Successful treatment of cervical spinal epidural empyema secondary to grass awn migration in a cat

2007 ◽  
Vol 9 (4) ◽  
pp. 340-345 ◽  
Author(s):  
Nicolas Granger ◽  
Antoine Hidalgo ◽  
Dimitri Leperlier ◽  
Kirsten Gnirs ◽  
Jean-Laurent Thibaud ◽  
...  

Spinal epidural empyema (SEE) represents a severe pyogenic infection of the epidural space. Clinical signs of the disease are non-specific – increased body temperature, intense neck pain, neurological signs of a transverse myelopathy – and can lead to severe and permanent neurological deficits. This report describes the diagnosis and successful surgical treatment of cervical SEE secondary to grass awn migration in a cat. Although it is uncommon, this disease should be suspected in cats with progressive myelopathy. Early diagnosis and emergency surgery combined with antibiotic therapy are required to allow a complete recovery.

2010 ◽  
Vol 8 (4) ◽  
pp. 477-479 ◽  
Author(s):  
Luciano Miller Reis Rodrigues ◽  
Felipe Abreu ◽  
Edison Noboru Fujiki ◽  
Carlo Milani

ABSTRACT To describe the mechanism that causes spinal epidural hematoma with neurologic deficit and review the literature. We report a case of a 62-year-old man with post-traumatic epidural hematoma in the cervicothoracic spine, who developed progressive neurological deficit which eventually resulted in complete paralysis below T1. During surgical evacuation significant spine compression due to an organizing hematoma was observed. After surgery, the patient's motor function improved and there was a complete recovery of the neurologic deficit after a rehabilitation program. Conclusion: Epidural hematoma can happen after delayed traumatic event leading to a variable degree of neurologic damage.


Author(s):  
Peter A. Pahapill ◽  
Stephen P. Lownie

ABSTRACT:Background:In cases of acute spontaneous spinal epidural hematoma producing neurological deficits, emergency surgical evacuation is the standard treatment.Methods:Such a case is presented in which complete resolution of neurological deficits occurred without surgical intervention.Results:This is the fifth reported case of complete recovery in a patient managed conservatively. In most reports, significant and sustained neurological recovery had occurred within 12 hours of impairment of walking.Conclusion:In cases of acute spontaneous spinal epidural hematoma in which neurological deterioration is followed by early and sustained recovery, non-operative therapy may be considered.


2017 ◽  
Vol 182 (13) ◽  
pp. 380-380 ◽  
Author(s):  
Emili Alcoverro ◽  
James Fraser McConnell ◽  
Daniel Sanchez-Masian ◽  
Luisa De Risio ◽  
Steven De Decker ◽  
...  

Spinal cord dysfunction secondary to spinal arachnoid diverticula (SAD) has been widely reported in the veterinary literature and there is some suggestion that surgical treatment may provide better outcomes than medical treatment. Despite this, previous reports have mentioned cases with recurrence of clinical signs following surgical treatment but the cause for this has not been further investigated. The medical records of seven dogs and one cat which presented for investigation of recurrence of neurological deficits at least six months after surgery for SAD were retrospectively reviewed. Median time to relapse of the neurological deficits was 20.5 months after surgery. On repeated imaging, 3/8 cases showed clear regrowth of diverticulum, 2/8 cases showed dorsal compression at the previous laminectomy site (presumed to be the laminectomy membrane), and 3/8 cases showed herniation of the spinal cord through the laminectomy defect associated with a stellate appearance to the spinal cord with small multiloculated areas of dilation of the subarachnoid space. Repeat surgical intervention was most successful in the cases where SAD recurrence was identified while medical treatment resulted in either subtle improvement or stabilisation on the clinical signs, sometimes followed by slow deterioration.


2021 ◽  
Vol 49 ◽  
Author(s):  
Mariana Andrade Mousquer ◽  
Leandro Americo Rafael ◽  
Nathalia De Oliveira Ferreira ◽  
Margarida Aires da Silva ◽  
Taís Scheffer del Pino ◽  
...  

 Background: Temporohyoid osteoarthropathy (THO) is a progressive disease that causes acute onset of peripheral vestibular signs with or without facial paralysis. Ankylosis of temporhyoid joint occurs which predispose to fractures of the involved bones and consequently causes the commonly neurological signs observed. Clinical signs vary depending on the stage of the disease and the nerves affected. Surgical treatment is advised to improve survival rates in which the ceratohyoidectomy is currently known as the most advantageous. The aim of the present study is to report a case and outcome of a ceratohyoidectomy procedure in a Criollo mare presenting THO of the right temporohyoid joint.Case: A 17-year-old Criollo mare was referred to the Equine clinical hospital of the Federal University of Pelotas with a 5-day history of facial paralysis on the right side, head tilt and difficulty to chew and swallow. Auricular, palpebral and labial ptosis along with deviation of the lip and nostril to the left were observed. A corneal ulcer was also identified in the right eye. Complementary imaging exams (endoscopy of the guttural pouches and radiography of the head) were performed and showed thickening of the right stylohyoid bone confirming a diagnosis of THO. Anti-inflammatory and antibiotic therapy were administered and the corneal ulcer was treated with topical antibiotics and autologous serum. Due to rapid deterioration of clinical signs, the mare was referred to surgery. A ceratohyoidectomty procedure was performed under general anesthesia. In this procedure, the ceratohyoid bone was disarticulated from the ceratohyoid-basihyoid joint and removed. During the procedure, a branch of the linguofacial vein was accidentally incised causing hemorrhage, the branch was identified and successfully ligated. Recovery was uneventful. Supportive treatment with anti-inflammatory and antibiotics was continued after surgery and two sessions of electro-acupuncture was also performed to improve the nerve paralysis. The electro-acupuncture was discontinued due to mare’s negative behavior on needle insertion in the face. The treatment of the ulcer was changed since no improvement was observed in the first days. Twenty-eight days after hospitalization, the mare was discharged with the ulcer healed and significant improvement of neurological signs. A complete recovery occurred within three months.Discussion: The Criollo mare was referred to the hospital presenting mild neurological signs consistent with vestibular alteration and facial nerve paralysis. The THO diagnosis was confirmed using complementary imaging exams in which the endoscopy of the guttural pouch is considered the most common when computed tomography, a more sensitive one, is not available. Unilateral ceratohyoidectomy was performed as a surgical choice of treatment since it has a higher survival rate and lower recurrence rate in comparison to medical treatment and to stylohyoidectomy. As the main intraoperative complication, a vessel was accidentally incised, however this is described to occur in some cases. Despite that, the procedure was successfully performed and the mare had a complete recovery of the neurological signs and corneal ulcer. In conclusion, this report showed that it is important to have a complete diagnosis of these diseases and a consistent treatment plan to improve patient’s survival and quality of life.Keywords: neurologic disease, peripheral vestibular signs, facial paralysis, ceratohyoid bone, ceratohyoidectomy.


2020 ◽  
Vol 48 ◽  
Author(s):  
Maria Eduarda Dos Santos Lopes Fernandes ◽  
Luiza De Albuquerque Carvalho ◽  
Marina Galindo Chenard ◽  
Cícero Araújo Pitombo ◽  
Orlei Justen Dos Santos ◽  
...  

Background: Flexural deformities are anatomical deviations, in varying degrees, of one or more joints, and may have a congenital or acquired origin. Congenital contracture of the deep digital flexor tendon (DDFT) affects newborn calves and results in hyperflexion of the metacarpal-phalangeal joint, which in severe cases means that the animal must support its own weight on its fetlock joints. The aim of this study is to report the rapid and successful result of applying bilateral total tenotomy technique on a newborn bovine that had been diagnosed with severe bilateral DDFT contracture in the thoracic limbs.Case: A 3-week-old male bovine with a history of difficulty in maintaining a quadrupedal position was attended at the Veterinary Hospital of the Federal University of Tocantins. The animal had severe bilateral locomotor alterations in the thoracic members to the point that he walked on his fetlock joints. The physical examination revealed clinical parameters within the normal range. However, the locomotor system examination showed severe flexor deformity in the bilateral metacarpal-phalangeal joints, and the limbs were being supported on the dorsal face of the fetlock joints, which presented ulcerations, and was suggestive of a shortening of the DDFT. Based on the patient's history and clinical examination, as well as the severity of the tendon contractures, surgical treatment using the DDFT bilateral total tenotomy technique was decided upon. Postoperative treatment consisted of 2.5 mg/kg of enrofloxacin intramuscularly (IM), SID, for 5 days and 0.5 mg/kg meloxicam via IM, SID, for 3 days; as well as a dressing (cotton, medical bandage and a PVC mold) on the thoracic limbs to provide support and allow the animal to walk, until its complete recovery. One day after the surgery, the animal was able to walk with difficulty and some trembling; however, on the third day after the surgical procedure, it could stand up by itself, walk and graze normally. The surgical stitches were removed seven days after the operation, as the surgical wounds had healed adequately. The animal was followed-up for a one-month period after the total tenotomy, with no recurrence of any of the clinical signs, and the thoracic limbs had regained normal biomechanics.Discussion: Congenital flexural deformities are common in newborn calves of different breeds and their incidence is mainly in the thoracic limbs, especially in the carpal, distal interphalangeal and metacarpal-phalangeal joints as was reported in the animal in this study. The history and anamnesis of the animal, along with a thorough physical examination, in order to rule out any other congenital alterations, was extremely important in the diagnosis, and the classification of the severity of the deformity along with the choice of appropriate treatment in the present study. Although total tenotomy is rarely reported in the literature, and there are controversial results with calves, the surgical treatment was chosen in the present case due to the severity of the case. The DDFT bilateral total tenotomy surgical technique gave satisfactory results for the correction of severe bilateral flexor deformity in the thoracic limbs of the newborn crossbred calf. Complete recovery of the limb biomechanics was rapid, and there was no post-surgical complications, thus ensuring the animal could have a good and healthy life. Total DDFT tenotomy is considered a viable surgical procedure for calves with severe congenital flexor deformities; however, post-operative care is also important to ensure good final results.


2014 ◽  
Vol 27 (7) ◽  
pp. 395-400 ◽  
Author(s):  
Björn P. Robach ◽  
Thomas R. Niethammer ◽  
Alexander C. Paulus ◽  
Carolin Melcher ◽  
Christof Birkenmaier ◽  
...  

2020 ◽  
pp. 97-99
Author(s):  
U. V. Kukhtenko ◽  
O. A. Kosivtsov ◽  
L. A. Ryaskov ◽  
E. I. Abramian

A clinical case of successful surgical treatment of a patient with a giant cervical retrosternal nontoxic goiter with severe cardiac pathology is presented. Thyroidectomy from cervical access without sternotomy was performed. At the follow-up examination 5 months after the operation, instrumental and clinical signs of disease relapse were not detected.


Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 747
Author(s):  
Nicola Pusterla ◽  
Samantha Barnum ◽  
Julia Miller ◽  
Sarah Varnell ◽  
Barbara Dallap-Schaer ◽  
...  

Here we report on an EHV-1 outbreak investigation caused by a novel genotype H752 (histidine in amino acid position 752 of the ORF 30 gene). The outbreak involved 31 performance horses. Horses were monitored over a period of 35 days for clinical signs, therapeutic outcome and qPCR results of EHV-1 in blood and nasal secretions. The morbidity of the EHV-1 outbreak was 84% with 26 clinically infected horses displaying fever and less frequently anorexia and distal limb edema. Four horses showed mild transient neurological deficits. Clinically diseased horses experienced high viral load of EHV-1 in blood and/or nasal secretions via qPCR, while subclinically infected horses had detectable EHV-1 mainly in nasal secretions. The majority of infected horses showed a rise in antibody titers to EHV-1 during the outbreak. All 31 horses were treated with valacyclovir, while clinically infected horses further received flunixin meglumine and sodium heparin. This investigation highlights various relevant aspects of an EHV-1 outbreak caused by a new H752 genotype: (i) importance of early detection of EHV-1 infection; (ii) diagnostic challenge to assess H752 genotype; (iii) apparent benefit of valacyclovir use in the early stage of the outbreak; and (iv) weekly testing of blood and nasal secretions by qPCR in order to monitor individual infection status and lift quarantine.


Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1017
Author(s):  
Julian Zipfel ◽  
Meizer Al-Hariri ◽  
Isabel Gugel ◽  
Alexander Grimm ◽  
Volker Steger ◽  
...  

Most sporadic peripheral nerve sheath tumors in adults are schwannomas. These tumors usually present with significant pain but can also cause neurological deficits. Symptomatology is diverse, and successful surgical interventions demand interdisciplinarity. We retrospectively reviewed 414 patients treated between 2006 and 2017 for peripheral nerve sheath tumors. We analyzed clinical signs, symptoms, histology, and neurological function in the cohort of adult patients with schwannomas without a neurocutaneous syndrome. In 144 patients, 147 surgical interventions were performed. Mean follow-up was 3.1 years. The indication for surgery was pain (66.0%), neurological deficits (23.8%), significant tumor growth (8.8%), and suspected malignancy (1.4%). Complete tumor resection was achieved on 136/147 occasions (92.5%). The most common location of the tumors was intraspinal (49.0%), within the cervical neurovascular bundles (19.7%), and lower extremities (10.9%). Pain and neurological deficits improved significantly (p ≤ 0.003) after 131/147 interventions (89.1%). One patient had a persistent decrease in motor function after surgery. Complete resection was possible in 67% of recurrent tumors, compared to 94% of primary tumors. There was a significantly lower chance of complete resection for schwannomas of the cervical neurovascular bundle as compared to other locations. The surgical outcome of sporadic schwannoma surgery within the peripheral nervous system is very favorable in experienced peripheral nerve surgery centers. Surgery is safe and effective and needs a multidisciplinary setting. Early surgical resection in adult patients with peripheral nerve sheath tumors with significant growth, pain, neurological deficit, or suspected malignancy is thus recommended.


2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Abdurrahman Aycan ◽  
Ozgür Yusuf Aktas ◽  
Feyza Karagoz Guzey ◽  
Azmi Tufan ◽  
Cihan Isler ◽  
...  

Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.


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