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01.08.2003

Aktuelle Probleme der Diagnose und Therapie zerebraler Venen- und duraler Sinusthrombosen

verfasst von: Priv.-Doz. Dr. S. Schwarz, M. Daffertshofer, T. Schwarz, D. Georgiadis, R. W. Baumgartner, M. Hennerici, C. Groden

Erschienen in: Der Nervenarzt | Ausgabe 8/2003

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Zusammenfassung

Neue radiologische Methoden und klinische Studien haben die Diagnostik und Therapie der Sinusthrombose entscheidend verändert. Die Sinusthrombose gilt heute als Erkrankung mit guter Prognose. Die Mortalität liegt unter 10%, und die überwiegende Mehrzahl der Patienten erholt sich ohne Residuen. Die Akutbehandlung mit Heparin hat sich allgemein durchgesetzt, obwohl die Effektivität dieser Therapie nicht überzeugend bewiesen ist. Über den Nutzen einer längerfristigen Antikoagulation gibt es keine gesicherten Erkenntnisse. Bei Vorliegen eines Hyperkoagulabilitätssyndroms wird eine Antikoagulation über 6 Monate empfohlen. APC-Resistenz, Hyperhomocysteinämie und die Prothrombinmutation G20210A wurden in den letzten Jahren als Risikofaktoren etabliert. Fraglich bleibt, ob eine längerfristige Antikoagulation auch bei idiopathischer Sinusthrombose sinnvoll ist. Die konventionelle Angiographie wird heute nur noch selten eingesetzt, da mit der MRT inklusive MR-Venographie und der CT-Venographie nichtinvasive Verfahren mit hoher Zuverlässigkeit verfügbar sind. Systemische und lokale Fibrinolyse sowie interventionelle rekanalisierende Verfahren können nicht allgemein empfohlen werden.

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Titel: Aktuelle Probleme der Diagnose und Therapie zerebraler Venen- und duraler Sinusthrombosen
verfasst von: Priv.-Doz. Dr. S. Schwarz
M. Daffertshofer
T. Schwarz
D. Georgiadis
R. W. Baumgartner
M. Hennerici
C. Groden
Publikationsdatum: 01.08.2003
Verlag: Springer-Verlag
Erschienen in: Der Nervenarzt / Ausgabe 8/2003
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-003-1526-1

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