scholarly journals Presumptive acute non-compressive nucleus pulposus extrusion in 11 cats: clinical features, diagnostic imaging findings, treatment and outcome

2016 ◽  
Vol 19 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Frances E Taylor-Brown ◽  
Steven De Decker
Keyword(s):  
Spinal Cord ◽  
Diagnostic Imaging ◽  
Nucleus Pulposus ◽  
Clinical Features ◽  
Clinical Signs ◽  
Clinical History ◽  
Imaging Findings ◽  
Term Outcome ◽  
Long Term Outcome ◽  
External Trauma

Objectives The aim of the study was to describe the clinical features, diagnostic imaging findings, treatment and outcome in cats diagnosed with presumptive acute non-compressive nucleus pulposus extrusion. Methods Medical records and imaging studies of cats diagnosed with presumptive acute non-compressive nucleus pulposus extrusion were retrospectively reviewed. Information on long-term outcome was acquired from patient records and from either owners or referring veterinary surgeons via a telephone questionnaire. Results Eleven cats met the inclusion criteria. All cats had a peracute onset of clinical signs, with eight cats experiencing witnessed (n = 6) or suspected (n = 2) external trauma based on imaging findings. Neuroanatomical localisation included C1–C5 (n = 1), T3–L3 (n = 7) and L4–S3 (n = 3) spinal cord segments. MRI revealed acute non-compressive nucleus pulposus extrusions located at C3–C4 (n = 1), T12–T13 (n = 1), T13–L1 (n = 1), L1–L2 (n = 1), L3–L4 (n = 3), L4–L5 (n = 1) and L5–L6 intervertebral disc spaces (n = 3). Treatment included supportive care and 10 cats were discharged with a median hospitalisation time of 10 days (range 3–26 days). One cat was euthanased during hospitalisation owing to complications unrelated to neurological disease. All cats that presented as non-ambulatory regained an ambulatory status with the median time to ambulation of 17 days (range 6–21 days). Overall, the outcome for cats diagnosed with acute non-compressive nucleus pulposus extrusion was successful, with almost 90% returning to ambulation with urinary and faecal continence. Conclusions and relevance The majority of cats diagnosed with acute non-compressive nucleus pulposus extrusion had good outcomes. Acute non-compressive nucleus pulposus extrusion should be considered as a differential diagnosis for cats presenting with peracute onset of spinal cord dysfunction, particularly if there is a clinical history or evidence of trauma.

scholarly journals Thoracic vertebral canal stenosis in cats: clinical features, diagnostic imaging findings, treatment and outcome

2020 ◽  
Vol 22 (12) ◽  
pp. 1191-1199
Author(s):  
Sabrina Gillespie ◽  
Steven De Decker
Keyword(s):  
Diagnostic Imaging ◽  
Clinical Features ◽  
Clinical Signs ◽  
Imaging Findings ◽  
Vertebral Canal ◽  
Canal Stenosis ◽  
Veterinary Surgeons ◽  
Initial Improvement ◽  
Multiple Levels ◽  
And Control

Objectives The aim of this study was to describe the clinical features, diagnostic imaging findings, treatment and outcome in cats with thoracic vertebral canal stenosis (TVCS). Methods Medical records and imaging studies of cats with TVCS were retrospectively reviewed. Outcome was acquired from patient records and from owners or referring veterinary surgeons via a telephone questionnaire. For each case, breed-, age- and sex-matched controls were identified with CT imaging of the thoracic vertebral column. For each cat, vertebral canal height was determined at three levels for each thoracic vertebra. Vertebral canal heights were compared between control cats of different breeds and between affected and control cats of the same breed. Results Nine TVCS cases were included. British Shorthairs and male neutered cats were over-represented ( P <0.05). Median age at presentation was 9 years. All cats were presented for a chronic, progressive, painful, ambulatory, T3–L3 myelopathy. Five cats were treated conservatively, three surgically and one was euthanased. Two cats treated surgically demonstrated improvement of clinical signs and one demonstrated initial improvement followed by deterioration. Of the conservatively treated cats, three deteriorated and two improved. Compared with controls, affected cats had a lower vertebral canal height at multiple thoracic vertebral levels, being most prominent for British Shorthairs and domestic shorthairs ( P <0.05). Unaffected British Shorthairs had a lower thoracic vertebral canal height at multiple levels than control domestic shorthairs ( P <0.05). Conclusions and relevance TVCS should be considered a differential diagnosis in middle-aged to older cats presenting with a chronic, progressive, painful, T3–L3 myelopathy. The predisposition of British Shorthairs could be explained by a narrower vertebral canal in this breed.

scholarly journals Retrospective study of 37 Cavalier King Charles Spaniel dogs diagnosed with Chiari-like malformation and Syringomyelia

2018 ◽  
Vol 2 (3) ◽  
pp. 161-164
Author(s):  
Cătălina Anca Cucoș ◽  
Radu Constantinescu ◽  
Ateș Barut ◽  
Iuliana Ionașcu ◽  
Constantin Vlăgioiu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Clinical Signs ◽  
Clinical History ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Thoracic Spinal Cord ◽  
Cavalier King Charles Spaniel ◽  
Thoracic Spinal

Abstract Chiari-like malformation represents a congenital anomaly that affects the bony cranial base and the hindbrain, leading to fluid filled cavities formation in the spinal cord, condition named Syringomyelia. This paper aims to assess the variety of the clinical signs and to evaluate the magnetic resonance imaging findings in thirty- seven Cavalier King Charles Spaniel dogs. The study was performed over a four-year period, from 2013 to 2017, all cases underwent neurological examination, full diagnostic work-up, including magnetic resonance imaging scans of the brain, cervical and upper thoracic spinal cord. Thirty-seven dogs were included in this study, 23 females and 14 males, with a mean age of 3.6±2.1years. The commonest clinical findings encountered were neuropathic pain and vocalization, seen in all 37 cases, followed by scratching, facial rubbing, paw licking, air licking, tail chasing, seizures and unilateral facial paralysis. Different grades of cerebellar herniation and cervical syrinxes were noted in all cases, other magnetic resonance imaging findings encountered were medullary kinking, presyrinx and ventriculomegaly. In establishing the diagnosis of the Chiari-like malformation and Syringomyelia, the breed, clinical history and the symptomatology are very important, but only magnetic resonance imaging technique can provide quantitative assessment of the nervous system lesions.

scholarly journals Comparison of medical and surgical treatment for acute cervical compressive hydrated nucleus pulposus extrusion in dogs

2017 ◽  
Vol 181 (23) ◽  
pp. 625-625 ◽  
Author(s):  
Tana Borlace ◽  
Rodrigo Gutierrez-Quintana ◽  
Frances Ellen Taylor-Brown ◽  
Steven De Decker
Keyword(s):  
Surgical Treatment ◽  
Nucleus Pulposus ◽  
Medical Management ◽  
Clinical Presentation ◽  
Imaging Findings ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Successful Outcomes

Although successful outcomes have been reported after medical and surgical treatment for dogs with cervical hydrated nucleus pulposus extrusion (HNPE), it is unknown which treatment option is preferred. Thirty-four dogs treated medically (n=18) or surgically (n=16) for cervical HNPE were retrospectively identified. Signalment, clinical presentation and imaging findings were compared between medically and surgically treated dogs. Medical management consisted of restricted exercise in combination with physiotherapy. Surgical treatment consisted of a ventral slot procedure. Short-term follow-up information was retrieved from re-examination visits. Long-term outcome was obtained via telephone interviews. More dogs in the surgical group demonstrated cervical hyperaesthesia on initial clinical presentation (P=0.045), otherwise there was no significant difference in signalment, clinical presentation or imaging findings between both groups. Two dogs in the medically managed group underwent surgical decompression due to an unsatisfactory response to medical management. All cases for which long-term information was available (n=30) were neurologically normal at the time of data collection. There were no significant differences for any of the short-term or long-term outcome variables between both treatment groups. This study demonstrated successful outcomes after medical or surgical treatment and suggests that both treatment modalities can be considered for dogs with cervical HNPE.

Clinical features and long-term outcome of ipsilateral delayed endolymphatic hydrops

2019 ◽  
Vol 69 (3) ◽  
Author(s):  
Andrea Albera ◽  
Claudia Cassandro ◽  
Carmine F. Gervasio ◽  
Sergio Lucisano ◽  
Marco Boldreghini ◽  
...  
Keyword(s):  
Clinical Features ◽  
Endolymphatic Hydrops ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Delayed Endolymphatic Hydrops

scholarly journals Long term outcome of functional independence and quality of life after traumatic SCI in Germany

Spinal Cord ◽  
2021 ◽  
Author(s):  
Florian Möller ◽  
Rüdiger Rupp ◽  
Norbert Weidner ◽  
Christoph Gutenbrunner ◽  
Yorck B. Kalke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Independence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cord Injury ◽  
Over Time

Abstract Study design Multicenter observational study. Objective To describe the long-term outcome of functional independence and quality of life (QoL) for individuals with traumatic and ischemic SCI beyond the first year after injury. Setting A multicenter study in Germany. Methods Participants of the European multicenter study about spinal cord injury (EMSCI) of three German SCI centers were included and followed over time by the German spinal cord injury cohort study (GerSCI). Individuals’ most recent spinal cord independence measure (SCIM) scores assessed by a clinician were followed up by a self-report (SCIM-SR) and correlated to selected items of the WHO short survey of quality of life (WHO-QoL-BREF). Results Data for 359 individuals were obtained. The average time passed the last clinical SCIM examination was 81.47 (SD 51.70) months. In total, 187 of the 359 received questionnaires contained a completely evaluable SCIM-SR. SCIM scores remained stable with the exception of reported management of bladder and bowel resulting in a slight decrease of SCIM-SR of −2.45 points (SD 16.81). SCIM-SR scores showed a significant correlation with the selected items of the WHO-QoL-BREF (p < 0.01) with moderate to strong influence. Conclusion SCIM score stability over time suggests a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting paralleled by positively related QoL measurements but bladder and bowel management may need special attention.

Posttraumatic spinal cord tethering and syringomyelia: surgical treatment and long-term outcome

2009 ◽  
Vol 11 (4) ◽  
pp. 445-460 ◽  
Author(s):  
Scott P. Falci ◽  
Charlotte Indeck ◽  
Daniel P. Lammertse
Keyword(s):  
Spinal Cord ◽  
Spinal Injury ◽  
Treatment Center ◽  
Term Outcome ◽  
Repeat Surgery ◽  
Long Term Outcome ◽  
Progressive Myelopathy ◽  
Cord Injury ◽  
Spinal Cord Tethering

Object Permanent neurological loss after spinal cord injury (SCI) is a well-known phenomenon. There has also been a growing recognition and improved understanding of the pathophysiological mechanisms of late progressive neurological loss, which may occur after SCI as a result of posttraumatic spinal cord tethering (SCT), myelomalacia, and syringomyelia. A clinical study of 404 patients sustaining traumatic SCIs and undergoing surgery to arrest a progressive myelopathy caused by SCT, with or without progressive myelomalacia and cystic cavitation (syringomyelia) was undertaken. Both objective and subjective long-term outcomes were evaluated. To the authors' knowledge, this is the first series of this size correlating long-term patient perception of outcome with long-term objective outcome analyses. Methods During the period from January 1993 to November 2003, 404 patients who had previously sustained traumatic SCIs underwent 468 surgeries for progressive myelopathies attributed to tethering of the spinal cord to the surrounding spinal canal, with or without myelomalacia and syrinx formation. Forty-two patients were excluded because of additional pathological entities that were known to contribute to a progressive myelopathy. All surgeries were performed by the same neurosurgeon at a single SCI treatment center and by using a consistent surgical technique of spinal cord detethering, expansion duraplasty, and when indicated, cyst shunting. Results Outcome data were collected up to 12 years postoperatively. Comparisons of pre- and postoperative American Spinal Injury Association sensory and motor index scores showed no significant change when only a single surgery was required (86% of patients). An outcome questionnaire and phone interview resulted in > 90% of patients self-assessing arrest of functional loss; > 50% of patients self-assessing improvement of function; 17 and 18% self-assessing improvement of motor and sensory functions to a point greater than that achieved at any time postinjury, respectively; 59% reporting improvement of spasticity; and 77% reporting improvement of hyperhidrosis. Conclusions Surgery for spinal cord detethering, expansion duraplasty, and when indicated, cyst shunting, is a successful treatment strategy for arresting a progressive myelopathy related to posttraumatic SCT and syringomyelia. Results suggest that surgery leads to functional return in ~ 50% of patients, and that in some patients posttraumatic SCT limits maximal recovery of spinal cord function postinjury. A patient's perception of surgery's failure to arrest the progressive myelopathy corresponds closely with the need for repeat surgery because of retethering, cyst reexpansion, and pseudomeningocele formation.

scholarly journals Study of hypoglycemia in neonates with low birth weight

2020 ◽  
Vol 7 (8) ◽  
pp. 409-413
Author(s):  
Dr. Ekta Acharya ◽  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Clinical Signs ◽  
Time Interval ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Low Birth Weight Babies ◽  
Short And Long Term ◽  
Heel Prick ◽  
Glycogen Stores

Background and Aim: The maintenance of normoglycemia in newborns depends upon theadequacy of glycogen stores, maturation of glycogenolytic and gluconeogenic pathways, andintegrated endocrine response. The current study, therefore, proposes to observe the clinical profileof low-birth-weight babies concerning the occurrence of hypoglycemia. Materials and Methods:The neonates with a weight of fewer than 2500 grams were included in the study. A total of 100infants were included in the study. They were divided into two groups with infants withhypoglycemia in one group and infants with normoglycemic in another group. The aseptic conditionwas maintained and with the help of heel prick, the capillary blood was collected. The capillary bloodwas screened with the help of reagent strips. Results: Out of the total 100 neonates, a total of 76neonates were normoglycemic and 24 neonates had hypoglycaemic episodes. Overall 22 episodes ofhypoglycemia were recorded. There was no significant association between birth weight andepisodes of hypoglycemia. The majority of hypoglycaemic infants were male. Conclusion:Hypoglycemia associated with abnormal clinical signs (symptomatic hypoglycemia) has a poor short-and long-term outcome but evidence of risk in the absence of clinical signs (asymptomatichypoglycemia) is inconclusive. Small for gestational age is a significant determinant forhypoglycemia. Hypoglycaemic episodes were significantly noticed in the first 24 hours as comparedto another time interval.

Orofacial granulomatosis: Clinical features and long-term outcome of therapy

2010 ◽  
Vol 62 (4) ◽  
pp. 611-620 ◽  
Author(s):  
Khalid A. Al Johani ◽  
David R. Moles ◽  
Tim A. Hodgson ◽  
Stephen R. Porter ◽  
Stefano Fedele
Keyword(s):  
Clinical Features ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Orofacial Granulomatosis
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