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Perinataler Schlaganfall und Sinusvenenthrombose: Klinik, Diagnostik und therapeutische Ansätze

Perinatal stroke and sinus thrombosis: clinical, diagnostic and therapeutic approaches

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Zusammenfassung

Der perinatale Schlaganfall, der den arteriellen ischämischen Schlaganfall und die Sinusvenenthrombose beinhaltet, kann beim Neugeborenen zu erheblichen neurologischen Problem führen. Motorische und kognitive Langzeitdefizite machen ein frühzeitiges Erkennen, Bestätigen der Diagnose und ggf. auch den Beginn therapeutischer Interventionen und rehabilitativer Maßnahmen notwendig. Bei der Mehrzahl der Kinder sind fokale zerebrale Krampfanfälle das erste klinische Zeichen und die MRT ist die Methode der Wahl zur frühen und sicheren Diagnostik. Obwohl sich das Verständnis für die Ätiologie und mögliche Risikofaktoren deutlich verbessert hat, sind die Fortschritte bezüglich therapeutischer Möglichkeiten limitiert. Die Suche nach neuroprotektiven Strategien sollte daher, neben Untersuchungen zum Langzeitverlauf, im Mittelpunkt zukünftiger Forschungen stehen.

Abstract

Perinatal stroke, represented by arterial ischemic stroke and cerebral sinus venous thrombosis, continues to be a serious problem for the neonate. Long-term neurological morbidity, including motor and cognitive disabilities, can follow perinatal stroke, necessitating early recognition, diagnosis, initiation of therapy and rehabilitation. Seizures are the most common clinical sign and MRI is the optimal tool for early and correct diagnosis. Although our understanding of the aetiology and possible risk factors has considerably improved, only little progress has been made towards therapeutic options. Considering the incidence of neurological sequelae, the need for standardized neurological follow-up and development of neuroprotective strategies is high and should be the focus of future research.

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Authors and Affiliations

  1. Klinik für Kinderheilkunde I, Neonatologie, Pädiatrische Intensivmedizin, Neuropädiatrie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland

    M. Dzietko, U. Schara & U. Felderhoff-Müser

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  1. M. Dzietko
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  2. U. Schara
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  3. U. Felderhoff-Müser
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Correspondence to M. Dzietko.

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M. Dzietko, U. Schara und U. Felderhoff-Müser geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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B. Koletzko, München

T. Lücke, Bochum

E. Mayatepek, Düsseldorf

N. Wagner, Aachen

S. Wirth, Wuppertal

F. Zepp, Mainz

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Dzietko, M., Schara, U. & Felderhoff-Müser, U. Perinataler Schlaganfall und Sinusvenenthrombose: Klinik, Diagnostik und therapeutische Ansätze. Monatsschr Kinderheilkd 165, 596–604 (2017). https://doi.org/10.1007/s00112-016-0132-9

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  • DOI: https://doi.org/10.1007/s00112-016-0132-9

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