成人初级中枢神经系统血管炎
Carlo Salvarani1, Robert D Brown, Gene G Hunder
1Unit of Rheumatology, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy. salvarani.carlo@asmn.re.it
Lancet (London, England)
|May 12, 2012
概括
主要中枢神经系统 (CNS) 血管炎会影响大脑和脊髓,呈现出各种神经症状. 早期诊断和治疗对于预防严重后果至关重要.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
背景情况:
- 主要中枢神经系统 (CNS) 血管炎是一种罕见的,异常性炎症性疾病,影响大脑和脊髓.
- 它通常影响50岁左右的个体,呈现出各种神经症状,如头痛,认知变化,焦点弱或中风.
研究的目的:
- 总结主要中枢神经系统血管炎的关键方面,包括其表现,诊断挑战和管理.
- 突出早期识别对有效治疗和改善患者治疗结果的重要性.
主要方法:
- 审查关于初级中枢神经系统血管炎的现有文献.
- 诊断标准的分析,包括神经成像 (MRI),脑脊液分析和活检.
- 讨论治疗策略和差异诊断.
主要成果:
- 血清炎症标志物通常是正常的,而脑脊液异常是常见的 (80-90%).
- 正常的大脑MRI使得诊断不太可能;中枢神经系统组织活检是最终的诊断测试.
- 血管造影是经常使用的,但具有中度的灵敏度和特异性.
结论:
- 早期识别初级中枢神经系统血管炎对于及时干预至关重要.
- 用皮质类固醇和潜在的细胞毒药物治疗可以预防严重的神经系统损伤.
- 将初级中枢神经系统血管炎与可逆大脑血管收缩综合征和二次血管炎等疾病区分开来至关重要.
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