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DOI: 10.1055/s-2008-1038221
Akuttherapie des Schlaganfalls
Acute Therapy of StrokePublikationsverlauf
Publikationsdatum:
19. August 2008 (online)

Lernziele
In dieser Übersichtsarbeit wird neben der Vermittlung von epidemiologischen Aspekten auf den besonderen Stellenwert der Prähospitalphase eingegangen. Weiter werden die wesentlichen Stützpfeiler der Stroke-Unit-Behandlung beschrieben. Ein besonderer Schwerpunkt wird auf die Stroke-Unit-Behandlung im derzeitigen DRG-System gelegt (DRG = Diagnosis related Groups). Im Weiteren werden in dieser Arbeit neben neuen Entwicklungen in der Bildgebung die aktuellen Therapieverfahren zur Akutbehandlung des Schlaganfalls, die zuletzt veröffentlichten negativen Studien sowie die derzeit laufenden Studien beschrieben.
Literatur
- 1
Adams Jr H P, Bendixen B H, Kappelle L J. et al .
Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter
clinical trial. TOAST. Trial of Org 10 172 in Acute Stroke Treatment.
Stroke.
1993;
24
35-41
MissingFormLabel
- 2
Rothwell P M, Giles M F, Flossmann E. et al .
A simple score (ABCD) to identify individuals at high early risk of stroke after transient
ischaemic attack.
Lancet.
2005;
366
29-36
MissingFormLabel
- 3
Rothwell P M, Coull A J, Silver L E. et al .
Population-based study of event-rate, incidence, case fatality, and mortality for
all acute vascular events in all arterial territories (Oxford Vascular Study).
Lancet.
2005;
366
1773-1783
MissingFormLabel
- 4
Candelise L, Gattinoni M, Bersano A. et al .
Stroke-unit care for acute stroke patients: an observational follow-up study.
Lancet.
2007;
369
299-305
MissingFormLabel
- 5
Govan L, Langhorne P, Weir C J.
Does the prevention of complications explain the survival benefit of organized inpatient
(stroke unit) care?: further analysis of a systematic review.
Stroke.
2007;
38
2536-2540
MissingFormLabel
- 6
Indredavik B, Slordahl S A, Bakke F. et al .
Stroke unit treatment. Long-term effects.
Stroke.
1997;
28
1861-1866
MissingFormLabel
- 7
Indredavik B, Bakke F, Slordahl S A. et al .
Stroke unit treatment. 10-year follow-up.
Stroke.
1999;
30
1524-1527
MissingFormLabel
- 8
Sherman D G, Albers G W, Bladin C. et al .
The efficacy and safety of enoxaparin versus unfractionated heparin for the prevention
of venous thromboembolism after acute ischaemic stroke (PREVAIL Study): an open-label
randomised comparison.
Lancet.
2007;
369
1347-1355
MissingFormLabel
- 9
Hacke W, Donnan G, Fieschi C. et al .
Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS,
and NINDS rt-PA stroke trials.
Lancet.
2004;
363
768-774
MissingFormLabel
- 10
Wahlgren N, Ahmed N, Davalos A. et al .
Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation
of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study.
Lancet.
2007;
369
275-282
MissingFormLabel
- 11
Lindsberg P J, Mattle H P.
Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial
and intravenous thrombolysis.
Stroke.
2006;
37
922-928
MissingFormLabel
- 12
Smith W S, Sung G, Saver J. et al .
Mechanical thrombectomy for acute ischemic stroke: final results of the Multi MERCI
trial.
Stroke.
2008;
39
1205-1212
MissingFormLabel
- 13
Schulte-Altedorneburg G, Mayer T E.
Management of acute basilar artery occlusion.
Radiologe.
2007;
47
355-335
MissingFormLabel
- 14
Schellinger P D, Thomalla G, Fiehler J. et al .
MRI-based and CT-based thrombolytic therapy in acute stroke within and beyond established
time windows: an analysis of 1210 patients.
Stroke.
2007;
38
2640-2645
MissingFormLabel
- 15
Thomalla G, Schwark C, Sobesky J. et al .
Outcome and symptomatic bleeding complications of intravenous thrombolysis within
6 hours in MRI-selected stroke patients: comparison of a German multicenter study
with the pooled data of ATLANTIS, ECASS, and NINDS tPA trials.
Stroke.
2006;
37
852-858
MissingFormLabel
- 16
Davis S M, Donnan G A, Parsons M W. et al .
Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic
Evaluation Trial (EPITHET): a placebo-controlled randomised trial.
Lancet Neurol.
2008;
7
299-309
MissingFormLabel
- 17
Vahedi K, Hofmeijer J, Juettler E. et al .
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
MissingFormLabel
- 18
Shuaib A, Lees K R, Lyden P. et al .
NXY-059 for the treatment of acute ischemic stroke.
N Engl J Med.
2007;
357
562-571
MissingFormLabel
- 19
Diener H C, Lees K R, Lyden P. et al .
NXY-059 for the Treatment of Acute Stroke. Pooled Analysis of the SAINT I and II Trials.
Stroke.
2008;
MissingFormLabel
- 20
Adams Jr H P, Effron M B, Torner J. et al .
Emergency administration of abciximab for treatment of patients with acute ischemic
stroke: results of an international phase III trial: Abciximab in Emergency Treatment
of Stroke Trial (AbESTT-II).
Stroke.
2008;
39
87-99
MissingFormLabel
- 21
Mendelow A D, Gregson B A, Fernandes H M. et al .
Early surgery versus initial conservative treatment in patients with spontaneous supratentorial
intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage
(STICH): a randomised trial.
Lancet.
2005;
365
387-397
MissingFormLabel
PD Dr. Martin Liebetrau
Neurologische Klinik, Dr. Horst Schmidt Klinik
Ludwig-Erhard-Str.100
65199 Wiesbaden
eMail: martin.liebetrau@hsk-wiesbaden.de