Skip to main content
Erschienen in: Neurosurgical Review 2/2019

12.11.2017 | Review

Systemic autoimmune diseases complicated with hydrocephalus: pathogenesis and management

verfasst von: Junji Wei, Hexiang Yin, Li Wang, Liying Cui, Renzhi Wang

Erschienen in: Neurosurgical Review | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Systemic autoimmune diseases (SAIDs) represent a group of syndromes involving at least two organ systems. Classical SAIDs include connective tissue diseases, vasculitis, and granulomatous diseases, many of which involve the nervous system and result in different neurological manifestations. Hydrocephalus can be a rare but lethal complication of various SAIDs, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), sarcoidosis, and primary vasculitis. However, the pathogenesis of SAIDs complicated with different types of hydrocephalus is varied and difficult to determine using the existing published data, and various manifestations and expressive forms of the conditions bring a substantial challenge to a timely clinical diagnosis and treatment. The commonly used medical management programs based on the etiology of hydrocephalus are anti-inflammatory or anti-infectious therapies, while surgical management such as ventriculoperitoneal shunts is effective most of the time. Further research should be directed toward improving our understanding of the pathogenesis of these conditions and determining the most effective method for treating this life-threatening condition.
Literatur
1.
Zurück zum Zitat Liang MH, Corzillius M, Bae SC, Lew RA, Fortin PR, Gordon C, Isenberg D, Alarcon GS, Straaton KV, Denburg S et al (1999) The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 42:599–608CrossRef Liang MH, Corzillius M, Bae SC, Lew RA, Fortin PR, Gordon C, Isenberg D, Alarcon GS, Straaton KV, Denburg S et al (1999) The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 42:599–608CrossRef
2.
Zurück zum Zitat Jeltsch-David H, Muller S (2014) Neuropsychiatric systemic lupus erythematosus: pathogenesis and biomarkers. Nat Rev Neurol 10:579–596CrossRefPubMed Jeltsch-David H, Muller S (2014) Neuropsychiatric systemic lupus erythematosus: pathogenesis and biomarkers. Nat Rev Neurol 10:579–596CrossRefPubMed
3.
Zurück zum Zitat Nayak R, Behera JN, Mallick A, Mohapatra S (2014) Communicating hydrocephalus in systemic lupus erythematosus. Indian Pediatr 51:577–578CrossRefPubMed Nayak R, Behera JN, Mallick A, Mohapatra S (2014) Communicating hydrocephalus in systemic lupus erythematosus. Indian Pediatr 51:577–578CrossRefPubMed
4.
Zurück zum Zitat Kitching GB, Thompson JR, Hasso AN, Hirst AE (1977) Angiographic demonstration of lupus cerebral phlebitis with communicating hydrocephalus. J Med Genet 14:445–447CrossRef Kitching GB, Thompson JR, Hasso AN, Hirst AE (1977) Angiographic demonstration of lupus cerebral phlebitis with communicating hydrocephalus. J Med Genet 14:445–447CrossRef
5.
Zurück zum Zitat Mortifee PR, Bebb RA, Stein H (1992) Communicating hydrocephalus in systemic lupus erythematosus with antiphospholipid antibody syndrome. Radiol Med 84:236–241 Mortifee PR, Bebb RA, Stein H (1992) Communicating hydrocephalus in systemic lupus erythematosus with antiphospholipid antibody syndrome. Radiol Med 84:236–241
6.
Zurück zum Zitat Borenstein DG, Jacobs RP (1982) Aqueductal stenosis: a possible late sequela of central nervous system inflammation in systemic lupus. Am J Dis Child 136:556–557 Borenstein DG, Jacobs RP (1982) Aqueductal stenosis: a possible late sequela of central nervous system inflammation in systemic lupus. Am J Dis Child 136:556–557
7.
Zurück zum Zitat de Oliveira FF, Cardoso TA, Sampaio-Barros PD, Damasceno BP (2013) Normal pressure hydrocephalus in the spectrum of neurological complications of systemic lupus erythematosus. Neurol Sci 34:1009–1013CrossRefPubMed de Oliveira FF, Cardoso TA, Sampaio-Barros PD, Damasceno BP (2013) Normal pressure hydrocephalus in the spectrum of neurological complications of systemic lupus erythematosus. Neurol Sci 34:1009–1013CrossRefPubMed
8.
Zurück zum Zitat You HY, Wang SR (1998) Normal pressure hydrocephalus in a patient with systemic lupus erythematosus: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 61:551–555 You HY, Wang SR (1998) Normal pressure hydrocephalus in a patient with systemic lupus erythematosus: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 61:551–555
9.
Zurück zum Zitat Uhl MD, Werner BE, Romano TJ, Zidar BL (1990) Normal pressure hydrocephalus in a patient with systemic lupus erythematosus. J Rheumatol 17:1689–1691PubMed Uhl MD, Werner BE, Romano TJ, Zidar BL (1990) Normal pressure hydrocephalus in a patient with systemic lupus erythematosus. J Rheumatol 17:1689–1691PubMed
10.
Zurück zum Zitat Honda K, Matsumoto M, Kaneko T, Kamei I, Tatsumi H, Murai N, Mineharu Y, Oita J (2004) Linear deposition of immunoglobulins and complement components on the dura in normal pressure hydrocephalus complicating systemic lupus erythematosus. J Clin Neurosci 11:561–563CrossRefPubMed Honda K, Matsumoto M, Kaneko T, Kamei I, Tatsumi H, Murai N, Mineharu Y, Oita J (2004) Linear deposition of immunoglobulins and complement components on the dura in normal pressure hydrocephalus complicating systemic lupus erythematosus. J Clin Neurosci 11:561–563CrossRefPubMed
11.
Zurück zum Zitat Tsushima K, Kubo K (1999) Tuberculous meningitis developed during treatment for systemic lupus erythematosus (SLE). Clin Lab Haematol 21:413–416CrossRef Tsushima K, Kubo K (1999) Tuberculous meningitis developed during treatment for systemic lupus erythematosus (SLE). Clin Lab Haematol 21:413–416CrossRef
12.
Zurück zum Zitat McCaffrey LM, Petelin A, Cunha BA (2012) Systemic lupus erythematosus (SLE) cerebritis versus Listeria monocytogenes meningoencephalitis in a patient with systemic lupus erythematosus on chronic corticosteroid therapy: the diagnostic importance of cerebrospinal fluid (CSF) of lactic acid levels. Heart Lung 41:394–397CrossRefPubMed McCaffrey LM, Petelin A, Cunha BA (2012) Systemic lupus erythematosus (SLE) cerebritis versus Listeria monocytogenes meningoencephalitis in a patient with systemic lupus erythematosus on chronic corticosteroid therapy: the diagnostic importance of cerebrospinal fluid (CSF) of lactic acid levels. Heart Lung 41:394–397CrossRefPubMed
13.
Zurück zum Zitat Mc-Nab P, Fuentealba C, Ballesteros F, Pacheco D, Alvarez M, Dabanch J, Cona E (2000) Nocardia asteroides infection in a patient with systemic lupus erythematosus. Rev Med Chil 128:526–528CrossRefPubMed Mc-Nab P, Fuentealba C, Ballesteros F, Pacheco D, Alvarez M, Dabanch J, Cona E (2000) Nocardia asteroides infection in a patient with systemic lupus erythematosus. Rev Med Chil 128:526–528CrossRefPubMed
14.
Zurück zum Zitat Ito H, Kobayashi S, Iino M, Kamei T, Takanashi Y (2008) Listeria monocytogenes meningoencephalitis presenting with hydrocephalus and ventiriculitis. Intern Med 47:323–324CrossRefPubMed Ito H, Kobayashi S, Iino M, Kamei T, Takanashi Y (2008) Listeria monocytogenes meningoencephalitis presenting with hydrocephalus and ventiriculitis. Intern Med 47:323–324CrossRefPubMed
15.
Zurück zum Zitat Schwerk C, Tenenbaum T, Kim KS, Schroten H (2015) The choroid plexus—a multi-role player during infectious diseases of the CNS. Front Cell Neurosci 9:80CrossRefPubMedPubMedCentral Schwerk C, Tenenbaum T, Kim KS, Schroten H (2015) The choroid plexus—a multi-role player during infectious diseases of the CNS. Front Cell Neurosci 9:80CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Benarroch EE (2016) Choroid plexus—CSF system Recent developments and clinical correlations. Neurology 86:286–296CrossRefPubMed Benarroch EE (2016) Choroid plexus—CSF system Recent developments and clinical correlations. Neurology 86:286–296CrossRefPubMed
17.
Zurück zum Zitat Turesson C, O’Fallon WM, Crowson CS, Gabriel SE, Matteson EL (2002) Occurrence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol 29:62–67PubMed Turesson C, O’Fallon WM, Crowson CS, Gabriel SE, Matteson EL (2002) Occurrence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol 29:62–67PubMed
18.
Zurück zum Zitat Joaquim AF, Appenzeller S (2015) Neuropsychiatric manifestations in rheumatoid arthritis. Autoimmun Rev 14:1116–1122CrossRefPubMed Joaquim AF, Appenzeller S (2015) Neuropsychiatric manifestations in rheumatoid arthritis. Autoimmun Rev 14:1116–1122CrossRefPubMed
19.
Zurück zum Zitat Ramos-Remus C, Duran-Barragan S, Castillo-Ortiz JD (2012) Beyond the joints neurological involvement in rheumatoid arthritis. Clin Rheumatol 31:1–12CrossRefPubMed Ramos-Remus C, Duran-Barragan S, Castillo-Ortiz JD (2012) Beyond the joints neurological involvement in rheumatoid arthritis. Clin Rheumatol 31:1–12CrossRefPubMed
20.
Zurück zum Zitat Markusse HM, Hilkens PH, van den Bent MJ, Vecht CJ (1995) Normal pressure hydrocephalus associated with rheumatoid arthritis responding to prednisone. Am J Kidney Dis 25:489–491CrossRef Markusse HM, Hilkens PH, van den Bent MJ, Vecht CJ (1995) Normal pressure hydrocephalus associated with rheumatoid arthritis responding to prednisone. Am J Kidney Dis 25:489–491CrossRef
21.
Zurück zum Zitat Catananti C, Mastropaolo S, Calabrese C, Silveri MC, Onder G (2010) A case of normal-pressure hydrocephalus associated with rheumatoid arthritis. Aging Clin Exp Res 22:189–191CrossRefPubMed Catananti C, Mastropaolo S, Calabrese C, Silveri MC, Onder G (2010) A case of normal-pressure hydrocephalus associated with rheumatoid arthritis. Aging Clin Exp Res 22:189–191CrossRefPubMed
22.
Zurück zum Zitat Williams ME, Richman J, Scatliff J (1996) A 67-year-old woman with a progressive gait disturbance. J Am Geriatr Soc 44:843–846CrossRefPubMed Williams ME, Richman J, Scatliff J (1996) A 67-year-old woman with a progressive gait disturbance. J Am Geriatr Soc 44:843–846CrossRefPubMed
23.
Zurück zum Zitat Toolanen G, Knibestol M, Larsson SE (1985) Dilatation of cerebral ventricles in patients with rheumatoid vertical atlanto-axial subluxation. Scand J Rheumatol 14:298–302CrossRefPubMed Toolanen G, Knibestol M, Larsson SE (1985) Dilatation of cerebral ventricles in patients with rheumatoid vertical atlanto-axial subluxation. Scand J Rheumatol 14:298–302CrossRefPubMed
24.
Zurück zum Zitat Collee G, Breedveld FC, Algra PR, Padberg GW (1987) Rheumatoid arthritis with vertical atlanto-axial subluxation complicated by hydrocephalus. Br J Rheumatol 26:56–58CrossRefPubMed Collee G, Breedveld FC, Algra PR, Padberg GW (1987) Rheumatoid arthritis with vertical atlanto-axial subluxation complicated by hydrocephalus. Br J Rheumatol 26:56–58CrossRefPubMed
25.
Zurück zum Zitat Rillo OL, Rabadan A, Houssay R, Schillaci R, Pardal E (1989) Atlantoaxial subluxation and hydrocephalus [corrected] in rheumatoid arthritis. J Rheumatol 16:121–125PubMed Rillo OL, Rabadan A, Houssay R, Schillaci R, Pardal E (1989) Atlantoaxial subluxation and hydrocephalus [corrected] in rheumatoid arthritis. J Rheumatol 16:121–125PubMed
26.
Zurück zum Zitat Naredo SE, Carceller BF, Campos FC, Perez AM, de Perez AC, Martin ME (1996) Hydrocephalus and secondary syndrome of inappropriate antidiuretic hormone due to rheumatoid vertical atlantoaxial subluxation. J Rheumatol 23:1098–1102 Naredo SE, Carceller BF, Campos FC, Perez AM, de Perez AC, Martin ME (1996) Hydrocephalus and secondary syndrome of inappropriate antidiuretic hormone due to rheumatoid vertical atlantoaxial subluxation. J Rheumatol 23:1098–1102
27.
Zurück zum Zitat Hoitsma E, Faber CG, Drent M, Drent M, Sharma OP (2004) Neurosarcoidosis: a clinical dilemma. Lancet Neurol 3:397–407CrossRefPubMed Hoitsma E, Faber CG, Drent M, Drent M, Sharma OP (2004) Neurosarcoidosis: a clinical dilemma. Lancet Neurol 3:397–407CrossRefPubMed
28.
Zurück zum Zitat Ibitoye RT, Wilkins A, Scolding NJ (2016) Neurosarcoidosis: a clinical approach to diagnosis and management. J Neurol 22:22 Ibitoye RT, Wilkins A, Scolding NJ (2016) Neurosarcoidosis: a clinical approach to diagnosis and management. J Neurol 22:22
29.
Zurück zum Zitat Hebel R, Dubaniewicz-Wybieralska M, Dubaniewicz A (2015) Overview of neurosarcoidosis: recent advances. J Neurol 262:258–267CrossRefPubMed Hebel R, Dubaniewicz-Wybieralska M, Dubaniewicz A (2015) Overview of neurosarcoidosis: recent advances. J Neurol 262:258–267CrossRefPubMed
30.
Zurück zum Zitat Gascon-Bayarri J, Mana J, Martinez-Yelamos S, Murillo O, Rene R, Rubio F (2011) Neurosarcoidosis: report of 30 cases and a literature survey. Eur J Intern Med 22:e125–e132CrossRefPubMed Gascon-Bayarri J, Mana J, Martinez-Yelamos S, Murillo O, Rene R, Rubio F (2011) Neurosarcoidosis: report of 30 cases and a literature survey. Eur J Intern Med 22:e125–e132CrossRefPubMed
31.
Zurück zum Zitat Joseph FG, Scolding NJ (2009) Neurosarcoidosis: a study of 30 new cases. J Neurol Neurosurg Psychiatry 80:297–304CrossRefPubMed Joseph FG, Scolding NJ (2009) Neurosarcoidosis: a study of 30 new cases. J Neurol Neurosurg Psychiatry 80:297–304CrossRefPubMed
32.
Zurück zum Zitat Fritz D, van de Beek D, Brouwer MC (2016) Clinical features, treatment and outcome in neurosarcoidosis: systematic review and meta-analysis. BMC Neurol 16:220CrossRefPubMedPubMedCentral Fritz D, van de Beek D, Brouwer MC (2016) Clinical features, treatment and outcome in neurosarcoidosis: systematic review and meta-analysis. BMC Neurol 16:220CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Benzagmout M, Boujraf S, Gongora-Rivera F, Bresson D, Van-Effenterre R (2007) Neurosarcoidosis which manifested as acute hydrocephalus: diagnosis and treatment. Intern Med 46:1601–1604CrossRefPubMed Benzagmout M, Boujraf S, Gongora-Rivera F, Bresson D, Van-Effenterre R (2007) Neurosarcoidosis which manifested as acute hydrocephalus: diagnosis and treatment. Intern Med 46:1601–1604CrossRefPubMed
34.
Zurück zum Zitat Joaquim AF, Appenzeller S (2006) Neurological involvement in patients with rheumatic disease. QJM 99:69–79CrossRef Joaquim AF, Appenzeller S (2006) Neurological involvement in patients with rheumatic disease. QJM 99:69–79CrossRef
35.
Zurück zum Zitat Lundh T, Wikkelsö C (1987) Sarcoidosis with hydrocephalus: report of a case successfully treated with a ventriculo-peritoneal shunt and methylprednisolone pulse therapy. Acta Neurol Scand 76:365–368CrossRefPubMed Lundh T, Wikkelsö C (1987) Sarcoidosis with hydrocephalus: report of a case successfully treated with a ventriculo-peritoneal shunt and methylprednisolone pulse therapy. Acta Neurol Scand 76:365–368CrossRefPubMed
36.
Zurück zum Zitat Westhout FD, Linskey ME (2008) Obstructive hydrocephalus and progressive psychosis: rare presentations of neurosarcoidosis. Surg Neurol 69:288–292CrossRefPubMed Westhout FD, Linskey ME (2008) Obstructive hydrocephalus and progressive psychosis: rare presentations of neurosarcoidosis. Surg Neurol 69:288–292CrossRefPubMed
38.
Zurück zum Zitat Tabuchi S, Uno T (2013) Hydrocephalus with panventricular enlargement as the primary manifestation of neurosarcoidosis: a case report. J Med Case Rep 7:240CrossRefPubMedPubMedCentral Tabuchi S, Uno T (2013) Hydrocephalus with panventricular enlargement as the primary manifestation of neurosarcoidosis: a case report. J Med Case Rep 7:240CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Labarca G, Ramirez R, Monsalve X, Mira-Avendano I (2016) Dementia, gait disturbance, and urinary incontinence in a patient with pulmonary sarcoidosis. Respirol Case Rep 4:e00182PubMedPubMedCentral Labarca G, Ramirez R, Monsalve X, Mira-Avendano I (2016) Dementia, gait disturbance, and urinary incontinence in a patient with pulmonary sarcoidosis. Respirol Case Rep 4:e00182PubMedPubMedCentral
40.
41.
Zurück zum Zitat Kasama T, Maeoka A, Oguro N (2016) Clinical features of neuropsychiatric syndromes in systemic lupus erythematosus and other connective tissue diseases. Clin Med Insights Arthritis Musculoskelet Disord 9:1–8CrossRefPubMedPubMedCentral Kasama T, Maeoka A, Oguro N (2016) Clinical features of neuropsychiatric syndromes in systemic lupus erythematosus and other connective tissue diseases. Clin Med Insights Arthritis Musculoskelet Disord 9:1–8CrossRefPubMedPubMedCentral
42.
Zurück zum Zitat Koga H, Ooch IN, Osato S, Ishida I, Hirakata H, Okuda S, Fujishima M (1994) Case report: Wegener’s granulomatosis accompanied by communicating hydrocephalus. Am J Med Sci 307:278–281CrossRefPubMed Koga H, Ooch IN, Osato S, Ishida I, Hirakata H, Okuda S, Fujishima M (1994) Case report: Wegener’s granulomatosis accompanied by communicating hydrocephalus. Am J Med Sci 307:278–281CrossRefPubMed
43.
Zurück zum Zitat Bertken RD, Cooper VR (1997) Wegener granulomatosis causing sellar mass, hydrocephalus, and global pituitary failure. West J Med 167:44–47PubMedPubMedCentral Bertken RD, Cooper VR (1997) Wegener granulomatosis causing sellar mass, hydrocephalus, and global pituitary failure. West J Med 167:44–47PubMedPubMedCentral
44.
Zurück zum Zitat Scarrow AM, Segal R, Medsger TAJ, Wasko MC (1998) Communicating hydrocephalus secondary to diffuse meningeal spread of Wegener’s granulomatosis: case report and literature review. Neurosurgery 43:1470–1473PubMed Scarrow AM, Segal R, Medsger TAJ, Wasko MC (1998) Communicating hydrocephalus secondary to diffuse meningeal spread of Wegener’s granulomatosis: case report and literature review. Neurosurgery 43:1470–1473PubMed
45.
Zurück zum Zitat Rangel-Castilla L, Barber SM, Zhang YJ (2011) Hydrocephalus in Wegener’s granulomatosis: neuroendoscopic findings and management. J Rheumatol 38:2277–2278CrossRefPubMed Rangel-Castilla L, Barber SM, Zhang YJ (2011) Hydrocephalus in Wegener’s granulomatosis: neuroendoscopic findings and management. J Rheumatol 38:2277–2278CrossRefPubMed
46.
Zurück zum Zitat Tokumaru AM, Obata T, Kohyama S, Kaji T, Okizuka H, Suzuki K, Kusano S (2002) Intracranial meningeal involvement in Churg-Strauss syndrome. AJNR Am J Neuroradiol 23:221–224PubMed Tokumaru AM, Obata T, Kohyama S, Kaji T, Okizuka H, Suzuki K, Kusano S (2002) Intracranial meningeal involvement in Churg-Strauss syndrome. AJNR Am J Neuroradiol 23:221–224PubMed
47.
48.
Zurück zum Zitat Challagundla SR, Joseph G, Brown J, McLean AN, Fraser MH (2008) Hydrocephalus complicating a cervical spine fracture in a patient with ankylosing spondylitis. Br J Neurosurg 22:700–701CrossRefPubMed Challagundla SR, Joseph G, Brown J, McLean AN, Fraser MH (2008) Hydrocephalus complicating a cervical spine fracture in a patient with ankylosing spondylitis. Br J Neurosurg 22:700–701CrossRefPubMed
49.
Zurück zum Zitat Wani AM, Hussain WM, Fatani MI, Qadmani A, Maimani GA, Turkistani A, Dairi KS, Abumatar A, Bafaraj MG (2009) Lower cranial nerve palsy, aseptic meningitis and hydrocephalus: unusual presentation of primary antiphospholipid syndrome. BMJ Case Rep 2009 Wani AM, Hussain WM, Fatani MI, Qadmani A, Maimani GA, Turkistani A, Dairi KS, Abumatar A, Bafaraj MG (2009) Lower cranial nerve palsy, aseptic meningitis and hydrocephalus: unusual presentation of primary antiphospholipid syndrome. BMJ Case Rep 2009
Metadaten
Titel
Systemic autoimmune diseases complicated with hydrocephalus: pathogenesis and management
verfasst von
Junji Wei
Hexiang Yin
Li Wang
Liying Cui
Renzhi Wang
Publikationsdatum
12.11.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Neurosurgical Review / Ausgabe 2/2019
Print ISSN: 0344-5607
Elektronische ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-017-0917-x

Weitere Artikel der Ausgabe 2/2019

Neurosurgical Review 2/2019 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.