Retrospective evaluation of the clinical presentation, magnetic resonance imaging findings, and outcome of dogs diagnosed with intracranial empyema (2008–2015): 9 cases

Forward, Alexander K.; Plessas, I. N.; Guilherme, Sérgio; Decker, Steven De

doi:10.1111/vec.12859

Cited by 10 publications

(44 citation statements)

References 27 publications

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“…In agreement with the results of previous studies, elevated CSF TNCC, TP and neutrophilic pleocytosis can be identified in dogs with intracranial empyema 25,32 . Although the number of cases in this study was small, all dogs diagnosed with intracranial empyema had an increased TNCC, increased TP and abnormal cytology.…”

Section: Discussionsupporting

confidence: 92%

“…In agreement with the results of previous studies, elevated CSF TNCC, TP and neutrophilic pleocytosis can be identified in dogs with intracranial empyema. 25,32 Although the number of cases in this study was small, all dogs diagnosed with intracranial empyema had an increased TNCC, increased TP and abnormal cytology. Although further studies are necessary, this result could indicate the clinical usefulness of CSF analysis to diagnose intracranial empyema as a cause of vestibular syndrome in dogs.…”

Section: Discussionmentioning

confidence: 86%

“…A diagnosis of intracranial empyema, caused by extension of otitis media interna, was based on a combination of clinical and imaging findings, which was characterised by hyperintense T2-weighted and iso-to hypointense T1-weighted, contrastenhancing extra-axial material, extending from the inner ear into the region of the brainstem and with concurrent imaging findings compatible with otitis media interna. 25,26 Metronidazole neurotoxicity was defined as a bilateral central vestibular syndrome in dogs receiving high doses (>65 mg/kg/day) of metronidazole, and in which clinical signs improved after discontinuation of this drug. Diagnosis was further supported by MR images showing T2-weighted bilateral symmetrical hyperintensity in the dentate nuclei.…”

Section: Methodsmentioning

confidence: 99%

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Cerebrospinal fluid analysis lacks diagnostic specificity in dogs with vestibular disease

et al. 2021

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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. K E Y W O R D S central vestibular syndrome, CSF, idiopathic vestibular disease, MUO, peripheral vestibular syndrome, vestibular disease

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

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Cerebrospinal fluid analysis lacks diagnostic specificity in dogs with vestibular disease

et al. 2021

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“…The most unusual finding in our case was a compressive SFA, a MRI feature that is commonly associated with subdural empyema [ 20 ], traumatic [ 21 ] or non-traumatic hematoma [ 22 , 23 ] or as the result of overshunting after ventriculoperitoneal shunt insertion in dogs [ 24 ] but has never been described as MRI feature in CPCs. At the time of presentation, the underlying cause of this lesion was unclear.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Subdural Fluid Accumulation Associated with a Choroid Plexus Carcinoma in a Dog

Schneider

Blutke

Matiasek

et al. 2022

Veterinary Sciences

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Choroid plexus tumors are commonly described as intraventricular mass lesions and account for 7–10% of intracranial, primary tumors in dogs. A 3-year-old Shetland sheepdog was presented with a history of slowly progressive lethargy, vision impairment and cognitive deficits. On magnetic resonance imaging, a subdural fluid accumulation (SFA) overlying and compressing the left parietotemporal lobe as well as multifocal changes consisting of cyst-like lesions, supposed intra-axial brain lesions and mild, multifocal meningeal thickening and generalized contrast enhancement were identified. Cerebrospinal fluid (CSF) analysis showed a mononuclear pleocytosis with negative results for infectious agents. The dog was treated with prednisolone followed by burr hole craniotomy with puncture of the SFA, which macroscopically appeared to be CSF-like fluid. After initial improvement, the dog deteriorated despite continuation of prednisolone and cytarabine therapy and was euthanized four weeks after surgery. Histopathology was consistent with a disseminated, neuroinvasive choroid plexus carcinoma (CPC) that involved the entire neuroaxis including the meninges of the brain and spinal cord. Immunohistochemical examination showed a strong Kir7.1 and a heterogenous cytokeratin-immunoreactivity in neoplastic cells. In conclusion, a CPC should be considered as a possible cause of a SFA even in the absence of an intraventricular mass lesion.

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“…Still, to date in veterinary medicine, the incidence and mortality are not well established [ 3 , 8 ]. The number of studies on SEE [ 3 , 4 , 8 , 11 , 12 , 16 ] and intracranial empyema [ 18 , 19 , 20 , 21 ] published in the last 15 years remains relatively low. In human medicine, the incidence of hospital admission for this condition has tripled [ 5 ], and the mortality rates are estimated at 5–16% worldwide, with less than 50% of surviving patients achieving full recovery [ 1 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation, MRI Characteristics, and Outcome of Conservative or Surgical Management of Spinal Epidural Empyema in 30 Dogs

Blanco¹,

Moral²,

Mínguez

et al. 2022

Animals

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Spinal epidural empyema (SEE) represents a neurological emergency in veterinary medicine, but information on this condition is limited to date. This retrospective case series study describes the clinical and magnetic resonance imaging (MRI) features, and the outcome of conservative or surgical management of SEE in 30 dogs diagnosed with SEE from September 2015 to March 2020 at one referral neurology centre. The most frequent clinical sign was pain 28/30 (93%), and 22/30 (73%) showed neurological signs with ambulatory paraparesis/tetraparesis 15/30 (50%), monoparesis 1/30 (3.3%), non-ambulatory paraparesis 3/30 (10%), or paraplegia 3/30 (10%). MRI was valuable for the diagnosis and in the follow-up. In this group of dogs, 24/30 (80%) were conservatively treated and 6/30 (20%) were surgically treated. The outcome was considered favourable in all dogs: 20/30 (66.6%) achieved full recovery (3 surgically treated and 17 medically treated) and 10/30 (33.3%) dogs had an improvement in the neurological signs with residual ambulatory paresis (3 surgically treated and 7 medically treated). Surgical treatment showed better short-term (7 days) outcomes than medical treatment in non-ambulatory paraparetic or paraplegic dogs (33%). Nevertheless, this study suggests that a good recovery may be achieved with conservative treatment even for non-ambulatory or paraplegic dogs. Further prospective studies, with a standardised protocol of diagnostic tests and a homogeneous distribution of conservatively and surgically treated dogs, are needed to establish treatment guidelines.

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Retrospective evaluation of the clinical presentation, magnetic resonance imaging findings, and outcome of dogs diagnosed with intracranial empyema (2008–2015): 9 cases

Cited by 10 publications

References 27 publications

Cerebrospinal fluid analysis lacks diagnostic specificity in dogs with vestibular disease

Cerebrospinal fluid analysis lacks diagnostic specificity in dogs with vestibular disease

Intracranial Subdural Fluid Accumulation Associated with a Choroid Plexus Carcinoma in a Dog

Clinical Presentation, MRI Characteristics, and Outcome of Conservative or Surgical Management of Spinal Epidural Empyema in 30 Dogs

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