Der erhöhte intrakranielle Druck – Therapiestrategien und Outcomerelevanz bei unterschiedlichen neurologischen und neurochirurgischen Krankheitsbildern

Zusammenfassung

Die Therapie eines erhöhten intrakraniellen Druckes (intracranial pressure, ICP) bei unterschiedlichen Gehirnerkrankungen erfolgte lange analog den Leitlinien zum Schädel-Hirn-Trauma. Erste randomisierte Studien zeigen nun, dass in Zukunft je nach Erkrankung ein differenzierter Einsatz insbesondere von hyperosmolaren Substanzen, Hyperventilation, Hypothermie, Steroiden und der Dekompressionskraniektomie notwendig ist. Prinzipiell sollte die ICP-Therapie um die Aufrechterhaltung einer ausreichenden zerebralen Perfusion und Oxygenierung ergänzt werden.

Abstract

Elevated intracranial pressure (ICP) in various brain diseases has for long time been treated according to guidelines for traumatic brain injury. First data of randomized study reveal, that specific treatment options like decompressive craniectomy, hyperosmotic agents, hyperventilation, hypothermia and steroids should have specific indications to control elevated ICP in future. In general, optimal ICP-treatment should also target sufficient cerebral perfusion and oxygenation.

Schlüsselwörter:

intrakranieller Druck - Schlaganfall - intrakranielle Blutung - Hirntumor - Meningoenzephalitis

Keywords:

intracranial pressure - stroke - intracranial hemorrhage - brain tumor - meningoencephalitis

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