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Neue Therapiestrategien bei zerebraler intraventrikulärer Blutung

New treatment strategies for intraventricular hemorrhage

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Zusammenfassung

Tritt nach einer intrazerebralen Blutung (ICB) zusätzlich eine intraventrikuläre Blutung (intraventrikuläre Hämorrhagie, IVH) auf, ist dies mit einer mehrfach erhöhten Mortalität und einem schlechteren funktionellen Outcome verbunden. Obwohl für diese Entität noch keine evidenzbasierte spezifische Therapie existiert, ist das Verständnis der Pathophysiologie der IVH in den letzten Jahrzehnten gewachsen und hat zu der Entwicklung viel versprechender Behandlungskonzepte geführt. Die intraventrikuläre Fibrinolyse (IVF) beschleunigt die Auflösung und die Entfernung des Hämatoms aus dem Ventrikelsystem. Die zusätzliche Anwendung lumbaler Drainagen reduziert möglicherweise die Inzidenz permanenter Liquorresorptionsstörungen. Die Auswirkungen dieser Therapiemodalitäten auf das funktionelle Outcome nach ICB mit IVH werden in laufenden Studien untersucht. Die vorliegende Übersicht beschäftigt sich mit pathophysiologischen und klinischen Aspekten der IVH unter besonderer Berücksichtigung neuer Therapieoptionen.

Abstract

The presence of additional intraventricular hemorrhage (IVH) in patients with intracerebral hemorrhage (ICH) is associated with a much higher mortality and worse functional outcome. Although evidence-based specific treatment options for this entity are still lacking, knowledge about the pathophysiology of IVH has grown in recent decades, leading to the development of promising treatment strategies. Intraventricular fibrinolysis (IVF) accelerates IVH resolution and removal from the ventricular system. The additional usage of lumbar drains probably reduces the incidence of permanent posthemorrhagic hydrocephalus. The influence of these treatment modalities on functional outcome is currently being investigated in ongoing studies. The present article gives an overview of pathophysiological and clinical aspects of IVH, emphasizing novel treatment options.

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  1. Neurologische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland

    D. Staykov, H.B. Huttner & S. Schwab

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  1. D. Staykov
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  2. H.B. Huttner
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  3. S. Schwab
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Correspondence to D. Staykov.

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Staykov, D., Huttner, H. & Schwab, S. Neue Therapiestrategien bei zerebraler intraventrikulärer Blutung. Med Klin Intensivmed Notfmed 107, 192–196 (2012). https://doi.org/10.1007/s00063-012-0100-7

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  • DOI: https://doi.org/10.1007/s00063-012-0100-7

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