Delayed traumatic pneumocephalus and cervical pneumorrhachis in a dog

Abstract

A 7‐year‐old female spayed Labrador Retriever was referred for generalised seizures which initiated 48 hours prior to presentation. Physical examination revealed facial asymmetry and enucleation of the right eye due to head trauma 6 years earlier. Neurological examination showed depressed mental status, absent menace response of the left eye, non‐ambulatory tetraparesis, absent postural reactions in all four limbs and normal spinal reflexes. Neuroanatomical localisation was prosencephalic (forebrain). MRI study of the brain allowed a diagnosis of pneumocephalus and pneumorrhachis as the cause of neurological signs. The dog was hospitalised and treated conservatively with anticonvulsants, antimicrobials and oxygen therapy. During hospitalisation, no further seizures were observed, the neurological condition improved progressively, and the dog was discharged with oral anticonvulsant treatment 4 days after admission. Eight months later, the dog was still seizure‐free, and the follow‐up MRI showed no lesions consistent with the previously diagnosed pneumocephalus and pneumorrhachis.

Computed tomography myelography description of pneumorrhachis secondary to a degenerative intervertebral disk disease in a cross‐breed dog

“…PR is a rare affection that has been described in both human and veterinary medicine. 1,4,8,11 This condition is usually asymptomatic and represents an incidental finding, especially in humans, 1,2,7,12 or causes back pain that can be managed conservatively. 4,7,8,12 In dogs, it is often associated with degenerative IVDD, with only six cases reported in the literature.…”

“…CT is the gold standard in the diagnosis of PR, as it is more sensitive and specific than MRI to detect gas and offers a better spatial resolution. [1][2][3]8,12,19,20 Furthermore, when PR is associated with trauma, gas can also be found in other parts of the body, 1,11,[13][14][15] and a wider diagnostic investigation may be indicated, making CT a more convenient diagnostic tool. However, as intradural-extramedullary PR may be difficult to differentiate from extradural PR with conventional CT, other diagnostic techniques such as MRI or CTM can be further indicated to determine the correct location of the lesion.…”

“…6,9,10 In rare cases, the accumulated gas is released in the vertebral canal during IVD herniation and forms an encapsulated gas bubble, [5][6][7][8] resulting in extradural spinal cord or foraminal compression, 7 which leads to chronic pain or neurological signs. 2,4,7 While few cases have been described using computed tomography (CT) and magnetic resonance imaging (MRI), 2,7,8,[11][12][13][14][15] there is no available description of PR in a dog using computed tomography myelography (CTM) in the veterinary literature. To the authors' knowledge, this is the first known CTM description of PR in a dog.…”

Dynamics and diagnosis of severe pneumocephalus of unknown etiology in dog

“…The course of the disease is characterized by a long latent phase and rapid exacerbation of clinical symptoms and, in the absence of proper treatment, leads to death (Andrews & Canalis, 1986;Garosi et al, 2002;Cunqueiro & Scheinfeld, 2018). Pneumocephalus, in most cases, occurs due to disruption of the integrity of the skull bones and meninges after surgery or injury, which leads to the formation of fistulas between nerve tissue and the environment (Cavanaugh et al, 2008;Shea et al, 2018;Moral et al, 2021), as well as the possibility of gas-producing infection (Escherichia coli, Enterobacter cloacae, Klebsiella aerogenes, Aspergillus spp.) (Tanaka et al, 1989;Fletcher et al, 2006;Launcelott et al, 2016), with the subsequent development of inflammatory processes in the parenchyma of the brain and its meninges (Aksoy et al, 2013).…”