Management von intrakraniellen Aneurysmen und Subarachnoidalblutungen: Vorstellung der Leitlinien der europäischen Schlaganfallorganisation (ESO)

Zusammenfassung

Die europäische Schlaganfallgesellschaft (ESO) hat in diesem Jahr eine Leitlinie zur Behandlung der SAB (mit und ohne Nachweis von Aneurysmen) und von unrupturierten Aneurysmata (UIA) veröffentlicht. Wir stellen hier die Inhalte dieser Leitlinie im Sinne einer Übersetzung auf Deutsch vor. Wenige Passagen wurden gekürzt. Wichtige Publikationen, die in der Originalarbeit nicht berücksichtigt werden konnten, wurden unter entsprechender Kenntlichmachung (#) ergänzt. ­Subarachnoidalblutungen (SAB) stellen ein relevantes Gesundheitsproblem dar: weltweit wird die Inzidenz von SABs mit etwa 9/100000 angegeben, wobei deutliche regionalspezifische Unterschiede bestehen, mit Inzidenzen von bis zu 20/100000 in einigen Ländern. Die Mortalitätsraten konservativ behandelter Patienten liegen bei etwa 50–60% innerhalb von 30 Tagen. Ohne die Versorgung eines rupturierten Aneurysmas stirbt etwa ein Drittel der Patienten an einer Rezidivblutung innerhalb von 6 Monaten. Die Prognose wird vom Auftreten zerebraler Vasospasmen, eines Hydrozephalus, eines verzögerten ischämischen Defizits und weiteren Komplikationen beeinflusst.

Abstract

This year the European Stroke Organisation (ESO) published guidelines for the treatment of SAH (with and without associated aneurysms) and for unruptured intracranial aneurysms (UIA). Here we present these European guidelines as a translation into German. A few paragraphs were shortened. The data was supplemented by recent publications which had not been considered in the original article. Additional references are marked by (#). Subarachnoid haemorrhages (SAH) are of particular medical importance. The overall incidence of SAH is 9/100000, with a broad regionally specific range with up to 20/100000 cases per year in some countries. Patients who are treated conservatively have mortality rates up to 50–60% after 30 days. Approximately a third of patients with an untreated ruptured aneurysm die during the following 6 months due to a rebleeding. Furthermore, the prognosis is influenced by medical complications, such as cerebral vasospasms, hydrocephalus and delayed ischaemic deficits.

Schlüsselwörter

Subarachnoidalblutung - intrakranielles Aneurysma - perimesenzephale Subarachnoidalblutung - Management - Leitlinie

Keywords

subarachnoid haemorrhage - intracranial aneurysm - perimesencephalic subarachnoid haemorrhage - management - guidelines

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