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Grundlagen der Therapie von Aneurysmen

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Zerebrale Aneurysmen und Gefäßmalformationen

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Zusammenfassung

Das Wissen über Hirnarterienaneurysmen und ihr Blutungsrisiko hat seit den 1990er-Jahren stetig zugenommen. Die Daten- und Faktenlage hat sich aufgrund multizentrischer Studien und großer veröffentlichter Fallserien geändert, und mit den endovaskulären Interventionsmöglichkeiten sind mannigfaltige neue Behandlungsoptionen hinzugekommen. Im Verlauf führte dies zu einer gravierenden Änderung der Behandlungsempfehlungen. Bei der Entscheidung, welche Läsion behandelt wird und welche nicht, ist eine stringente Risiko-Nutzen-Abwägung notwendig. Auch für die Entscheidung über die Art der Behandlung ist eine individuelle Abwägung vieler Einflussgrößen erforderlich. Aufgrund der mittlerweile bekannten vielen Einflussfaktoren auf das Blutungs-, aber auch das Behandlungsrisiko sind die Therapieempfehlungen deswegen mittlerweile äußerst komplex geworden. In diesem Kapitel werden in kondensierter Form die Grundlagen für die Entscheidungsfindung und für Empfehlungen in einer Beratungssituation dargestellt.

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  1. Medizinischer Campus Universität Oldenburg, Universitätsklinik für Neurochirurgie Evangelisches Krankenhaus Oldenburg, Steinweg 13–17, 26122, Oldenburg, Deutschland

    Thomas Kretschmer

  2. Medizinischer Campus Universität Oldenburg, Universitätsklinik für Neurochirurgie Evangelisches Krankenhaus Oldenburg, Steinweg 13–17, 26122, Oldenburg, Deutschland

    Thomas Schmidt

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    Thomas Kretschmer

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Kretschmer, T., Schmidt, T. (2017). Grundlagen der Therapie von Aneurysmen. In: Kretschmer, T. (eds) Zerebrale Aneurysmen und Gefäßmalformationen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-50478-9_4

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