Der Nervenarzt

, Volume 77, Issue 6, pp 671–681 | Cite as

Antikoagulanzienassoziierte Hirnblutungen

  • H. B. Huttner
  • E. Jüttler
  • A. Hug
  • M. Köhrmann
  • P. D. Schellinger
  • T. Steiner
Übersichten

Zusammenfassung

Eine lebensbedrohliche intrakranielle Blutung (ICB) ist die schwerwiegendste Komplikation einer Therapie mit oralen Antikoagulanzien (OAT). Die zunehmende Verwendung von OAT resultiert in einer Steigerung der Inzidenz von ICB. Die Mortalität ist annähernd 65% und Patienten, die überleben, sind meist schwer behindert. Während in letzter Zeit erhebliche Fortschritte bei der Behandlung der spontanen ICB erreicht wurden, bleiben weiterhin die Unterschiede in der Pathophysiologie und im Akutmanagement von antikoagulanzienassoziierter ICB (OAT-ICB) und spontaner ICB ungeklärt. Deshalb sind effektive Behandlungsstrategien essenziell, um das Outcome zu verbessern. Diese Arbeit gibt einen Überblick über die Epidemiologie, Pathophysiologie und akute Behandlungsstrategien von OAT-ICB und diskutiert offene Fragen insbesondere hinsichtlich neuer medikamentöser Ansätze.

Schlüsselwörter

Intrakranielle Blutung Orale Antikoagulanzien  Mortalität  Epidemiologie  Pathophysiologie  Behandlungsstrategien  

Intracerebral hemorrhage related to anticoagulant therapy

Summary

Intracerebral hemorrhage (ICH) is the most serious complication of oral anticoagulant therapy (OAT). The growing use of OAT has resulted in an increase of fatal ICH. The mortality rate is about 65%, and most of the surviving patients remain disabled. While improvements in the treatment of spontaneous ICH have recently been described, there are no internationally accepted guidelines for managing patients with OAT-ICH. Therefore, identifying effective treatments is essential for improving clinical outcome. This article reviews the epidemiology of OAT-ICH, its pathophysiology, and current treatment options and discusses open questions with particular respect to more recent pharmacological therapies.

Keywords

Intracerebral hemorrhage Oral anticoagulants Mortality Epidemiology Pathophysiology Treatment strategies  

Notes

Interessenkonflikt

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  • H. B. Huttner
    • 2
  • E. Jüttler
    • 1
  • A. Hug
    • 1
  • M. Köhrmann
    • 1
  • P. D. Schellinger
    • 1
  • T. Steiner
    • 1
  1. 1.Abteilung für NeurologieRuprecht-Karls-Universität Heidelberg
  2. 2.Abteilung für NeurologieRuprecht-Karls-Universität HeidelbergHeidelbergDeutschland

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