Bleeding in the Skull Region extracranial

(kefalhaematoma externum, subperiostal, subaponeurotic)

intracranialextracerebral intracerebral

Bleeding in the Skull Region – intracranial haemorrhages

extracerebralepiduralsubduralsubarachnoideal

intracerebralcapillaryvenousarterial

circumscribeddestructive

Fetal & Neonatal Bleeding

Germinal Zone (GZ) Bleeding

25% neonates (decreased recently)

GZ: periventricular, large calibre capillaries, highly vascularized esp. in the 3rd. trimestre

Patogenesis of GZ Bleeding

Perinatal ev. intranatal hypoxia– disorder of cerebral perfusion autoregulation– ischemic endothelial capillary lesions in the GZ– myocardial energy reserves exhausted– perinatal circulation failure– cerebral hypoxia venous haemorrhage

Blood pressure increase– muscle activity of neonate– resuscitation– arteficial ventilation

Closed Cerebral Trauma –traumatology classification

Type of injury Diffuse

– commotion– diffuse axonal injury

Focal– contusion

Compression– hematomas (epidural,

subdural, intracranial)– hygroma

Therapy Conserv.

Conserv.sometimesevacuation

SURGICAL

Brain Perfusion Failure

Encephalomalaciawhiteredmixed

Causes ischemia

venostasisPostencephalomalatic pseudocyst (event.)

Cerebral Arteries Atherosclerosis

Morphological features – encephalomalacia– encephalopathia angiosclerotica:

atrophia cerebri diffusa status cribrosus status lacunaris hydrocephalus ext. et int. e vacuo

Cerebral Arteries Atherosclerosis

Clinical features – cerebral infarction (event. death)

– pyramidal and extrapyramidal signs

– atherosclerotic (multiinfarct) demention

(-100ml!)