Diese Übersichtsarbeit gibt anhand von Fallmaterial aus den Archiven des American
Institute for Radiologic Pathology einen Überblick über ein breites Spektrum von ZNS-Infektionen
durch Viren und Prionen sowie über die relevanten klinischen und neuroradiologischen
Merkmale. Sie versteht sich als Ergänzung eines früheren Artikels zu bakteriellen,
mykotischen und parasitären ZNS-Infektionen [1 ].
Abstract
Viral infections of the central nervous system (CNS) range in clinical severity, with
the most severe proving fatal within a matter of days. Some of the more than 100 different
viruses known to affect the brain and spinal cord are neurotropic with a predilection
for producing CNS infection. The host response to viral infection of the CNS is responsible
for the pathophysiology and imaging findings seen in affected patients. Viral CNS
infections can take the form of meningitis, encephalitis, encephalomyelitis, or, when
involving the spinal cord and nerve roots, encephalomyeloradiculitis. In 1982, an
infectious particle termed a prion that lacked nucleic acid and therefore was not
a virus was reported to produce the fatal neurodegenerative disease Creutzfeldt-Jakob
disease and related disorders. These prion diseases produce characteristic neuroimaging
findings that are distinct from those seen in most viral infections. The clinical
and imaging findings associated with viral CNS infection are often nonspecific, with
microbiologic analysis of cerebrospinal fluid the most useful single test allowing
for diagnosis of a specific viral infection. This review details the spectrum of viral
CNS infections and uses case material from the archives of the American Institute
for Radiologic Pathology, with a focus on the specific clinical characteristics and
magnetic resonance imaging features seen in these infections. Where possible, the
imaging features that allow distinction of these infections from other CNS inflammatory
conditions are highlighted.
Schlüsselwörter Infektionen des zentralen Nervensystems - Viren - Prionen - Bildgebung
Keywords infections of the central nervous system - viruses - prions - neuroimaging
