Grundlagen Der Neurologischen Intensivmedizin
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Das vorliegende Kliniktaschenbuch ist eine Zusammenfassung der gewonnenen Erfahrungen während meiner Tätigkeit an der Neuro- chirurgischen Universitätsklinik Essen und der Neurologischen Uni- versitätsklinik Göttingen. Unter Berücksichtigung neuer Literatur sollten die besonderen Er- fordernisse neurologisch-neurochirurgischer Intensivpatienten in be- zug auf Diagnostik, Therapie und weiterführende Rehabilitations- ma nahmen dargestellt werden. Meinen Lehrern Prof. Dr. Grote und Prof. Dr. Bauer möchte ich an dieser Stelle für ihre Unterstützung und fachliche Unterweisung herzlich danken. Ebenso allen ärztlichen Kollegen sowie den Ange- hörigen des intensivmedizinischen und operativen Personals, ohne deren Mitwirkung ein gro er Teil der Untersuchungen nicht hätte durchgeführt werden können. Göttingen, Juli 1980 Wolfgang Gobiet v Inhaltsverzeichnis A. Beurteilung und Diagnostik 1 I. Bewu tseinslage ........ . 1 11. Besondere motorische Antworten 5 III. Hirnnerven . . . . . . . . . . 6 1. Nervus opticus . . . . . . . 6 2. Oculo-und Pupillomotorik 7 a) Pupillomotorik 8 b) Oculomotorik . 10 c) Blickparese .. 10 3. Übrige Hirnnerven 11 IV. Hirnstammfunktion 11 1. Schutzreflexe 11 2. Vegetative Störungen 12 3. Hirnstammsyndrome 13 V. Reflexstatus ..... 15 VI. Unterscheidung zwischen supratentoriellen und infraten- toriellen Prozessen sowie toxischen bzw. metabolischen Einflüssen 15 1. Supratentorielle Prozesse 15 2. Infratentorielle Prozesse . 16 3. Toxische oder metabolische Einflüsse 17 4. Grenzfälle .... 17 5. Zusammenfassung 17 VII. Diagnostik ..... 18 1. Äu ere Symptome 18 2. Laboruntersuchungen 20 3. Technische Untersuchungen 20 VII a) Basisuntersuchungen .. . . ... . . . 20 b) Spezielle Untersuchungen . . . . . . . . 22 4. Chirurgisches oder konservatives Vorgehen 31 5. Hirnstamm-Dysfunktion ... . . ... . . 33 B. Erstversorgung nach dem Ereignis und in der Klinik 34 I. Primärversorgung 36 11. Versorgung in der Klinik 37 1. Infusionstherapie 38 2. Sedierung 39 3. Venenkatheter ..
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