Cerebral vasculitis

In the cerebral vasculitis is very rare immunologically induced inflammation of the vessel walls.

Cerebral vasculitis can ( isolated CNS vasculitis) or incidental occur during the so-called primary CNS vasculitis in systemic vasculitis or infectious diseases. An unclear stroke symptoms in younger patients should be cause for exclusion diagnosis of vasculitis.

Symptoms are headache, neurological deficits and care changes as well as strokes. A characteristic feature of systemic vasculitis are acute signs of inflammation and the combination with peripheral neurological manifestations ( often painful inflammation of nerves ) and manifestations in other organs (joints, skin, eyes, kidneys, lungs, and heart).

When it emerges from the combination of neurological and systemic symptoms is reason to clinical suspicion of vasculitis, must prior to the initiation of immunosuppressive therapy - this also includes corticosteroids - the diagnosis are limited. For this purpose a wide organ-related and laboratory diagnosis is necessary in most cases.

In the isolated CNS vasculitis, a pathological cerebrospinal fluid findings ( CSF) is critical. Leading the way in diagnostic imaging techniques (magnetic resonance imaging, magnetic resonance angiography ), cerebrospinal fluid and serum findings and the histological confirmation of the diagnosis. Conventional angiography is usually also required. The differential diagnosis in the differentiation from other forms of tumors arises in MRI / CT is very difficult there and can usually only be done postoperatively by the pathologist.

Therapeutically is treated depending on the cause usually with corticosteroids and other immunosuppressive immunosuppressive (cyclophosphamide, azathioprine ). Even with appropriate tumor -like lesion may be required neurosurgical intervention.