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Intensivmedizin up2date 2015; 11(02): 161-176
DOI: 10.1055/s-0041-101343
Neuro-Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Dekompressive Hemikraniektomie beim malignen Mediainfarkt

Hermann Neugebauer
,
Eric Jüttler
,
Oliver W. Sakowitz
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Publication Date:
28 April 2015 (online)

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Kernaussagen

  • Die DHC wird zunehmend häufiger zur Behandlung des MMI eingesetzt, auch wenn die absolute Zahl der Eingriffe aufgrund der Seltenheit der Erkrankung gering bleibt.

  • Neueste Studien aus der Neuroradiologie legen eine zuverlässige frühe Vorhersage eines MMI anhand der Infarktausdehnung, der Schwere des Perfusionsdefizits und des intrakraniellen Reservevolumens nahe.

  • Die bekannte Effektivität der DHC bei der Behandlung jüngerer MMI-Patienten wurde auch bei älteren Patienten nachgewiesen, der Behandlungseffekt ist jedoch geringer.

  • Da ältere Patienten ein weniger gutes Behandlungsergebnis erreichen, wird die Debatte um das akzeptable Maß an Behinderung bei Überlebenden eines MMI erneut aufleben.

 

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