Zusammenfassung
Die Versorgung von Schädel-Hirn-Traumen (SHT) hat in Mitteleuropa einen hohen Standard erreicht. Das SHT bleibt dennoch die Haupttodesursache bei Kindern und jungen Erwachsenen. Während die Langzeitergebnisse beim schweren SHT relativ gut dokumentiert sind, wissen wir wenig über die Ergebnisse bei leichten und mittelschweren SHTs. Es fehlen valide Kostenabschätzungen der Folgekosten nach SHT. Akute Wirbelsäulenverletzungen entstehen durch äußerliche Gewalteinwirkung. In der Regel handelt es sich nicht nur um eine lokale Schädigung, sondern auch um eine Traumatisierung weiterer Körperareale. Neurologische Ausfälle treten bei etwa 30 % der Patienten mit Wirbelsäulenverletzungen auf. Die Traumatisierung des Rückenmarks beeinflusst verschiedene Organsysteme.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Zu 38.1
Adams H, Mitchell DE, Graham DI, Doyle D (1977) Diffuse brain damage of immediate impact type- Ist relationship tp primary brain stem damage in head injury. Brain 100:489–502
Andrews PJD et al (2011) European society of intensive care medicine study of therapeutic hypothermia (32–35 °C) for intracranial pressure reduction after traumatic brain injury (the Eurotherm3235Trial). Trials 12:8
Baker SP, O’Neill B, Haddon W Jr., Long WB (1974) The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 143:187–196
Beckmann SB, Scholten DJ, Bonnell BW, Bukrey CD (1989) Long bone fractures in the polytrauma patient. The role of early operative fixation. Am Surg 55:356–358
Bouma GJ (1992) Blood pressure and intracranial pressure-volume dynamics in severe head injury: relationship with cerebral blood flow. Neurosurg 77:15–19
Bouma GJ, Muizelaar JP (1990) Relationship between cardiatic output and cerebral blood flow in patients with intact and impaired autoregulation. J Neurosurg 73:368–374
Braakmann R, Habbema JDF, Gelpke GJ (1986) Prognosis and Prediktion of Outcome in Comatose Head Injured Patients. Acta Neurochir Suppl 36:112–117
Brain Trauma Foundation: Guidelines for Management of Serve Traumatic Brain Injury, 3rd ed. www.braintrauma.org/pdf/protected/Guidelines_Management_2007w_bookmarks.pdf
Brain Trauma Foundation: www.braintrauma.org/pdf/protected/surgical_Guidelines_article2.pdf
Caricato A, Conti G, Della Corte F, Mancino A, Santilli F, Sandroni C, Proietti R, Antonelli M (2005) Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: the role of respiratory system compliance. J Trauma 58:571–576
Citerio G, Cormio M, Polderman KH (2004) Moderate hypothermia in traumatic brain injury: results of clinical trials. Minerva Anestesiol 70:213–218
Charash WE, Fabian TC, Croce MA (1994) Delayed surgical fixation of femur fractures is a risk for pulmonary failure independent of thoracic trauma. J Trauma 37:667–672
Chesnut R, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W (2012) A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367:2471–2481
Clifton GL (2004) Is keeping cool still hot? An update on hypothermia in brain injury. Curr Opin Crit Care 10:116–119
Clifon et al (2001) Lack of effect of hypothermia after brain injury. N Eng J Med 344:556–563
Deeren DH, Dits H, Malbrain ML (2005) Correlation between intra-abdominal and intracranial pressure in nontraumatic brain injury. Intensive Care Med 31:1577–1581
Dent D, Croce MA, Menke PG, Young BH, Hinson MS (1995) Prognostic Factors after acute subdural hematoma. J Trauma Injury Infection Crit Care 39:36–42
Deutsche Gesellschaft für Neurochirurgie, Leitlinie zum Schädel-Hirn-Trauma: www.awmf.org/uploads/tx_szleitlinien/008-001_S2e_Schaedel-Hirn-Trauma_im_Erwachsenenalter_leitlinientext_07-2007_07-2012.pdf
Edwards P et al (2005) Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet 365(9475):1957–1959
Farahvar A, Gerber LM, Chiu YL, Carney N, Härtl R, Ghajar J (2012) Increased mortality in patients with severe traumatic brain injury treated without intracranial pressure monitoring. J Neurosurg 117:729–734
Firsching R, Woischneck D, Klein LS, Reissberg S, Döhring W, Peters B (2001) Classification of severe head injury based on magnetic resonance imaging. Acta Neurochir (Wien) 143:263–271
Fitzal S (1997) Ketamin und Neuroprotektion: Klinischer Ausblick. Anaesthesist 46:65–70
Frowein RA (1976) Classification of Coma. Acta Neurochir 34:5–10
Gaab MR, Seegers K, Smedema RJ (1990) A comparative analysis of THAMm (Tris-buffer) in traumatic brain edema. Acta Neurochir (Wien) Suppl 51:320–323
Gennarelli TA (1982) Cerebral concusssion snd diffuse brain injuries. In: Cooper P (Hrsg) Head injury. Williams and Wilkins, Baltimore, S 83–97
Glenn TC, Kelly DF, Boscardin WJ, McArthur DL, Vespa P, Oertel M (2003) Energy dysfunction as a predictor of outcome after moderate or severe head injury: indices of oxygen, glucose, and lactate metabolism. J Cereb Blood Flow Metab 23:1239–1250
Grände PO (2011) PRO: The ″Lund Concept″ for Treatment of Patients With Severe Traumatic Brain Injury. J Neurosurg Anesthesiol 23:251–255
Hansson PG (1986) Injury Scaling. Acta Neurochirurgia (Suppl) 36:21–22
Hallbach J, von Meyer I, Maurer HH (2002) Empfehlungen des Arbeitskreises Klinische Toxikologie und Forensische Chemie (GTFCh) für die toxikologische Analytik im Rahmen der Hirntoddiagnostik. Toxichem-Krimtech 69:124–127
Heinzelmann M, Platz A, Imhof HG (1996) Outcome after acute extradural heamatoma influence of additional injuries and neurological complications in the ICU. Injury 27:345–349
Horn P, Munch E, Vajkoczy P, Herrmann P, Quintel M, Schilling L, Schmiedek P, Schurer L (1999) Hypertonic saline solution for control of elevated intracranial pressure. Neurol Res 21:758–764
Huynh T, Messer M, Sing RF, Miles W, Jacobs DG, Thomason MH (2002) Positive end-expiratory pressure alters intracranial and cerebral perfusion pressure in severe traumatic brain injury. J Trauma 53:488–492
Jaichs RR, Cohn SM, Moller BA (1997) Early fracture fixation may be deleterious after head injury. J Trauma 42:1–5
Jennett B (1996) Epidemiology of head injury. J Neurol Neurosurg Psychiatry 60:362–369
Johson KD, Cadambi A, Seibert GB (1985) Incidence of adult respiratory distress syndrome in patients with multiple musculosketal injuries: effect of early operative stabilization of fractures. J Trauma 25:375–384
Kleist-Welch Guerra W, Gaab MR, Dietz H, Mueller JU, Piek J, Fritsch MJ (1999) Surgical decompression for traumatic brain swelling: Indications and results. J Neurosurg 90:187–96
König K, Rickels E, Heissler HE, Zumkeller M, Samii M (2001) Artificial elevation of brain tissue glycerol by administration of a glycerol containing agent. J Neurosurg 94:621–623
Lehmann U, Rickels E, Krettek C (2001) Polytrauma mit Schädel-Hirn-Trauma. Unfallchirurgie 104:196–217
Longhi L, Stocchetti N (2004) Hyperoxia in head injury: therapeutic tool? Curr Opin Crit Care 10:105–109
Maas AIR, Dearden M, Teasdale GM, Braakman R, Cohadon F (1997) EBIC Guidelines for the management of severe head injury in adults. Acta Neurochirugia (Wien) 139:286–294
Marion DW, Cartier PM (1994) Problems with initial Glasgow Coma Scale Assessment caused by prehospital treatment of patients with head injuries: results of a national survey. J Trauma 36:89–95
Marshall LF, Smith RS, Shapiro HM (1979) The outcome with aggressive treatment in severe head injuries Part I. The significance of intracranial pressure monitoring. J Neurosurg 50:20–25
Nardi G, Lattuada I, Scian F, Sanson GF, Di Bartolomeo S, Michelutto V (1999) Epidemiological study on high upgrade trauma. Minerva Anesthesiol 65:348
Neugebauer EAM, Waydhas C, Lendemans S, Rixen D, Eikermann M, Pohlemann T (2012) Clinical Practice Guideline: The Treatment of Patients With Severe and Multiple Traumatic Injuries. Dtsch Arztebl Int 109:102–108
Nygren A, Hansson PG, Tingvall C (1986) Acute Injury Scaling Related to Residual Disability. Acta Neurochirurgia (Suppl) 36:25–27
Ommaya AK (1977) Mechanism of cerebral concussion, contusion and other effects of head injury. In: Newman’s Neurological Surgery, Bd. IV.
Oppenheimer DR (1968) Microscopic lesions in the brain following head injury. J Neurol Neurosur Psychiatry 31:299–306
Piek J (1999) Ernährungstherapie. In: Piek J, Unterberg A (Hrsg) Grundlagen neurochirurgischer Intensivmedizin. Zucherschwerdt, München, S 259–268
Pietropaoli JA, Rogers FB, Shackford SR, Wald SL, Schmoker JD, Zhuang J (1992) The deleterious effects of intraoperative hypotension on outcome in patients with severe head injury. J Trauma 33:403–407
Polderman KH (2004) Application of therapeutic hypothermia in the ICU: Opportunities and pitfalls of a promising treatment modality. Part 2: Practical aspects and side effects. Crit Care Med 30:757–769
Regel G, Lobenhoffer P, Grotz M, Pape HC, Lehmann U, Tscherne H (1995) Treatment and results of patients with multiple trauma: an analysis of 3406 cases treated between 1972 and1991 in a German level I trauma center. J Trauma 38:70–78
Rickels E, von Wild K, Wenzlaff P (2011) Treatment of traumatic brain injury in Germany. Unfallchirurg 114:417–423
Rickels E, von Wild K, Wenzlaff P (2010) Head injury in Germany: A population-based prospective study on epidemiology, causes, treatment and outcome of all degrees of head-injury severity in two distinct areas. Brain Inj 24:1491–1504
Roberts I (2000) Aminosteroids for acute traumatic brain injury. Cochrane Database Syst Rev 4:CD001527
Rosner MJ, Daughton S (1990) Cerebral perfusion pressure management in head injury. J Trauma 30:933–940
Sahuquillo J, Arikan F (2006) Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury. Cochrane Database Syst Rev 1:CD003983
Sarvadei F, Vergoni G, Staffa G, Zappi D, Nasi MT, Donati R, Arista A (1995) Extradural Haematomas: How many can be avoided? Acta Neurochirugia 133:50–55
Sarvadei F (1997) Prognostic factors in severely head injured adult patients with epidural heamatoma. Acta neurochirurgia 139:273–278
Sarvadei F (1997) Prognostic Factors in Severely Head Injured Adult Patients with Acute Subdural Haematomas. Acta Neurochirgia 139:279–285
Schatzmann CF, Heissler HF, König K, Rickels E, Mühling M, Boerschel M, Samii M (1998) Treatment of elevated intracranial pressure by infusion of 10 % Saline in Severely Head Injured Patients. Acta Neurochir 71:31–33
Seibel R, LaDuca J, Hassett JM, Babikkian G, Mills B, Border DO, Border JR (1985) Blunt multiple trauma, femur fracture and the pulmonary failure-septic state. Ann Surg 202:283–295
Siesjö BK (1988) Calcium, ischemia, and cell death of brain cells. Ann NY Acad Sci 522:638–661
Starmark JE, Stalhammer D, Holmgren E, Rosander B (1988) A comparison of Glasgow-Coma-Scale and the Reaction Level Scale (RLS 85). J Neurosurg 69:699–706
Statistisches Jahrbuch, Wiesbaden, Jahrgang 1998
Strich S (1956) Diffuse degeneration of the cerebral white matter in severe dementia following head injury. J Neurol Neurosurg Psychiatry 19:163–185
Talving P, Karamanos E, Teixeira PG, Skiada D, Lam L, Belzberg H, Inaba K, Demetriades D (2013) Intracranial pressure monitoring in severe head injury: compliance with Brain Trauma Foundation guidelines and effect on outcomes: a prospective study. J Neurosurg 119:1248–1254
Teasdale E, Jennett B (1974) Assessment of coma in impaired consciousness: a practical scale. Lancet ii:81–84
Trost HA, Gaab MR (1992) Plasma Osmolality, Osmoregulation and Prognosis after Head Injury. Acta Neurochir (Wien) 116:33–37
Tscherne H, Regel G (1997) Traumamanagement Unfallchirurgie, Bd. 1. Springer, Heidelberg, S 257–260
Unterberg AW, Sarrafzadeh AS, Lanksch WR (1999) Das Schädel-Hirn-Trauma im Rahmen des Polytraumas – Aufgaben der Neurochirurgie. Anästhesiol Intensivmed Notfallmed Schmerzther (Suppl 1):13–19
van Dellen JR, Becker DP (1988) Craniocerebraal Trauma. Current concept. Upjohn Company, Kalamazoo, S 10–11
Werner C, Recker W, Engelhardt K, Lu H, Kochs E (1997) Ketamine racemate and S-(+)- ketamine. Cerebrovascular effects and neuroprotection following focal ischemia. Anaesthesist 46:55–60
White RJ, Likavec MA (1992) The diagnosis and initial management of head injury. N Engl J Med 327:1507–1511
Wirth A, Baethmann A, Schlesinger-Raab A, Assal J, Aydemir S (2004) Prospective documentation and analysis of the pre- and early clinical management in severe head injury in southern Bavaria at a population based level. Acta Neurochir Suppl 89:119–123
Zu 38.2
American Spinal Injury Association (2001) Classification Worksheet. http://www.asia-spinalinjury.org/elearning/ISNCSCI.php
ASIA (American Spinal Injury Association) Impairment Scale. www.pmr.vcu.edu/presentations/wmckinley/asia/sld017.htm
Amar AP (1999) Pathogeneisis and Pharmacological Strategies for Mitigating Secondary Damage of Acute Spinal Cord Injury. Neurosurgery 44:1027–1040
Burgi U, Stocker R (2000) Intensive care treatment concepts after traumatic spinal cord injury. Schweiz Med Wochenschr 130:811–815
Crozier KS, Graziani V, Ditunno JF (1991) Spinal cord injury: prognosisi for ambulation based on sensory examination in patients who are initially motor complete. Arch Phys Med Rehabil 72:119–121
Ditunno JF, Young W, Donovan WH (1994) The international standards booklet for neurological and functional classification of spinal cord injury. Paraplegia 32:70–80
Foo D, Subrahmanyan TS (1981) Postraumatic acute anterior spinal cord syndrome. Paraplegia 19:201–205
Frankel HL, Hancock DO, Melzak J, Michaelis LS, Ungar GH et al (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tretaplegia. Paraplegia 73:179–192
Hawryluk GW, Rowland J, Kwon BK, Fehlings MG (2008) Protection and repair of the injured spinal cord: a review of completed, ongoing and planed clinical trials for acute spinal cord injury. Neurosurgical Focus 25:E2
Junghanns H (1955) Wirbelsäule. In: Rostock, Rostock P (Hrsg) Handbuch der gesamten Unfallchirugie, S 520–564
Magerl F, Gertzbein SD, Harms J, Narzarian A (1994) A comprehensive classifcation of thoracic and lumbar injuries. Eur Spine 3:184–201
Maynard FM, Reynold GG, Wilmore C, Hamilton R (1979) Neurological prognosis after traumatic qudriplegia. J Neurosurg 50:611–616
Nicoll E (1949) Fractures of the dorso-lumbar spine. J Bone Joint Surg 31:376–394
Tscherne H, Blauth M (1998) Grundlagen der Wirbelsäulentraumatologie. In: Wirbelsäule. Unfallchirugie in 13 Bänden. Springer, S 5–8
White APM (1990) The Problem of Clinical Istability. In: White AA, Panjabi MM (Hrsg) Clinical biomechanics of the spine. Lippincott, Philadelphia, S 227–378
White APM, Panjabi MM (1990) Kinematics of the spine. In: White AA, Panjabi MM (Hrsg) Clinical biomechnism of the spine. Lippincott, Philadelphia, S 85–125
Whiesides TE (1977) Traumatic kyphosis of the thoracolumbar spine. Clin Orthop 128:78–92
York DH, Raffensberger M, Spangnola T, Joye C (1983) Utilisation somatosensory evoked cortical potentials in spinal cord injury. Spine 8:832–839
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Rickels, E., Unterberg, A. (2015). Trauma. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46500-4_38
Download citation
DOI: https://doi.org/10.1007/978-3-662-46500-4_38
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-46499-1
Online ISBN: 978-3-662-46500-4
eBook Packages: Medicine (German Language)