Department of Small Animal Medicine, University of Leipzig, Leipzig, Germany.
J Vet Intern Med. 2012 Jul-Aug;26(4):969-76. doi: 10.1111/j.1939-1676.2012.00961.x. Epub 2012 Jun 18.
The diagnosis of encephalitis is usually presumptive based on MRI, cerebrospinal fluid analysis, or both. A definitive diagnosis based on histopathology, however, is required for optimizing treatment strategies.
To investigate the diagnostic yield and adverse effects of minimally invasive brain biopsies in dogs with encephalitis.
Seventeen dogs with suspected encephalitis, based on MR imaging and cerebrospinal fluid analysis.
Retrospective study. Minimally invasive, free-hand brain biopsy specimens were taken from forebrain lesions through a 4-mm burr hole using a Sedan side-cutting needle. Routine histopathological examination was performed. The adverse effects were assessed by MRI evaluations after biopsy procedure (12/17) and by sequential neurological examinations.
The overall diagnostic yield with regard to a specific type of encephalitis was 82%. Encephalitis was evident in an additional 12%, but a specific disease could not be determined. There were no deaths caused by the biopsy procedure itself, but the indirect case fatality rate was 6%. Morbidity was 29%, including stupor, seizures, tetraparesis, hemiparesis, ataxia, and loss of conscious proprioception. All these signs resolved within 3-14 days.
Minimally invasive brain biopsy in dogs with suspected encephalitis leads to a definite diagnosis in the majority of dogs, allowing for a specific treatment. The advantages of a definite diagnosis outweigh potential case fatality rate and temporary neurological deficits.
脑炎的诊断通常基于 MRI、脑脊液分析或两者结合做出推测。然而，基于组织病理学的明确诊断对于优化治疗策略是必需的。
调查在患有脑炎的犬中，微创脑活检的诊断效果和不良反应。
17 只疑似脑炎的犬，基于 MRI 和脑脊液分析。
回顾性研究。使用 Sedan 侧切针通过 4mm 钻头在大脑前病变处进行微创、徒手脑活检。进行常规组织病理学检查。通过活检后（12/17）的 MRI 评估和连续的神经学检查评估不良反应。
特定类型脑炎的总体诊断效果为 82%。在另外 12%的病例中可以发现脑炎，但无法确定具体疾病。没有因活检程序本身导致的死亡，但间接病死率为 6%。发病率为 29%，包括昏迷、癫痫、四肢瘫痪、偏瘫、共济失调和意识性本体感觉丧失。所有这些症状都在 3-14 天内得到解决。
在疑似脑炎的犬中进行微创脑活检，可使大多数犬得到明确诊断，从而进行特异性治疗。明确诊断的优势超过潜在的病死率和暂时的神经功能缺损。
