Management des Schädel-Hirn-Traumas beim Polytrauma – Diagnostik und Therapie

Ein zwischen den einzelnen Fachdisziplinen festgelegter Behandlungsplan sorgt für einen optimierten Ablauf bei der Diagnostik und Behandlung dieser schwerstverletzten Patienten. Durch die Differenzierung der Traumanetzwerke in überregionale, regionale und lokale Traumazentren wird eine optimale Versorgung von traumatisierten Patienten, entsprechend der Verletzungsschwere, gewährleistet.

Schlüsselwörter

Schädel-Hirn-Trauma - Kopfverletzung - Hirnverletzung - Schockraum - Gehirnblutung - Schädelfraktur

• Literatur

• 1 Maegele M, Lefering R, Sakowitz O. et al. The incidence and management of moderate to severe head injury. Dtsch Arztebl Int 2019; 116: 167-173
• 2 Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 2: 81-84
• 3 Kinoshita K. Traumatic brain injury: pathophysiology for neurocritical care. J Intensive Care 2016; 4: 29
• 4 Büki A, Povlishock JT. All roads lead to disconnection?--Traumatic axonal injury revisited. Acta Neurochir (Wien) 2006; 148: 181-193
• 5 Pettus EH, Christman CW, Giebel ML. et al. Traumatically induced altered membrane permeability: its relationship to traumatically induced reactive axonal change. J Neurotrauma 1994; 11: 507-522
• 6 Newcombe VF, Williams GB, Nortje J. et al. Analysis of acute traumatic axonal injury using diffusion tensor imaging. Br J Neurosurg 2007; 21: 340-348
• 7 Saatman KE, Duhaime AC, Bullock R. et al. Classification of traumatic brain injury for targeted therapies. J Neurotrauma 2008; 25: 719-738
• 8 Hackenberg K, Unterberg A. Schädel-Hirn-Trauma. Nervenarzt 2016; 87: 203-216
• 9 AWMF. S2-Leitlinie Schädel-Hirn-Trauma im Erwachsenenalter. Accessed March 19, 2024 at: https://register.awmf.org/de/leitlinien/detail/008–001
• 10 AWMF. S3-Leitlinie Polytrauma/Schwerverletzten-Behandlung. Accessed March 19, 2024 at: https://register.awmf.org/de/leitlinien/detail/187–023
• 11 Guidelines for the Surgical Management of Traumatic Brain Injury. Neurosurgery [Anonym]. 2006; 58 (Suppl. 3) S2–1-S2–62
• 12 Bor-Sheng-Shu E, Figueiredo EG, Amorim RL. et al. Decompressive craniectomy: a meta-analysis of influences on intracranial pressure and cerebral perfusion pressure in the treatment of traumatic brain injury. J Neurosurg 2012; 117: 589-596
• 13 Metz C, Taeger K. Schädel-Hirn-Trauma und zerebrale Hypoxie. Diagnostik – Monitoring – Therapie. Anaesthesist 2000; 49: 332-339
• 14 Greiner G. Indikation und Durchführung der dekompressiven Kraniektomie. Anästhesiol Intensivmed Notfallmed Schmerzther 2008; 43: 682-691
• 15 Fourcade O, Fuzier R, Daboussi A. et al. Craniectomie décompressive et hypertension intracrânienne. Ann Fr Anesth Reanim 2006; 25: 858-862
• 16 Stock AL, Collins HP, Davidson TM. Anatomy of the superficial temporal artery. Head Neck Surg 1980; 2: 466-469
• 17 Yasargil MG, Reichmann MV, Kubik S. Preservation of the frontotemporal branch of the facial nerve using the interfascial temporalis flap for pterional craniotomy. J Neurosurg 1987; 67: 463-466
• 18 Johnson RD, Maartens NF, Teddy PJ. Technical aspects of decompressive craniectomy for malignant middle cerebral artery infarction. J Clin Neurosci 2011; 18: 1023-1027
• 19 Huang X, Wen L. Technical considerations in decompressive craniectomy in the treatment of traumatic brain injury. Int J Med Sci 2010; 7: 385-390
• 20 Quinn TM, Taylor JJ, Magarik JA. et al. Decompressive craniectomy: technical note. Acta Neurol Scand 2011; 123: 239-244
• 21 Fernandez R, Firsching R, Lobato R. et al. Guidelines for treatment of head injury in adults. Opinions of a group of neurosurgeons. Zentralbl Neurochir 1997; 58: 72-74
• 22 Furlow B. Diagnostic imaging of traumatic brain injury. Radiol Technol 2006; 78: 145-159
• 23 Iaccarino MA, Bhatnagar S, Zafonte R. Rehabilitation after traumatic brain injury. Handb Clin Neurol 2015; 127: 411-422
• 24 Skoglund TS, Nellgard B. Long-time outcome after transient transtentorial herniation in patients with traumatic brain injury. Acta Anaesthesiol Scand 2005; 49: 337-340
• 25 Sahuquillo J, Martinez-Ricarte F, Poca MA. Decompressive craniectomy in traumatic brain injury after the DECRA trial. Where do we stand?. Curr Opin Crit Care 2013; 19: 101-106
• 26 Hutchinson P, Timofeev I, Kirkpatrick P. Surgery for brain edema. Neurosurg Focus 2007; 22: E14
• 27 Tagliaferri F, Zani G, Iaccarino C. et al. Decompressive craniectomies, fact and fiction: a retrospective analysis of 526 cases. Acta Neurochir (Wien) 2012; 154: 919-926
• 28 Polin RS, Shaffrey ME, Bogaev CA. et al. Decompressive bifrontal craniectomy in the treatment of severe refractory posttraumatic cerebral edema. Neurosurgery 1997; 41: 84-92