Zusammenfassung
In dieser Übersicht werden die isolierte ZNS-Vaskulitis, die zerebrale Beteiligung
bei systemischen Vaskulitiden und Kollagenosen auf neuestem Stand dargestellt. ZNS-Vaskulitiden
zeigen sich mit der Kombination von Kopfschmerzen, multifokalen Ausfällen und Enzephalopathie.
In der Diagnostik sind MRT, digitale Subtraktionsangiographie, Liquor- und Serumbefunde
hilfreich. Laborchemische und neuroradiologische Befunde sind aber letztlich unspezifisch
- sie können die Verdachtsdiagnose einer Vaskulitis nie beweisen; mit Ausnahme des
Behçet-Syndroms gilt für alle Vaskulitiden und Kollagenosen, dass die Diagnose bioptisch
abgesichert werden muss, bevor eine immunsuppressive Therapie eingeleitet wird. Therapie
der Wahl ist zumeist die kombinierte Gabe von Kortikosteroiden und Cyclophosphamid.
Abstract
This review focuses on isolated CNS-angiitis and cerebral involvement in systemic
vasculitides and collagen vascular diseases. CNS-vasculitis presents with headache,
multifocal symptoms, and encephalopathy, respectively. Clinical diagnosis is based
on MRI, angiography and both CSF and serum examinations. But neither laboratory nor
neuroradiological findings are specific - in all vasculitides with the exception of
the Behçet-syndrome a biopsy is necessary before immunosuppressive treatment is started.
Therapy of choice is the combination of corticosteroids and cyclophosphamide.
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Prof. Dr med. P. Berlit
Alfried-Krupp-Krankenhaus
Alfried-Krupp-Straße 21
45117 Essen
Email: peter.berlit@krupp-krankenhaus.de
