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Spontane intrazerebrale Hämatome

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Der Schlaganfall

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Zusammenfassung

Die erste wissenschaftliche Beschreibung von 4 Patienten, die nach intrazerebralen Blutungen starben, stammt von J.J. Wepfer (1620–1685). Der aus Schaffhausen stammende und am fürstlichen Hof in Stuttgart tätige Leibarzt überlieferte 4 Sektionsprotokolle [372]. Er verglich erstmals klinische Befunde und Sektionsergebnisse und kam dabei zu dem Schluß, daß ein harter unregelmäßiger Puls und eine livide Gesichtsfarbe zu Hirnblutungen prädisponieren. Ihm blieb jedoch verborgen, daß die Blutungen zu einer Lähmung der kontralateralen Körperhälfte führen. Ein weiterer Schritt gelang J.M. Charcot (1825–1893), der zusammen mit C. Bouchard (1825–1883) am Rande großer Blutungshöhlen eine große Anzahl mikroskopisch kleiner, beerförmiger Erweiterungen an kleinen Arteriolen fand, die späteren sog. Charcot-Bouchard-Aneurysmen, von denen er annahm, daß sie die eigentliche Blutungsquelle seien [60]. R.W. Ross Russell bestätigte später mit Hilfe von Postmortem-Bariumsulfat-Angiographien die Existenz dieser miliaren Mikroaneurysmen in Striatum, Thalamus, N. caudatus, Brücke und N. dentatus sowie im subkortikalen Marklager, den Regionen, in denen die häufigsten hypertonischen Massenblutungen auftreten [69, 300, 330].

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  1. Neurologische Universitätsklinik, Sigmund-Freud-Straße 25, 53105, Bonn, Germany

    A. Hartmann

  2. Max-Planck-Institut für Neurologische Forschung und Klinik und Poliklinik für Neurologie und Psychiatrie, Universität Köln, Gleueler Straße 50, 50931, Köln, Germany

    W.-D. Heiss

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Schütz, H. (2001). Spontane intrazerebrale Hämatome. In: Hartmann, A., Heiss, WD. (eds) Der Schlaganfall. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57629-4_13

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