Basiswissen für Mediziner und Pflegekräfte Dieses Buch vermittelt allen Medizinern und Pflegekräften, die mit neurochirurgischen Intensivpatienten zu tun haben, ein gutes Basiswissen. Zentral sind die häufigsten Krankheitsbilder, Behandlungs- und klinischen und technischen Überwachungsverfahren. In klinischer Hinsicht geht es um Bewusstseinsstörungen, Hirnnervenausfälle, zentrale Störungen der Motorik und der Sprache. Bei den technischen Überwachungsverfahren um das Monitoring, den intrakraniellen Druck, EEG, evozierte Potenziale, die Hirndurchblutung und sonografische Methoden. Es folgt ein umfangreiches Kapitel zur Überwachung und Behandlung von Notaufnahmepatienten, u. a. bei Schädel-Hirn-Trauma, Aneurysmen, Hirnabszessen und spinalen Traumata, und ein Kapitel zu Patienten nach Wahleingriffen. Am Ende des Buches wird das Thema Hirntod behandelt und die wichtigsten Skalen und Scores in der Neurochirurgie sind übersichtlich zusammengestellt. Mediziner und Pflegende erhalten einen fundierten Überblick über den aktuellen Stand in der neurochirurgischen Intensivmedizin. Das Grundlagenwerk ist durchgehend bebildert und enthält zahlreiche Tabellen und praxisrelevante Schemata.

Neurosurgery is a rapidly developing field of medicine. Therefore, staying keeping track of the advancements in the field is paramount for trainees as well as fully trained neurosurgeons. This book, fully available online, is a part of our effort of improving availability of medical information for anyone who needs to keep up-to-date.

Objective: Nationwide data on the epidemiology, treatment characteristics, and long-term outcome of severe traumatic brain injury (TBI) in Germany is not yet existing. Neurosurgeons from the German Neurosurgery Society (DGNC) and traumatologists from the German Trauma Society (DGU), therefore, joined forces in 2016 to conceptualize a TBI module for the well-established Trauma Register of the DGU (TR-DGU). Here, we report how this “German National TBI registry (GNTR)” has been developed, implemented, and tested in a recently completed pilot period. Methods: The conception and implementation process of the GNTR from August 2016 to February 2019 is described, and results of its 23-months long pilot period from February 2019 to December 2020 are presented. For the pilot period, TBI patients were prospectively enrolled at nine neurosurgical and traumatological hospitals across Germany. Inclusion criteria were treatment on the ICU ≥ 24h, or an ISS score ≥ 16. A variety of clinical, imaging, and laboratory parameters were collected, and the GOSE score was used to assess the outcome at discharge and 6- and 12 months follow-up. Results: Details on the structure and dataset of the GNTR as well as milestones and pitfalls during its conception and implementation, are outlined. During the pilot period, a total of 264 TBI patients were enrolled. Their demographic characteristics, clinical, imaging, and radiological findings, and their early mortality and functional outcome are described. Furthermore, factors associated with an unfavorable outcome (GOSE 1-4) are assessed using uni- and multivariate regression analyses. Finally, problems and future directions of the GNTR are discussed. Conclusion: The pilot period of the GNTR offers a first glance at the current epidemiology and treatment characteristics of TBI patients in Germany. More importantly, they show how a national TBI registry yielding high-quality prospective data can be developed, implemented, and tested within four years