Das Schädel-Hirn-Trauma ist ein komplexes Krankheitsbild mit hoher Mortalität. Ziel
ist es primär, die Homöostase des Gehirns anhand physiologischer Zielwerte aufrechtzuerhalten.
Daneben gilt es, die weitere Therapie an der zerebralen Durchblutung und dem intrakraniellen
Druck auszurichten. Teil 1 adressiert die primäre Therapiestrategie, das hämodynamische
Management und das multimodale Monitoring, Teil 2 sekundäre Behandlungsstrategien,
Langzeitergebnis, Neuroprognostik und Chronifizierung [1 ].
Abstract
This two-part article deals with the intensive medical care of traumatic brain injury.
Part 1 addresses the primary treatment strategy, haemodynamic management and multimodal
monitoring, Part 2 secondary treatment strategies, long-term outcome, neuroprognostics
and chronification. Traumatic brain injury is a complex clinical entity with a high
mortality rate. The primary aim is to maintain homeostasis based on physiological
targeted values. In addition, further therapy must be geared towards intracranial
pressure. In addition to this, there are other monitoring options that appear sensible
from a pathophysiological point of view with appropriate therapy adjustment. However,
there is still a lack of data on their effectiveness. A further aspect is the inflammation
of the cerebrum with the “cross-talk” of the organs, which has a significant influence
on further intensive medical care.
Schlüsselwörter Schädelhirntrauma - Behandlungsstrategien - Hämodynamik - multimodales Monitoring
- erhöhter Hirndruck
Keywords traumatic brain injury - primary treatment strategy - haemodynamic management - multimodal
monitoring - increased intracranial pressure
