gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Current management of aneurysmal subarachnoid hemorrhage in Germany: a survey of practice among 100 neurosurgical departments

Die gegenwärtige Behandlung aneurysmatischer Subarachnoidalblutungen in Deutschland: Ergebnisse einer Umfrage unter 100 neurochirurgischen Kliniken

Meeting Abstract

  • corresponding author O. W. Sakowitz - Abteilung für Neurochirurgie, Universitätsklinikum Heidelberg
  • D. Vucak - Abteilung für Neurochirurgie, Universitätsklinikum Heidelberg
  • K. L. Kiening - Abteilung für Neurochirurgie, Universitätsklinikum Heidelberg
  • A. W. Unterberg - Abteilung für Neurochirurgie, Universitätsklinikum Heidelberg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-10.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0134.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Sakowitz et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective

To assess the status quo of clinical management in patients with ruptured intracranial aneurysms in Germany. In addition to preferences in vascular treatment (i.e. surgical vs. endovascular), the choice of diagnostics and treatment options in the pre- and post-operative/interventional phase is emphasized.

Methods

A postal survey was conducted between March and September 2004. Participants were representatives of neurosurgical departments in Germany (n=130).

Results

The overall response rate was 77% (n=100). Pre-operative assessment was standardised by computed tomography and conventional angiography. Endovascular treatment options were used in 71% of all responding centres. 63% of all ruptured aneurysms were treated surgically. Anterior circulation aneurysms were operated in 91%. In contrast, endovascular treatment was preferred for posterior circulation aneurysms. Acute posthemorrhagic hydrocephalus was treated routinely by external ventricular drainage (97%). Doppler-sonography, monitoring of cerebral perfusion pressure and electrophysiology were used by a significant number of respondents. Specific treatment of SAH patients included calcium-antagonists (69%), glucocorticosteroids (34%) and hemorrheologic agents (29%). Delayed ischemia was treated by prophylactic and/or therapeutic volume expansion, induced hypertension and hemodilution (40 and 20%, respectively).

Conclusions

In Germany, clinical management of SAH patients is standardized in preoperative diagnostics, intensive care unit (ICU) monitoring and post-operative treatment. Preferred treatment for anterior circulation aneurysms is surgical, while endovascular treatment options are preferentially used in the posterior circulation. This survey should help to compare the current treatment status with previously published guidelines, to analyze future developments in the management of SAH and finally in identifying new standards in both national and international level.