Cerebral atrophy and subcortical arteriosclerotic encephalopathy

First, brain atrophy

According to the different scope of brain atrophy, it is divided into two categories
: extensive and limited.
The former includes cerebral cortex, medulla, and whole brain atrophy, while the latter includes local, hemisphere, or cerebellum and brainstem atrophy
.

CT flat sweep:

Cortical atrophy: only the surface of the brain is enlarged (>5 mm), the subarachnoid space is widened, and the cerebral pool is enlarged
.

Cerebral medullary atrophy: only the ventricles are enlarged (the third ventricle is >5 mm in diameter), and the size of the sulcus and cistern is normal;

Whole brain atrophy: the ventricles, sulcus, and pools are enlarged
.

Localized cerebral atrophy: local enlargement of the ventricles or enlargement of the local sulcus and pools;

Atrophy of one side of the cerebral hemisphere: the enlarged midline structure of the ventricle and pool on one side shifts to the diseased
side.

Degeneration and atrophy of the brainstem and cerebellum: manifested by significant enlargement of the basal pool IV.
chamber enlargement, cerebellar hemisphere, and widening of the worm sulcus (more than two cerebellar grooves in the cerebellar hemisphere, more than four in the vermicular sulcus), and the width of the sulcus is > 2 mm, and the occipital pool is enlarged
.

In healthy elderly people over 60 years of age, the brain pool, sulcus and ventricles can be larger than normal adults, and are physiological changes (senile brain atrophy or senile brain changes).

【Case】

1.
Patient male, 87 years old
.
Complaint: Unfavorable speech for 3 days
.
CT pan scan of the head (Fig.
1-5-1-1-a~c) shows: senile cortical cerebral atrophy, enlarged sulcus, and widening
of the subarachnoid space.

2.
Patient female, 76 years old
.
Complaint: dizziness with limb tremor for 1 month
.
Physical examination: blood pressure 200/80mmHg.

。 CT pan scan (Fig.
1-5-1-2-a~c) shows: senile cerebral atrophy (the sulcus and ventricles are larger than normal adults).