Evaluation of cerebral blood flow with transcranial Doppler ultrasound in a dog with surgically treated intracranial subdural empyema

A three-year-old spayed female Yorkshire terrier presented with a three-week history of lethargy and weight loss. Physical examination showed left exophthalmos with left nasal discharge. A lesion in the left brainstem was suspected based on the neurological examination. Pre/postcontrast CT images we...

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Bibliographic Details
Published in:Veterinary record case reports 2019-12, Vol.7 (4), p.n/a
Main Authors: Santiago, Raquel, Ros, Carlos, García de Carellán Mateo, Alejandra, Laborda-Vidal, Patricia
Format: Article
Language:English
Subjects:
Blood
Brain cancer
Case reports
Cellular biology
cerebral blood flow
Flow velocity
intracranial empyema
Methadone
Neutrophils
transcranial Doppler ultrasound
Ultrasonic imaging
Veins & arteries
Ventilators
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Summary:A three-year-old spayed female Yorkshire terrier presented with a three-week history of lethargy and weight loss. Physical examination showed left exophthalmos with left nasal discharge. A lesion in the left brainstem was suspected based on the neurological examination. Pre/postcontrast CT images were consistent with an extensive subdural empyema in the region of the left forebrain, extending from the level of the frontal to the occipital lobe. At presentation, transcranial Doppler (TCD) ultrasound was performed in the left (LMCA) and right middle cerebral arteries (RMCA) showing marked hyperaemia (LMCA velocity: 81.9 cm/s; RMCA velocity: 90.3 cm/s; reference ranges: LMCA velocity 62.3±10.9 cm/s; RMCA velocity 62.5±10.9 cm/s). A left-sided rostrotentorial craniectomy was performed, followed by medical treatment. TCD was monitored daily postoperatively returning to within the reference range five days after surgery (LMCA velocity: 54.9 cm/s; RMCA velocity: 63.6 cm/s). Normalisation of the systolic velocity was associated with clinical improvement. TCD is a useful and non-invasive method for monitoring of cerebral blood flow in patients with intracranial empyema.
ISSN:2052-6121
2052-6121
DOI:10.1136/vetreccr-2019-000935