intracranial disease in dogs

Introduction There are four main locations and causes of blindness: lesions that produce opacification of the ocular media, Advanced Imaging– Computed tomography (CT scan) is very useful in determining the size and location of the tumor. Intracranial Arachnoid Cysts in Dogs Curtis W. Dewey, Ithaca, New York Intracranial arachnoid cyst (IAC), also termed intraarachnoid cyst and quadrigeminal cyst, is a developmental brain disorder in which cerebrospinal fluid (CSF) is believed to accumulate within a split of the arachnoid membrane during embryogenesis. USA, Cerebrospinal fluid: culture and sensitivity, Hematology: activated partial thromboplastin time (APTT). Other clinical signs frequently associated with a brain tumor in dogs include circling, altered posture, gait abnormalities, ataxia (loss of the ability to coordinate muscular movement), head tilt, behavior change, depression, incontinence (inability to control excretory functions) and cervical spinal hyperesthesia (abnormal increase in sensitivity to stimuli of the senses). Treatment Once an animal has been diagnosed, antibiotics are usually started to treat for the common infectious diseases. Vernau KM, LeCouteur RA, Sturges BK, et al. b. Ganglioglioma– They arise from ganglion cells in the central nervous system. These tumors resemble testicular seminomas and are also called embryonal carcinomas and ovarian seminomas. They are generally associated with the pituitary gland which may be trapped within or replaced by the germ cell tumor. Hemorrhage (intraparenchymal, intraventricular, extradural or subdural). T cell, B cell and histiocytic sarcoma fall within this category. They usually occur in animals between 3-5 yrs of age. Unlike neoplasms, their growth is limited. With treatment they have an overall favorable outcome. Around 30% of them have been reported to metastasize. They have a tendency to protrude into the fourth ventricle replacing part of the cerebellar vermis (it is a wormlike structure between the hemispheres of the cerebellum) and compressing the mid brain rostrally and brain stem ventrally. Hyperventilating and administration of mannitol help to decrease increased ICP before CSF collection. They are known as adenocarcinomas, or pituitary macroadenomas. These cells may be sensitive at certain dosages which are toxic to the normal brain or other organs. But it can certainly give owners and pets some temporary relief. Lomustine, carmustine and temozolomide have proved successful in the treatment of gliomas by disrupting BBB. The midline location in the brain is not explained clearly. Radiography can be useful if the tumors develop in the skull or nasal cavity that involve the brain by local extension. This primary injury may initiate a number of secondary pathophysiological sequelae such as: Metabolic alterations in neuronal or glial cells. Skull lesions that affect the brain by local extension include osteosarcoma (most common type of primary malignant bone tumor), chondrosarcoma (type of bone cancer) and multilobular osteochondrosarcoma (uncommon tumor that affects the skull). They have a mixed appearance of astrocytomas and oligodendrocytomas. Vasculopathy, eg secondary to radiation therapy, Thrombosis, infarction and hemorrhage can occur spontaneously, secondary to drug therapy (L-asparaginase, anticoagulants), with thrombocytopenia and other bleeding disorders. They are generally mixed cell tumors containing both neural ganglionic cells (cells that arise from ganglion) and neural glial cells (they provide protection and nutrition to neurons and participate in the signal transmission in the nervous system). Recovery should be rapid to reduce the likelihood of hypoventilation, but excitement should be avoided, so as not to exacerbate any increased ICP (Lozano et al. These tumors have a very poor prognosis, since they have traveled through the body depositing clusters of abnormal tissues in their course. Four methods of   therapy for a brain tumor include surgery, irradiation, chemotherapy and immunotherapy. Another one is increasing the delivery of genetic material. They arise within the cranial cavity and invade the brain. They are believed to result from extensive migration of germ cells during embryogenesis (process by which embryo is developed). Tumors of the Ependyma and Choroid plexus: a. Ependymoma– They develop from the epithelium lining and the central canal of the spinal cord. Capillaries tend to proliferate within these tumors, producing glomerulus-like (capillary tuft) structures. intracranial pressure (ICP) may be present in association with a brain tumor, and ... Cerebrovascular Disease of Dogs & Cats Cerebrovascular disease is defined as any abnormality of the brain resulting from a pathologic process affecting its blood supply. Blood leaks directly into the brain, forming a hematoma within the brain parenchyma, or into the subarachnoid or subdural space, leading to physical disruption of the tissue and pressure on the surrounding brain. Description– There is not enough data supporting the incidence of brain tumors in dogs. Extracranial caus… Pituitary adenoma or adrenocorticism: . But in dogs there seem to be a number of complications though clinical trials are underway. Poor transfection (opening of pores in cell membranes for the uptake of genetic materials like DNA) of the tumor mass appears to be the greatest hurdle. The size, location and the extent of proliferativeness of the lesion help in determining whether the vets should go for complete surgical excision. Causes– The etiology of brain tumors is not known. Breeds over 5 years of age are highly predisposed. They may infiltrate the meninges, spread within the CSF pathways, and result in obstructive hydrocephalus. Although brain tumors can affect any breed at any age, they are most frequent in older dogs. b. Oligodendrocytomas are seen frequently in brachycephalic breeds. Several types of CNS malignancies vary in their degree of sensitiveness to cytotoxic drugs. b) Pre-anesthetic Medications i) Benzodiazepines are generally well tolerated. 2009). They account for 35% of all spinal cord tumors in dogs. They are located in the superior portion of the nasal cavity and may present with blockage or hemorrhage. Pressure alterations associated with CSF drainage may result in brain herniation (deadly side effect of increased intracranial pressure). They are believed to arise from choroid plexus epithelium. b. Hamartomas– They are elements formed by abnormal growth of local tissue elements. There is a broad spectrum of tumors that occur in the intracranial cavity of dogs. Canine breeds that probably have the highest incidence include Boxer, Golden Retriever, Doberman pinscher, Scottish terrier and Old English Sheepdog. Irradiation can be used alone or in combination with other treatments. It arises in the arachnoid mater of the meninges. It mostly occurs in the cerebellopontine angle (common site for growth of acoustic neuromas [benign tumor of the 8th cranial nerve]). Intracranial Disease Management Basics : Bob Stein : December, 2004 : 1) RECOMMENDATIONS a) General Approach i) Avoid any increase in intracranial pressure. If the seizures occur when the dog is younger than six months or older than five years, it may be metabolic or intracrainal (within the skull) in origin; this will rule out hypoglycemia in older dogs. The brain may be imaged with an MRI or CT scan before a spinal tap to look for signs of elevated intracranial pressure and to rule out other causes of neurological disease. The dog had marked neutrophilia with a toxic left shift and monocytosis. Canine breeds that probably have the highest incidence include Boxer, Golden Retriever, Doberman pinscher, Scottish terrier and Old English Sheepdog. The normal autoregulation of CBF may be impaired following intracranial bleed, causing blood flow to damaged regions to become directly dependent on systemic blood pressure. ii. Rare cause of neurological disease → rapid cerebral dysfunction. Difficulties in balance or gait are due to cerebellar or vestibular (contributes to balance and sense of spatial orientation) involvement. Primary brain tumors arise from the brain, spinal cord, and associated tissues -collectively known as the central nervous system (CNS). In cytoreduction (decrease in number of cells) the volume of tumor available for therapy is reduced by other means of treatment like radiation therapy. Besides, helping in tissue biopsy, partial removal of a brain neoplasm may eliminate signs of cerebral dysfunction and also makes the dog amenable to other kinds of therapies. Radiation may also be useful in managing lymphoma. Additionally, dexmedetomidine may reduce cognitive dysfunction related to ischemic cerebrovascular disease. Secondary brain tumors represent metastasis of a tumor to the brain from any other part of the body. They mostly occur in doliococephalic breeds of dogs like the Golden Retriever. The most widely seen secondary tumors of dogs include local extension of nasal adenocarcinoma, metastases from mammary, prostatic or pulmonary adenocarcinoma, metastases from hemangiosarcoma and extension of pituitary adenoma or carcinoma. The selection of radiation dose is based on considerations like tumor type, location, and partially on tolerance of the tissues surrounding the lesion. They don’t expand further. They are generally seen in brachycephalic breeds. Dogs were classified into 3 groups based on MRI findings: no structural diseases (group I), structural disease without MRI evidence of intracranial hypertension (group II), and structural disease with MRI evidence of intracranial hypertension (group III). Certain breeds also have relatively higher incidence. – Not a specific test for idiopathic epilepsy. It is believed to secrete melatonin, and may therefore be part of the body’s sleep-regulation apparatus). These damaged cells are good targets for gene therapy. A dogs immune system is a network of white blood cells, antibodies, and other defenses in the body that fight off infections and foreign substances, including bacteria and viruses. b. Neuroblastoma– It is a solid lesion that usually originates in one of the adrenal glands, but can also arise in nerve tissues in the neck, chest abdomen or pelvis. Intraparenchymal hemorrhage is most common, although subdural hematoma is possible. Brain tumors may lead to an accumulation of fluid (edema) around them. Neoplasms result due to damage in the DNA as a result of carcinogens or during DNA replication. Suddenly it started showing signs of seizures (epileptic feat, convulsions) and also developed personality changes. Cerebrospinal fluid analysis– Examination of CSF is important in the diagnosis of brain tumors. III. But it is gradually gaining importance as an alternative therapy for cancer. Diagnostic techniques- The diagnostic tests for dogs with clinical dysfunction include a hemogram, serum chemistry panel and urinanalysis. It could either be a generalized seizure or a focal seizure. In one survey, 2.83% of 6,175 dogs examined at necropsy had intracranial neoplasia. Certain breeds also have relatively higher incidence. VI. In contrast to the high incidence in man, intracerebral hemorrhage resulting from spontaneous rupture of vessels is rare in dogs. Doberman Pinschers are slightly predisposed. They grow by expansion, and have a granular papillary (they look like round or cone shaped protuberances) appearance. They may be seen in the cervical, lumbar or thoracic cord regions. Nerve sheath lesions that originate from cranial nerves like the oculomotor nerve (controls most of the eye movements) and the trigeminal nerve (responsible for sensation in the face) may also occur in dogs. Intra-arterial administration (infusion of drug via injection into an artery) of drugs, high dose systemic therapy and blood brain barrier disruption are all under investigation in dogs. Exhaustion of the compensating mechanisms for an intracranial space occupying lesion results in further increases in the volume of the hematoma, producing massive elevations in ICP. With palliative therapy, the prognosis is very poor. Surgical therapy of IAC involves Like humans, dogs may also develop severe headaches, but since they cannot articulate, symptoms like decreased frequency of barking or diminished levels of activity. A recent innovation is the CT-guided stereotactic biopsy system. The median survival time has been found to be 2-4 months. Primary brain tumors include meningioma, glioma, choroid plexus papilloma, pituitary adenoma or adenocarcinoma and others. Withrow and MacEwen’s Small Animal Clinical Oncology- Stephen J. Withrow, DVM, DACVIM (Oncology), Director, Animal Cancer Center Stuart Chair In Oncology, University Distinguished Professor, Colorado State University Fort Collins, Colorado; David M. Vail, DVM, DACVIM (Oncology), Professor of Oncology, Director of Clinical Research, School of Veterinary Medicine University of Wisconsin-Madison Madison, Wisconsin, New Choices in Natural Healing for Dogs and Cats (Rodale Press, Inc., 1999)-, Learn More About the NCCF, our Mission and Canine Cancer. c. Oligogastrocytomas are usually rare. The most prominent signs associated with a brain neoplasm in dog is seizures, especially if it occurs in the animal after 4 years of age. They are mostly seen in the cerebellum Many dogs with such acute onset of neurological dysfunction (brain tumours excluded) may recover within a couple of weeks despite their initial severe clinical appearance. Overall, the majority of seizures in dogs are caused by intracranial diseases. The classification of the tumors of the central nervous system (CNS) is based on the traits of the constituent cell type, pathologic behavior, topographic pattern and secondary changes present within and surrounding the tumor. Immunotherapy– The treatment of dogs with meningiomas using repeated intracisternal injections (infusion into the cisterna which carry golgi enzymes, to modify cargo proteins traveling through them but destined for other parts of the body) of stimulated lymphocytes (a type of white blood cells in the vertebrate immune system) have resulted in the reduction of tumor size and also in the improvement of clinical symptoms. VIII. b. Choroid plexus papilloma– These tumors can be either benign or malignant that tend to develop in the ventricular system and can obstruct the drainage of CSF. Primary brain tumors are categorized as benign (noncancerous) or malignant (cancerous). In these circumstances, systemic hypotension can result in inadequate perfusion of the brain, which leads to cerebral ischemia and secondary neuronal injury. Cambridge CB21 4EN Intracranial causes of seizure are functional diseases such as idiopathic epilepsy, or structural (active or inactive) diseases, such as brain tumors or glial scars caused by a past brain injury. Lymphomas and various hematopoietic tumors: a. Histiocytic sarcomas– They are malignant tumors that arise from histiocytic cells like the macrophages and the dendritic cells which form an integral part of the immune system. – For dogs with idiopathic epilepsy, it does not necessarily help with prognosis or treatment. fi nding. Vascular (related to blood vessels) hamartomas are not common in animals, but several cases of congenital hamartomas have been reported in dogs. They have been further classified on the basis of the infiltrativeness of reticulohistiocytic cells (B cell lymphoid tumors) around the vessels with different patterns of reticulin production (scleroprotein responsible for maintaining the structural integrity of most organs) combined with inflammatory cells of varying populations. The purpose of these tests is to rule out extracranial causes for symptoms of cerebral dysfunction. Both procedures have been reported in dogs with intracranial arachnoid cyst. Morphologically, these are heterogeneous. Vet Radiol Ultrasound 2002;43:449-454. d. Intradural extramedullary spinal cord tumor in young dogs– They grow within the spinal canal but outside the nerves. In dogs, there are two main ligaments that stabilize the knee joint (also called the stifle joint). Multiple meningiomas and cerebrospinal fluid (CSF, it is a clear bodily fluid in which the brain floats) metastases of medulloblastoma (it is a highly malignant primary brain tumor that originates in the cerebellum or posterior fossa) or choroid plexus carcinoma have been reported to occur in dogs. Figure 1. This alters CNS volume/pressure relationships, with the possibility of increasing intracranial pressure (ICP) and decreasing cerebral blood flow (CBF). Disadvantage – Expensive. They are seen frequently in dogs and is also the primary cause of hyperadrenocorticism (Cushing’s syndrome). They derive from remnants of the notochord (rod like structure in embryos from which the spinal column develops). Surgical management of intracranial arachnoid cyst in people is typically via cyst fenestration or cystoperitoneal shunt placement. A.D. Shojai. Medi-cal therapy of IAC focuses on management of increased intracranial pressure and sei-zures, if the latter are part of the clinical complaints. Garosi L S, Platt S R, McConnell J F, Wray J D & Smith K C (2005). When IAC is responsible for neurologic disease in dogs, generalized seizures and cerebellovestibular dysfunction are the most common clinical presentations. A seizure occurs when the cerebral cortex, a part of the brain, functions in an abnormal way. a. Olfactory neuroblastoma– They are highly malignant neurorectodermal tumor. Fort Mill SC 29707 In dogs with intracranial disease, the recovery period is a crucial time. Weakness and loss of energy usually indicate a tumor in the cerebral frontoparietal or sensory motor regions. Images obtained by MRI are way advanced to those of CT in certain brain regions like the brain stem. Focal seizures or the presence of neurologic deficits, meanwhile, indicate structural intracranial disease. Although laryngeal paralysis in mature animals is often considered ‘idiopathic' there is some evidence that it commonly occurs as one, particularly prominent, component of a generalised polyneuropathy. Several types of CNS malignancies vary in their degree of sensitiveness to cytotoxic drugs. Meningiomas, which are located over the cerebral convexities or the frontal lobes of the cereberum may be eradicated by means of surgery. Radiography– It is of practically no use when it comes to detecting primary brain tumors. They infiltrate into the ventricular system and the meninges. b. Germ cell tumors– The fertilized mammalian ovum differentiates into extraembryonic and embryonic tissues. According to a report, 14.5 per 100,000 of the population are at a risk of  contracting the disease. But intracranial neoplasms appear to affect dogs more than any other domestic species. Teratoma– They are solid tumors containing differentiated tissue from two or three cell lines. Intracranial intra-arachnoid cyst with intracystic hemorrhage in two dogs. Seizures can occur in dogs for many different reasons. Anaesthetic management of dogs and cats with an intracranial mass Author : Miguel Martinez Categories : Companion animal, Vets Date : March 14, 2017 Intracranial disease and its associated clinical neurological signs are relatively common in dogs and cats, with increased incidence in middle-aged and old individuals. But in some cases, they expand quickly and compress the overlying brain. UK, 9789 Charlotte Hwy Aust Vet J 2003;81:340-343. They are located dorsal to the sella turcica (saddle shaped depression in the sphenoid bone [bone situated at the base of the skull]). The inability of the cell to correct this damage due to mutated DNA repair genes or absence of normal cell cycle may lead to abnormal growth of cells. Perfusion of the clinical diagnosis is named after the area of the tumor stem! 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