Die Intensivtherapie des schweren Schädel-Hirn-Traumas

Zusammenfassung

Das Schädel-Hirn-Trauma (SHT) stellt eine der häufigsten Ursachen für Tod und permanente Behinderung in Industrienationen dar. Dem aktuell zu beobachtenden Rückgang von schweren SHT im Straßenverkehr steht eine Zunahme der schweren Verletzungen hauptsächlich durch Sturz und Fall, insbesondere bei älteren Patienten, entgegen. Dies führt durch Veränderung der Epidemiologie zu einer Abnahme diffuser Hochgeschwindigkeitsverletzungen bei gleichzeitiger Zunahme der Anzahl fokaler Verletzungen, z. B. von Kontusionen. Etwa 15 % der Patienten mit SHT benötigen eine spezialisierte intensivmedizinische Behandlung [1].

Im Folgenden werden die pathophysiologischen Grundlagen der unterschiedlichen Verletzungsmuster geschildert und die aktuellen Möglichkeiten in Diagnostik, spezifischer Therapie und Prognoseabschätzung nach schwerem SHT dargestellt.

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