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Intensivmedizin up2date 2015; 11(02): 177-184
DOI: 10.1055/s-0041-101114
Neuro-Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Welche intrazerebralen Blutungen sollte man operativ behandeln?

Berk Orakcioglu
,
Andreas Unterberg
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Publication Date:
21 April 2015 (online)

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Kernaussagen

  • Bei ICB-Patienten mit einem GCS von 9 – 13 kann eine operative Therapie eine sinnvolle Therapieoption sein.

  • Die Auswahl des geeigneten Therapieverfahrens (Kraniotomie, Endoskopie, Kathetereinlage, externe Ventrikeldrainage) sollte von Fall zu Fall diskutiert werden. Zu fordern ist aber die Verwendung der Neuronavigation zur Senkung der zugangsassoziierten Morbidität.

  • Vor einer operativen Therapie sollte man spezifische Gerinnungstests durchführen, medikamenteninduzierte Gerinnungsstörungen ausgleichen und einen entgleisten Blutdruck normalisieren.

 

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