Debreuque M, Ducerveau MN, Valin I, de Fornel P, Manassero M, Thibaud JL. Symptomatic lateral ventricular cystic lesion in a young cat.
JFMS Open Rep 2020;
6:2055116920930181. [PMID:
32595977 PMCID:
PMC7303770 DOI:
10.1177/2055116920930181]
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Abstract
Case summary
A 1.5-year-old male neutered Persian cat was referred for acute
deterioration of chronic left head tilt and ataxia. A lateral
intraventricular cystic lesion, closely associated with the left
choroid plexus, was identified on MRI. The intralesional signal
intensity and cytological analysis of the fluid revealed a
liquid similar to cerebrospinal fluid. After trepanation, an
endoscopic-assisted fenestration and aspiration of the cyst were
performed to temporally relieve the high intracranial pressure
while waiting for surgical cystoperitoneal shunt placement.
Three weeks after surgery, clinical relapse and recurrence of
the lesion were noted on the pre-cystoperitoneal shunting MRI.
During anaesthesia, the cat arrested. Cardiac resuscitation was
successfully performed and cystoperitoneal shunting was
postponed. Global brain ischaemia was then suspected, based on
major forebrain clinical signs and MRI abnormalities. During a
6-month recovery period, a further three fine-needle CT-guided
aspirations of the lesion were required, owing to clinical
recurrence and increased cyst size. Cystoperitoneal shunting was
eventually performed, allowing persistent reduction of the
lesion and long-term improvement of the cat’s neurological
status.
Relevance and novel information
This is the first report of a symptomatic lateral intraventricular
cystic lesion in a cat. A left lateral intraventricular choroid
plexus cyst was suspected based on the MRI features. Our case
suggests that endoscopic fenestration and CT-guided aspiration
are not adequate treatments for long-term management.
Cystoperitoneal shunting may be a safe procedure, allowing
significant and stable reduction of the cystic lesion,
associated with improvement in the cat’s neurological status by
preventing high intracranial pressure.
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