[Stroke management in a stroke unit with rural catchment area]. / Schlaganfallversorgung in einer Stroke Unit mit ländlichem Einzugsgebiet.

The experiences of a rural stroke unit since 1997 are reported. A special referral concept was developed with the emergency services and hospitals of the region. As a result, 35% of patients arrived in the stroke unit within 3 hours after onset of stroke symptoms. This corresponds with the data from larger cities. The major peculiarity of the Günzburg Stroke Unit is that, after emergency diagnostic and therapeutic procedures, 41% of the patients with mainly internistic problems were transferred to another regional hospital and only 40% were admitted to the inpatient stroke unit. Moreover, among these were an above-average proportion of patients with intracerebral hemorrhage (24% of the inpatients in 1998), and complete acute treatment and rehabilitation were carried out in the same hospital according to an integrative treatment concept. Since 1997, the average hospitalization duration decreased from 11.4 days to 5.9 days and the number of patients per month increased to an average of 22.3. The total hospitalization duration--including inpatient rehabilitation--was 33.9 days. All in all, a comparably good stroke treatment thus is possible outside urban regions.

[Ischemic cerebral infarct in young adults. An overview of epidemiology, etiology, diagnosis and prognosis]. / Der ischämische Hirninfarkt bei jungen Erwachsenen. Eine Ubersicht über Epidemiologie, Atiologie, Diagnostik und Prognose.

Some 5 to 10% of all ischemic insults occur in young adults and constitute a diagnostic-therapeutic challenge. The leading causes are atherosclerotic disease, vascular dissections, vasculitis and, in particular, cardioembolic events. In addition, there exists a broad spectrum of relatively rare disorders most of which need to be dealt within specialized neurological stroke units. Nevertheless, the etiology of up to 20% of such events remains unexplained. The present article provides an up-to-date review of the necessary etiological considerations, diagnostic measures, and results relevant to the prognosis of juvenile ischemic stroke.

[Early detection and chances for healing in recurrences of colorectal cancers]. / Früherkennung und Heilungschanchen bei Rezidiven colorectaler Carcinome.

In patients with colorectal carcinoma operated curatively or questionable curatively, the computer-controlled postoperative care showed that in more than one third of the patients with recurrence the diagnosis was made before clinical symptoms appeared. By early detection, the recurrence could be resected curatively in twice as many patients with regular postoperative care as in patients without regular care. Furthermore could be proved that regular postoperative care caused a clear prolongation of the survival time.