Download PDF
intensiv 2013; 21(06): 299-306
DOI: 10.1055/s-0033-1359747
CNE Schwerpunkt
Schädel-Hirn-Trauma
Georg Thieme Verlag KG Stuttgart · New York

Klinik und Therapie des Schädel-Hirn-Traumas

Johannes Wölfer
Further Information

Publication History

Publication Date:
08 November 2013 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Bei einer Verletzung des Schädels unter Beteiligung des Gehirns reichen die Ausprägungen von einer leichten Gehirnerschütterung, von denen der Patient sich oft schnell wieder erholt, bis hin zu schweren Schädigungen des Gehirns, bei denen Koma oder Tod die Folge sein können. In jedem Fall erfordert die Diagnose eine umgehende und eingehende Untersuchung des Patienten, denn einige Krankheitsabläufe entfalten sich erst nach einer gewissen Zeit. Je schneller erste Therapien greifen, umso größer ist die Chance für den Patienten auf Heilung.

 

  • Literatur

  • 1 Bushe KA, Collmann H. Neurochirurgie von den Anfängen bis zum späten 19. Jahrhundert. In: Neurochirurgie in Deutschland: Geschichte und Gegenwart. Berlin, Wien: 2001: 1-25
    Google Scholar
  • 2 Girard P. Geschichte der Neurologie. In: Toellner R. Illustrierte Geschichte der Medizin. Bd. 2 Salzburg: 1986: 1105-1123
    Google Scholar
  • 3 Statistisches Bundesamt. Gesundheit – Todesursachen in Deutschland. Fachserie 12, Reihe 4 Wiesbaden: Statistisches Bundesamt; 2011
    Google Scholar
  • 4 Reilly PL, Graham DI, Adams JH et al. Patients with head injury who talk and die. Lancet 1975; 2: 375-377
    Google Scholar
  • 5 Chesnut R, Marshall L, Klauber M et al. The role of secondary brain injury in determining outcome from severe head injury. J Trauma 1993; 34: 216-222
    CrossrefGoogle Scholar
  • 6 Robertson C, Valadka A, Hannay H et al. Prevention of secondary ischemic insults after severe head injury. Crit Care Med 1999; 27: 2086-2095
    CrossrefPubMedGoogle Scholar
  • 7 Yeung D, Manias J, Stewart D et al. Decreased junctional adhesion molecule-A expression during blood-brain barrier breakdown. Acta Neuropathol 2008; 115: 635-642
    CrossrefGoogle Scholar
  • 8 Nag S, Manias J, Stewart D. Pathology and new players in the pathogenesis of brain edema. Acta Neuropathol 2009; 118: 197-217
    CrossrefGoogle Scholar
  • 9 Teasdale G, Jennett B. Assessment and prognosis of coma after head injury. Acta Neurochir 1976; 34: 45-55
    CrossrefPubMedGoogle Scholar
  • 10 Ghajar J. Intracranial pressure monitoring techniques. New Horiz 1995; 3: 395-399
    Google Scholar
  • 11 Lozier A, Sciacca R, Romagnoli M et al. Ventriculostomy-related infections: a critical review of the literature. Neurosurg 2002; 51: 170-181
    CrossrefGoogle Scholar
  • 12 Schregel W. Stellenwert der transkraniellen Dopplersonographie bei erhöhtem intrakraniellen Druck. Anästhesiol Intensivmed 1997; 38: 376-380
    Google Scholar
  • 13 Vajkoczy P, Roth H, Horn P et al. Continuous monitoring of regional cerebral blood flow: experimental and clinical validation of a novel thermal diffusion microprobe. J Neurosurg 2000; 93: 265-274
    CrossrefGoogle Scholar
  • 14 van den Brink W, van Santbrink H, Steyerberg E et al. Brain oxygen tension in severe head injury. Neurosurgery 2000; 46: 868-876
    PubMedGoogle Scholar
  • 15 Gütling E, Gonser A, Imhof H et al. Prognostic value of frontal and parietal somatosensory evoked potentials in severe head injury: a long-term follow-up study. Electroencephalogr Clin Neurophysiol 1994; 92: 568-570
    Google Scholar
  • 16 Bershad E, Humphreis W, Suarez J. Intracranial hypertension. Sem Neurol 2008; 5: 690-702
    Article in Thieme ConnectGoogle Scholar
  • 17 Maas A, Dearden M, Teasdale G et al. EBIC-guidelines for management of severe head injury in adults. European Brain Injury Consortium Acta Neurochir 1997; 139: 286-294
    CrossrefGoogle Scholar
  • 18 BTF/Brain Trauma Foundation, AANS/American Association of Neurological Surgeons, CNS/Congress of Neurological Surgeons, Joint Section on Neurotrauma and Critical Care, AANS/CNS. Bratton S, Chesnut R, Ghajar J et al. Guidelines for the management of severe traumatic brain injury. J Neurotrauma 2007; 24 (Suppl. 01) S1-106
    CrossrefGoogle Scholar
  • 19 Marmarou A, Anderson R, Ward J et al. Impact of ICP instability and hypotension on outcome in patients with severe head trauma. J Neurosurg 1991; 75: S59-S66
    Google Scholar
  • 20 Stubbe H, Wölfer J. Schädel-Hirn-Trauma beim Erwachsenen. Intensivmed Up2date 2012; 8: 253-269
    Article in Thieme ConnectGoogle Scholar
  • 21 Roberts I. Barbiturates for acute traumatic brain injury. Volume 4 The Cochrane library; 2005
    Google Scholar
  • 22 Sioutos P, Orozco J, Carter L et al. Continuous regional cerebral cortical blood flow monitoring in head-injured patients. Neurosurgery 1995; 36: 943-949
    CrossrefGoogle Scholar
  • 23 Muizelaar J, Marmarou A, Ward J et al. Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial. J Neurosurg 1991; 75: 731-739
    CrossrefGoogle Scholar
  • 24 Lam A, Winn H, Cullen B et al. Hyperglycemia and neurological outcome in patients with head injury. J Neurosurg 1991; 75: 545-551
    CrossrefGoogle Scholar
  • 25 Salim A, Hadjizacharia P, Dubose J et al. Persistent hyperglycemia in severe traumatic brain injury: an independent predictor of outcome. Am Surg 2009; 75 (01) 25-29
    Google Scholar
  • 26 Vahedi K, Hofmeijer J, Juettler E et al. DECIMAL, DESTINY, and HAMLET investigators. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials Lancet Neurol 2007; 6: 215-222
    CrossrefPubMedGoogle Scholar
  • 27 Cooper DJ, Rosenfeld JV, Murray L et al. for the DECRA Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group: Decompressive Craniectomy in Diffuse Traumatic Brain Injury. N Engl J Med 2011; 364 (16) 1493-1502
    CrossrefPubMedGoogle Scholar