Neuropsychologische Frühdiagnostik nach einem Schlaganfall – ein Überblick im deutschsprachigen Raum verfügbarer Instrumente und Vorstellung eines neuen Screening-Verfahrens

Zusammenfassung

Schlaganfall-induzierte neuropsychologische Einschränkungen stellen häufige und für die Prognose relevante Symptome dar, sodass ihre Diagnostik zum frühestmöglichen Zeitpunkt indiziert ist. Da Schlaganfall-Patienten in der Akut- und Subakutphase eines Schlaganfalls oft verlangsamt und vermindert belastbar sind, ist eine neuropsychologische Untersuchung häufig nur eingeschränkt und mit Instrumenten möglich, die an der Bettkante durchführbar und möglichst für diese Patientengruppe normiert sind. Hier wird ein Überblick über aktuell im deutschsprachigen Raum verfügbare neuropsychologische, diagnostische Instrumente gegeben, die für Schlaganfall-Patienten in frühen Schlaganfall- und Rehabilitations-Phasen entwickelt wurden oder bei diesen angewendet werden. Eines der neun hier vorgestellten Verfahren ist das neu entwickelte Kölner Neuropsychologische Screening für Schlaganfall-Patienten, das kurz vorgestellt wird. Die Verfahren unterscheiden sich deutlich in Form der Untersuchung, Bearbeitungsdauer, Materialaufwand und Normierung. Die Wahl des Verfahrens im klinischen und wissenschaftlichen Kontext hängt maßgeblich von der aktuellen Fragestellung sowie der Belastbarkeit des Patienten ab.

Abstract

Stroke-induced neuropsychological sequelae are frequent and highly relevant for the patient’s prognosis, so that their diagnostic assessment at an early point in time is highly advisable to allow for the initiation of appropriate treatment. Because stroke patients in the acute and sub-acute phase of a stroke often show a general slowing and restricted resilience, investigation may be limited and is often only manageable by means of instruments that can be used at bedside. Preferably such neuropsychological tests should also be normalised for the target group. An overview of the neuropsychological instruments available in German, which were developed for or applied to stroke patients in the early phases of stroke and rehabilitation, is provided here. One of the nine instruments presented is the newly developed Cologne Neuropsychological Screening for Stroke Patients (German: Kölner Neuropsychologisches Screening für Schlaganfall-Patienten), which is introduced here. The instruments differ in form of investigation, duration, material volume and standardisation. The choice of a particular instrument in a given clinical or scientific context explicitly depends on the diagnostic goal as well as the resilience of the patient.

Schlüsselwörter

Neuropsychologie - Schlaganfall - Diagnostik - Kognition - Affekt - Rehabilitation

Key words

neuropsychology - stroke - diagnostics - cognition - affect - rehabilitation

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