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Computertomographie beim Schlaganfall

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Die Notfalltherapie und Intensivtherapie bei Schlaganfall

Summary

Computed tomography (CT) enables differentiating the causes of stroke and the underlying pathophysiology. Brain imaging is thus a critical step in the assesment of suspected ischemic stroke and aa precondition for a carefully guided treatment. This paper describe the impact of unenhanced CT on diagnosis, treatment, and highly sensitive and patients aare intracranial blood and ischemic brain edema. Patients with a relatively small edema compared to the affected arterial territory benefit from thrombolysis. Patients with extended ischemic edema (>one third of the middle cerebral artery territory or >150ml) do not benefit from thrombolysis and bear a high risk for futheer clinical deterioration.

Zusammenfassung

Die Computertomographie (CT) ermöglicht eine ätiologische und pathophy siologische Differenzierung des Syndroms „Schlaganfall“ und schafft damit die Voraussetzungen für eine gezielte Behandlung. Diese Arbeit beschreibt die Sicherheit der diagnostischen Aussage bei Patienten mit Schlaganfall und den Einfluss des nativen CT-Befundes auf die Diagnose, die Behandlung und die Prognose. Die wichtigsten und hoch sensitiven Aussagen der CT bestehen im Ausschluss einer intra-kraniellen Blutung und in der Abbildung des ischämischen Hirnödems. Patienten ohne ischämischen Hirnödem trotz Schlaganfall symptomatik haben in der Regel eine guten spontanen Verlauf. Patienten mit begrenztem ödem in einem arteriellen Territorium profitieren von der Thrombolyse. Patienten mit ausgedehntem Hirnödem (> ein Drittel des Territoriums der A. cerebri media oder >1SO ml) profitieren nicht von der Thrombolyse und tragen ein hohes Risiko für eine weitere klinische Verschlechterung. d Intensivtherapie bei Schlaganfall

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  1. Abteilung Neuroradiologie, Universitätsklinikum Carl-Gustav-Carus Technische Universität, Fetscherstr 74, Dresden, 01307, Germany

    I. Dzialowski & R. von Kummer

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  1. I. Dzialowski
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  2. R. von Kummer
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Dzialowski, I., von Kummer, R. (2003). Computertomographie beim Schlaganfall. In: Die Notfalltherapie und Intensivtherapie bei Schlaganfall. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57384-2_4

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  • DOI: https://doi.org/10.1007/978-3-642-57384-2_4

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-7985-1384-6

  • Online ISBN: 978-3-642-57384-2

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