Akuttherapie des ischämischen Schlaganfalls

Autor: Corinna Schranz, E. Bonmann
Rok vydání: 2002
Předmět:
Zdroj: Intensivmedizin und Notfallmedizin. 39:161-170
ISSN: 1435-1420
0175-3851
DOI: 10.1007/s003900200021
Popis: Measures for the handling of strokepatients can be commenced only if the diagnosis is confirmed by imaging procedures and initial information about the etiology is present. Up to this time and also in the subsequent period, stabilization of vital-parameters represents the basis for all therapeutic procedures. At present, thrombolysis is the only approved specific therapy for ischemic stroke. The use of rtPA is approved within the USA (1996), Canada (1998), and since 2000 also in Germany for intravenous therapy within 3 hours after symptom onset with numerous restrictions. In some centers thrombolytic therapy is per-formed as a non-standard therapy for individual patiens also. in an extended 3-6 hours Mt: f,fIn such cas 774tillirf anglta for the patients should be insured, e.g. using Stroke MRI with diffusion and perfusion-weighted sequences and MRA. Nevertheless it has to be considered that thrombolytic therapy is and will remain an option for a minority of all strokepatients. Education about symptoms and the emergency character of the disease are important to increase this proportion.The early secondary prevention after ischemic stroke is still a controversial topic. Some trials revealed that the comedication of lowdose Heparin s.c. and ASS is particularly effective for the avoidance of recurrent stroke, combined with a low bleeding risk. Nevertheless some indications for treatment with i.v. Heparin remain.
Databáze: OpenAIRE
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