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Das chronische Subduralhämatom im Alter

Chronic subdural hematoma in the elderly

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Zusammenfassung

Das chronische Subduralhämatom (cSDH) ist ein häufiges Krankheitsbild, das durch die zunehmende Alterung der Gesellschaft und die immer häufigere Einnahme blutverdünnender Medikamente in seiner Inzidenz weiter steigt. Es macht sich durch unspezifische Symptome und neurologische Defizite bemerkbar und wird in den meisten Fällen operativ behandelt. Hierzu haben sich sowohl die Bohrlochtrepanation als auch die Twist-Drill-Kraniostomie durchgesetzt, während eine Kraniotomie nur noch selten bei Rezidiven durchgeführt wird. Trotz verhältnismäßig häufiger Rezidive wird in der überwiegenden Anzahl der Fälle ein gutes Behandlungsergebnis auch im hohen Alter erreicht. Da das cSDH aber mit internistischen Erkrankungen korreliert, ist es hinweisend auf eine erhöhte Morbidität und Mortalität. Es muss in kontrollierten Studien ermittelt werden, ob neben der operativen Therapie auch medikamentöse Behandlungsansätze wirkungsvoll sind.

Abstract

Chronic subdural hematoma (cSDH) is a common condition, the frequency of which further increases due to an aging population and more frequent use of antithrombotic drugs. It leads to unspecific symptoms and neurological deficits and is usually treated surgically. Burr hole trepanation and twist drill craniostomy have become the therapeutic standards with craniotomy being rarely used for recurrent cases. Although recurrences are relatively common, in most cases a good outcome can be achieved even in the elderly; however, as cSDH is associated with other comorbidities, it is indicative of an increased morbidity and mortality. Controlled trials need to be carried out to determine whether pharmacological therapies can also be beneficial in addition to surgical treatment.

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Authors and Affiliations

  1. Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland

    T. A. Juratli, J. Klein & G. Schackert

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  1. T. A. Juratli
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Correspondence to T. A. Juratli.

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T. A. Juratli, J. Klein und G. Schackert geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Juratli, T.A., Klein, J. & Schackert, G. Das chronische Subduralhämatom im Alter. Chirurg 88, 131–135 (2017). https://doi.org/10.1007/s00104-016-0343-6

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