Neurointensivmedizin: aneurysmatische Subarachnoidalblutung – State of the Art

Zusammenfassung

Die spontane, nicht traumatische Subarachnoidalblutung ist eine lebensbedrohliche Erkrankung, die mit vielfältigen Komplikationen und einer hohen Morbidität und Mortalität vergesellschaftet ist. In den ersten 24 Stunden hat die Ausschaltung der Blutungsursache Vorrang. Die Patienten sollen intensivmedizinisch überwacht und behandelt werden. Stringente Diagnostik und konsequente Behandlung verbessern das Outcome der Patienten nachweislich.

Abstract

The aneurysmal subarachnoid hemorrhage is a life threatening disorder associated with high morbidity and mortality. Identification and treatment of the bleeding source is mandatory within the first 24 hours to prevent rebleeding. Patients suffering from subarachnoid hemorrhage should be managed on an intensive care unit experienced in the treatment of this condition. Most frequent complications in the clinical course are hydrocephalus, requiring temporary or permanent shunting, and delayed cerebral ischemia. Consequent monitoring of the patients including transcranial doppler sonography and undelayed treatment of complications can improve the outcome of the patient substantially. Longterm neuropsychological sequelae may hamper the patient and thwart his reconstitution, thus requiring psychological intervention.

Schlüsselwörter

Subarachnoidalblutung - Aneurysma - Vasospasmus - prolongiertes neurologisches Defizit - Hydrozephalus

Key words

subarachnoid hemorrhage - aneurysm - vasospasm - delayed cerebral ischemia - hydrocephalus

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