Das Gehirn auf Drogen: Bildgebung drogenassoziierter Veränderungen im zentralen Nervensystem^[1]

Zusammenfassung

Drogenmissbrauch ist in der heutigen Gesellschaft ein schwerwiegendes Problem, das mit signifikanter Morbidität und Mortalität einhergeht. Verschiedene Drogen haben massive Auswirkungen auf das Gehirn, und es ist von entscheidender Bedeutung, die radiologischen Befunde dieser Komplikationen zu erkennen, um umgehend die angemessene medizinische Versorgung einleiten zu können. Das zentrale Nervensystem ist ein Zielorgan für Drogen ebenso wie für bestimmte Medikamente. Zu den Drogen, die das zentrale Nervensystem schädigen, zählen Kokain, Heroin, Alkohol, Amphetamine, Toluol und Cannabis. Verschreibungspflichtige Medikamente und Behandlungsmaßnahmen, die sich auf das zentrale Nervensystem auswirken können, sind Immunsuppressiva, Antiepileptika, Distickstoffmonoxid und totale parenterale Ernährung. Die das zentrale Nervensystem betreffenden Komplikationen dieser Medikamente umfassen neurovaskuläre Komplikationen, Enzephalopathie, Atrophie, Infektionen, Veränderungen des Corpus callosum und verschiedene andere Veränderungen. Radiologische Anomalien, die auf solche Komplikationen hinweisen, zeigen sich sowohl in der Magnetresonanztomografie als auch in der Computertomografie. Für den Radiologen ist es entscheidend, mit Drogen assoziierte Komplikationen ebenso zu erkennen wie iatrogene Auswirkungen verschiedener Medikamente. Diagnostische Bildgebungsverfahren, wie Magnetresonanztomografie und Computertomografie, können daher eine zentrale Rolle bei der Erkennung und zügigen Behandlung von drogenbedingten, das zentrale Nervensystem betreffenden Komplikationen spielen.

Abstract

Drug abuse is a substantial problem in society today and is associated with significant morbidity and mortality. Various drugs are associated with serious complications affecting the brain, and it is critical to recognize the imaging findings of these complications to provide prompt medical management. The central nervous system (CNS) is a target organ for drugs of abuse as well as specific prescribed medications. Drugs of abuse affecting the CNS include cocaine, heroin, alcohol, amphetamines, toluene, and cannabis. Prescribed medications or medical therapies that can affect the CNS include immunosuppressants, antiepileptics, nitrous oxide, and total parenteral nutrition. The CNS complications of these drugs include neurovascular complications, encephalopathy, atrophy, infection, changes in the corpus callosum, and other miscellaneous changes. Imaging abnormalities indicative of these complications can be appreciated at both magnetic resonance (MR) imaging and computed tomography (CT). It is critical for radiologists to recognize complications related to drugs of abuse as well as iatrogenic effects of various medications. Therefore, diagnostic imaging modalities such as MR imaging and CT can play a pivotal role in the recognition and timely management of drug-related complications in the CNS.

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