Intraventrikuläre Blutungen

Kernaussagen

• Die ernste Prognose eines Patienten mit ventrikulärer Blutung hat sich in den letzten Jahren durch neue Therapieverfahren deutlich verbessert.

• Derzeit sind diese Therapieverfahren noch experimentell und sollten bevorzugt im Rahmen laufender klinischer Studien und in Zentren mit ausgewiesener Expertise durchgeführt werden.

• Die intraventrikuläre Fibrinolyse über eine externe Ventrikeldrainage kann bei schweren Ventrikelblutungen möglicherweise die Mortalität senken und das funktionelle Outcome verbessern.

• Alternativ oder in Kombination hierzu ist eine lumbale Drainage möglich.

• Insbesondere in Kombination mit einer intraventrikulären Lyse kann die lumbale Drainage möglicherweise permanente shuntpflichtige Liquorzirkulationsstörungen reduzieren.

• Nach einer Subarachnoidalblutung kann die lumbale Drainage die Inzidenz von Vasospasmen senken.

• Literatur

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