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Frontalhirn pp 111-144 | Cite as

Frontallappendegenerationen und verwandte Erkrankungen

  • H. Förstl

Zusammenfassung

1892 beschrieb Arnold Pick den Fall eines dementen Patienten mit auffallender Aphasie und betonter linksseitiger Temporalhirnnatrophie (Pick 1892). Insgesamt publizierte Pick die klinischen und makropathologischen Befunde von 6 Patienten mit fokal betonter Rindenatrophie; nicht alle zeigten eine Degeneration des Frontalkortex (Tabelle 5.1 nach Förstl u. Baldwin 1994). Argyrophile Einschlusskörperchen als ein Substrat fokal betonter Hirnrindenatrophien wurden erstmals von Alois Alzheimer beschrieben (1911). Diese Auflistung zeigt, dass Pick mehr daran gelegen war, Zusammenhänge zwischen Herdsymptomen und kortikaler Lokalisation der Hirnveränderungen zu studieren, als eine neue Krankheit zu entdecken. Das Eponym M. Pick für neuro-degenerativ bedingte Lobäratrophien entspricht keiner scharf definierten Krankheitseinheit (Gans 1923; Onari u. Spatz 1926). Vielmehr sind die frontotemporalen Degenerationen (FTD) eine heterogene Gruppe von Krankheiten mit unterschiedlicher klinischer Symptomatik, verschiedenen morphologischen Grundlagen und uneinheitlicher Genetik. Erst im letzten Jahrzehnt wurden operationalisierte Diagnosekriterien eingefordert und erarbeitet (Tabelle 5.2).

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