gap?

Tom lai: Ton thng hay gap?

Tom lai: Ton thng hay gap?

TH T PHAN TCH PHIM

1. Hop so 2. Khoang ngoai mang cng

3. Khoang di mang cng


4. Khoang di nhen 5. Nhu mo nao 6. Nao that

TH T PHAN TCH PHIM


1. HOP SO : Tu mau di da, v so

2. KHOANG NGOAI MANG CNG: TMNMC 3. KHOANG DI MANG CNG : TMDMC 4. KHOANG DI NHEN : XHKDN 5. NHU MO NAO: Dap, phu, chay mau

6. NAO THAT: Xuat huyet nao that

ANH GIA PHIM CT CHAN THNG SO NAO CAP ? ng gia Bat thng am o, hnh dang hai ban cau Cac be nao, ranh nao [be tren yen (pentagon) be cu nao sinh t (smile sign)] Nao that (ben, IV)

Co mau tu-hieu ng choan cho hay khong?

ANH GIA PHIM CT THEO DOI CHAN THNG SO NAO So sanh cac phim >< tnh trang lam sang ? Xuat hien ton thng mi, thay oi ton thng cu? Mc o hieu ng choan cho (thoat v)?

Co thay oi so vi phim trc?

KET LUAN
Ton thng CTSN tren CT a dang CT rat gia tr trong CTSN

XIN CAM N

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