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2013 | OriginalPaper | Buchkapitel

13. Verlaufsmonitoring von Bewusstseinsstörungen und Enzephalopathien

verfasst von : H.-C. Hansen, W. Haupt, S. Zschocke

Erschienen in: Bewusstseinsstörungen und Enzephalopathien

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Im Grundsatz dient der klinisch-neurologische Befund soweit möglich als Maßstab des Krankheitsverlaufs, muss aber wegen der eingeschränkten Untersuchbarkeit des Patienten (Weckbarkeit, Hirnstammreflexe) durch neurophysiologi sche, labormedizinische und/oder neuroradiologische Untersuchungsbefunde ergänzt werden. Dies dient sowohl der frühen Erkennung einer Krankheitsverschlechterung, aber auch der Identifikation einer Remission, z. B. aus dem Koma. Viele Aussagen der einzelnen Verfahren in der Prognosenerstellung sind im Hinblick auf die Zeitpunkte der erhobenen Befunde und die gewählten Therapie verfahren (z.B. Hypothermie) und nicht zuletzt die Primärschädigung (traumatisch vs. nicht-traumatisch) zu bewerten.

Dies illustriert das praktisch häufige Beispiel des schwierigen CCT-Befundes einer „fraglichen Hirnschwellung“ beim jugendlichen Patienten nach leichter Gehirnerschütterung. Nach Ausschluss einer stattgehabten Bewusstseinsstörung ist dies eher als Normalvariante des Hirnvolumens zu hinterfragen. Dennoch wird man, je nach Intensität des Traumas, zu vorübergehenden posttraumatischen Verlaufskontrollen raten.

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Titel: Verlaufsmonitoring Verlaufsmonitoring von Bewusstseinsstörungen und Enzephalopathien
verfasst von: H.-C. Hansen
W. Haupt
S. Zschocke
Verlag: Springer Berlin Heidelberg
Buch: Bewusstseinsstörungen und Enzephalopathien
Print ISBN: 978-3-642-36914-8

Electronic ISBN: 978-3-642-36915-5

Copyright-Jahr: 2013
DOI: https://doi.org/10.1007/978-3-642-36915-5_13

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Springer Medizin

13. Verlaufsmonitoring von Bewusstseinsstörungen und Enzephalopathien

Zusammenfassung

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Hinter dieser Appendizitis steckte ein Erreger

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Springer Medizin

Zusammenfassung

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Neu im Fachgebiet AINS

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

S3-Leitlinie zu Pankreaskrebs aktualisiert

Update AINS