Intraventrikuläre Blutungen

Die Ventrikelblutung ist eine häufige Komplikation sowohl der intrazerebralen als auch der subarachnoidalen Blutung und führt zu einer deutlichen Erhöhung der Morbidität und Mortalität dieser Erkrankungen. Die in den letzten Jahren erweiterte Kenntnis der zugrunde liegenden Pathomechanismen der Ventrikelblutung hat zur Entwicklung spezifischer Therapieansätze beigetragen. Dieser Artikel stellt sie vor.

Kernaussagen

• Die Ventrikelblutung ist eine häufige Komplikation der intrazerebralen und subarachnoidalen Blutung und verschlechtert signifikant die Prognose.

• Eine akute lebensbedrohliche Komplikation der Ventrikelblutung ist der obstruktive Hydrozephalus. In diesem Fall ist eine Ventrikeldrainage die Therapie der Wahl.

• Bisherige Studien haben verschiedene Therapieoptionen für die Behandlung der Ventrikelblutung untersucht. Dazu gehören:

  • die intraventrikuläre Lyse,

  • die endoskopische Hämatomevakuation,

  • die lumbale Drainage.

• Die intraventrikuläre Lyse scheint bei Patienten mit intrazerebraler Blutung mit Ventrikeleinbruch die Mortalität zu verringern.

• Nach aktueller Datenlage ist keine der genannten Therapiemodalitäten mit einem überzeugenden funktionellen Outcomevorteil assoziiert.

• Die Anwendung dieser Therapiestrategien bleibt derzeit im klinischen Alltag nach wie vor eine individuelle Entscheidung.

Schlüsselwörter

Ventrikelblutung - Gehirnblutung - Hydrozephalus - Hirndruck - Ventrikeltamponade

Publication History

Article published online:
01 December 2020

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