Neurointensivmedizin: aneurysmatische Subarachnoidalblutung – State of the Art

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.

• Literatur

• 1 Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet 2017; 389: 655-666 . doi: 10.1016/S0140-6736(16)30668-7
• 2 Connolly ES jr, Rabinstein AA, Carhuapoma JR. et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association / American Stroke Association. Stroke 2012; 43: 1711-1737 . doi: 10.1161/STR.0b013e3182587839
• 3 Passier PE, Visser-Meily JM, Rinkel GJ. et al. Life satisfaction and return to work after aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis 2011; 20: 324-329 . doi:10.1016/j. jstrokecerebrovasdis.2010.02.001
• 4 Mills JN, Mehta V, Russin J. et al. Advanced imaging modalities in the detection of cerebral vasospasm. Neurol Res Int 2013; 2013: 415960 . doi:10.1155/2013/415960
• 5 Mueller OM, Schlamann M, Mueller D. et al. Intracranial aneurysms: optimized diagnostic tools call for thorough interdisciplinary treatment strategies. Ther Adv Neurol Disord 2011; 4: 267-279 . doi:10.1177/1756285611415309
• 6 Ringelstein A, Mueller O, Monninghoff C. et al. 3 D rotational angiography after non-traumatic SAH. Rofo 2014; 186: 675-679 . doi:10.1055/s-0033-1356325
• 7 Ringelstein A, Mueller O, Goericke SL. et al. Benefit of second catheter angiography in patients with nontraumatic subarachnoidal hemorrhage. Clin Neuroradiol 2015; 25: 13-17 . doi:10.1007/s00062-013-0271-5
• 8 Ahmadian A, Mizzi A, Banasiak M. et al. Cardiac manifestations of subarachnoid hemorrhage. Heart Lung Vessel 2013; 5: 168-178
• 9 Garfinkle AM, Danys IR, Nicolle DA. et al. Tersonʼs syndrome: a reversible cause of blindness following subarachnoid hemorrhage. J Neurosurg 1992; 76: 766-771 . doi:10.3171/jns.1992.76.5.0766
• 10 Ohkuma H, Tsurutani H, Suzuki S. Incidence and significance of early aneurysmal rebleeding before neurosurgical or neurological management. Stroke 2001; 32: 1176-1180
• 11 Whitfield PC, Kirkpatrick PJ. Timing of surgery for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev 2001 (02) : CD001697 . doi:10.1002/14651858.CD001697
• 12 Suarez JI, Zaidat OO, Suri MF. et al. Length of stay and mortality in neurocritically ill patients: impact of a specialized neurocritical care team. Crit Care Med 2004; 32: 2311-2317
• 13 Treggiari MM. Participants in the International Multi-disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage. Hemodynamic management of subarachnoid hemorrhage. Neurocrit Care 2011; 15: 329-335 . doi:10.1007/s12028-011-9589-5
• 14 Rowland MJ, Hadjipavlou G, Kelly M. et al. Delayed cerebral ischaemia after subarachnoid haemorrhage: looking beyond vasospasm. Br J Anaesth 2012; 109: 315-329 . doi:10.1093/bja/aes264
• 15 Vergouwen MD, Vermeulen M, van Gijn J. et al. Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group. Stroke 2010; 41: 2391-2395 . doi:10.1161/STROKEAHA. 110.589275
• 16 Simard JM, Aldrich EF, Schreibman D. et al. Low-dose intravenous heparin infusion in patients with aneurysmal subarachnoid hemorrhage: a preliminary assessment. J Neurosurg 2013; 119: 1611-1619 . doi:10.3171/2013.8.JNS1337
• 17 Chen S, Luo J, Reis C. et al. Hydrocephalus after subarachnoid hemorrhage: pathophysiology, diagnosis, and treatment. Biomed Res Int 2017; 2017: 8584753 . doi:10.1155/2017/8584753
• 18 Bardutzky J, Witsch J, Juttler E. et al. EARLYDRAIN – outcome after early lumbar CSF-drainage in aneurysmal subarachnoid hemorrhage: study protocol for a randomized controlled trial. Trials 2011; 12: 203 . doi:10.1186/1745-6215-12-203
• 19 Jabbarli R, Bohrer AM, Pierscianek D. et al. The CHESS score: a simple tool for early prediction of shunt dependency after aneurysmal subarachnoid hemorrhage. Eur J Neurol 2016; 23: 912-918 . doi:10.1111/ene.12962
• 20 Muroi C, Keller M, Pangalu A. et al. Neurogenic pulmonary edema in patients with subarachnoid hemorrhage. J Neurosurg Anesthesiol 2008; 20: 188-192 . doi:10.1097/ANA.0b013e3181778156
• 21 Rinkel GJ, Algra A. Long-term outcomes of patients with aneurysmal subarachnoid haemorrhage. Lancet Neurol 2011; 10: 349-356 . doi:10.1016/S1474-4422(11)70017-5