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Rofo 2021; 193(11): 1269-1276
DOI: 10.1055/a-1447-0264
Review

MRT-Befunde bei der idiopathischen intrakraniellen Hypertension (Pseudotumor cerebri)

Article in several languages: English | deutsch
Julia Juhász
  Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
,
Johannes Hensler 
  Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
,
Olav Jansen
  Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein – Campus Kiel, Germany
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Zusammenfassung

Hintergrund Der Pseudotumor cerebri, auch idiopathische intrakranielle Hypertension genannt, ist eine Erkrankung mit erhöhtem Liquordruck unklarer Genese. Leitsymptom sind Kopfschmerzen, dessen Charakteristiken anderen Kopfschmerzerkrankungen ähneln, weshalb die idiopathische intrakranielle Hypertension oft unerkannt bleibt. Die Inzidenz wird mit 1/100 000 angegeben, wobei die Dunkelziffer wesentlich höher liegt. Dieser Artikel weist auf die essenzielle Rolle der MRT-Bildgebung in der Differenzialdiagnostik hin.

Methode Es wurde eine Literaturrecherche zu dem Syndrom IIH und Pseudotumor cerebri in englischer und deutscher Sprache durchgeführt. Berücksichtigt wurden sowohl Original- und Übersichtsarbeiten als auch Fallbeispiele. Da der Schwerpunkt des Artikels die MRT-Diagnostik ist, wurde eine Bilderauswahl getroffen, um die charakteristischen MR-morphologischen Merkmale zu veranschaulichen.

Ergebnisse und Schlussfolgerung Die Diagnose der idiopathischen intrakraniellen Hypertension beruht auf einem Ausschlussverfahren. Die typischen klinischen Symptome sind Kopfschmerzen, Sehstörung, pulsatiler Tinnitus und Übelkeit. Findet man eine zugrunde liegende Ursache für den erhöhten intrakraniellen Druck, spricht man von einer sekundären intrakraniellen Hypertension. Die Diagnostik beinhaltet eine ausführliche Anamnese, neurologische und ophthalmologische Untersuchungen, Lumbalpunktion und neuroradiologische bildgebende Verfahren. Insbesondere die MRT hat in den letzten Jahren an Bedeutung gewonnen, da mittlerweile gut erkennbare Zeichen einer Liquordruckänderung definiert sind. Die Therapieansätze sind symptomorientiert und haben das Ziel der Drucksenkung. Bei genauer Diagnostik und rechtzeitigem Therapiebeginn hat die idiopathische intrakranielle Hypertension eine gute Prognose, besonders was die Erhaltung der Sehfähigkeit betrifft.

Kernaussagen: 

  • Die idiopathische intrakranielle Hypertension ist eine wichtige Differenzialdiagnose bei unspezifischen Kopfschmerzen und Sehstörungen.

  • Betroffen sind v. a. übergewichtige Frauen im gebärfähigen Alter.

  • Wichtigster Baustein in der Diagnostik ist die MRT.

Zitierweise

  • Juhász J, Hensler J, Jansen O. MRI-findings in idiopathic intracranial hypertension (Pseudotumor cerebri). Fortschr Röntgenstr 2021; 193: 1269 – 1276

Key words

pseudotumor cerebri - idiopathic intracranial hypertension - secondary intracranial hypertension - MRI - MR-venography


Publication History

Received: 31 October 2020

Accepted: 03 March 2021

Article published online:
12 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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