Zusammenfassung
Der Schlaganfall stellt nach kardiovaskulären Erkrankungen und Tumorerkrankungen die dritthäufigste Todesursache innerhalb der westlichen Industrieländer dar. In Europa versterben zwischen 63,5/100000 Männer (Schweiz 1992) bis 273,4/100000 Frauen (Russland 1991) pro Jahr als Folge eines Schlaganfalls (Bogousslavsky et al. 2000). Die Schlaganfallinzidenz in Deutschland wird mit 127000-200000 pro Jahr angegeben (Berlit et al. 1997, Bogousslavsky et al. 2000). Etwa 80% aller Schlaganfälle sind auf einen ischämischen Schlaganfall, also eine zerebrale Ischämie, zurückzuführen. Die verbleibenden 20% setzen sich aus intrazerebralen Blutungen (hämorrhagische Schlaganfälle) und Subarachnoidalblutungen zusammen. Die Mortalität der zerebralen Ischämie wird mit etwa 15-20% innerhalb der ersten 4 Wochen nach dem Ereignis angegeben. Im ersten Jahr nach einem ischämischen Hirninfarkt verstirbt etwa ein Drittel aller betroffenen Patienten. Die herausragende sozioökonomische Bedeutung des Schlaganfalls und damit der zerebralen Ischämie ergibt sich aus der Tatsache, dass ein Drittel aller Patienten aufgrund einer persistierenden Behinderung lebenslang hilfebedürftig bleibt und nicht wieder in den Arbeitsprozess integriert werden kann. Damit sind zerebrovaskuläre Erkrankungen die häufigste Ursache einer lebenslangen Behinderung mit z. Z. etwa 800 000–1 000 000 betroffenen Bundesbürgern. Diese Zahlen verdeutlichen eindrucksvoll, dass es sich beim Schlaganfall nicht nur um ein individuelles Schicksal und medizinisches Problem, sondern auch um eine der weltweit kostenintensivsten Erkrankungen handelt. In einigen europäischen Ländern ist der Schlaganfall die Erkrankung mit den höchsten stationären Behandlungskosten (Bogousslavsky et al. 2000). In den USA werden die direkten und indirekten Kosten als Folge von Schlaganfällen für das Jahr 1998 auf etwa 43,3 Mrd. US Dollar geschätzt (White et al. 2000).
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Weise, J., Bähr, M. (2004). Molekulare Veränderungen beim ischämischen Schlaganfall. In: Ganten, D., Ruckpaul, K., Ruiz-Torres, A. (eds) Molekularmedizinische Grundlagen von altersspezifischen Erkrankungen. Molekulare Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18741-4_9
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