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Wednesday, January 2, 2008


NC453G-1王思婷 9580047

撰寫人:9580047 王思婷NC453- Glossary

No matter how much reading or research you do, learn to grasp the essence of the subject.

What are the most important things in this part?

- concept

- translation of terms

- etymology

- anatomical picture (if the term refers to a neuroanatomical / neuroscientific concept) or video (disease picture etc.) to help you understand the concept

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Narrow canal within the brainstem that connects the third and fourth ventricles.





1. 導管是有機體或身體部分的通道或通路,尤指用於輸送液體的這樣一個通道。

2. Aqueduct →A conductor, conduit, or artificial channel for conveying water, especially one for supplying large cities with water. The term is also applied to a structure (similar to the ancient aqueducts), for conveying a canal over a river or hollow; more properly called an aqueduct bridge. A canal or passage; as, the aqueduct of Sylvius, a channel connecting the third and fourth ventricles of the brain. →Origin: F. Aqueduc, OF. Aqueduct (Cotgr), fr. L. Aquaeductus; aquae, gen. Of aqua water + ductus a leading, ducere to lead. See Aqua, Duke. →Source: Websters Dictionary

3. 相關病變認識Dandy Walker Syndrome Dandy Walker Syndrome是因胚胎時期後腦(Hind brain)的發育異常而導致的腦部病變,主要出現的是後顱窩的大型囊腫,而經常合併有水腦症(Hydrocephalus)。Dandy Walker Syndrome常發生的機率大約是25000分之一。就與水腦症發生關係而言,約佔新生兒水腦患者的1~4%,通常女性患者稍多。事實上,發生後顱窩的囊腫病變有多種,且與Dandy Walker syndrome類似,故其命名方式也可能不盡相同。 正常的後顱窩構造主要包含小腦、腦幹及第四室。第四腦室藉由大腦導水管(Aqueduct of Sylvius)與大腦的腦室系統相連。所謂的典型(ClassicDandy Walker Syndrome便是指小腦不良發育,後顱窩形成巨大水囊,這個水囊對周圍腦組織產生壓迫,使小腦天幕(Tentorium???)上提,以及腦水循環異常而致水腦症。 Dandy Walker syndrome病患通常併隨其他腦發育不良,如 連接兩側大腦半球之corpus callosum喪失(Agenesis)。除腦部外,其他器官發育異常比率也高,約有30%病患可能出現如:唇顎裂(cleft lippalate )、心臟異常(cardiac malformation)、骨骼異常或呼吸道、泌尿道異常。Genetic cause!!! 大部分的Classic Dandy Walker Syndrome病人因水腦及顱內高壓而於一歲前診斷出來。從外觀而言,病患頭圍增加、頭形明顯增大且前囪門(Anterior fontanell)突出。病患可能因頸部肌肉無力以至頭部支撐不良。 Dandy Walker syndrome患童約有20~30%可能有癲癇症(Seizure,智能發展遲緩是很常見的徵候。肢體及姿勢協調異常及行走困難也很常見。 Dandy Walker syndrome患者大部分需要外科手術治療。最常使用的手術方法是囊腔或腦室分流(Diversion)手術。做法是將一含有壓力控制瓣(Pressure controlled valve)導管的一端置入囊腔或腦室內,將腦脊髓液(CSF)引流至腹膜腔或其他體腔中。術前的MRI診斷對手術的選擇是很重要的,手術醫師可藉由MRI影像判斷是先進行天幕上或後顱窩CSF引流或是兩者需同時進行。 雖然,我們藉由腦水引流手術可改善病患症狀,但因疾病的成因事先天性發展異常,這部份是無法手術矯治的。病患協調異常、平衡不良、行走困難、學習障礙等皆須長期仰賴小兒科、小兒神經科、小兒復健科、兒童心智科等專科醫師長期密切進行追蹤及治療,使病童在身心發展,教育及生活上能趨於正常。


aqueous humor

Watery substance, similar to cerebrospinal fluid, that is continuously produced and drained in the posterior chamber of the anterior ocular cavity.



1. the watery fluid that fills the anterior and posterior chambers of the eye. It is secreted by the ciliary processes within the posterior chambers and passes through the the pupil into the anterior chamber where it filters through the trabecular meshwork and is reabsorbed into the venous system at the iridocorneal angle by way of the sinus venosus of the sclera; Syn: humor aquosus TA, intraocular fluid

2. A transparent liquid contained in the anterior and posterior chambers of the eye, produced by the ciliary process it passes to the venous system via the canal of Schlemm. The aqueous humor fills the anterior and posterior chambers of the eyeball. It is small in quantity, has an alkaline reaction, and consists mainly of water, less than one-fiftieth of its weight being solid matter, chiefly chloride of sodium.

3. Henry Gray (1825–1861). Anatomy of the Human Body. 1918. cone-fibers of which are almost horizontal in direction; (3) an exceedingly thin inner plexiform layer. The pigmented layer is thicker and its pigment more pronounced than elsewhere. The color of the macula seems to imbue all the layers except that of the rods and cones; it is of a rich yellow, deepest toward the center of the macula, and does not appear to be due to pigment cells, but simply to a staining of the constituent parts. At the ora serrata the nervous layers of the retina end abruptly, and the retina is continued onward as a single layer of columnar cells covered by the pigmented layer. This double layer is known as the pars ciliaris retinæ, and can be traced forward from the ciliary processes on to the back of the iris, where it is termed the pars iridica retinæ or uvea. The arteria centralis retinæ (Fig. 879) and its accompanying vein pierce the optic nerve, and enter the bulb of the eye through the porus opticus. The artery immediately bifurcates into an upper and a lower branch, and each of these again divides into a medial or nasal and a lateral or temporal branch, which at first run between the hyaloid membrane and the nervous layer; but they soon enter the latter, and pass forward, dividing dichotomously. From these branches a minute capillary plexus is given off, which does not extend beyond the inner nuclear layer. The macula receives two small branches (superior and inferior macular arteries) from the temporal branches and small twigs directly from the central artery; these do not, however, reach as far as the fovea centralis, which has no bloodvessels. The branches of the arteria centralis retinæ do not anastomose with each other—in other words they are terminal arteries. In the fetus, a small vessel, the arteria hyaloidea, passes forward as a continuation of the arteria centralis retinæ through the vitreous humor to the posterior surface of the capsule of the lens. Interior of posterior half of bulb of left eye. The veins are darker in appearance than the arteries.

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4. 水樣液 是水樣式蛋白的液體,存在角膜與水晶體之間的間隙,這一間隙由虹膜分為前後二部,前部稱為「前房」,後部稱為「後房」。前房與後房充滿水樣液,所以又稱為眼房水。水樣液由睫狀體分泌,除了有屈折光線的功能,又可提供角膜及水晶體養份。

5. 眼睛是視覺器官,眼球上下有眼瞼可以防止異物的入侵,外上側有淚腺,可以分泌眼淚滋潤眼球。眼球後方有六條肌肉,可使眼球上下左右轉動。 眼球壁可分三層:鞏膜、脈絡膜、視網膜。鞏膜是堅硬的白色結締組織,可以保護眼球。脈絡膜是供應血球營養的主要部份。視網膜則負責視覺傳遞與形成。脈絡膜在眼球前方特化成虹膜,虹膜間的空洞稱為瞳孔,可以容納光線的進入。視覺的形成是光線經由角膜折射之後,經過水漾液及玻璃狀液到達視網膜,經由視神經傳送到大腦的視覺區,形成影像。

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Middle protective meningeal layer that covers the central nervous system.




1. 腦的層層外膜(腦膜) 有好幾層組織將你的腦部與外界隔離。第一層是皮膚(頭皮)。皮膚底下是骨頭(頭蓋骨)。頭蓋骨下面還有三層特殊的外膜叫做腦膜。你可能聽過一種病叫做腦膜炎。這種病就是腦膜受到感染。

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腦的層層外膜 英文中,有個簡單的方法幫你記住腦膜的次序: 「腦膜墊著(PAD)腦部」 PAD集合了三層腦膜的第一個字母:軟腦脊膜(Pia); 蛛網膜(Arachnoid); 硬膜(Dura).

2. 英文中蛛網膜(arachnoid)這個字來自希臘文中arachne" "-oid" 兩個字的結合,意思是"像蜘蛛網一般"。蛛網膜是由荷蘭解剖學家Gerardus Blasius在西元1664年發現的。 Arachne 英文中是蜘蛛的意思,這個字起源於希臘神話。這則神話是說有一個叫做arachne的女孩,是一位傑出的織布女。因此她向希臘女神雅典娜挑戰,比賽織布。當arachne織出一張美麗又完美的織錦時,雅典娜確打砸了織布機,還將她變成了一隻蜘蛛。

This part is very well done! Bravo! Some more information:

Picture / website of this Greek mythology?

3. 腦和脊髓的被膜的總稱。包裹腦的叫腦膜﹐包裹脊髓的叫脊膜。它們自外向內是由硬腦()膜﹑蛛網膜和軟腦()3層被膜構成。 軟腦膜和蛛網膜還合稱軟-蛛網膜或軟性膜。腦()膜對腦和脊髓起支持和保護作用。低等脊椎動物僅有一層未經分化的原腦膜。兩棲和爬行動物出現了硬腦膜和軟-蛛網膜。鳥類的軟-蛛網膜已可分為蛛網膜和軟膜。哺乳動物﹐包括人﹐明顯地分出硬腦膜﹑蛛網膜和軟腦膜。 腦和脊髓分別位於顱腔和椎管內﹐腦()膜就包襯在腦﹑脊髓與堅硬的骨套之間。硬膜厚而堅韌﹑襯在顱腔和椎管內面﹔它的深處為薄而透明的蛛網膜﹔最內則是緊貼腦﹑脊髓表面的軟膜﹐3層被膜之間以及硬脊膜與骨膜之間都留有間隙。位於蛛網膜和軟膜間的叫蛛網膜下腔﹐腔內充滿腦脊液。

4.相關病變水腦症 水腦症解剖生理 人類中樞神經系統係由腦及脊髓構成。腦及脊髓的表面從內至外覆蓋著軟腦脊膜、網蛛膜及硬腦膜。軟腦脊膜與蛛網膜間的空腔稱為蛛網膜下腔。硬腦脊膜之為顱脊椎骨包蓋保護。硬腦膜的夾層有靜脈竇構造,按所在位置分為矢竇、橫竇、及S狀竇。從蛛網膜腔伸展入靜脈竇內的細胞團結構稱蛛網膜絨毛。蛛網膜絨毛外層為內皮組織與靜脈竇內壁連接。腦的內部有連通的空腔構造,稱為腦室系統。脊髓內有中央管,但在嬰幼兒時期多數已經關閉。 腦室系統按位置可分為左右側腦室、Monro氏孔、三腦室、大腦導水管、四腦室、左右Luschka氏孔、及中央Magendie氏孔。腦室內有脈絡叢組織是產生腦脊髓液的主要組織。腦脊髓液(cerebrospinal fluidCSF)是無色透明液體,在腦室及蜘蛛膜下腔內流動。腦及脊髓組織的細胞之間為有水液的細微空間,細胞間的水液稱為細胞間液,與腦脊髓液雷同。腦脊髓液主要產生於腦室的脈絡叢及腦脊髓組織之微血管內皮(enothelium),因此大部分的腦脊髓液產生於腦室內。 臨床研究顯示,人類腦脊髓液產生量約為 20毫升/時,或 500毫升/天,亦有報告說嬰兒腦脊髓液的產量約為每天200毫升。幼童腦液的產量約為每分鐘0.3毫升。腦脊髓液正常的流向是隨著心臟、腦血管、脈絡叢的搏動,形成動流,由側腦室經Monro氏孔流入第三腦室,再經由大腦導水管流入第四腦室。第四腦室內的腦脊髓液從在中央的Magendie氏孔道,及兩側的Lusohka氏孔道注入腦及脊髓表面之蛛網膜下腔。在腦底部較為膨大的蛛網膜下腔稱為基底池(basal cistern)。在正常狀態,大部分的腦脊髓液因顱內及靜脈竇間的液體壓力差距,從蛛網膜絨毛單向流入靜脈竇,融入血液循環。此外,腦脊髓液又可以在腦細胞間的空隙流通,從腦室流向腦表面的蛛網膜下腔,或反方向從蜘蛛膜下腔至腦室。腦脊髓液也可以沿顱神經與脊髓神經外的蜘蛛膜下腔與環神經腔流出,為附近之淋巴組織吸收。這些輔助性腦脊髓液吸收的功能,在發生水腦症時,可以取代蛛網膜絨毛而成為重要的吸收腦脊髓液的途徑。

5. 腦脊液

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腦脊液(Cerebrospinal fluid,簡稱CSF),是充滿在腦部內顱骨與大腦皮質之間的蛛網膜下腔的透明體液,準確的來說是位於腦膜的蛛網膜和軟腦膜之間。它是一種含有微神經膠細胞的純生理鹽水,主要用作對大腦皮質的機械性緩衝。在腦部及脊髓的腦室內亦有腦脊液存在。

[生理學] 腦脊液完全是在腦和脊髓內部合成和循環的,這是一個體現腦與軀體其它部分隔離的一個典型例子。生產腦脊液的部位是脈絡叢。脈絡叢穿過脈絡裂,沿著穹隆/海馬傘的軌跡進入側腦室;同時通過其頂部進入第三腦室和第四腦室。腦脊液在脈絡叢生成後,通過室間孔進入第三腦室,而後通過中腦水道進入第四腦室,隨後通過腦脊髓水庫(cerebromedullary cistern)進入脊髓、地道大腦半球外部。腦脊液可以通過蜘蛛膜顆粒進入靜脈系統。


[病理學] 腦脊液有著多種的作用包括腦部的機械性保護、分配神經內分泌因子及促進腦血流量。為了要保證腦內穩定的氧合,動脈血液的流動型式須嚴謹地調節。腦脊液運動就像一個彈簧,可以幫助動脈的膨脹及收縮,並且防止了頭顱內血流的重大變動。當腦脊液流動出現問題時,這不單止影響腦脊液運動,更會影響頭顱內血流,而最終造成神經元及神經膠質的弱點。


[診斷及治療] 腦脊液可以用作診斷多種神經失調的測試。從腰椎穿刺可以獲取腦脊液,並從中測出細胞的數量及脂肪與葡萄糖的份量。這些資料本身已經對診斷蛛網膜下腔出血及中樞神經系統的感染,如腦膜炎。Incomplete sentence?再者,腦脊液的培植測試可以獲得產生感染的微生物。若使用尖端的技術,如偵測寡克隆區explain?,可以確定正在發炎的情況(如多發性硬化症)。β-2轉鐵蛋白的分析是高度獨特及敏銳於偵測腦脊液外漏。腰椎穿刺亦可以用作量度在某些腦水腫的種類下會增加的顱內壓。


7. The Arachnoid—The arachnoid is a delicate membrane enveloping the brain and medulla spinalis and lying between the pia mater internally and the dura mater externally; it is separated from the pia mater by the subarachnoid cavity, which is filled with cerebrospinal fluid.

arachnoid trabeculae

Fibrous tissue that maintains the subarachnoid space by serving as a ridge between the meningeal membranes of the arachnoid and the pia matter.




1. Fine, delicate strands composed of fibroblast and extracellular collagen that traverse the subarachnoid space between the arachnoid mater, which is attached to the dura, and the pia mater, which is adherent to the surface of the brain.

2. trabecula (tra•be•cu•la) (trə-bĕ´ku-lə) pl. trabe´culae [L., dim. of trabs] [TA] in anatomical nomenclature, a supporting or anchoring strand of connective tissue, such as one extending from a capsule into the substance of the enclosed organ.

arachnoid trabeculaetrabeculae arachnoideae [TA] delicate fibrous threads connecting the inner surface of the arachnoid to the pia mater.

trabeculae of bone anastomosing bony spicules in cancellous bone which form a meshwork of intercommunicating spaces that are filled with bone marrow.

trabe´culae car´neae cor´dis [TA] fleshy trabeculae of heart: irregular bundles and bands of muscle projecting from a great part of the interior of the walls of the ventricles of the heart. They occur as three types: as simple muscular ridges, as bundles attached at both ends but free in the middle, or as papillary muscles (q.v.), projecting from the heart wall and attaching to the chordae tendineae cordis.

trabe´culae cor´porum cavernoso´rum pe´nis [TA] trabeculae of corpora cavernosa of penis: numerous bands and cords of fibromuscular tissue traversing the interior of the corpora cavernosa of the penis, attached to the tunica albuginea and septum and creating the cavernous spaces that become filled with blood during erection.

trabe´culae cor´poris spongio´si pe´nis [TA] trabeculae of corpus spongiosum of penis: numerous bands and cords of fibromuscular tissue traversing the interior of the corpus spongiosum of the penis, creating the cavernous spaces that give the structure its spongy character.

trabe´culae cra´nii a pair of longitudinal cranial bars of cartilage in the embryo, bounding the pituitary space that becomes the sella turcica.

trabeculae no´di lympha´tici , trabe´culae no´di lymphoi´dei [TA] trabeculae of lymph node: strands of dense connective tissue radiating out from the capsule through the interior of the node.

trabe´culae sple´nicae [TA] trabeculae of spleen: fibrous bands that pass into the spleen from the tunica fibrosa and form the supporting framework of the organ; called also trabeculae lienis [TA alternative].

trabeculae (tra•be•cu•lae) (trah-bek´u-le) [L.] plural of trabecula.


arachnoid villi ( granulations )

Wormlike tufted structures that drain cerebrospinal fluid from the subarachnoid space into the superior sagittal sinus.




腦脊髓液 (CSF) 是由側腦室、第三腦室和第四腦室內的脈絡叢 (choroid plexus) 經由液體靜壓漏出而成,一天產量為 500ml。由上矢狀竇 (superior sagittal sinus) 的蜘蛛膜絨毛 (arachnoid villi) 吸收進入靜脈系統。CSF 在蜘蛛膜下腔 (subarachnoid space) 大約有150ml,其功能在保護及支撐中樞神經系統的架構。

中樞神經系統(腦及脊髓)平常是被液體包圍,此液體即為腦脊髓液(CSF),可以緩衝震盪力以保護神經組織免於受傷。腦脊髓液之分泌主要來自腦室內之脈絡叢,腦室系統是位於腦內部的空腔,其內為腦脊髓液循流地方。   腦脊髓液於側腦經室間孔流至第三腦室,再經大腦導水管流至第四腦室,最後由第四腦室之中央孔及側孔進入蜘蛛膜下腔,並由此逐漸被蜘蛛膜絨毛(Arachnoid villi)回吸收進入靜脈系統。任何原因造成循流系統阻塞(腫瘤、出血、腦腫脹)、分泌過多或吸收不良,均會造成顱內水分過多、顱內壓增高,對腦產生壓迫而造成神經損傷,甚至有生命危險。

腦室系統與腦脊液 整個中樞神經系統沈浸在一層澄淨透明的腦脊液(cerebrospinal fluidCSF)。腦脊液被包含在一個充滿液體的空腔內,稱為腦室(ventricles)。 在下面的這張中央矢狀腦切片裡,腦室標示為藍色。

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腦室 腦脊液主要由位於側腦室,第三,第四腦室的脈絡叢(choroid plexus)所產生。透過腦室間孔interventricular foramen (foramen of Monro),腦脊液由側腦室流向第三腦室。第三與第四腦室藉著大腦導水管(cerebral aqueduct或稱aqueduct of sylvius)彼此相連。然後腦脊液通過正中孔(foramina of Luschka,有兩個)和外側孔(foramen of Magendie只有一個)流入蛛網膜下腔。 腦脊液的功能包括: 保護:腦脊液的功能在於 「緩衝]」,如同墊子,保護腦部減少損傷。 浮力:因為腦沈浸在液體中,腦的重量由1,400 變成50。於是,腦部底層的壓力減輕。 新陳代謝:腦脊液至血液的單向流通方式,帶走所有可能對腦有害的代謝物質,藥物以及其他物質。 腦內激素:腦脊液運送荷爾蒙到腦部其他部分。被釋放進入腦脊液之荷爾蒙「遠渡」至腦中可能作用的位置。 Image adapted from Biodidac

藉由蜘蛛膜絨毛(arachnoid villi)此構造,腦脊液在前矢狀切面竇被吸收進入血管當中。當腦脊液的壓力比靜脈壓來的大,腦脊液將流向血管。然而,蜘蛛網絨毛的作用如同"單向閥"...假如CSF的壓力比靜脈壓小,蜘蛛膜絨毛並不允許血液流入腦室循環系統。

Ventricles of the Brain


arachnoid villi Tufted prolongations of pia-arachnoid that protrude through the meningeal layer of the dura mater and have a thin limiting membrane; collections of arachnoid villus form arachnoid granulations that lie in venous lacunae at the margin of the superior sagittal sinus; the spongy tissue of the a. Villus contains tubules that serve as one-way valves for transfer of cerebrospinal fluid from the subarachnoid space to the venous system. Both a. Villus and the granulations formed from them are major sites of fluid transfer. 1. granulationes arachnoideae. 2. numerous microscopic projections of the arachnoid into some of the venous sinuses, which are thought by some to enlarge in man with advancing age to become the granulationes arachnoideae (q.v.). Intestinal villus.

Arachnoid granulation(From Wikipedia, the free encyclopedia) Arachnoid granulations (or arachnoid villi) are small protrusions of the arachnoid (the thin second layer covering the brain) through the dura (the thick outer layer). They protrude into the venous sinuses of the brain, and allow cerebrospinal fluid (CSF) to exit the brain, and enter the blood stream. Largest granulations lie along the superior sagittal sinus, a large venous space running from front to back along the centre of the head (on the inside of the skull). They are, however, present along other dural sinuses as well. Smaller granulations are called villi, large calcified ones are referred to as pacchionian bodies. Diagrammatic representation of a section across the top of the skull, showing the membranes of the brain, etc. ("Arachnoid granulation" label is at top right.)

Function The arachnoid granulations act as one-way valves. Normally the pressure of the CSF is higher than that of the venous system, so CSF flows through the villi and granulations into the blood. If the pressure is reversed for some reason, fluid will not pass back into the subarachnoid space (of the brain). The reason for this is not known. It has been suggested that the endothelial cells of the venous sinus create vacuoles of CSF, which move through the cell and out into the blood. Eponym Occasionally, they are referred to by their old name: Pacchioni's granulations or pacchionian bodies, named after Italian anatomist Antonio Pacchioni.

Additional images Left parietal bone. Inner surface. Frontal bone. Inner surface.

相關疾病 內聽道內之腦膜瘤 腦膜瘤源自於負責吸收腦脊髓液的蜘蛛膜絨毛(arachnoid villi)。後者主要分佈於各靜脈竇,但在顱底各神經孔及內聽道內亦有少量分佈。內聽道之腦膜瘤多由後顱窩發源,而脫垂進入內聽道。水腦 甲、 水腦之概念

1.定義:HydrocephalusCSF,因分泌過多或管道不通或吸收不良在腦室內異常的貯留,造成急慢性腦室擴張,顱內壓急性或慢性升高之病況現象。當arachnoid villi (granulations)吸收能力下隆時大量CSF堆積形成(external hydrocephalus)或交通性水腦(commumicating hydrocephalus)。當Luschkamagendie孔堵塞或腦室內系統阻塞,CSF會堆積在阻塞的近心端形成Internal hydrocephalusnon-commuricating hydrocephalus.

2.CSF之分布與循環 CSF之產量:嬰兒為每日200ml,成人為每日500ml 循環:由側腦室(LV)、第三(V3)、第四(V4)腦室內的choroid plexus分泌,流向為LV→Monro→V3→Aqueduct(AD)→V4→Manendie, Luschka→basal cistern及蜘蛛下腔(SA)→villi吸收→sinus 乙、 NPH(正常壓水腦)

1.診斷: 1.症狀:dementia, gait disturbance, urinary incontinence 2.CT:腦室擴大,尤其是前角,合併periventricular lucency 3.Lumbar punctureCSF壓力〈180mmH2O2.原因:CVA, post-SAH, post-traumatic, post-meningitic, following posterior fossa surgery, Alzheimer s disease 丙、 Subdural effusion (SDE)

嬰兒(好發於出生三至六個月)因外傷或腦膜炎而致硬腦膜下有液體儲留,如液體是CSF則稱subdural hydromas or subdural effusion,若為血水則稱chronic subdural hematoma,治療以觀察為主,若有IICP症狀,則將chronic SDH引流或將SDES-P shunt (subdural - peritoneal shunt). 丁、 治療水腦以手術為主: 手術方式: 1.腦室腹膜腔引流(V-P shunt) 2.腦室心室引流(V-A shunt) 3.腰椎腹膜腔引流(L-P shunt) 4.阻塞性水腦可用腦內視鏡做第三腦室造口術 Top 一般開顱手術後病患之觀察治療 一般開顱手術後病患(包括腫瘤、血管瘤、動靜脈畸型、顱內出血),於急性危險期過後,由ICU轉入一般病房。 治療原則 1.生命表徵、GCS、每4-6小時評估記錄一次。 2.簡單神經學之檢查,如瞳孔、其它腦神經功能和肢體力量之變化。 3.手術後若有頭痛,可以一般止痛藥或DEMEROL,減輕病患之痛苦,但勿用Morphine,以免抑制呼吸或改變意識程度。 4.注意水份及電解質平衡,若口部進食量可,輸液僅用作維持一靜脈注射之管道。 5.因長期臥床或頭痛不敢用力,病患常有排便之困擾,可以軟便劑調整之。 6.意識不清(GCS9)之病患,可採側臥或半俯臥姿勢,每二小時調整一次,以幫助痰液之排出,必要時要抽痰,並防止褥瘡發生。 7.若發燒疑有感染要查感染來源:呼吸道、泌尿道、傷口、CVP line, shuntCNS infection,要做sputum, urine, blood, wound, CSF culture 8.復健會診。

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