Weis Serge, Büttner Andreas
Division of Neuropathology, Department of Pathology and Neuropathology, Kepler University Hospital and School of Medicine, Johannes Kepler University, Linz, Austria.
Department of Forensic Medicine, University of Rostock, Rostock, Germany.
Handb Clin Neurol. 2017;145:181-192. doi: 10.1016/B978-0-12-802395-2.00014-6.
Neuropsychiatric disorders caused by toxic substances pose a great diagnostic challenge due to the large variety of changes caused in the central and peripheral nervous system. The pathogenetic mechanisms at work are multifaceted and partly not solved. In human drug abusers (cannabis, opiates, cocaine, amphetamines, methamphetamine and "designer drugs"), a broad spectrum of central nervous system alterations are observed including infarction, intracerebral and subarachnoidal hemorrhage, hypoxic-ischemic leukoencephalopathy, infections, neuronal loss, specific astroglial and microglial reaction patterns, and vascular changes, including the endothelial cell as well as the basal lamina.
由有毒物质引起的神经精神障碍对诊断提出了巨大挑战，因为中枢和外周神经系统会发生各种各样的变化。起作用的致病机制是多方面的，部分尚未得到解决。在人类药物滥用者（大麻、阿片类药物、可卡因、安非他明、甲基苯丙胺和“设计药物”）中，观察到广泛的中枢神经系统改变，包括梗死、脑内和蛛网膜下腔出血、缺氧缺血性白质脑病、感染、神经元丢失、特定的星形胶质细胞和小胶质细胞反应模式以及血管变化，包括内皮细胞和基底膜。
