U-Vet Animal Hospital, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia.
Small Animal Specialist Hospital, Level 1, 1 Richardson Place, North Ryde, New South Wales, 2113, Australia.
Aust Vet J. 2022 Sep;100(9):433-439. doi: 10.1111/avj.13178. Epub 2022 Jun 2.
Global brain ischaemia following cardiopulmonary arrest is uncommonly reported in veterinary medicine yet neurologic injury after arrest is a known morbidity.
An 18-week-old male entire Cavalier King Charles Spaniel-Poodle was referred following 3 days of neurologic abnormalities after cardiopulmonary arrest. After resuscitation, the animal had decerebrate rigidity, a stuporous mentation and intermittent episodes of vocalisation and apnoea. A brain magnetic resonance imaging (MRI) was undertaken 4 days after cardiopulmonary arrest, with standard sequences (T1-weighted, T2-weighted and fluid-attenuated inversion recovery) as well as diffusion-weighted imaging to better discern ischaemic injury and cytotoxic oedema for prognostic reasons. MRI findings were consistent with global brain ischaemia affecting the hippocampus, cerebellum and substantia nigra, the latter two not previously identified in canine cases of global brain ischaemia. The patient was euthanased on day eight post-cardiopulmonary arrest due to a lack of neurological improvement and developing sepsis as a complication. Ante-mortem identification of affected areas of the brain was confirmed on histological examination, with evidence of ischaemic injury seen in the cerebrum, hippocampus, cerebellum, basal nuclei and thalamus.
This report describes ante-mortem MRI and postmortem findings in a dog with global brain ischaemia following cardiopulmonary arrest. A multimodal approach to neuroprognostication in patients recovering from cardiopulmonary arrest is recommended.
心肺骤停后全球脑缺血在兽医领域罕见报道，但众所周知，心跳骤停后会发生神经损伤。
一只 18 周龄雄性全尺寸可卡颇犬-贵宾犬，在心肺骤停后 3 天出现神经异常后被转诊。复苏后，动物出现去大脑僵直、昏迷状态，间歇性出现发声和呼吸暂停。心肺骤停后 4 天进行了脑部磁共振成像（MRI）检查，使用了标准序列（T1 加权、T2 加权和液体衰减反转恢复）以及扩散加权成像，以便更好地识别缺血性损伤和细胞毒性水肿，以便进行预后评估。MRI 结果与影响海马体、小脑和黑质的全脑缺血一致，后两者以前在犬全脑缺血病例中没有发现。由于缺乏神经改善和发生作为并发症的败血症，该患者在心肺骤停后第 8 天被安乐死。组织学检查证实了大脑受影响区域的生前识别，大脑、海马体、小脑、基底核和丘脑都有缺血性损伤的证据。
本报告描述了心肺骤停后犬全脑缺血的 MRI 及死后发现。建议对心肺骤停后恢复的患者采用多模态神经预后评估方法。
