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Diagnostik und Prognostik von Bewusstseinsstörungen und Enzephalopathien

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Bewusstseinsstörungen und Enzephalopathien

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Zusammenfassung

Zusätzlich zur klinischen Diagnostik sind apparative Verfahren aus Labormedizin, Neuroradiologie, Ultraschall und Neurophysiologie in der Einschätzung und Prognosenerstellung bei Bewusstseinsstörungen und Enzephalopathien unerlässlich. Dies gilt einerseits zur Ausschlussdiagnostik bezüglich ZNS-Trauma, Schlaganfall, Neoplasien, ZNS-Infektion, andererseits zur Gewinnung korrespondierend-bestätigender Befunde wie z.B. den Biomarkern der Hypoxie und Surrogatmarkern des erhöhten intrakraniellen Drucks. Die betreffenden Methoden werden hier systematisch im Hinblick auf Indikationsstellung und Durchführung besprochen, auch bezüglich ihrer Grenzen der Aussagekraft und den Anforderungen an den Patienten. Die gestufte Serumdiagnostik bei Bewusstseinsstörung und Enzephalopathien und eine Aufstellung der Biomarker bei Sepsis bilden den Auftakt.

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Notes

  1. 1.

    Der Liquor darf nicht bei 4°C gelagert werden, sondern rasch (innerhalb von weniger als 30 Minuten) bei Raumtemperatur mit 5% Serum-enthaltendem Medium.

  2. 2.

    Beispielsweise muss 5% Hitze inaktiviertes fetales Rinder Serum (FBS) – in RPMI-1640, 25 mM HEPES, 1 mM L-Glutamin und 2% Penicillin/Streptomycin 1:1 verdünnt – rasch ins Labor gebracht und untersucht werden (de Graaf et al. 2011).

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Authors and Affiliations

  1. Klinik für Neurologie und Psychiatrie, Friedrich-Ebert-Krankenhaus GmbH Neumünster, Friesenstr. 11, 24534, Neumünster, Deutschland

    H.-C. Hansen

  2. Institut für Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Deutschland

    O. Jansen & C. Cnyrim

  3. Klinik für Neurologie, Dr. Horst Schmidt Kliniken GmbH, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland

    G. Hamann

  4. Abteilung für Pädiatrische Radiologie, AKK Altonaer Kinderkrankenhaus, Bleickenallee 38, 22763, Hamburg, Deutschland

    K. Helmke

  5. Neurologische Klinik, Kath. Marienkrankenhaus gGmbH, Alfredstraße 9, 22087, Hamburg, Deutschland

    T. Weber

  6. Universitätskrankenhaus Hamburg-Eppendorf, Altonaer Straße 348 a, 25469, Halstenbek, Deutschland

    S. Zschocke

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    Hans-Christian Hansen

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Hansen, HC. et al. (2013). Diagnostik und Prognostik von Bewusstseinsstörungen und Enzephalopathien. In: Hansen, HC. (eds) Bewusstseinsstörungen und Enzephalopathien. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36915-5_11

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