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DiPaola E, Cameron S, Rylander H, Zidan N, Hetzel S. Comparison of D-dimer concentration and thromboelastography for diagnosis of cerebrovascular accidents in dogs: A retrospective study. J Vet Intern Med 2024; 38:1083-1091. [PMID: 38328940 PMCID: PMC10937503 DOI: 10.1111/jvim.17000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Cerebrovascular accidents (CVAs) in dogs are diagnosed using magnetic resonance imaging (MRI). This modality is sometimes unavailable, and CVAs can resemble other lesions on MRI. D-dimer concentration and thromboelastography (TEG) are utilized in human medicine in addition to diagnostic imaging to support diagnosis of CVAs, but their use in veterinary patients has not been assessed. OBJECTIVE Assess utility of blood D-dimer concentration and TEG in supporting the imaging diagnosis of CVAs in dogs. ANIMALS Sixty-eight client-owned dogs with neurologic signs that had brain MRI and D-dimer concentration or TEG performed. METHODS Multicenter, retrospective study. The incidence of abnormal D-dimer concentration or TEG was compared between patients with MRI evidence of CVA and a control population. Analysis methods included Fisher's exact test or Chi-squared test for association and comparison of independent proportions. RESULTS Neither D-dimer concentration nor TEG was significantly associated with a CVA (P = .38 and .2, respectively). D-dimer testing was performed in a low-risk population and showed low sensitivity (30.8%; 95% confidence interval [CI], 10%-61%) and high specificity (86.4%; 95% CI, 64%-96%) for CVA diagnosis. Thromboelastography was performed in a high-risk population and showed moderate sensitivity (64.3%; 95% CI, 44%-81%) and specificity (66.7%; 95% CI, 24%-94%) for CVA diagnosis. Abnormal D-dimer concentration or TEG were not helpful in differentiating hemorrhagic from ischemic stroke (P = .43 and .41, respectively). CONCLUSIONS Although blood D-dimer concentration or TEG alone are not diagnostic of CVAs in dogs, a positive D-dimer result supports additional testing for CVA.
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Affiliation(s)
- Elizabeth DiPaola
- Department of Medical SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Starr Cameron
- Department of Medical SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Helena Rylander
- Department of Medical SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Natalia Zidan
- Department of Medical SciencesUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Scott Hetzel
- Department of Biostatistics and Medical InformaticsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Xu H, Xu Z, Long S, Li Z, Jiang J, Zhou Q, Huang X, Wu X, Wei W, Li X. The role of the gut microbiome and its metabolites in cerebrovascular diseases. Front Microbiol 2023; 14:1097148. [PMID: 37125201 PMCID: PMC10140324 DOI: 10.3389/fmicb.2023.1097148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Abstract
The gut microbiome is critically involved in maintaining normal physiological function in the host. Recent studies have revealed that alterations in the gut microbiome contribute to the development and progression of cerebrovascular disease via the microbiota-gut-brain axis (MGBA). As a broad communication network in the human body, MGBA has been demonstrated to have significant interactions with various factors, such as brain structure and function, nervous system diseases, etc. It is also believed that the species and composition of gut microbiota and its metabolites are intrinsically linked to vascular inflammation and immune responses. In fact, in fecal microbiota transplantation (FMT) research, specific gut microbiota and downstream-related metabolites have been proven to not only participate in various physiological processes of human body, but also affect the occurrence and development of cerebrovascular diseases directly or indirectly through systemic inflammatory immune response. Due to the high mortality and disability rate of cerebrovascular diseases, new treatments to improve intestinal dysbacteriosis have gradually attracted widespread attention to better ameliorate the poor prognosis of cerebrovascular diseases in a non-invasive way. This review summarizes the latest advances in the gut microbiome and cerebrovascular disease research and reveals the profound impact of gut microbiota dysbiosis and its metabolites on cerebrovascular diseases. At the same time, we elucidated molecular mechanisms whereby gut microbial metabolites regulate the expression of specific interleukins in inflammatory immune responses. Moreover, we further discuss the feasibility of novel therapeutic strategies targeting the gut microbiota to improve the outcome of patients with cerebrovascular diseases. Finally, we provide new insights for standardized diagnosis and treatment of cerebrovascular diseases.
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Affiliation(s)
- Hongyu Xu
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Ziyue Xu
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Shengrong Long
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Zhengwei Li
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Jiazhi Jiang
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Qiangqiang Zhou
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Xiaopeng Huang
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Xiaohui Wu
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- *Correspondence: Xiaohui Wu,
| | - Wei Wei
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Wei Wei,
| | - Xiang Li
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Brain Research Center, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
- Xiang Li,
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Lu L, Zhang Y, Chen C, Field RW, Kahe K. Radon exposure and risk of cerebrovascular disease: a systematic review and meta-analysis in occupational and general population studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:45031-45043. [PMID: 35460001 PMCID: PMC9209369 DOI: 10.1007/s11356-022-20241-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
Although it is biologically plausible, findings relating radon exposure to the risk of cerebrovascular disease (CeVD) are inconsistent and inconclusive. To investigate whether radon exposure was associated with the risk of CeVD, we qualitatively and quantitatively summarized the literature on radon and CeVD in both occupational and general populations. A search of PubMed, Embase, Scopus, and Web of Science was performed for peer-reviewed articles published through March 2022. Studies were excluded if radon exposure was not assessed separately from other ionizing radiation. In the meta-analysis, excess relative risks (ERRs) were converted to relative risks (RRs), and the pooled RRs and 95% confidence intervals (CIs) were determined using the random-effects model (DerSimonian and Laird). In the systematic review, nine eligible studies were summarized. Six occupational studies indicated inconsistent associations between cumulative radon exposure and CeVD mortality among mine workers. With available data from four updated occupational studies (99,730 mine workers and 2745 deaths), the pooled RR of radon exposure with CeVD mortality showed a non-significant association (1.10, 95% CI 0.92, 1.31). Three studies (841,270 individuals and 24,288 events) conducted in general populations consistently demonstrated a significant inverse relationship between residential radon exposure and risk of CeVD. The existing literature suggested a potential link between radon exposure and CeVD risk in general population. The inconsistent association in occupationally exposed populations may be explained by different methods of radon assessment and other methodological issues. Since radon exposure is a common public health issue, more rigorously designed epidemiologic studies, especially in the general population are warranted.
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Affiliation(s)
- Liping Lu
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Yijia Zhang
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Cheng Chen
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA
| | - Robert William Field
- Department of Occupational and Environmental Health and Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA
| | - Ka Kahe
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY, 10032, USA.
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Unilateral decrease in inner ear signal in fluid-attenuated inversion recovery sequences in previously suspected canine idiopathic vestibular syndrome. Vet J 2021; 277:105748. [PMID: 34537343 DOI: 10.1016/j.tvjl.2021.105748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
The aetiology of canine idiopathic vestibular syndrome (IVS) remains unclear. In human medicine, characteristic magnetic resonance imaging (MRI) techniques are used to demonstrate differences in endolymph composition between affected and unaffected inner ears. The purpose of this study was to determine whether similar MRI techniques could help to detect changes in the inner ears of canine IVS patients. Medical records from two veterinary referral clinics were reviewed retrospectively. Dogs were included if they had a diagnosis of IVS, obvious lateralisation of clinical signs, and an MRI of the vestibular system. A region of interest (ROI) was manually outlined by defining the anatomical area of the inner ear in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. In order to calculate the ratio of FLAIR suppression of each ear, the mean grey value of the ROI was determined in both sequences. If a unilateral decrease in suppression was identified, it was compared with the direction of clinical signs. In total, 80 dogs were included in the study. There was a significantly lower degree of suppression on the affected compared to the unaffected side (0.8886 vs. 0.9348, respectively; P = 0.0021). In 92.5% of cases, there was agreement between the most suppressed side on MRI and the direction of clinical signs. This study provides preliminary evidence about the appearance of endolymph on MRI of dogs with IVS. Further studies are needed to investigate associations between the severity of MRI changes and prognosis.
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Danciu CG, Szladovits B, Crawford AH, Ognean L, De Decker S. Cerebrospinal fluid analysis lacks diagnostic specificity in dogs with vestibular disease. Vet Rec 2021; 189:e557. [PMID: 34101197 DOI: 10.1002/vetr.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 04/20/2021] [Accepted: 05/23/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Although, vestibular syndrome is a common neurological presentation, little is known about the diagnostic value of cerebrospinal fluid (CSF) analysis in vestibular syndrome in dogs. METHODS Medical records were retrospectively reviewed, and dogs with vestibular disease that had undergone magnetic resonance imaging of the head, CSF analysis and were diagnosed with central or peripheral vestibular syndrome were included. Disorders affecting the central vestibular system included meningoencephalitis of unknown origin (MUO), brain neoplasia, ischaemic infarct, intracranial empyema or metronidazole toxicity. Disorders affecting the peripheral vestibular system included idiopathic vestibular disease, otitis media/interna or neoplasia affecting the inner ear structures. Total nucleated cell concentration (TNCC), total protein concentration (TP) and cytologic assessment were recorded. RESULTS A total of 102 dogs met the inclusion criteria. The sensitivity and specificity of increased CSF TNCC to differentiate central from peripheral vestibular syndrome was 49% and 90%, while the sensitivity and specificity of increased TP was 58% and 39%, respectively. The TNCC and TP in dogs with MUO were significantly higher than in dogs with idiopathic vestibular disease (p = 0.000 and p = 0.004). MUO was associated with lymphocytic pleocytosis, while idiopathic vestibular disease and ischaemic infarct were associated with the presence of activated macrophages or normal cytology (p = 0.000). CONCLUSION Although consistent CSF abnormalities were observed in dogs with MUO, CSF analysis did not allow reliable differentiation between central and peripheral vestibular syndrome. CSF analysis is not reliable as the sole diagnostic technique in dogs with vestibular disease.
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Affiliation(s)
- Cecilia Gabriella Danciu
- Department of Veterinary Preclinical and Clinical Science and Service, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, Cluj-Napoca, Romania
| | - Balazs Szladovits
- Department of Pathobiology and Populations Sciences, Royal Veterinary College, University of London, Hatfield, UK
| | - Abbe Harper Crawford
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
| | - Laurentiu Ognean
- Department of Veterinary Preclinical and Clinical Science and Service, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, Cluj-Napoca, Romania
| | - Steven De Decker
- Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK
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Arnold SA, Platt SR, Gendron KP, West FD. Imaging Ischemic and Hemorrhagic Disease of the Brain in Dogs. Front Vet Sci 2020; 7:279. [PMID: 32528985 PMCID: PMC7266937 DOI: 10.3389/fvets.2020.00279] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/27/2020] [Indexed: 01/12/2023] Open
Abstract
Strokes, both ischemic and hemorrhagic, are the most common underlying cause of acute, non-progressive encephalopathy in dogs. In effect, substantial information detailing the underlying causes and predisposing factors, affected vessels, imaging features, and outcomes based on location and extent of injury is available. The features of canine strokes on both computed tomography (CT) and magnetic resonance imaging (MRI) have been described in numerous studies. This summary article serves as a compilation of these various descriptions. Drawing from the established and emerging stroke evaluation sequences used in the investigation of strokes in humans, this summary describes all theoretically available sequences. Particular detail is given to logistics of image acquisition, description of imaging findings, and each sequence's advantages and disadvantages. As the imaging features of both forms of strokes are highly representative of the underlying pathophysiologic stages in the hours to months following stroke onset, the descriptions of strokes at various stages are also discussed. It is unlikely that canine strokes can be diagnosed within the same rapid time frame as human strokes, and therefore the opportunity for thrombolytic intervention in ischemic strokes is unattainable. However, a thorough understanding of the appearance of strokes at various stages can aid the clinician when presented with a patient that has developed a stroke in the days or weeks prior to evaluation. Additionally, investigation into new imaging techniques may increase the sensitivity and specificity of stroke diagnosis, as well as provide new ways to monitor strokes over time.
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Affiliation(s)
- Susan A Arnold
- Department of Veterinary Clinical Sciences, University of Minnesota Twin Cities, St. Paul, MN, United States
| | - Simon R Platt
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, United States
| | - Karine P Gendron
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, United States
| | - Franklin D West
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, United States
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8
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Platt SR, Coates JR, Eifler DM, Edwards GL, Kent M, Bulsara KR. Effect of treatment with simvastatin and cyclosporine on neurotransmitter concentrations in cerebrospinal fluid after subarachnoid hemorrhage in dogs. Am J Vet Res 2013; 74:1111-7. [PMID: 23879849 DOI: 10.2460/ajvr.74.8.1111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To measure concentrations of glutamate, aspartate, γ-aminobutyric acid (GABA), and glycine in CSF of dogs with experimentally induced subarachnoid hemorrhage (SAH) and to assess effects of cyclosporine and simvastatin on these concentrations. SAMPLE CSF samples from 13 dogs. PROCEDURES In a previous study, SAH was induced in dogs via 2 injections of autologous blood into the cerebellomedullary cistern 24 hours apart. Dogs were untreated (control; n = 5) or received simvastatin alone (4) or simvastatin in combination with cyclosporine (4). Samples of CSF were collected before the first blood injection (baseline; time 0), before the second blood injection, and on days 3, 7, and 10. For the study reported here, neurotransmitter concentrations in CSF were analyzed via high-performance liquid chromatography. Data were analyzed with a repeated-measures model with adjustments for multiple comparisons by use of the Tukey method. RESULTS In control dogs, the glutamate concentration peaked on day 3 and there was a significant increase in GABA and glutamate concentrations. Glutamate concentrations were significantly lower and glycine concentrations significantly higher on day 3 after administration of simvastatin alone or simvastatin in combination with cyclosporine, compared with concentrations for the control group. No significant differences in GABA and aspartate concentrations were detected among treatment groups at any time point. CONCLUSIONS AND CLINICAL RELEVANCE Glutamate concentrations were increased in the CSF of dogs with SAH. Simvastatin administration attenuated high glutamate concentrations. A combination of immunosuppression and upregulation of nitric oxide synthase may be useful in lowering high glutamate concentrations in ischemic CNS conditions.
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Affiliation(s)
- Simon R Platt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
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José-López R, la Fuente CD, Añor S. Presumed brain infarctions in two dogs with systemic leishmaniasis. J Small Anim Pract 2012; 53:554-7. [PMID: 22882167 DOI: 10.1111/j.1748-5827.2012.01259.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Clinical signs and magnetic resonance imaging findings of multiple brain infarcts in two dogs infected with Leishmania spp. are reported. Clinical signs of intracranial dysfunction were peracute and there was no further deterioration. Magnetic resonance images of the brain were consistent with multifocal, non-haemorrhagic, ischaemic lesions. Routine serum biochemistry revealed hyperproteinaemia and hyperglobulinaemia. Serum antibody titres were highly positive for Leishmania infantum and Leishmania amastigotes were seen within bone marrow macrophages in both cases. Canine leishmaniasis can cause cerebrovascular alterations, such as vasculitis, that might predispose dogs to brain infarcts.
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Affiliation(s)
- R José-López
- Department of Animal Medicine and Surgery, Veterinary School, Universitat Autònoma de Barcelona, 08193, Bellaterra (Barcelona), Spain
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Jacqmot OD, Snaps FR, Maquet NM, Heinen MPA, Gabriel AE. Arterial Head Vascularization Cartographies of Normal Metencephalic Dogs Using Magnetic Resonance Angiography. Anat Rec (Hoboken) 2011; 294:1834-41. [DOI: 10.1002/ar.21479] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 07/29/2011] [Indexed: 11/10/2022]
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TIDWELL AMYS, ROBERTSON IAND. MAGNETIC RESONANCE IMAGING OF NORMAL AND ABNORMAL BRAIN PERFUSION. Vet Radiol Ultrasound 2011; 52:S62-71. [DOI: 10.1111/j.1740-8261.2010.01786.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Altay UM, Skerritt GC, Hilbe M, Ehrensperger F, Steffen F. Feline Cerebrovascular Disease: Clinical and Histopathologic Findings in 16 Cats. J Am Anim Hosp Assoc 2011; 47:89-97. [DOI: 10.5326/jaaha-ms-5480] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sixteen cats with cerebrovascular disease confirmed via histology to be of nontraumatic and nonneoplastic origins are described. In addition, the anatomy of the arterial supply of the cat's brain is reviewed. It is suggested that this unique arterial design may influence the incidence of cerebrovascular accidents in this species. Of the 16 cats reviewed, seven cats had ischemic infarctions, five had hemorrhagic infarctions, and four were diagnosed with intracranial hemorrhage. The median age was 8 yr and 9.5 yr in cats with infarctions and intracranial hemorrhages, respectively. Clinical signs were severe, acute, consistent with the localization of the cerebrovascular lesion, and influenced by underlying pathology. Four cats with infarction showed lateralized neurologic signs. Four cats with infarctions were diagnosed with pulmonary disease antemortem and three cats had hyperthyroidism. Cerebrospinal fluid analysis and computed tomography scans were available in two cats. None of the infarctions were grossly visible. All cats with hemorrhagic infarcts had severe liver pathology and nephritis was identified in four cats. Hypoxia was a feature in four cats and one cat suffered cardiac failure. In conclusion, the clinical picture is influenced by the type of cerebrovascular disease, the localization of the intracranial lesions, and any underlying pathology.
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Affiliation(s)
- Ulrike Michal Altay
- Department of Small Animals, Clinic of Small Animal Surgery/Neurology (U.M.A., F.S.) and the Institute of Veterinary Pathology (F.E., M.H.), Vetsuisse Faculty University of Zurich, Zurich, Switzerland; and ChesterGates Referral Hospital, Chester, UK (U.M.A., G.S.)
| | - Geoff C. Skerritt
- Department of Small Animals, Clinic of Small Animal Surgery/Neurology (U.M.A., F.S.) and the Institute of Veterinary Pathology (F.E., M.H.), Vetsuisse Faculty University of Zurich, Zurich, Switzerland; and ChesterGates Referral Hospital, Chester, UK (U.M.A., G.S.)
| | - Monika Hilbe
- Department of Small Animals, Clinic of Small Animal Surgery/Neurology (U.M.A., F.S.) and the Institute of Veterinary Pathology (F.E., M.H.), Vetsuisse Faculty University of Zurich, Zurich, Switzerland; and ChesterGates Referral Hospital, Chester, UK (U.M.A., G.S.)
| | - Felix Ehrensperger
- Department of Small Animals, Clinic of Small Animal Surgery/Neurology (U.M.A., F.S.) and the Institute of Veterinary Pathology (F.E., M.H.), Vetsuisse Faculty University of Zurich, Zurich, Switzerland; and ChesterGates Referral Hospital, Chester, UK (U.M.A., G.S.)
| | - Frank Steffen
- Department of Small Animals, Clinic of Small Animal Surgery/Neurology (U.M.A., F.S.) and the Institute of Veterinary Pathology (F.E., M.H.), Vetsuisse Faculty University of Zurich, Zurich, Switzerland; and ChesterGates Referral Hospital, Chester, UK (U.M.A., G.S.)
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Abstract
Cerebrovascular disease is defined as any abnormality of the brain resulting from a pathologic process affecting its blood supply. Stroke or cerebrovascular accident (CVA) is the most common clinical manifestation of cerebrovascular disease, and can be broadly divided into ischemic stroke and hemorrhagic stroke. Ischemic stroke results from occlusion of a cerebral blood vessel by a thrombus or embolism, depriving the brain of oxygen and glucose, whereas hemorrhagic stroke results from rupture of a blood vessel wall within the brain parenchyma or subarachnoid space. Previously considered uncommon, CVA is being recognized with greater frequency in veterinary medicine since magnetic resonance imaging has become more readily available. Once the diagnosis of ischemic or hemorrhagic stroke is confirmed, potential underlying causes should be sought after and treated accordingly.
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Kang BT, Lee JH, Jung DI, Park C, Gu SH, Jeon HW, Jang DP, Lim CY, Quan FS, Kim YB, Cho ZH, Woo EJ, Park HM. Canine model of ischemic stroke with permanent middle cerebral artery occlusion: clinical and histopathological findings. J Vet Sci 2008; 8:369-76. [PMID: 17993751 PMCID: PMC2868153 DOI: 10.4142/jvs.2007.8.4.369] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of the present study was to assess the clinical and histopathological findings in a canine model of ischemic stroke. Cerebral ischemic stroke was induced by middle cerebral artery occlusion in four healthy beagle dogs using silicone plugs. They showed neurological signs of forebrain dysfunction such as reduced responsiveness, head turning, circling, postural reaction deficits, perceptual deficits, and hemianopsia. These signs gradually regressed within 4 weeks without therapy. On magnetic resonance imaging, T2 hyperintensity and T1 hypointensity were found in the cerebral cortex and basal ganglia. These lesions were well-defined and sharply demarcated from adjacent brain parenchyma with a homogenous appearance. No abnormalities of the cerebrospinal fluid were observed. At necropsy, atrophic and necrotic lesions were observed in the cerebral cortex. The cerebral cortex, basal ganglia, and thalamus were partially unstained with triphenyl- tetrazolium chloride. Histopathologically, typical features of infarction were identified in cortical and thalamic lesions. This study demonstrates that our canine model resembles the conditions of real stroke patients.
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Affiliation(s)
- Byeong-Teck Kang
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 143-701, Korea
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Irwin JC, Dewey CW, Stefanacci JD. Suspected cerebellar infarcts in 4 dogs. J Vet Emerg Crit Care (San Antonio) 2007. [DOI: 10.1111/j.1476-4431.2007.00220.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cherubini GB, Rusbridge C, Singh BP, Schoeniger S, Mahoney P. Rostral cerebellar arterial infarct in two cats. J Feline Med Surg 2007; 9:246-53. [PMID: 17317258 PMCID: PMC10822625 DOI: 10.1016/j.jfms.2006.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2006] [Indexed: 11/25/2022]
Abstract
A 10-year-old female neutered domestic shorthair (DSH) cat and a 6-year-old female neutered Siamese cat were presented following a peracute onset of decerebellate rigidity and a cerebellar vestibular syndrome, respectively. In both cats, physical examination and routine blood tests were unremarkable, as was routine analysis of cerebrospinal fluid obtained from the DSH cat. Based on the magnetic resonance imaging (MRI) features - focal wedge-shaped lesion in the cerebellum characterised by hyperintensity in T2-weighted, T2( *)-gradient echo and fluid attenuated inversion recovery (FLAIR) images - a presumptive diagnosis of cerebellar infarct was made in both cases. In the DSH cat, the post-mortem examination confirmed the diagnosis of cerebellar infarct and additionally found acute renal infarcts and a pulmonary neoplasia. In the Siamese cat, ultrasonographic evaluation of the heart revealed a probable low-grade chronic valvular endocarditis which was thought to be a potential source of thromboembolism. This paper describes the first two cases - one confirmed and the other suspected - of cerebellar infarct in the cat. The in vivo potential diagnostic value of the MRI study is highlighted. Cerebellar infarcts should be included in the differential diagnosis of cat with a peracute onset of cerebellar signs regardless of the severity of neurological deficits.
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Affiliation(s)
- Giunio Bruto Cherubini
- The Queen Mother Hospital for Animals, The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Herts AL9 7TA, UK.
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Garosi L, McConnell J, Platt S, Barone G, Baron J, Lahunta A, Schatzberg S. Clinical and Topographic Magnetic Resonance Characteristics of Suspected Brain Infarction in 40 Dogs. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb02862.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Abstract
Cerebrovascular accidents, also known as strokes, are one of the major causes of disability and mortality among adult humans. The increased availability of magnetic resonance imaging in veterinary medicine means they are being increasingly recognised in dogs, too. Cerebrovascular accident is defined as the sudden onset of non-progressive, focal brain dysfunction as a result of ischaemic infarction or haemorrhage. Focal ischaemic stroke is caused by interruption of the arterial blood flow to a dependent area of brain parenchyma by a thrombus or an embolus. Once the diagnosis of ischaemic stroke is confirmed, potential sources of thrombosis or embolism should be investigated and treated accordingly. Dogs with ischaemic stroke tend to recover within several weeks with supportive care only.
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Affiliation(s)
- L S Garosi
- Animal Health Trust, Centre for Small Animal Studies, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU
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19
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Garosi L, McConnell J, Platt S, Barone G, Baron J, Lahunta A, Schatzberg S. Results of Diagnostic Investigations and Long-Term Outcome of 33 Dogs with Brain Infarction (2000-2004). J Vet Intern Med 2005. [DOI: 10.1111/j.1939-1676.2005.tb02752.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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McConnell JF, Garosi L, Platt SR. MAGNETIC RESONANCE IMAGING FINDINGS OF PRESUMED CEREBELLAR CEREBROVASCULAR ACCIDENT IN TWELVE DOGS. Vet Radiol Ultrasound 2005; 46:1-10. [PMID: 15693551 DOI: 10.1111/j.1740-8261.2005.00001.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The magnetic resonance imaging (MRI) findings of presumed cerebrovascular accident in 12 dogs are described. Fourteen lesions were seen, commonly (11 of 14) within the gray matter of the cerebellar hemispheres or vermis. Thirteen lesions were hyperintense on T2-weighted images (in 11 dogs) and one was hypointense. Eleven of 14 lesions were within the region supplied by the rostral cerebellar artery or one of its main branches and there was no, or minimal, mass effect. Contrast enhancement was only seen in six lesions and was mild in all. Gradient-echo images provided additional information in two dogs. The appearance of infarction in dogs with diffusion-weighted images (DWI) is similar to that in humans, and provided supportive evidence for the diagnosis of infarction in five dogs. The use of gradient-echo and DWI is recommended for the evaluation of suspected cerebrovascular accidents in dogs. Six of the 12 affected animals were spaniels or spaniel crosses, suggesting a possible breed predisposition.
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Affiliation(s)
- J F McConnell
- Animal Health Trust, Newmarket, Centre for Small Animal Studies, Suffolk CB8 7UU, UK.
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21
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Panarello GL, Dewey CW, Barone G, Stefanacci JD. Magnetic resonance imaging of two suspected cases of global brain ischemia. J Vet Emerg Crit Care (San Antonio) 2004. [DOI: 10.1111/j.1476-4431.2004.04007.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Lema PP, Girard C, Vachon P. Evaluation of dexamethasone for the treatment of intracerebral hemorrhage using a collagenase-induced intracerebral hematoma model in rats. J Vet Pharmacol Ther 2004; 27:321-8. [PMID: 15500570 DOI: 10.1111/j.1365-2885.2004.00597.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dexamethasone was evaluated for the treatment of intracerebral hemorrhage using a rat model of cerebral hematoma induced by intracerebral injection of collagenase. The treatment group consisted of hematoma rats receiving dexamethasone 1 mg/kg intraperitoneal (i.p.) at 1 and 24 h following surgery. Controls included hematoma rats receiving saline i.p. and sham-operated animals receiving saline i.p. Each animal was evaluated neurologically prior to, as well as 24 and 48 h following surgery. After the last neurological evaluation, animals were deeply anesthetized and the brain was removed following perfusion for microscopic examination and glial fibrillary acidic protein immunohistochemistry. Behavioral scores were significantly improved in the treated group (P < 0.0001). The hematoma volume was significantly smaller (P < 0.02). Neutrophils and astrocytes were less numerous in the hematoma of dexamethasone-treated animals (P < 0.001), however the number of necrotic neurons in the penumbra was not changed by the treatment. The number of necrotic neurons in the cerebral cortex was less in treated than in nontreated animals (P < 0.01). Controls had many vascular changes including necrotic endothelium and fibrin deposits compared with treated animals. In conclusion, dexamethasone administered shortly after an intracerebral hematoma appears beneficial for the treatment of this condition.
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Affiliation(s)
- P P Lema
- Department of Veterinary Biomedicine, Faculty of Veterinary Medicine, University of Montreal, C.P. 5000, St-Hyacinthe, QC, Canada J2S 7C6
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23
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Muhle AC, Kircher P, Fazer R, Scheidegger J, Lang J, Jaggy A. Intracranial haemorrhage in an eight-week-old puppy. Vet Rec 2004; 154:338-9. [PMID: 15068045 DOI: 10.1136/vr.154.11.338] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A C Muhle
- Section of Veterinary Neurology, Department for Clinical Veterinary Medicine, University of Berne, Bremgartenstrasse 109a, 3012 Berne, Switzerland
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24
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Troxel MT, Vite CH, Massicotte C, McLear RC, Winkle TJV, Glass EN, Tiches D, Dayrell-Hart B. Magnetic Resonance Imaging Features of Feline Intracranial Neoplasia: Retrospective Analysis of 46 Cats. J Vet Intern Med 2004. [DOI: 10.1111/j.1939-1676.2004.tb00158.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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25
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Affiliation(s)
- Simon R Platt
- The Animal Health Trust, Centre for Small Animal Studies, Newmarket, Suffolk, England, United Kingdom, CB8 7UU
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26
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Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) are helpful in the diagnosis of many nonneoplastic brain disorders in the dog and cat. The ability of CT and MRI to depict normal and abnormal anatomy facilitates the identification of developmental anomalies, including hydrocephalus, Chiari malformations, arachnoid cysts, and cerebellar hypoplasia. These imaging modalities also allow the detection of hemorrhage and infarction and are therefore useful in the evaluation of spontaneous cerebrovascular disorders and head trauma. Finally, many inflammatory diseases, such as encephalitis, brain abscess, and parasite migration, cause abnormalities detectable by CT and MRI. Although more research on the imaging features of specific nonneoplastic brain disorders is needed, current information indicates that CT and MRI are useful in the management of these disorders.
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Affiliation(s)
- W B Thomas
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville 37901-1071, USA
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Bagley RS, Gavin PR. Seizures as a complication of brain tumors in dogs. CLINICAL TECHNIQUES IN SMALL ANIMAL PRACTICE 1998; 13:179-84. [PMID: 9775508 DOI: 10.1016/s1096-2867(98)80039-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Seizures are a common reflection of a variety of intracranial physiologic abnormalities in dogs. In dogs with brain tumors, seizures often provide the clinical clue to the existence of an underlying structural brain disease. The majority of brain tumors that result in seizures affect the supratentorial nervous system, especially the olfactory and frontal lobes. Diagnosis requires advanced imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) to establish the presence of a structural abnormality. Therapy is directed both at tumor and seizure control to afford the best chance of successful management of dogs with brain tumors.
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Affiliation(s)
- R S Bagley
- Department of Clinical Sciences, Washington State University, College of Veterinary Medicine, Pullman 99164-6610, USA
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28
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Abstract
Of the various neurologic diseases that affect dogs and cats, some are more often encountered in older animals. Physical diagnosis may be challenging, as multiple disease processes that may minic neurologic disease can be present in the same animal. A diligent, complete neurologic examination should lend for an accurate neuroanatomical diagnosis. Once a level of involvement is determined, knowledge of diseases affecting the particular area of the nervous system will provide for appropriate diagnosis, treatment, and prognosis. Although neurologic diseases are still often devastating, successful management of many of these diseases will afford better quality of life during the geriatric years.
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Affiliation(s)
- R S Bagley
- Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, USA
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