engleski

The role of ultrasound in diagnosing nonatherosclerotic vasculopathies of the nervous system

Vasculitis of the nervous system includes a group of disorders characterised by the histologic feature of inflammation of blood vessels. Vasculitides are divided into primary and secondary vasculitides. Primary vasculitides are those without identifiable underlying pathogenesis, and are further divided according to the pattern of histologic abnormalities and distribution of clinical features. Secondary vasculitides are caused by infectious, toxic or neoplastic vascular inflammation, or may be associated with collagen vascular diseases. In diagnosing primary vasculitides, secondary ones must be excluded. Nonatherosclerotic vasculopathies may cause ischemic lesions in the central nervous system, especially in women. Ultrasound examinations such as a color Doppler of the neck may help in the diagnosis of some types of vasculopathies (such as a giant cell arteritis or fibromuscular dysplasia, where concentric stenosis or dissection can be seen). Transcranial color coded sonography of the circle of Willis may show obliterative disease (Moya Moya disease) or redistribution of hemodynamics due to extracranial occlusive disease. Also, changed spectra of a higher resistance pattern suggest distal involvement. TCD with its modifications (detection of emboli, functional tests) may point to the organ involvement (heart) or may show impaired autoregulation due to distal involvement, which cannot be seen directly.

ultrasound; vasculopathies; nervous system

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