Hirndruck und Hirn?dem

详细信息    查看全文

• 作者：W. Dietrich (1)
  Prof. Dr. F. Erbguth (1)
  
• 关键词：Intrazerebrale Blutung ; Intrakranieller Druck ; Zerebraler Perfusionsdruck ; Neuromonitoring ; Koma ; Intracranial hemorrhage ; Intracranial pressure ; Cerebral perfusion pressure ; Neuromonitoring ; Coma
• 刊名：Medizinische Klinik
• 出版年：2013
• 出版时间：March 2013
• 年：2013
• 卷：108
• 期：2
• 页码：157-171
• 全文大小：862 KB
• 参考文献：1. Andrews PJD, Sinclair HL, Battison CG et al (2011) European society of intensive care medicine study of therapeutic hypothermia (32-5°C) for intracranial pressure reduction after traumatic brain injury (the Eurotherm3235Trial). Trials 12:8 CrossRef
  2. Bratton SL, Chestnut RM, Ghajar J et al (2007) Guidelines for the management of severe traumatic brain injury: intracranial pressure thresholds, 3rd edn. J Neurotrauma 24(Suppl 1):S55–S58
  3. Brouwer MC, McIntyre P, Gans J de et al (2010) Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev 9:CD004405
  4. Chesnut RM, Temkin N, Carney N et al (2012) A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367:2471-481 CrossRef
  5. Clifton GL, Miller ER, Choi SC et al (2001) Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 344:556-63 CrossRef
  6. Coles JP, Fryer TD, Coleman MR et al (2007) Hyperventilation following head injury: effect on ischemic burden and cerebral oxidative metabolism. Crit Care Med 35:568-78 CrossRef
  7. Cooper DJ, Rosenfeld JV, Murray L et al (2011) Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 364:1493-502 CrossRef
  8. Hays AN, Lazaridis C, Neyens R et al (2011) Osmotherapy: use among neurointensivists. Neurocrit Care 14:222-28 CrossRef
  9. Huang SJ, Hong WC, Han YY et al (2007) Clinical outcome of severe head injury in different protocol-driven therapies. J Clin Neurosci 14:449-48 CrossRef
  10. Jantzen JPAH (2007) Prevention and treatment of intracranial hypertension. Best Pract Res Clin Anaesthesiol 21:517-38 CrossRef
  11. Kollmar R et al (2012) EuroHYP-1 trial: EU-funded therapy study on he effectiveness of mild therapeutic hypothermia for acute ischemic stroke. Nervenarzt 83:1252-259 CrossRef
  12. Mendelow AD, Gregson BA, Fernandes HM et al (2005) Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral hematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomized trial. Lancet 365:387-97
  13. Peterson K, Carson S, Carney N (2008) Hypothermia treatment for traumatic brain injury: a systematic review and metaanalysis. J Neurotrauma 25:62-1 CrossRef
  14. Poungvarin N, Bhoopat W, Viriyavejakul A et al (1987) Effects of dexamethasone in primary supratentorial intracerebral hemorrhage. N Engl J Med 316:1229-233 CrossRef
  15. Roberts I, Schierhout G (2004) Hyperventilation therapy for acute traumatic brain injury. Cochrane Database Syst Rev 3:10-6
  16. Rosenthal C, Wolf S, Weber-Carstens S, Salih F (2012) Der erh?hte intrakranielle Druck -Therapiema?nahmen. An?sthesiol Intensivmed Notfallmed Schmerzther 47:30-8 CrossRef
  17. Sahuquillo J, Arikan F (2006) Decompressive craniotomy fort he treatment of refractory high intracranial pressure in traumatic brain injury. Cochrane Database Syst Rev CD003983
  18. Salih F, Rosenthal C, Wolf S (2012) Der erh?hte intrakranielle Druck -Therapiestrategien und Outcome-Relevanz bei unterschiedlichen neurologischen und neurochirurgischen Krankheitsbildern. An?sthesiol Intensivmed Notfallmed Schmerzther 47:50-5 CrossRef
  19. Schirmer CM, Holt DA, Malek AM (2007) Decompressive hemicraniectomy for the treatment of intractable intracranial hypertension after aneurysmal subarachnoid hemorrhage. Stroke 38:987-92 CrossRef
  20. Vahedi K, Hofmeijer J, Juettler E et al (2007) Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 6:215-22 CrossRef
  21. Schwab S, Schellinger P, Werner C (Hrsg) (2012) NeuroIntensiv, 2. überarb akt Aufl. Springer, Berlin Heidelberg New York Tokio
  
• 作者单位：W. Dietrich (1)
  Prof. Dr. F. Erbguth (1)
  
  1. Klinik für Neurologie, Klinikum Nürnberg, Breslauer Str. 201, 90471, Nürnberg, Deutschland
  
• ISSN：1615-6722

文摘

In primary and secondary brain diseases, increasing volumes of the three compartments of brain tissue, cerebrospinal fluid, or blood lead to a critical increase in intracranial pressure (ICP). A rising ICP is associated with typical clinical symptoms; however, during analgosedation it can only be detected by invasive ICP monitoring. Other neuromonitoring procedures are not as effective as ICP monitoring; they reflect the ICP changes and their complications by other metabolic and oxygenation parameters. The most relevant parameter for brain perfusion is cerebral perfusion pressure (CPP), which is calculated as the difference between the middle arterial pressure (MAP) and the ICP. A mixed body of evidence exists for the different ICP-reducing treatment measures, such as hyperventilation, hyperosmolar substances, hypothermia, glucocorticosteroids, CSF drainage, and decompressive surgery.