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Gepubliceerd in:
2022 | OriginalPaper | Hoofdstuk
4. Middelzwaar en ernstig traumatisch hoofd-/hersenletsel
Auteurs : Dr. B. Jacobs, Prof. dr. J. van der Naalt
Gepubliceerd in: Handboek traumatisch hersenletsel
Uitgeverij: Bohn Stafleu van Loghum
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Samenvatting
Middelzwaar en ernstig traumatisch hoofd-/hersenletsel (THL) kennen een hoge morbiditeit en mortaliteit. Hypoxie en/of hypotensie in de acute fase zijn geassocieerd met een ongunstig herstel. Beeldvorming middels CT laat bij een groot deel van de patiënten traumatische (intra)craniële afwijkingen zien, niet zelden is hiervoor een neurochirurgische behandeling noodzakelijk. Patiënten met ernstig THL worden opgenomen op de intensive care, waar het voorkómen en zo nodig behandelen van verhoogde intracraniële druk centraal staat. Posttraumatische endocriene stoornissen, meningitis en epilepsie kunnen als complicaties optreden. Er zijn zowel patiënt- als traumagerelateerde factoren geassocieerd met een ongunstig functioneel herstel. Dit betreft onder meer leeftijd, Glasgow Coma Schaal (GCS)-score, pupilreacties en bepaalde CT-afwijkingen. Deze factoren worden in prognostische modellen toegepast om de functionele uitkomst van een individuele patiënt te voorspellen. Gedragsregulatiestoornissen, die vaak voorkomen, bepalen in belangrijke mate de prognose, naast cognitieve stoornissen. De behandeling van patiënten met middelzwaar en ernstig THL is bij uitstek een multidisciplinair proces.
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Metagegevens
- Titel
- Middelzwaar en ernstig traumatisch hoofd-/hersenletsel
- Auteurs
-
Dr. B. Jacobs
Prof. dr. J. van der Naalt
- Copyright
- 2022
- Uitgeverij
- Bohn Stafleu van Loghum
- Boek
-
Handboek traumatisch hersenletsel
Print ISBN: 978-90-368-2658-7
Elektronisch ISBN: 978-90-368-2659-4
Copyright: 2022
- DOI
- https://doi.org/10.1007/978-90-368-2659-4_4