Neurologische Allgemein- Und Intensivtherapie
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1 Einleitung.- 2 Grundsätze der Therapie.- 2.1 Kausale oder symptomatische Behandlung.- 2.2 Therapiemöglichkeiten.- 2.2.1 Medikamentöse Therapie.- 2.2.2 Physiotherapie.- 2.2.3 Elektrotherapie.- 2.2.4 Operative Ma nahmen.- 2.2.5 Strahlentherapie.- 2.2.6 Psychotherapie.- 2.2.7 Unkonventionelle Therapieverfahren.- 2.3 Behandlungsfehler und Rechtsfragen.- Literatur.- 3 Behandlung häufiger neurologischer Symptome und Syndrome.- 3.1 Paresen.- 3.1.1 Schlaffe Paresen.- 3.1.2 Spastische Paresen.- 3.1.3 Schluckstörungen und Singultus.- 3.2 Neurogene Blasenstörungen.- 3.2.1 Schockblase.- 3.2.2 Automatenblase.- 3.2.3 Autonome Blase.- 3.2.4 Blaseninkontinenz.- 3.3 Querschnittslähmungen.- 3.3.1 Regulierung der Darmfunktion.- 3.3.2 Dekubitus.- 3.3.3 Tracheostoma.- 3.3.4 Sexualstörungen.- 3.3.5 Zentrale Regulationsstörungen.- 3.3.6 Hyperhidrosis.- 3.3.7 Physiotherapie.- 3.4 Analgesie und Sedierung.- 3.4.1 Schmerzbehandlung.- 3.4.1.1 Analgetika.- 3.4.1.2 Psychopharmaka und Besonderheiten der konservativen Schmerzbehandlung.- 3.4.1.3 Operative Eingriffe.- 3.4.1.4 Elektrostimulation des Nervensystems.- 3.4.1.5 Suggestivma nahmen.- 3.4.1.6 Psychotherapie.- 3.4.2 Sedierung.- 3.5 Schlafstörungen.- 3.6 Schwindeltherapie.- 3.6.1 Antivertiginosa in der Akuttherapie.- 3.6.2 Therapie der Bewegungskrankheit ("Kinetosen", "Reisekrankheit").- 3.6.3 Therapie peripher vestibulärer und cochleärer Störungen mit Betahistinderivaten.- 3.6.4 Beeinflussung des vaskulären Schwindels.- 3.6.5 Schwindel bei Blutdruckregulationsstörungen.- 3.6.6 Lagetrainingsprogramm bei benignem paroxysmalem Lagerungsschwindel (Cupulolithiasis).- 3.6.7 Operative Ma nahmen.- 3.7 Hirndrucksteigerungen.- 3.7.1 Konservative Hirndrucktherapie.- 3.7.2 Operative Ma nahmen.- Literatur.- 4 Neurologische Intensivmedizin.- 4.1 Bewu tseinsstörungen.- 4.1.1 Systematik und Pathogenese.- 4.1.2 Allgemeine Therapiema nahmen.- 4.1.3 Differentialdiagnose organischer Bewu tseinsstörungen.- 4.2 Atemstörungen - Pathophysiologie, Diagnostik, Therapie.- 4.2.1 Physiologie der Atmung.- 4.2.2 Pathophysiologie der Ateminsuffizienz und cerebrale Hypoxie.- 4.2.3 Ursachen akuter/subakuter Ateminsuffizienz.- 4.2.4 Symptomatik der Ateminsuffizienz und Beatmungsindikationen.- 4.2.5 Behandlung der Ateminsuffizienz.- 4.2.5.1 Freihaltung der Atemwege.- 4.2.5.2 Endotracheale Intubation.- 4.2.5.3 Bronchialtoilette.- 4.2.5.4 Sauerstoff-Therapie.- 4.2.5.5 Apparative Beatmung (Indikation und Technik).- 4.2.5.6 Entwöhnung von der Maschine und Extubation.- 4.2.5.7 Tracheotomie.- 4.3 Störungen des Säure-Basen-Haushaltes.- 4.3.1 Physiologie.- 4.3.2 Pathophysiologie.- 4.3.3 Technik der Blutabnahme.- 4.3.4 Therapiema nahmen bei Azidosen oder Alkalosen.- 4.4 Künstliche Ernährung (enterai und parenteral) und Regulierung des Flüssigkeits- und Elektrolythaushaltes.- 4.4.1 Sondennahrung.- 4.4.2 Parenterale Ernährung.- 4.4.3 Flüssigkeitsbedarf und Regulierung des Wasserhaushaltes.- 4.4.4 Regulierung des Elektrolythaushaltes.- 4.5 Besonderheiten der pflegerischen Intensivmedizin (A. Schürmann u.J.Jörg).- 4.5.1 Organisation.- 4.5.2 Hygienische Ma nahmen.- 4.5.3 Überwachung.- 4.5.4 Pflegerische Ma nahmen in der Prophylaxe und Therapie neurologischer "Intensivpatienten".- 4.6 Thromboseschutz, Antikoagulation, Fibrinolyse- und Antifibrinolyse-Therapie.- 4.6.1 Antikoagulation.- 4.6.2 Thrombozytenaggregationshemmer.- 4.6.3 Fibrinolytika.- 4.6.4 Antifibrinolytika.- 4.7 Blutdruckregulationsstörungen.- 4.7.1 Hypotonien.- 4.7.2 Schock-Behandlung.- 4.7.3 Hypertonie.- 4.8 Infektionen.- 4.8.1 Infektionsprophylaxe.- 4.8.2 Antibiotikaeinsatz.- 4.8.2.1 Prophylaktische Antibiotika- und Infektionsprophylaxe.- 4.8.2.2 Antibiotikatherapie und-auswahl.- 4.9 Besondere Notfallma nahmen auf neurologischem und allgemeinmedizinischem Gebiet.- 4.9.1 Therapie häufiger neurologischer Komplikationen.- 4.9.1.1 Temperaturregulationsstörungen.- 4.9.1.2 Magen-Darm-Störungen.- 4.9.1.3 Diabetes insipidus.- 4.9.1.4 Hypophysä
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