Dissektionen der hirnversorgenden Arterien, spontan und traumatisch, extra – und intrakraniell – Aktuelle Konzepte zur Pathophysiologie, Diagnostik und Therapie

Zusammenfassung

Dissektionen hirnversorgender Arterien entstehen durch Bildung eines intramuralen Hämatoms, das spontan oder nach einem Trauma in den extrakraniellen (häufig) oder intrakraniellen (seltener) Arteriensegmenten entstehen kann. In dieser Übersichtsarbeit werden die Unterschiede zwischen spontanen und traumatischen Dissektionen analysiert und eine neue Hypothese zur Pathophysiologie spontaner Dissektionen vorgestellt. Diese Arbeit soll zudem auch eine Übersicht über die variablen klinischen Symptome, die aktuellen diagnostischen Standards, die neuesten Entwicklungen der bildgebenden Diagnostik sowie die medikamentösen und interventionellen Therapieoptionen spontaner oder traumatischer, extra- und intrakranieller Dissektionen geben.

Abstract

Dissections of the brain-supplying arteries arise from the formation of an intramural haematoma, which can occur spontaneously or after a trauma in the extracranial (frequently) and intracranial (less frequently) arterial segments. In this overview, the differences between spontaneous and traumatic dissections are analysed and a new pathophysiological concept of the origin of spontaneous dissections is presented. This paper also provides an overview about the various clinical symptoms, the current diagnostic standards, the recent developments of diagnostic imaging and the state of the art medical and interventional therapy for spontaneous or traumatic extra- and intracranial dissections.

Schlüsselwörter

Dissektion - Trauma - intrakraniell hirnversorgende Arterien - Ultraschall - MRT - CT - Angiografie

Key words

dissection - trauma - intracranial brain-supplying arteries - ultrasound - MRI - CT - angiography

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