Our services at a glance:
Stroke Unit / Vorderpfalz Coordinating Centre
In our Unit's specialist care for patients with acute stroke is provided by our multidisciplinary team of doctors, specialist care staff and therapists. The level of specialist care provided is reflected in the technological complexity of our equipment and services and the high staffing levels available. An important aim of our Unit is the quickest possible provision of acute treatment for stroke as is the prevention and, where necessary, treatment of possible complications associated with stroke as well as the provision of individualised treatment programmes to ensure early rehabilitation. Not only does this approach provide an improved chance of survival, it also minimises the extent of any long-term effects.
Our Stroke Unit has been certified (August 2010) as complying with the new and rigorous standards of the German Stroke Society, the German Stroke Foundation and the regional certification institute (LGA InterCert GmbH) and continues to provide patients with acute stroke with round the clock care from a dedicated tream of specialists. The Neurology Clinic's Stroke Unit has been steadily growing since its opening in 1998. It now offers 12 beds and the highest standards in monitoring equipment available, including monitoring patients' blood pressure, heart function (ECG), respiratory rate, blood oxygen, blood sugar and temperature. Our specialist team of neurologists and specialists in internal medicine and neuroradiology is available to patients around the clock, as is the most modern diagnostic and therapeutic equipment, including Computed Tomography (CT), ultrasound and MRI scanning and angiography, as well as systemic and local thrombolysis ("clot-busting" treatment). Treatment within the Unit follows our internal set of standards which are based on the guidelines of the German Society of Neurology (Deutsche Gesellschaft für Neurologie) and the recommendations of the European Stroke Initiative (EUSI). Where necessary, patients can be transferred to the Neurological Intensive Care Unit, which is located in the same building. The Unit works in close cooperation with the Surgical Clinic B (Chirurgische Klinik B), which offers vascular surgery, as well as the Neurosurgical Clinics in Mannheim and Heidelberg.
Following admission, stroke patients will remain in the Stroke Unit for the acute phase of their treatment, which usually lasts between one and five days. Early rehabilitation can start as soon as this initial treatment phase is completed, and is provided by specially trained physiotherapists, speech and language therapists and occupational therapists. Following treatment in the Stoke Unit, patients are transferred to an appropriate Ward for further treatment. Where appropriate, patients may be transferred directly to a rehabilitation clinic. In this case, patients will have the support of the Clinic's Social Services Team, who will arrange continued care for the patient as well as providing advice and support for members of the patient's family.
Our services at a glance:
- Prompt diagnosis of, and treatment for, acute stroke, delivered in a specialist setting
- Option of emergency thrombolysis ("clot-busting" treatment) in selected stroke patients, including catheter-based procedures
- Round the clock availability of diagnostic techniques such as Computed Tomography, Magnetic Resonance Imaging, angiography, ultrasound scanning of the blood vessels supplying the brain, echocardiograms, laboratory testing and ECGs.
- 12 acute stroke unit beds with continuous physiological monitoring, including blood pressure, heart rate, respiratory rate and blood oxygen
- Comprehensive care provided by a multidisciplinary team of doctors, specialist care staff, physiotherapists, occupational therapists, speech and language therapists and social care staff
- Modern ultrasound diagnostics of cerebrovascular disorders
Contacts: Senior Consultant Prof. Dr. Armin Grau, Consultant Dr. Sabine Gass
Telefon: 0621 / 503-4235 (Stroke Unit)
Extrapyramidal movement disorders
Neurological disorders contribute to a number of conditions seen in gynaecology, urology and surgery. Included in this category are disorders of the bladder, erectile dysfunction and faecal incontinence, which can all occur as the result of nerve or muscle disorders.
As part of the assessment of these conditions, neurophysiological investigations of the pelvic floor are conducted as part of the treatment planning process, to ascertain whether symptoms might be caused by nerve or muscle damage.
Patients of the Clinic have access to multiple complementary methods of investigation:
In addition to performing a needle electromyography of the external anal sphincter we also measure the bulbocavernosus reflex and pudendal SEP in order to establish the exact condition of the somatic nerve fibres supplying the pelvic floor muscles.
A number of methods are also available that can measure the activity of the autonomic, i.e. not consciously controlled, nervous system, which works alongside the somatic nervous system and is responsible for controlling a number of important aspects of bladder and bowel function as well as sexual function.
Our close collaboration with the Surgical Clinic A, the Gynaecology Clinic, the Urology Clinic and the Institute for Physical and Rehabilitation Medicine ensures that a comprehensive neurological assessment can be offered in combination with a more targeted approach to the treatment of bladder, bowel and erectile dysfunction.
Referrals to our inpatient service are currently made by the Urology Clinic, the Gynaecology Clinic and Surgical Clinic A. The Neurology Clinic is also involved in the Hospital's Continence and Pelvic Floor Centre.
We offer an outpatient service for electromyography. This service requires a referral from a specialist neurology practice.
Telefon: 0621 503-4226
Neurological disorders are sometimes associated with impaired cognitive performance, including attention disorders, memory disorders and disturbance of language and cognitive function.
Patients can be assessed for such disorders using neuropsychological testing methods, which include formal interviews and standardised testing instruments to ascertain the patient's level of cognitive functioning. The results can be used in differential diagnostic procedures and provide guidance in relation to decisions regarding therapeutic and rehabilitation measures. Follow-up assessments are then used to document any changes in cognitive functioning and serve as a means of establishing treatment effectiveness.
Dementia - advice and counselling services
The effectiveness of treatment for dementia is highly dependent on early intervention. This is why, apart from monitoring disease progression, neuropsychological diagnostics focus mainly on the early diagnosis of dementia.
- ''Understanding Dementia'' courses: Participants will gain a basic understanding of the disorder. Different types of dementia are discussed, including symptoms, diagnosis, as well as treatment options and care.
- Advice and counselling: A meeting is arranged to discuss details of the patient's condition. This meeting involves the patient, members of their family and carer(s). Information on treatment options will be provided, including information on medical and psychosocial treatments available as part of inpatient, outpatient or combined inpatient/outpatient treatment programmes, which are aimed at being adaptable to the individual patient's needs.
- Support group for families and carers of dementia patients: These group sessions are aimed at finding out how best to deal with a person with dementia, as well as providing peer support for members of the group.
Contact: Dipl.-Psych. (qualified psychologist) Martina Schnitzler
Appointments: 0621 / 503-4246
Neurological intensive care
The Neurological Intensive Care Unit is an interdisciplinary unit combining internal medicine and neurology specialists to provide intensive care treatment across the entire spectrum of neurological disorders, including e.g. severe strokes and brain haemorrhages.
Monitoring options available include invasive neuromonitoring using transcranial probes for the monitoring of patients with elevated intracranial pressure, cerebrospinal fluid drainage and non-invasive electrophysiological neuromonitoring, the latter being used in the monitoring of patients with difficult-to-control epilepsy.
Close cooperation between specialists from neuroradiology, neurology and intensive care enables us to regularly perform intra-arterial recanalisations in acute stroke patients and allows us to treat patients who did not respond to standard stroke treatment.
Our interdisciplinary approach ensures optimal care for our patients. It is provided by an interdisciplinary team of medical and nursing specialists who are available round the clock.