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Neurochirurgie/Psychiatrie

  • Chapter
Anästhesiologie

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Zusammenfassung

Beim Menschen wird der zerebrale Blutfluß (CBF) nahezu vollständig über die Aa. carotides internae und Aa. vertebrales gewährleistet. Über den Circulus Willisii fließt das Blut in die paarig angelegten Aa. cerebri anteriores, mediae und posteriores und die penetrierenden Gefäße. Trotz einer teilweisen Überlappung im Versorgungsgebiet der kortikalen Endarterien durch die leptomeningealen Gefäße aus den Aa. carotides externae sind die Endstromgebiete gegenüber einer CBF-Reduktion besonders gefährdet. Die venöse Drainage aus dem Gehirn erfolgt über dünnwandige, klappenlose Venen. Diese konvergieren in die dickwandigen, nichtelastischen Durasinus. Zur Aufrechterhaltung des CBF muß der Druck in den venösen Gefäßen geringgradig über dem Druck im Liquor cerebrospinalis (CSF) liegen. Innerhalb der venösen Zirkulation wird das Blut aus verschiedenen Gefaßprovinzen durchmischt. Das Blut im Bulbus venae jugularis stammt zu ca. 60% aus der ipsilateralen und zu 30% aus der kontralateralen Hemisphäre. Etwa 5% stammen aus extrazerebralen Gefäßen.

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Authors
  1. E. Kochs
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  2. H. Thiel
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Editors and Affiliations

  1. Institut für experimentelle Anästhesiologie, Ludwig-Maximilians-Universität, Bereich Poliklinik, Pettenkoferstr. 8 a, D-80336, München, Deutschland

    Alfred Doenicke

  2. Zentrum Anästhesiologie, Rettungs- und Intensivmedizin, Universität Göttingen, Robert-Koch-Str. 40, D-37070, Göttingen, Deutschland

    Dietrich Kettler

  3. Universitätsklinik für Anästhesiologie, LKH Graz, Auenbruggerplatz, A-8036, Graz, Österreich

    Werner F. List

  4. Klinik für Anästhesiologie und Operative Intensivmedizin, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Straße 40, D-06097, Halle (Saale), Deutschland

    Joachim Radke

  5. Institut für klinische Anästhesiologie, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, D-40001, Düsseldorf, Deutschland

    Jörg Tarnow

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Kochs, E., Thiel, H. (1995). Neurochirurgie/Psychiatrie. In: Doenicke, A., Kettler, D., List, W.F., Radke, J., Tarnow, J. (eds) Anästhesiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-97553-0_20

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