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产后创伤性事件是犬猫脑穿通畸形病变被低估的一个原因吗?

Are postnatal traumatic events an underestimated cause of porencephalic lesions in dogs and cats?

作者信息

Davini Tommaso, Mattei Chiara, La Rosa Claudia, Remelli Carlotta, Specchi Swan, Lionello Elena, Dell'Era Elena, Bernardini Marco

机构信息

Anicura I Portoni Rossi Veterinary Hospital, Zola Predosa, Bologna, Italy.

Antech Imaging Service, Fountain Valley, CA, United States.

出版信息

Front Vet Sci. 2023 Dec 6;10:1302399. doi: 10.3389/fvets.2023.1302399. eCollection 2023.

Abstract

INTRODUCTION

Porencephaly is defined as a fluid-filled cavity of variable size in the brain cortex. It is regarded as a congenital condition and is typically considered a developmental or an encephaloclastic defect. Our hypothesis is that postnatal traumatic events in the first few months of life may represent a cause of canine and feline porencephaly that is more common than generally suspected. The aims of this study were to retrospectively investigate porencephaly in a large population of dogs and cats, detect MRI features that might be useful to differentiate postnatal acquired traumatic forms from congenital/perinatal porencephaly, and define the prevalence of seizure activity in porencephalic patients.

MATERIALS AND METHODS

This is a double-center, descriptive, retrospective case series. Databases were searched for cases within a 17-year time span that involve dogs and cats with an MRI-based diagnosis of cerebral cavitary lesions. Animals were included if a complete signalment and an exhaustive MRI of the brain were available. Besides the porencephalic lesions, MRIs of the head were reviewed to detect concomitant musculoskeletal abnormalities.

RESULTS

Thirty-two cases involving nine cats and twenty-three dogs were selected. Of all the cases, 21.9% were aged six years or older at the time of diagnosis. All patients in which the neuroanatomical localization was available showed clinical signs of a prosencephalic disorder. Epileptic seizures were observed in 71.8% of cases. A single porencephalic cavity was found in 78.1% of cases. The most affected cerebral lobe was the parietal lobe ( = 20). The defects involved both the grey and white matter in 78.1% of cases. Twenty cases showed concomitant musculoskeletal abnormalities overlying the porencephalic cavities. Fourteen of twenty cases showed evidence of fractures, of which thirteen showed depression of the calvarium and twelve masticatory muscle abnormalities. Of these, seven of fourteen had a history consistent with a head trauma in the first period of life.

CONCLUSION

The recognition of skull fractures and muscular abnormalities closely associated with the porencephalic cavity may support a diagnosis of a postnatal traumatic origin of porencephaly. Therefore, this study highlights the importance of evaluating musculoskeletal structures in the MRIs of the heads of porencephalic cases.

摘要

引言

脑穿通畸形被定义为大脑皮质中大小不一的充满液体的腔隙。它被视为一种先天性疾病,通常被认为是发育性或脑破坏性缺陷。我们的假设是,出生后最初几个月的创伤性事件可能是犬猫脑穿通畸形的一个原因,其比一般怀疑的更为常见。本研究的目的是回顾性调查大量犬猫的脑穿通畸形,检测可能有助于区分出生后获得性创伤性类型与先天性/围生期脑穿通畸形的MRI特征,并确定脑穿通畸形患者癫痫发作的患病率。

材料与方法

这是一个双中心、描述性、回顾性病例系列。在17年的时间跨度内,检索数据库中基于MRI诊断为脑空洞性病变的犬猫病例。如果有完整的信号资料和详尽的脑部MRI,则纳入动物。除了脑穿通畸形病变外,还对头部MRI进行回顾以检测伴随的肌肉骨骼异常。

结果

选择了32例病例,其中包括9只猫和23只狗。在所有病例中,21.9%在诊断时年龄为6岁或以上。所有神经解剖定位明确的患者均表现出前脑疾病的临床症状。71.8%的病例观察到癫痫发作。78.1%的病例发现单个脑穿通腔。受影响最严重的脑叶是顶叶(n = 20)。78.1%的病例中,缺陷累及灰质和白质。20例病例显示脑穿通腔上方伴有肌肉骨骼异常。20例中有14例显示有骨折证据,其中13例显示颅骨凹陷,12例显示咀嚼肌异常。其中,14例中有7例有与出生后早期头部创伤相符的病史。

结论

认识到与脑穿通腔密切相关的颅骨骨折和肌肉异常可能支持脑穿通畸形出生后创伤性起源的诊断。因此,本研究强调了在脑穿通畸形病例头部MRI中评估肌肉骨骼结构的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52d3/10730935/1752d9de4843/fvets-10-1302399-g001.jpg

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