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Der Nervenarzt

, Volume 89, Issue 10, pp 1179–1194 | Cite as

Intrakranielle Gefäßmalformationen

  • D. F. Vollherbst
  • M. Bendszus
  • M. A. Möhlenbruch
CME

Zusammenfassung

Intrakranielle Gefäßmalformationen reichen von inzidentellen, asymptomatischen Gefäßveränderungen ohne Krankheitswert bis hin zu lebensbedrohlichen vaskulären Pathologien. Arteriovenöse Malformationen und durale arteriovenöse Fisteln sind intrakranielle Gefäßmalformationen mit arteriovenösen Kurzschlussverbindungen. Sie weisen meist ein erhöhtes Blutungsrisiko auf und können mitunter schwere Symptome verursachen. Therapeutisch stehen ein konservatives Vorgehen, die Mikroneurochirurgie, die endovaskuläre Embolisation und die Strahlentherapie zur Verfügung. Kavernöse Malformationen, „developmental venous anomalies“ (DVA) und kapilläre Teleangiektasien sind intrakranielle Gefäßmalformationen ohne arteriovenösen Kurzschluss. Kavernöse Malformationen werden selten in Form einer Hirnblutung oder durch Kopfschmerzen und Krampfanfälle symptomatisch. Dann kann eine operative Therapie indiziert sein. DVA und kapilläre Teleangiektasien sind meist asymptomatisch und bedürfen keiner Therapie.

Schlüsselwörter

Vaskuläre Erkrankungen Vaskuläre Malformationen des zentralen Nervensystems Intrakranielle arteriovenöse Malformationen Arteriovenöse Fistel Kapilläre Teleangiektasie 

Intracranial vascular malformations

Abstract

Intracranial vascular malformations range from incidental asymptomatic vascular alterations up to life-threatening vascular disorders. Arteriovenous malformations and dural arteriovenous fistulas are cerebral vascular malformations with arteriovenous shunting of blood. In the majority of cases they are accompanied by an elevated risk of intracerebral hemorrhage and can cause severe symptoms. They can be treated conservatively or interventionally via microneurosurgery, endovascular embolization and radiation therapy. Cavernous malformations, developmental venous anomalies (DVA) and capillary telangiectasia are cerebral vascular malformations without arteriovenous shunting. Cavernous malformations are rarely symptomatic in the form of cerebral hemorrhage, headache or seizures and in such cases an operative treatment can be indicated. The DVA and capillary telangiectasia are usually asymptomatic and do not require treatment.

Keywords

Vascular diseases Central nervous system vascular malformations Intracranial arteriovenous malformations Arteriovenous fistula Telangiectasia, capillary 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Bendszus: Referent bzw. Berater für Vascular Dynamics, Guerbet, Boehringer Ingelheim, Braun, Codman Neurovascular und Roche. M.A. Möhlenbruch: Berater, Referent oder Proctor für Balt, Cerenovus, Medtronic, MicroVention und Stryker. D.F. Vollherbst gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • D. F. Vollherbst
    • 1
  • M. Bendszus
    • 1
  • M. A. Möhlenbruch
    • 1
  1. 1.Abteilung für Neuroradiologie, Neurologische KlinikUniversitätsklinikum HeidelbergHeidelbergDeutschland

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