Diagnostic Yield and Adverse Effects of MRI‐Guided Free‐Hand Brain Biopsies through a Mini‐Burr Hole in Dogs with Encephalitis

Journal of Veterinary Internal Medicine

T. Flegel¹  A. Oevermann²  G. Oechtering¹ 

[1] Department of Small Animal Medicine, University of Leipzig, Leipzig, Germany;the Neurocenter, DCR-VPH, University of Bern, Bern, Switzerland

关键词: Canine;    GME;    NLE;    NME;   

DOI  :  10.1111/j.1939-1676.2012.00961.x

来源: Wiley

【 摘 要 】

Abstract

Background

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.

Objective

To investigate the diagnostic yield and adverse effects of minimally invasive brain biopsies in dogs with encephalitis.

Animals

Seventeen dogs with suspected encephalitis, based on MR imaging and cerebrospinal fluid analysis.

Methods

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.

Results

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.

Conclusions and Clinical Importance

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.

【 授权许可】

Unknown   
Copyright © 2012 by the American College of Veterinary Internal Medicine