Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Das Thema chronische Unterbauch- und Viszeralschmerzen wird im Live-Webinar am 7. Mai von 17.30 bis 19 Uhr aus internistischer, gynäkologischer und psychologisch-neurowissenschaftlicher Perspektive beleuchtet. Besprochen werden krankheitsbedingte Ursachen, Mechanismen der kognitiven Schmerzmodulation sowie mögliche Therapieoptionen. Die Fortbildung ist mit 2 CME-Punkten zertifiziert. Melden Sie sich jetzt an!
Erweiterte Suche
Anmelden
nach oben
Current Treatment Options in Cardiovascular Medicine
Erschienen in: Current Treatment Options in Cardiovascular Medicine 8/2020

01.08.2020 | Cerebrovascular Disease and Stroke (S Silverman, Section Editor)

Inflammatory Vasculitides of the Central Nervous System

verfasst von: Kelly L. Sloane, MD, Pria Anand, MD

Erschienen in: Current Treatment Options in Cardiovascular Medicine | Ausgabe 8/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose of review

To provide an approach to the evaluation and management of primary and secondary inflammatory vasculitides affecting the central nervous system (CNS).

Recent findings

Although early descriptions of inflammatory CNS vasculitis report a universally high mortality rate, more recent cohorts demonstrate that favorable outcomes rely on early diagnosis and treatment. New and re-purposed medications have shown promise in the treatment of CNS vasculitides, and novel imaging modalities may aid in diagnosis.

Summary

A broad array of diseases can affect CNS vasculature. Accurate diagnosis of CNS vasculitides requires a thorough exploration of systemic inflammatory diseases, as well as a clear understanding of the rare entities that cause vasculitides limited to the CNS.
Literatur
1.
Cravioto H, Feigin I. Noninfectious granulomatous angiitis with a predilection for the nervous system. Neurology. 1959;9:599–609.
2.
Byram K, Hajj-Ali RA, Calabrese L. CNS Vasculitis: an approach to differential diagnosis and management. Curr Rheumatol Rep. 2018;20:37.PubMed
3.
Salvarani C, Brown RD, Calamia KT, Christianson TJH, Weigand SD, Miller DV, et al. Primary central nervous system vasculitis: analysis of 101 patients. Ann Neurol. 2007;62:442–51.PubMed
4.
Salvarani C, Brown RD, Christianson T, Miller DV, Giannini C, Huston J, et al. An update of the Mayo Clinic cohort of patients with adult primary central nervous system vasculitis. Medicine (Baltimore). 2015;94:1–15.
5.
Calabrese LH, Mallek JA. Primary angiitis of the central nervous system: report of 8 new cases, review of the literature, and proposal for diagnostic criteria. Medicine (Baltimore). 1988;67(1):20–39.
6.
Lie JT. Malignant angioendotheliomatosis (intravascular lymphomatosis) clinically simulating primary angiitis of the central nervous system. Arthritis Rheum. 1992;35:831–4.PubMed
7.
De Boysson H, Zuber M, Naggara O, Neau JP, Gray F, Bousser MG, et al. Primary angiitis of the central nervous system: description of the first fifty-two adults enrolled in the french cohort of patients with primary vasculitis of the central nervous system. Arthritis Rheumatol. 2014;66:1315–26.PubMed
8.
Hajj-Ali RA, Furlan A, Abou-Chebel A, Calabrese LH. Benign angiopathy of the central nervous system: cohort of 16 patients with clinical course and long-term followup. Arthritis Rheum. 2002;47:662–9.PubMed
9.
Crane R, Kerr LD, Spiera H. Clinical analysis of isolated angiitis of the central nervous system: a report of 11 cases. Arch Intern Med. 1991;151:2290–4.PubMed
10.
Birnbaum J, Hellmann DB. Primary angiitis of the central nervous system. Arch Neurol. 2009;66:704–9.PubMed
11.
Alhalabi MMP. Serial angiography in isolated angiitis of the central nervous system. Neurology. 1994;44:1221–6.PubMed
12.
Mandell DM, Matouk CC, Farb RI, Krings T, Agid R, Terbrugge K, et al. Vessel wall MRI to differentiate between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis: preliminary results. Stroke. 2012;43:860–2.PubMed
13.
Thaler C, Kaufmann-Bühler AK, Gansukh T, Gansukh A, Schuster S, Bachmann H, et al. Neuroradiologic characteristics of primary angiitis of the central nervous system according to the affected vessel size. Clin Neuroradiol. 2019;29:37–44.PubMed
14.
Obusez EC, Hui F, Hajj-ali RA, Cerejo R, Calabrese LH, Hammad T, et al. Vasculopathy differentiation 2014 RCVS and vasculitis. Am J Neuroradiol. 2014;35:1527–32.PubMedPubMedCentral
15.
Salvarani C, Brown RD, Calamia KT, Huston J, Meschia JF, Giannini C, et al. Efficacy of tumor necrosis factor α blockade in primary central nervous system vasculitis resistant to immunosuppressive treatment. Arthritis Care Res. 2008;59:291–6.
16.
Calabrese LH, Dodick DW, Schwedt TJ, Singhal AB. Annals of internal medicine review narrative review : reversible cerebral vasoconstriction syndromes. Ann Intern Med. 2007;146:34–44.PubMed
17.
Singhal AB, Hajj-Ali RA, Topcuoglu MA, Fok J, Bena J, Yang D, et al. Reversible cerebral vasoconstriction syndromes: analysis of 139 cases. Arch Neurol. 2011;68:1005–12.PubMed
18.
Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser MG. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain. 2007;130:3091–101.PubMed
19.
Singhal AB, Caviness VS, Begleiter AF, Mark EJ, Rordorf G, Koroshetz WJ. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology. 2002;58:130–3.PubMed
20.
Singhal AB, Topcuoglu MA, Fok JW, Kursun O, Nogueira RG, Frosch MP, et al. Reversible cerebral vasoconstriction syndromes and primary angiitis of the central nervous system: clinical, imaging, and angiographic comparison. Ann Neurol. 2016;79:882–94.PubMed
21.
Rocha EA, Topcuoglu MA, Silva GS, Singhal AB. RCVS2 score and diagnostic approach for reversible cerebral vasoconstriction syndrome. Neurology. 2019;92:E639–47.PubMed
22.
Singhal AB, Topcuoglu MA. Glucocorticoid-associated worsening in reversible cerebral vasoconstriction syndrome. Neurology. 2017;88:228–36.PubMedPubMedCentral
23.
Al-Mufti F, Dodson V, Wajswol E, El-Ghanem M, Alchaki A, Nuoman R, et al. Chemical angioplasty for medically refractory reversible cerebral vasoconstriction syndrome*. Br J Neurosurg. 2018;32:431–5.PubMed
24.
Vinters HV. Cerebral amyloid angiopathy a critical review. Stroke. 1987;18:311–24.PubMed
25.
Greenberg S, Rebeck W, Vonsattel JPG, Gomez-Isla T, Hyman BT. Apolipoprotein E ϵ4 and cerebral hemorrhage associated with amyloid angiopathy. Ann Neurol. 1996;38(2):254–9.
26.
Eng JA, Frosch MP, Choi K, Rebeck GW, Greenberg SM. Clinical manifestations of cerebral amyloid angiopathy-related inflammation. Ann Neurol. 2004;55:250–6.PubMed
27.
Kinnecom C, Wendell L, Smith EE. Course of cerebral amyloid angiopathy – related inflammation. Neurology. 2007;68:1411–6.PubMed
28.
Auriel E, Charidimou A, Edip Gurol M, Ni J, Van Etten ES, Martinez-Ramirez S, et al. Validation of clinicoradiological criteria for the diagnosis of cerebral amyloid angiopathy-related inflammation. JAMA Neurol. 2016;73:197–202.PubMed
29.
Piazza F, Greenberg SM, Savoiardo M, Gardinetti M, Chiapparini L, Raicher I, et al. Anti-amyloid β autoantibodies in cerebral amyloid angiopathy-related inflammation: implications for amyloid-modifying therapies. Ann Neurol. 2013;73:449–58.PubMed
30.
Scolding NJ, Joseph F, Kirby PA, Mazanti I, Gray F, Mikol J, et al. Aβ-related angiitis: primary angiitis of the central nervous system associated with cerebral amyloid angiopathy. Brain. 2005;128:500–15.PubMed
31.
Salvarani C, Brown RD, Calamia KT, Christianson TJH, Huston J, Meschia JF, et al. Primary central nervous system vasculitis: comparison of patients with and without cerebral amyloid angiopathy. Rheumatology. 2008;47:1671–7.PubMed
32.
Rigby H, Easton A, Bhan V. Amyloid β-related angiitis of the central nervous system: report of 3 cases. Can J Neurol Sci. 2011;38:626–30.PubMed
33.
Child ND, Flanagan EP, Keegan BM. Clinical/scientific notes. Neurology. 2013;81:1796–9.PubMed
34.
Salvarani C, Hunder GG, Morris JM, Brown RD, Christianson T, Giannini C. Aβ-related angiitis: comparison with CAA without inflammation and primary CNS vasculitis. Neurology. 2013;81:1596–603.PubMedPubMedCentral
35.
Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised international Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheum. 2013;65:1–11.PubMed
36.
Zhang W, Zhou G, Shi Q, Zhang X, Zeng XF, Zhang FC. Clinical analysis of nervous system involvement in ANCA-associated systemic vasculitides. Clin Exp Rheumatol. 2009;27(1 Suppl 52):S65–9.
37.
Graf J. Central nervous system disease in antineutrophil cytoplasmic antibodies–associated vasculitis. Rheum Dis Clin N Am. 2017;43:573–8.
38.
Sada K e, Yamamura M, Harigai M, Fujii T, Dobashi H, Takasaki Y, et al. Classification and characteristics of Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study. Arthritis Res Ther. 2014;16(2):R101.
39.
Chen NC, Lai PH, Fang HC, Chou KJ, Chen CL. Microscopic polyangiitis with an initial presentation of pontine infarction. Am J Med Sci. 2012;344(2):163–5.
40.
Yanagiha K, Ishii K, Ueno T, Marushima A, Tamaoka A. Medial medullary infarction caused by antineutrophil cytoplasmic antibody-related vasculitis: case report and review of the literature. Medicine (Baltimore). 2017;96(33):e7722.
41.
Aratani S, Sakai Y, Tsuruoka S. A case of microscopic polyangiitis with subarachnoid hemorrhage and cardiovascular complications. J Nippon Med Sch. 2017;84:251–5.PubMed
42.
Ito Y, Suzuki K, Yamazaki T, Yoshizawa T, Ohkoshi N, Matsumura A. ANCA-associated vasculitis (AAV) causing bilateral cerebral infarction and subsequent intracerebral hemorrhage without renal and respiratory dysfunction. J Neurol Sci. 2006;240:99–101.PubMed
43.
Patel UV, Patel NJ. Posterior reversible leukoencephalopathy syndrome as a presenting manifestation of p-ANCA-associated vasculitis. BMJ Case Rep. 2014;2014:bcr2013202022.
44.
Marra AM, Barilaro G, Villella V, Granata M. Eosinophilic granulomatosis with polyangiitis (EGPA) and PRES: a case-based review of literature in ANCA-associated vasculitides. Rheumatol Int. 2015;35:1591–5.PubMed
45.
Salvarani C, Pipitone N, Hunder GG. Management of primary and secondary central nervous system vasculitis. Curr Opin Rheumatol. 2016;28:21–8.PubMed
46.
Criteria for Diagnosis of Behçet’s Disease. International study group for Behçet’s disease. 1990;335(8697):1078–80.
47.
Al-Araji A, Kidd DP. Neuro-Behçet’s disease: epidemiology, clinical characteristics, and management. Lancet Neurol. 2009;8:192–204.PubMed
48.
Zouboulis CC, Keitel W. A historical review of early descriptions of Adamantiades-Behçet’s disease. J Invest Dermatol. 2002;119:201–5.PubMed
49.
Siva A, Kantarci OH, Saip S, Altintas A, Hamuryudan V, Islak C, et al. Behçet’s disease: diagnostic and prognostic aspects of neurological involvement. J Neurol. 2001;248:95–103.PubMed
50.
Tavee JO, Stern BJ. Neurosarcoidosis. Contin Lifelong Learn Neurol. 2014;34(4):386–94.
51.
Degardin A, Devos P, Vermersch P, De Seze J. Cerebrovascular symptomatic involvement in sarcoidosis. Acta Neurol Belg. 2010;110(4):349–52.
52.
Choi KD, Choi JH, Park KP, Hak JK, Dae SJ. Involvement of the septum pellucidum and intracranial vessel in neurosarcoidosis. Arch Neurol. 2007;64(1):132–3.
53.
Stern BJ, Royal W, Gelfand JM, Clifford DB, Tavee J, Pawate S, et al. Definition and consensus diagnostic criteria for neurosarcoidosis: from the neurosarcoidosis consortium consensus group. JAMA Neurol. 2018;75:1546.PubMed
54.
Santos E, Shaunak S, Renowden S, Scolding NJ. Treatment of refractory neurosarcoidosis with infliximab. J Neurol Neurosurg Psychiatry. 2010;81:241–6.PubMed
55.
Moravan M, Segal BM. Treatment of CNS sarcoidosis with infliximab and mycophenolate mofetil. Neurology. 2009;72(4):337–40.
56.
Gelfand JM, Bradshaw MJ, Stern BJ, Clifford DB, Wang Y, Cho TA, et al. Infliximab for the treatment of CNS sarcoidosis. Neurology. 2017;89(20):2092–100.
Metadaten
Titel
Inflammatory Vasculitides of the Central Nervous System
verfasst von
Kelly L. Sloane, MD
Pria Anand, MD
Publikationsdatum
01.08.2020
Verlag
Springer US
Erschienen in
Current Treatment Options in Cardiovascular Medicine / Ausgabe 8/2020
Print ISSN: 1092-8464
Elektronische ISSN: 1534-3189
DOI
https://doi.org/10.1007/s11936-020-00817-x

Weitere Artikel der Ausgabe 8/2020

Current Treatment Options in Cardiovascular Medicine 8/2020 Zur Ausgabe

State-of-the-Arts Informatics (C Stultz, Section Editor)

Deep Learning for Cardiovascular Risk Stratification

Imaging (Q Truong, Section Editor)

Updates on Fractional Flow Reserve Derived by CT (FFRCT)

Heart Failure (W Tang, Section Editor)

Shock Team Approaches in Managing Cardiogenic Shock—Intersection Between Critical Care and Advanced Heart Failure and Transplant Cardiology

Imaging (Q Truong, Section Editor)

Cardiovascular Magnetic Resonance Imaging Tissue Characterization in Non-ischemic Cardiomyopathies

Cerebrovascular Disease and Stroke (S Silverman, Section Editor)

Imaging Features of Vulnerable Carotid Atherosclerotic Plaque and the Associated Clinical Implications

Cerebrovascular Disease and Stroke (S Silverman, Section Editor)

Infectious Vasculitides of the Central Nervous System

Neu im Fachgebiet Kardiologie

Das Risiko für Vorhofflimmern in der Bevölkerung steigt

02.05.2024 Vorhofflimmern Nachrichten

Das Risiko, im Lauf des Lebens an Vorhofflimmern zu erkranken, ist in den vergangenen 20 Jahren gestiegen: Laut dänischen Zahlen wird es drei von zehn Personen treffen. Das hat Folgen weit über die Schlaganfallgefährdung hinaus.

VHF-Ablation nützt wohl nur bei reduzierter Auswurfleistung

02.05.2024 Ablationstherapie Nachrichten

Ob die Katheterablation von Vorhofflimmern bei Patienten mit Herzinsuffizienz die Komplikationsraten senkt, scheint davon abzuhängen, ob die Auswurfleistung erhalten ist oder nicht. Das legen die Ergebnisse einer Metaanalyse nahe.

Weniger Extremitätenischämien mit dualer Plättchenhemmung

02.05.2024 Thrombozytenaggregationshemmer Nachrichten

Eine Behandlung mit Ticagrelor zusätzlich zu ASS kann das Risiko für Revaskularisierungen und Amputationen von Extremitäten bei Diabetikern mit stabiler KHK deutlich reduzieren, vor allem für solche mit PAVK. Dafür spricht eine Auswertung der Interventionsstudie THEMIS.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärzte und Psychotherapeuten.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise