Bimbingan Koass Neuroimejing

7/21/2019 Bimbingan Koass Neuroimejing

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1

Dr. ILMA FIDDIYANTI



Central Nervous System

• Consists of:

– Cerebrum – Telencephalon

– Brain stem – Truncus Cerebri

– Spinal Cord – Medulla Spinalis




• Cerebrum (Telencephalon) - subdivided

into four lobes:

– Frontal Lobes

– Parietal Lobes

– Oipital Lobes

– !emporal Lobes




• Brain stem (Truncus Cerebri) – onsists

of:

– "edulla Oblon#ata (MO)

– Pons

– "idbrain (Mesenchephalon)




• Cerebellum

– Loation:

• $bove t%e brainstem & beneat% t%e oipital lobes

at t%e base of t%e s'ull

– Fns

• (apid inte#ration of sensory input for e)uilibrium

• *nfluenes musle tone+ posture+ fine & s'illedmovements

• Balane & ,)uilibrium




• Spinal Cord (Medulla Spinalis)

– 1.-1/. lon#

– (uns from t%e foramen ma#num to t%e dis

level bet0een L1-L

– 2as 31 pairs or spinal nerves:

• Clinical Pearl: only t%e spinal ord itself is a part

of t%e CNS




• Spinal Cord (Medulla Spinalis)

– Composed of:

• 4ray "atter – Substantia Grisea

• 5%ite "atter – Substantia Alba



2indbrain



"idbrain



Forebrain: 6ienep%alon





Forebrain: Limbi System





Corte7: 8 Lobes



9asular: Cirle of 5illis



9asular Blood Supply; System



9entriles



1/

$7ial ant%omeatal; Cranial C!



1<




=


$ i l C t% t l; C i l



1

$7ial Cant%omeatal; Cranial

C!






3




8



Layers of Protetion: S'ull and

"enin#es



Layers of Protetion: S'ull

and "enin#es



>



,7tra-a7ial olletions





Brain %erniation

1?Subfaline %erniation

?!ranstentorial %erniation

- 6esendin# @nal %erniation;

- $sendin#

3? !onsillar %erniation

8? ,7ternal %erniation

Brain %erniation auses ompression of brain+ brain stem+ nerves+ and

blood vessels a#aints t%e ri#id bony and dural mar#ins



31

S'ull Frature

N,C! san s%o0s auteS62 $+ bla' arro0; 0it%

nondisplaed linear s'ull

frature B+ open arro0;+

overlyin# soft tissue

s0ellin# B+ 0%ite arro0;?



3

Subara%noid 2ematoma

S$2;N,C! san s%o0s edematous

ri#%t %emisp%ere+ traumati

S$2 over left %emisp%ere+

overlyin# salp s0ellin#?



33

Subdural 2ematoma S62;

N,C! san s%o0s S62

,A:• $vulsi v?pontine• !erbu'anya #ranulatio pa%ioni• !erlu'anya P6 pia mater A perdara%an

ontusio erebri

2ematome meluas mele0ati ruan#

subdural men#enai #yrus mayor

%emip%ere erebri dan mene'an ota' =-/=t%

!erdiri atas:

- $ute Sub 6ural 2ematoma

- $ute Sub 6ural 2y#roma

- C%roni Subdural 2ematomaCS2;



38

Subdural 2ematoma

$? $ute S62 B? subaute S62C? C%roni S62 6?

C%roni S62 0it% aute bleed?



3

,pidural 2ematoma

Perdara%an:• a? menin#ea media atau saal% satu

aban#nya• vena di dalam #ranulatio pa%ioniA

sinus

• tabula interna tulan# alvaria

DDD !emporo-parietal fossa ranial posteriol lebi% ba%aya6ara% men#an#'at duramater dari

alvaria

Lesi %iperdens berbentu' bionve'sellips; atau plano onve7 pada os

alvaria+ batas te#as++ terli%at mass

effet,62 'ronis mi7ed density area



3

,pidural 2ematoma ,62;

N,C! san s%o0 a rapidly developin# ,62



3>

*ntraventriular 2ematoma *92;

& Cortial Contusion



3/

Stro'e

*ntraerebral 2emorr%a#e *C2;



3<

Stro'e

Left lentiform nuleus infartion



8=



81



Case 1

=-year-old 0oman 0it% motoryle aident



Case

-year-old man 0it% motoryle aident



Brain %erniation

1?Subfaline %erniation

?!ranstentorial %erniation

- 6esendin# @nal %erniation;

- $sendin#

3? !onsillar %erniation

8? ,7ternal %erniation

Brain %erniation auses ompression of brain+ brain stem+ nerves+ and

blood vessels a#aints t%e ri#id bony and dural mar#ins



Case 8

3-year-old patient 0it% %ypertension and left %emiparesis



Case

$ patient 0it% sudden onset of %eada%e and alteration of

onsiousness

Case



$ute "C$ infartion

>/ –year-old 0oman 0it% sudden left %emiparesis 1 day P!$

N,C! s%o0s a %ypodense area of lar#e infartion involvin#

t%e ri#%t middle erebral artery vasular territory?

Case



3 yo+ 6ia#nosis C!E

8/

Case >

Case /



8<

Case /



Case <



1



Case 1=



3

Case 11

Lesi *ntra'ranial



Lesi *ntra'ranial

,62

*C2

S62

*92

6ifus *nury berdasar'an C! San



6ifus *nury berdasar'an C! San

Category Initial CT findings

Diffuse Injury I No vissible pathology. Diffuse injury II Cisterns are present !idline shift

" #!! and$or lesion densities

present% no high or !i&ed density

lesion ' (# !l% !ay in)lude bone

frag!ens and foreign bodies. Diffuse injury III Cisterns are )o!pressed or absent

*s+elling, !idline shift -# !!% no high or

!i&ed density lesion ' (# !l.

Diffuse injury I/ Midline shift ' # !!% no high or

*0hift, !i&ed density lesion ' (# !l.

1va)uated !ass Any lesion surgi)ally eva)uated.

Noneva)uated !ass 2igh or !i&ed density lesion '

(# !l% not surgi)ally eva)uated.



5%at is bri#%tAdar' on C!E

• !%e more dense t%etissue+ t%e bri#%ter itloo's on C!

• $ny alified strutureli'e t%e s'ull;appears bri#%t

• Ne0 %emorr%a#e in

t%e brain is also bri#%t• 5ater or CSF; loo'sdar' on C!

!%e t0o most ommon types of



!%e t0o most ommon types of

"( ima#es areG• !1-0ei#%ted "( ima#es-

useful to loo' at normal

anatomy of t%e brain

• !-0ei#%t "( ima#es -

useful to loo' at abnormal

proesses or pat%olo#y;

in t%e brain



5%at is bri#%tAdar' on !1E

• Fat is bri#%t

• 5%ite matter inner

part of brain; is

bri#%ter t%an #raymatter orte7 or

outer part of t%e

brain;

• 5ater CSF; is dar'



5%at is bri#%tAdar' on !E

• 5ater is bri#%t

• Blood is bri#%t

• 5%ite matter is dar'er

t%an #ray matter

01LAMAT 31LA4A5



067LL 85AY































































































































F($H!@( !@L$N4

!rauma Hepala

Li i F 't



Linier Fra'tur

!rauma Hepala

6 i F 't



6epresi Fra'tur

!rauma Hepala

St ll t F 't



Stellate Fra'tur

!rauma Hepala

P % l



Pneumoep%alus

!rauma Hepala

Cep%al%ematoma



Cep%al%ematoma

Fra'tur Faial

Le Fort * Fra'tur



Le Fort * Fra'tur

Fra'tur Faial

Le Fort ** Fra'tur



Le Fort ** Fra'tur

Fra'tur Faial

Le Fort *** Fra'tur



Le Fort *** Fra'tur

Fra'tur Cervial

lay s%ovelerIs Fra'tur



lay s%oveler s Fra'tur

Fra'tur Cervial

!eardrop Fra'tur



!eardrop Fra'tur

Fra'tur Cervial

2an#manJs Fra'tur



2an#man s Fra'tur

Fra'tur Cervial

Lamina Fra'tur



Lamina Fra'tur

Fra'tur Cervial

Kefferson Fra'tur



Kefferson Fra'tur

Fra'tur 9ertebra

Burst Fra'tur



Burst Fra'tur

Fra'tur 9ertebra

5ed#e Fra'tur



5ed#e Fra'tur



C%ip Fra'tur



$vulusi Fra'tur



4reen sti' Fra'tur



2airline Fra'tur



Obli)ue Fra'tur



Spiral Fra'tur



!ransverse Fra'tur



Comminuted Fra'tur

Fra'tur ,7tremitas *nferior

Salter 2arris !ype *** Fra'tur



Salter 2arris !ype *** Fra'tur

Fra'tur ,7tremitas Superior

Bo7ers Fra'tur



Bo7ers Fra'tur


HompresiABu'leA!orus Fra'tur



HompresiABu'leA!orus Fra'tur


4aleai Fra'tur



4aleai Fra'tur

Fra'tur ,7tremitas *nferior

"onte##ia Fra'tur



"onte##ia Fra'tur


Coles Fra'tur



Coles Fra'tur


Smit%s Fra'tur



Smit%s Fra'tur


BartonIs Fra'tur



Barton s Fra'tur


C%auffeur Fra'tur



C%auffeur Fra'tur


Bennett Fra'tur



Bennett Fra'tur



S,L$"$! B,L$K$(

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Bimbingan Koass Neuroimejing