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Differenzialdiagnose und Behandlung des akuten Kopfschmerzes

Differential diagnosis and treatment of acute headache

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Zusammenfassung

Kopfschmerzen sind ein häufiges Symptom in Notfallambulanzen. Der erstversorgende Arzt muss zeitnah unterscheiden können, ob es sich um einen primären oder einen sekundären Kopfschmerz handelt, der weiterführender Diagnostik und ggf. notfallmäßiger Versorgung bedarf. Hierfür müssen die möglichen Differenzialdiagnosen und die Warnzeichen, die auf einen symptomatischen Kopfschmerz hinweisen, bekannt sein. Nach initialer Diagnostik sollte eine suffiziente Schmerztherapie erfolgen, die sich nach der Verdachtsdiagnose richtet.

Abstract

Headache is a common symptom in emergency departments. In the initial period the treating physician has to decide rapidly between a primary headache and secondary headaches. This initial decision requires further diagnostic investigations and if necessary emergency treatment. The medical staff should be informed about possible differential diagnoses and warning signs that suggest a symptomatic headache. After the initial diagnostics sufficient treatment of the pain according to the suspected headache diagnosis will be arranged.

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Abbreviations

5-HT1B/1D:

5-Hydroxytryptamin, Subtyp 1B/1D

ASS :

Azetylsalizylsäure

BB:

Blutbild

BSG:

Blutsenkungsgeschwindigkeit

CCT:

Kraniale Computertomographie

CRP:

C-reaktives Protein

CT:

Computertomographie

CTA:

CT-Angiographie

DGN :

Deutsche Gesellschaft für Neurologie

EKG:

Elektrokardiogramm

EPH:

Epiduralhämatom

ICB:

Intrazerebrale Blutung

ICU:

„Intermediate Care Unit“

IHS :

„International Headache Society“

INR :

„International normalized ratio“

KG:

Körpergewicht

MRA:

Magnetresonanzangiographie

MRT:

Magnetresonanztomographie

NSAID:

„Non steroidal anti inflammatory drugs“

PCR:

Polymerasekettenreaktion

PRES :

Posteriores reversibles Enzephalopathiesyndrom

SAB:

Subarachnoidalblutung

SDH :

Subduralhämatom

SepNet:

Kompetenznetzwerk Sepsis

SHT:

Schädel-Hirn-Trauma

SUNCT:

„Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing“

SVT :

Sinusvenenthrombose

WFNS SAH:

„World Federation of Neurological Surgeons subarachnoid hemorrhage grading“

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  1. Westdeutsches Kopfschmerzzentrum, Klinik und Poliklinik für Neurologie, Universitätsklinik Essen, Hufelandstraße 55, 45147, Essen, Deutschland

    K. Rabe & O. Kastrup

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  1. K. Rabe
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  2. O. Kastrup
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Correspondence to K. Rabe.

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Rabe, K., Kastrup, O. Differenzialdiagnose und Behandlung des akuten Kopfschmerzes. Notfall Rettungsmed 15, 629–642 (2012). https://doi.org/10.1007/s10049-012-1653-y

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