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Fortschr Neurol Psychiatr 2022; 90(12): 571-579
DOI: 10.1055/a-1802-3852
Übersichtsarbeit

Akute Aortendissektion: Ein lebensbedrohlicher Notfall auch in der neurologischen Notfallmedizin

Acute Aortic Dissection: A Life-Threatening Disease Also in Neurological Emergency Medicine
Marie Madlener
1   Klinik und Poliklinik für Neurologie, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Germany
,
Oezguer A. Onur
1   Klinik und Poliklinik für Neurologie, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Germany
,
Jochen Müller-Ehmsen
2   Kardiologisch-Angiologische Praxis, Herzzentrum Bremen, Bremen, Germany
,
Gereon R. Fink
1   Klinik und Poliklinik für Neurologie, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Germany
3   Institut für Neurowissenschaften und Medizin (INM-3), Forschungszentrum Jülich, Jülich, Germany
,
Lothar Burghaus
1   Klinik und Poliklinik für Neurologie, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Köln, Germany
4   Klinik für Neurologie, Heilig Geist-Krankenhaus Köln, Köln, Germany
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Zusammenfassung

Eine akute Aortendissektion ist selten, aber lebensbedrohlich. Die Symptome hängen von der Lokalisation und Minderperfusion der nachgeschalteten Organe oder Extremitäten ab und sind dementsprechend variabel. Es können neurologische Symptome auftreten, die nicht unmittelbar zur Diagnosestellung führen und so die notwendige Therapie verzögern. Die Kenntnis der Frühsymptome und Warnsignale einer Aortendissektion sind deswegen auch in der neurologischen Notfallversorgung wichtig, um die Betroffenen schnell zu identifizieren und der Akuttherapie zuzuführen. Eine Fehldiagnose mit verzögerter Therapieeinleitung kann die Prognose der Patienten deutlich verschlechtern. Ziel dieser Arbeit ist es, einen standardisierten Diagnostik- und Therapiealgorithmus bei Verdacht auf eine akute Aortendissektion in der neurologischen Notfallversorgung zu etablieren. Eine enge interdisziplinärer Zusammenarbeit ist dabei essentiell.

Abstract

Acute aortic dissection is rare but life-threatening. The symptoms depend on the localization and reduced perfusion of the downstream organs or limbs and are therefore variable. Neurological symptoms may occur that do not immediately lead to a diagnosis and thus delay the necessary therapy. Knowing the early symptoms and warning signs of aortic dissection is therefore also crucial in neurological emergency care for quickly identifying the affected patients and for providing acute therapy. A misdiagnosis with delayed initiation of therapy can significantly worsen the patient's outcome. This study aims to establish a standardized diagnostic and therapeutic algorithm for suspected acute aortic dissection in neurological emergency care. Close interdisciplinary cooperation is mandatory.

Schlüsselwörter

akute Aortendissektion - Aortensyndrom - Malperfusionssyndrom - neurologische Symptome - Differentialdiagnose

Key words

acute aortic dissection - aortic syndrome - malperfusion syndrome - neurological symptoms - differential diagnosis


Publication History

Received: 13 October 2021

Accepted after revision: 03 March 2022

Article published online:
04 May 2022

© 2022. Thieme. All rights reserved.

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