Zusammenfassung

     Das Neurotrauma stellt als Folge einer Gewalteinwirkung auf Strukturen des zentralen sowie peripheren Nervensystems eine klinisch häufige und für das langfristige Outcome der Patienten hochrelevante Krankheitsentität dar. Dieser Beitrag beschreibt das aktuelle Management der beiden wichtigsten Verletzungsmuster des Neurotraumas: das Schädel-Hirn-Trauma und die Wirbelsäulenverletzung mit Rückenmarkbeteiligung. Abstract Neurotrauma results from violence on structures of the central or peripheral nervous system and is a clinically common disease entity with high relevance for patients’ long-term outcome. The application of evidence-based diagnostic and therapeutic concepts aims to minimize secondary injury and thus to improve treatment outcome. This article describes the current management of the two main injury patterns of neurotrauma – traumatic brain and spinal cord injury. Kernaussagen Das Neurotrauma entsteht als Folge einer Gewalteinwirkung auf Strukturen des zentralen oder peripheren Nervensystems. Das Schädel-Hirn-Trauma und das Wirbelsäulentrauma mit Rückenmarkverletzung stellen klinisch häufige und für das langfristige Outcome der Patienten hochrelevante Krankheitsentitäten dar. Die primäre Schädigung ist therapeutisch nicht mehr zu modulieren. Das evidenzbasierte, strukturierte Management des Neurotraumas zielt auf die Modulation der sekundären Schädigung ab und soll damit die Letalität reduzieren sowie das funktionelle Langzeit-Outcome verbessern. Konservative (intensivmedizinische) und therapeutische (chirurgische) Maßnahmen sollen beim schweren Neurotrauma in spezialisierten Traumazentren Anwendung finden. Eine engmaschige klinische Verlaufskontrolle, repetitiv durchgeführte Bildgebungen und eine interdisziplinäre Abstimmung im Trauma-Team zur Festlegung invasiver diagnostischer und therapeutischer Maßnahmen stellen die Leitsäulen des Konzepts dar. Die Behandlung von Patienten mit schwerem Neurotrauma erfordert ein hohes Maß an Expertise und Erfahrung in einem interdisziplinären Behandlungsteam. Daher sollten diese Patienten frühestmöglich in spezialisierten Traumazentren behandelt werden. Schlüsselwörter Schädel-Hirn-Trauma - Wirbelsäulentrauma - Polytrauma - neurokognitives Outcome Keywords traumatic brain injury - spinal trauma - polytrauma - neurocognitive outcome 24 June 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Literatur 1 Hoppe K, Klingler W. Traumatic brain injury: pathophysiology and emergency management. Anästh Intensivmed 2021; 62: 118-127 DOI: 10.19224/ai2021.118. 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