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Zerebrale Vaskulitis

Cerebral vasculitis

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Zusammenfassung

Zerebrale Vaskulitiden sind im klinischen Alltag des Neurologen selten, es ist jedoch wichtig, in der Differenzialdiagnose (z. B. bei Arteriitis cranialis, Kollagenosen, Behçet-Syndrom, Wegener-Granulomatose, Churg-Strauss-Syndrom, Lupus erythematodes, Sjögren-Syndrom) an sie zu denken. Leitsymptome sind, in variabler Kombination, Kopfschmerzen, multifokale Ausfälle und Enzephalopathie. Charakteristisch für systemische Vaskulitiden sind akute Entzündungszeichen und die Kombination mit peripher neurologischen Manifestationen (oft schmerzhafte Mononeuropathia multiplex) sowie Manifestationen an anderen Organen (Gelenke, Haut, Augen, Nieren, Lunge, Herz). Bei der isolierten ZNS-Vaskulitis ist ein pathologischer Liquorbefund entscheidend. Wegweisend in der Diagnostik sind bildgebende Verfahren, Liquor- und Serumbefunde; stets ist die histologische Absicherung der Diagnose erforderlich.

Abstract

Cerebral vasculitides are infrequent in neurological practice but important for the differential diagnosis of multifocal CNS symptoms. The clinical presentation is typically a combination of chronic headache, multiple strokes and encephalopathy. In systemic vasculitis, a combination of CNS symptoms with inflammatory signs and with peripheral nervous system symptoms (painful multiplex polyneuropathy) or other organ manifestations (skin, joints, kidney, heart, lungs, eye) are frequent. In isolated CNS angiitis, CSF examinations are of particular value. Besides MRI, angiography, CSF and serum examinations, the verification of the diagnosis by biopsy is mandatory.

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  1. Klinik für Neurologie mit Klinischer Neurophysiologie, Alfried-Krupp-Krankenhaus, Essen

    P. Berlit

  2. Klinik für Neurologie mit Klinischer Neurophysiologie, Alfried-Krupp-Krankenhaus, Alfried-Krupp-Straße 21, 45117, Essen

    P. Berlit

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Berlit, P. Zerebrale Vaskulitis . Nervenarzt 75, 817–830 (2004). https://doi.org/10.1007/s00115-004-1750-3

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