Zerebrale Mikroangiopathien

Die zerebrale Mikroangiopathie wird zunehmend in der Bildgebung entdeckt. Nicht immer findet sich eine klinische Symptomatik, da einige Veränderungen im Rahmen des Alterungsprozesses auftreten und lange Zeit inapparent bleiben können. Dennoch ist das Risiko für einen Schlaganfall und eine Demenz erhöht. Dieser Beitrag gibt einen Überblick über die zerebrale Mikroangiopathie mit ihren häufigsten Formen und zeigt aktuelle Entwicklungen auf.

Kernaussagen

• Zerebrale Mikroangiopathien gehören zu den häufigsten Ursachen des ischämischen Schlaganfalls und der vaskulären Demenz.

• CADASIL ist in der klinischen Präsentation heterogener als gedacht mit zunehmender Beschreibung auch milder Verläufe.

• Die Durchführung blutungssensitiver Sequenzen ist bei der zerebralen Mikroangiopathie wichtig, um das Blutungsrisiko abzuschätzen.

• Bei der zerebralen Amyloidangiopathie sollten blutverdünnende Medikamente nach Nutzen-Risiken-Abwägung verabreicht werden – eine orale Antikoagulation sollte aufgrund der zerebralen Blutungsgefahr vermieden werden.

• Therapeutisch wird die optimale Einstellung der vaskulären Risikofaktoren, insbesondere des Blutdrucks, empfohlen.

Schlüsselwörter

Schlaganfall - vaskuläre Demenz - CADASIL - zerebrale Amyloidangiopathie - Mikroangiopathie

Publikationsverlauf

Artikel online veröffentlicht:
02. Oktober 2025

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