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Klinische Neurophysiologie 2022; 53(04): 216-225
DOI: 10.1055/a-1888-8984
Übersicht

Strukturelle Gehirnveränderungen und Läsionen durch den Konsum illegaler Drogen und Psychedelika

Structural Changes in the Brain Induced by Illegal Drugs
Martin Wiesmann
1   Klinik für Diagnostische und Interventionelle Neuroradiologie, Uniklinik RWTH Aachen, Germany
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Zusammenfassung

Drogen können sowohl die Funktion wie auch die Struktur des Gehirns verändern. Gelegentlicher oder regelmäßiger Drogenkonsum ist in der Bevölkerung weit verbreitet. Daher ist die Kenntnis möglicher Nebenwirkungen und charakteristischer Bildbefunde bei Untersuchungen des Gehirns für den klinischen Alltag wichtig. Dieser Artikel beschreibt die für die am weitesten verbreiteten Substanzen typischen Komplikationen und morphologisch-radiologischen Veränderungen. Zu den möglichen Pathomechnismen gehören neurotoxische Effekte, die zu Leukenzephalopathie oder Hirnatrophie führen können, und vaskuläre Komplikationen wie Vasokonstriktion, Vaskulitis oder Hypertonus, durch die es zu intrazerebralen Blutungen oder Infarkten kommen kann. Da die klinische Präsentation oft unspezifisch ist, und die betroffenen Patienten ihren Drogenkonsum häufig verschweigen, ist das Erkennen typischer Bildbefunde essentiell für eine zuverlässige Diagnosestellung und zielgerichtete Therapie.

Abstract

Illegal drugs can alter both the function and structure of the brain. Because of the high prevalence of occasional or regular drug abuse in the population, knowledge of possible side effects and characteristic neuroimaging findings is important for clinical practice. This article describes the typical complications and structural brain imaging findings of the most widely used substances. Possible pathomechnisms include neurotoxic effects that may lead to leukencephalopathy or cerebral atrophy, or vascular complications such as vasoconstriction, vasculitis, or hypertension that may cause intracerebral hemorrhage or infarction. Since the clinical presentation is often nonspecific, and afflicted patients often conceal their drug use, recognition of typical imaging findings is essential to establish the diagnosis and initiate targeted therapy.

Schlüsselwörter

Drogenabusus - Magnetresonanztomographie - Computertomographie - Schlaganfall - intrazerebrale Blutung - Vasokonstriktion - Leukenzephalopathie - Hirnatrophie

Key words

Drug abuse - magnetic resonance imaging - computed tomography - stroke - intracerebral hemorrhage - vasoconstriction - leukoencephalopathy - brain atrophy


Publication History

Article published online:
28 September 2022

© 2022. Thieme. All rights reserved.

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