Bleeding in the Skull Region v extracranial (kefalhaematoma externum, subperiostal, subaponeurotic) v intracranial extracerebral intracerebral

Bleeding in the Skull Region – intracranial haemorrhages extracerebral epidural subdural subarachnoideal intracerebral capillary venous arterial circumscribed destructive

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 u Diffuse –commotion –diffuse axonal injury u Focal –contusion u Compression –hematomas (epidural, subdural, intracranial) –hygroma Therapy u Conserv. sometimes evacuation SURGICAL

Brain Perfusion Failure Encephalomalacia white red mixed Causes ischemia venostasis Postencephalomalatic pseudocyst (event.)

Cerebral Arteries Atherosclerosis Morphological features – encephalomalacia – encephalopathia angiosclerotica: v atrophia cerebri diffusa v status cribrosus v status lacunaris v hydrocephalus ext. et int. e vacuo

Cerebral Arteries Atherosclerosis Clinical features – cerebral infarction (event. death) – pyramidal and extrapyramidal signs – atherosclerotic (multiinfarct) demention (-100ml!)