Wrzosek M, Konar M, Vandevelde M, Oevermann A
Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
J Small Anim Pract. 2009 Jan;50(1):35-7. doi: 10.1111/j.1748-5827.2008.00653.x.
A comatose 30-month-old, entire male boxer was presented because of an acute history of a cluster of three to four seizures. Neurological examination suggested a diffuse to multifocal intracranial lesion. Magnetic resonance tomography revealed symmetrical multifocal to diffuse changes of the cerebral grey matter and ependymal lining with sediment in the lateral ventricles. Haematological examination revealed leucocytosis with neutrophilia. Cerebrospinal fluid examination revealed high protein concentration and polymorphonuclear pleocytosis. Despite antiepileptic treatment, therapy against increased intracranial pressure and antibiosis, the dog's condition continued to deteriorate and he was euthanased. Pathological examination revealed fibrinosuppurative meningo-ependymitis and necrotising arteritis throughout the brain. In addition, chronic inflammation and arterial stenosis was found in the spinal meninges. No infectious agent was found. A diagnosis of steroid-responsive meningitis arteritis was made. The massive extension into the meninges and ventricular system of the forebrain has not been described previously in dogs with steroid-responsive meningitis arteritis and should be considered in the differential diagnosis when an intracranial suppurative infection is suspected.
一只30个月大、未阉割的雄性拳师犬因出现三到四次癫痫发作的急性病史而前来就诊。神经系统检查提示存在弥漫性至多灶性颅内病变。磁共振断层扫描显示脑灰质和室管膜衬里有对称的多灶性至弥漫性改变,侧脑室内有沉积物。血液学检查显示白细胞增多伴中性粒细胞增多。脑脊液检查显示蛋白质浓度升高和多形核白细胞增多。尽管进行了抗癫痫治疗、降低颅内压治疗和抗生素治疗,但犬的病情仍持续恶化,最终实施了安乐死。病理检查发现全脑存在纤维蛋白化脓性脑膜室管膜炎和坏死性动脉炎。此外,在脊髓脑膜中发现了慢性炎症和动脉狭窄。未发现感染病原体。诊断为类固醇反应性脑膜炎动脉炎。在疑似颅内化脓性感染进行鉴别诊断时,类固醇反应性脑膜炎动脉炎病犬前脑脑膜和脑室系统的广泛受累情况此前未见报道,应予以考虑。