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Intrakranielle Blutungen

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Neurologische Notfälle

Zusammenfassung

Intrakranielle Blutungen treten mit steigender Tendenz und sehr häufig auf. Sie können spontan, nicht-läsionsbedingt, traumatisch bedingt oder aufgrund von Gefäßmalformationen auftreten. Etwa 20% aller „Schlaganfälle“ sind hämorrhagisch. Der neurologischen Notfallbehandlung fällt eine entscheidende Rolle im Hinblick auf die Prognose zu. An erster Stelle steht das schnellstmögliche Erkennen einer intrakraniellen Blutung und der vorliegenden Blutungsform. Ungeachtet der Blutungsform zielen die Notfallmaßnahmen im Wesentlichen darauf ab, die Vitalfunktionen zu sichern sowie eine Hirndrucksteigerung zu vermeiden, sie zu reduzieren und das Risiko für Nachblutungen zu senken. Daran schließt sich in entsprechenden Fällen die möglichst umgehende neurochirurgische oder neurointerventionelle Behandlung der Blutungsursache bzw. die Ausräumung der massenwirksamen Blutung an. Die zunehmende Behandlung mit hochwirksamen und schwer steuerbaren Gerinnungshemmern spielt eine relevante Rolle.

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  1. Klinik für Neurochirurgie/Campus Evang. Krankenhaus, Universität Oldenburg, Steinweg 13, 26122, Oldenburg, Deutschland

    Th. Kretschmer

  2. Klinik für Neurochirurgie/Campus Evang. Krankenhaus, Universität Oldenburg, Steinweg 13, 26122, Oldenburg, Deutschland

    Th. Schmidt

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  1. Klinik für Neurologie, RWTH Aachen , Aachen, Germany

    Jens Litmathe

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Kretschmer, T., Schmidt, T. (2016). Intrakranielle Blutungen. In: Litmathe, J. (eds) Neurologische Notfälle. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49775-3_2

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