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Notfallmedizin up2date 2015; 10(1): 45-60
DOI: 10.1055/s-0033-1358117
Spezielle Notfallmedizin
Georg Thieme Verlag KG Stuttgart · New York

Intrazerebrale Blutungen

Jens Kleffmann
,
Christian Roth
,
Ralf Siekmann
,
Wolfgang Deinsberger
Further Information

Publication History

Publication Date:
07 April 2015 (online)

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Kernaussagen

Prinzipiell differenziert man beim Schlaganfall zwischen

  • ischämischen Schlaganfällen (85 %) und

  • Hirnblutungen (ca. 15 %).

Eine Unterscheidung zwischen den beiden Entitäten ist anhand der klinischen Symptome nicht möglich. Der Verdacht auf einen Schlaganfall erfordert eine sofortige Bildgebung des Kopfes zur Differenzierung, da sich die Behandlungskonzepte konträr unterscheiden und die Therapie möglichst früh eingeleitet werden soll: „Time is Brain“.

Bei der Primärversorgung von Patienten mit V. a. ICB oder ischämischen Schlaganfall steht die Sicherung und Stabilisierung der Vitalfunktionen im Vordergrund.

Intrazerebrale Blutungen (ICB) sind trotz moderner Intensivmedizin weiterhin mit einer hohen Mortalitäts- und Komplikationsrate assoziiert.

Bei der ICB besteht die weitere Behandlung in Blutdruckeinstellung, antikonvulsiver, hämostatischer und Hirndrucktherapie, u. U. operativer Therapie.

 

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