Buczek Elżbieta, Mitosek-Szewczyk Krystyna, Szajnoga Beata, Wierzchowska-Cioch Ewa, Szewczyk Anna
ISPL Poradnia Neurologiczna w Biłgoraju, Polska.
Klinika Neurologii Dziecięcej, DSK w Lublinie, Polska.
Wiad Lek. 2016;69(6):773-777.
Vasculitides in autoimmune diseases are an important cause of secondary headaches. The article discusses the incidence of headache in primary and secondary vasculitides of the central nervous system. The symptoms of primary CNS vasculitis are presented. The occurrence of headache in large-vessel vasculitides, such as Takayasu arteritis and giant cell arteritis; medium-vessel vasculitides, such as polyarteritis nodosa and Kawasaki disease; and small-vessel vasculitides, such as microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis, are characterized. The occurrence of headache in vasculitides of different blood vessels, such as Behcet's disease and Cogan's syndrome, is presented as well. Systemic autoimmune diseases discussed in the paper are systemic lupus erythematosus, antiphospholipid antibody syndrome, rheumatoid arthritis, Sjogren's syndrome, and sarcoidosis. Vasculopathies which can mimic CNS vasculitides were discussed as well. Examples include reversible cerebral vasoconstriction, Susac's symdrome, and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).
自身免疫性疾病中的血管炎是继发性头痛的重要原因。本文讨论了中枢神经系统原发性和继发性血管炎中头痛的发生率。介绍了原发性中枢神经系统血管炎的症状。阐述了大动脉血管炎（如高安动脉炎和巨细胞动脉炎）、中动脉血管炎（如结节性多动脉炎和川崎病）以及小动脉血管炎（如显微镜下多血管炎、肉芽肿性多血管炎和嗜酸性肉芽肿性多血管炎）中头痛的发生情况。还介绍了不同血管的血管炎（如白塞病和科根综合征）中头痛的发生情况。本文讨论的全身性自身免疫性疾病包括系统性红斑狼疮、抗磷脂抗体综合征、类风湿关节炎、干燥综合征和结节病。文中还讨论了可模拟中枢神经系统血管炎的血管病变。例如可逆性脑血管收缩、苏萨克综合征和伴有皮质下梗死和白质脑病的脑常染色体显性动脉病（CADASIL）。
