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01.08.2011 | Leitthema

Grenzentscheidungen in der Schlaganfalltherapie

verfasst von: M. Endres, M. Grond, W. Hacke, M. Ebinger, P.D. Schellinger, Prof. Dr. M. Dichgans

Erschienen in: Der Nervenarzt | Ausgabe 8/2011

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Zusammenfassung

Bei der Behandlung von Schlaganfallpatienten ist für eine Vielzahl der therapeutischen Entscheidungen im Alltag die medizinische Evidenz begrenzt oder nicht vorhanden. Dies betrifft Behandlungssituationen sowohl in der Akuttherapie als auch in der Sekundärprävention. In diesem Beitrag werden solche Grenzsituationen aufgedeckt und diskutiert. Beispiele sind die Thrombolyse außerhalb geltender Zulassungskriterien (z. B. hohes Alter, orale Antikoagulation) und die Sekundärprävention bei Patienten mit konkurrierenden Behandlungsindikationen (z. B. Vorhofflimmern und frischer Stent) oder häufig diskutierten Risikokonstellationen (Demenz, Anamnese für Stürze, Zustand nach intrazerebraler Blutung). Neben der Diskussion der aktuellen Datenlage werden eigene Erfahrungen berichtet und konkrete Empfehlungen zum Vorgehen gegeben.

Akronym bestehend aus: „cardiac failure“, Hypertension, Alter ≥75 Jahre, Diabetes, Schlaganfall (zählt doppelt).

Akronym zusammengesetzt aus: Hypertension, abnormale Nieren- oder Leberfunktion, Schlaganfall, frühere Blutungen, labiler INR, „elderly“ (>65 Jahre), „drugs“ (z. B. Aspirin)/Alkohol (>20 Einheiten pro Woche).

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Titel: Grenzentscheidungen in der Schlaganfalltherapie
verfasst von: M. Endres
M. Grond
W. Hacke
M. Ebinger
P.D. Schellinger
Prof. Dr. M. Dichgans
Publikationsdatum: 01.08.2011
Verlag: Springer-Verlag
Erschienen in: Der Nervenarzt / Ausgabe 8/2011
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-011-3259-x

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