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Schlaganfall bei akutem Verschluss der A. basilaris

Diagnostik und Therapie

Stroke due to acute occlusion of the basilar artery

Diagnosis and treatment

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Zusammenfassung

Der akute Verschluss der A. basilaris ist eine seltene, sofern unbehandelt jedoch sehr schwer verlaufende neurovaskuläre Erkrankung mit hoher Mortalität. Die klinische Präsentation ist oft untypisch und die Diagnose verzögert. Aufgrund des schlechten Spontanverlaufs waren die rekanalisierenden Therapien oft aggressiver als bei Verschlüssen der vorderen Zirkulation. Eine gesicherte evidenzbasierte Therapie gibt es bisher nicht, die wesentlichen großen Registerstudien und Metaanalysen zeigten bisher keine klare Überlegenheit der endovaskulären Therapie gegenüber der reinen intravenösen Lysetherapie. Die aktuelle Übersichtsarbeit soll die wesentlichen Aspekte der klinischen Diagnose, der radiologischen Diagnostik und der Therapie der Basilaristhrombose zusammenfassen.

Abstract

Acute occlusion of the basilar artery is a rare and, if left untreated, severe neurovascular condition with a high mortality. The clinical presentation is often atypical and hence diagnosis may be delayed. Because of the devastating natural course, recanalization strategies were often more aggressive than in patients with occlusions in the anterior circulation. To date, there is no evidence-based therapy, and recent larger registry studies and meta-analyses do not show a clear superiority of endovascular approaches over systemic thrombolysis alone. The current review aims to provide an overview of the most critical aspects in clinical and radiological diagnosis and treatment of basilar artery thrombosis.

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Authors and Affiliations

  1. Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    S. Nagel

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  1. S. Nagel
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Correspondence to S. Nagel.

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S. Nagel erhielt Beraterhonorare von der Firma Brainomix Ltd., Reisekostenunterstützung und/oder Vortragshonorare von den Firmen Bayer, Böhringer Ingelheim, Brainomix, Medtronic und Pfizer.

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

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S. Schwab, Erlangen

M. Köhrmann, Essen

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Nagel, S. Schlaganfall bei akutem Verschluss der A. basilaris. Med Klin Intensivmed Notfmed 112, 679–686 (2017). https://doi.org/10.1007/s00063-017-0347-0

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