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Intensivtherapie des Schädel-Hirn-Traumas

Aktuelle Therapieprinzipien

Intensive care management of traumatic brain injury

Current treatment principles

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Trauma und Berufskrankheit

Zusammenfassung

Das schwere Schädel-Hirn-Trauma (SHT) ist mit einem Anteil von annähernd 20% aller Schädel-Hirn-Verletzungen nicht selten. Insbesondere die Frühphase seiner Versorgung ist für den gesamten weiteren Ablauf und damit die Prognose ausschlaggebend. Nach der präklinischen und notfallmäßigen operativen Versorgung ist es zentrale Aufgabe der neurochirurgischen Intensivmedizin, den zerebralen Sekundärschaden möglichst gering zu halten. Da die komplexen, zu einer Aggravation des initialen Traumas führenden pathologischen Mechanismen noch nicht vollständig geklärt sind, unterliegen die entsprechenden Behandlungsansätze einem ständigen Wandel. Es wird ein Überblick über die aktuellen gängigen Therapieprinzipien gegeben: Diese werden jedoch mit zunehmendem Verständnis der komplexen Vorgänge beim SHT eine weitere Optimierung und damit Veränderung erfahren.

Abstract

Severe traumatic brain injury (TBI) is not a rare occurrence, accounting for almost 20% of all craniocerebral injuries. The early phase of care is particularly crucial for the entire further course and hence the prognosis. After preclinical and emergency surgical care, the key task of neurosurgical intensive care medicine is to ensure that cerebral secondary damage is kept to a minimum. Since the complex pathological mediators and mechanisms leading to aggravation of the initial trauma are not yet fully clarified, the relevant treatment approaches are subject to constant change. This article presents an overview of the current treatment principles commonly observed: these will however be optimized and adapted as understanding of the complex processes involved in TBI increases.

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Schaan, M., Strowitzki, M. Intensivtherapie des Schädel-Hirn-Traumas. Trauma Berufskrankh 13 (Suppl 1), 171–175 (2011). https://doi.org/10.1007/s10039-011-1736-x

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  • DOI: https://doi.org/10.1007/s10039-011-1736-x

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