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Erschienen in: Notfall +  Rettungsmedizin 5/2011

01.08.2011 | CME Weiterbildung · Zertifizierte Fortbildung

Schlaganfallbehandlung 2011

Neue therapeutische Optionen

verfasst von: Prof. Dr. H.J. Audebert

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 5/2011

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Zusammenfassung

In der Akutbehandlung und Prävention des Schlaganfalls stehen neue therapeutische Möglichkeiten zur Verfügung. Trotzdem bleibt der Schlaganfall ein wichtiger Mortalitätsgrund und die häufigste Ursache für eine erworbene andauernde Behinderung. Aktuell sind nur 4 Therapieoptionen des akuten Schlaganfallmanagements evidenzbasiert. Dies sind die Behandlung in einer Stroke Unit für alle Subtypen des Schlaganfalls, die intravenöse Thrombolyse und frühe Gabe von Acetylsalicylsäure bei ischämischem Schlaganfall und die chirurgische Dekompression bei malignen Infarkten. Durch den Einsatz dieses therapeutischen Spektrums kann ein schlechtes Outcome um rund 20% (absolute Risikoreduktion) reduziert werden. Alle Patienten mit akutem Schlaganfall sollten auf eine Stroke Unit aufgenommen werden. Daher müssen neue Stroke Units in unterversorgten Regionen gegründet werden. Wie bei Schlaganfallzentren und telemedizinischen Netzwerken nachgewiesen, können Thrombolysraten von rund 20% erreicht werden, wenn das Bewusstsein der Öffentlichkeit und das akute Schlaganfallmanagement optimiert werden.
Patienten mit Schlaganfall und transitorisch ischämischer Attacke haben ein hohes Risiko eines erneuten Schlaganfalls oder eines anderen vaskulären Ereignisses. Verschiedene medikamentöse Behandlungen sind hoch effektiv, jedoch muss die Ätiologie des Schlaganfalls bestimmt werden, bevor die beste mögliche Sekundärprävention festgelegt werden kann. Die Umsetzung evidenzbasierter Therapien in die klinische Praxis ist eine wichtige Herausforderung der aktuellen Gesundheitsversorgung.
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Metadaten
Titel
Schlaganfallbehandlung 2011
Neue therapeutische Optionen
verfasst von
Prof. Dr. H.J. Audebert
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 5/2011
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-011-1472-6