Evaluation of Traumatic Intracranial Hemorrhage Using Computed Tomography and Magnetic Resonance Imaging in Four Dogs

개에서 컴퓨터단층촬영술과 자기공명영상을 이용한 창상성 두개관내 출혈의 평가

  • Choi Ho-Jung (College of Veterinary Medicine, Chungnam National University) ;
  • Lee Ki-Ja (College of Veterinary Medicine, Chungnam National University) ;
  • Kang Sang-Kyu (College of Veterinary Medicine, Chungnam National University) ;
  • Lee Hee-Chun (College of Veterinary Medicine, Gyeongsang National University) ;
  • Chang Dong-Woo (College of Veterinary Medicine, Chungbuk National University) ;
  • Lee Ki-Chang (College of Veterinary Medicine, Chonbuk National University) ;
  • Jeong Seong-Mok (College of Veterinary Medicine, Chungnam National University) ;
  • Cho Sung-Whan (College of Veterinary Medicine, Chungnam National University) ;
  • Lee Young-Won (College of Veterinary Medicine, Chungnam National University)
  • Published : 2006.06.01

Abstract

Four dogs with neurologic dysfunction resulted from intracranial hemorrhage by head trauma were referred to Veterinary Medical Teaching Hospital, Chungnam National University. There were no remarkable findings in survey radiography in four cases. CT and MRI scans were diagnostic in these cases. Three dogs underwent CT scanning. On CT images, the lesion was hyperdense and was not enhanced after intravenous contrast administration in dog 1 and dog 2. On CT of dog 4, there was no significant finding. All of four dogs were verified by dorsal, sagittal, and transverse T1-weighted (T1W) and T2-weighted (T2W) images. Appearance of the lesions in dog 1 and dog 2 was isointense (dog 2) or isointense with hyperintense rim (dog 1) on T1W images and hyperintense on T2W images. In dog 3 and dog 4, there were hypointense and hyperintense lesions on T1Wand T2W images respectively. The lesions in four dogs were located in the left intracerebral region, intracerebral and cerebellovestibular region, subdural space, and right cerebral hemisphere, respectively.

두개 창상에 의해 신경증상을 나타내는 4 마리의 환자가 내원하여 일반 방사선 검사 및 컴퓨터단층촬영술(CT)과 자기공명영상(MRI)을 실시하였다. 일반 방사선 사진에서는 내원한 4 마리의 개에서 모두 특이소견을 관찰할 수 없었다. 3마리 개에서 실시한 CT 결과, 3마리 중 2마리의 환자에서 전두엽 부위에 고밀도로 나타나는 병변을 확인할 수 있었으나 소뇌 부위의 병변은 관찰되지 않았다. 이어서 실시한 MRI 검사 결과, 일부의 환자에서는 T1-강조영상에서 저신호로 나타나고 T2-강조영상에서 고신호로 나타나거나 T1-강조영상과 T2-강조영상에서 각각 등신호, 고신호로 나타나는 병변을 확인할 수 있었다. 병변 부위는 좌측과 우측 대뇌 부위, 소뇌전정 부위, 경막하 부위로 다양했다. 이들 환자는 내과적 치료를 실시한 후, 임상적으로 호전되었음을 확인하고 일부 환자는 MRI를 통해 추적검사를 하였다.

Keywords

References

  1. Arnould MC, Grandin CB, Peeters A. Comparison of CT and three MR sequences for detecting and categorizing early (48 hours) hemorrhagic transformation in hyperacute ischemic stroke. Am J Neuroradiol. 2004; 25: 939-944
  2. Atlas SW, Thulbom KR. MR detection of hyperacute parenchymal hemorrhage of the brain. Am J Neuroradiol. 1998; 19: 1471-1417
  3. Berg JM, Joseph RJ. Cerebellar infarcts in two dogs diagnosed with magnetic resonance imaging. J Am Anim Hosp Assoc. 2003; 39: 203-207 https://doi.org/10.5326/0390203
  4. Chris P, Susan P. Brain tauma. In: Tschauner's Guide to small animal clinics, 1st ed. Sudz Publishing. 1999: 524-525
  5. David YK. Clinical evaluation of patients with head trauma. Neuroima. Clin N Am. 2002; 12: 165-174
  6. Dewey CW. Emergency management of the head trauma patient. Vet Clin North Am Small Anim Prac. 2000; 30: 207-225 https://doi.org/10.1016/S0195-5616(00)50010-2
  7. Dewey CW. Emergency management of the head trauma patient. Vet Clin North Am Small Anim Prac. 2000; 30: 207-225 https://doi.org/10.1016/S0195-5616(00)50010-2
  8. Forrest LJ. The head: Excluding the brain and orbit. Clin Tech Small Anim Pract. 1999; 14: 170-176 https://doi.org/10.1016/S1096-2867(99)80033-4
  9. Geddes JF, Hackshaw AK, Vowles GH. Neuropathology of inflicted head injury in children. Brain. 2001; 124: 1290-1306 https://doi.org/10.1093/brain/124.7.1290
  10. Gentry LR, Godersky JC. MR imaging of head trauma: Review of the distribution and radiopathologic features of traumatic lesions. Am J Roentgenol. 1988; 153: 663-672
  11. Han J, Kaufman B, Alfidi R. Head trauma evaluated by magnetic resonance and computed tomography: A comparison. Neuroradiology. 1984; 150: 71-77
  12. Linfante I, Llinas RH, Caplan LR, Warach S. MRI features of intracerebral hemorrhage within 2 hours from symptom onset. Stroke. 1999; 30: 2263-2267 https://doi.org/10.1161/01.STR.30.11.2263
  13. Michael DL, Joe NK. Stupor or coma. In: Handbook of veterinary neurology, 4th ed., London: Saunders. 2004: 297-322
  14. Nykamp S, Scrivani P, Yu-Speight A. Chronic subdural hematomas and hydrocephalus in a dog. Vet Radiol Ultrasound. 2001; 42: 511-514 https://doi.org/10.1111/j.1740-8261.2001.tb00978.x
  15. Patel MR, Edelman RR, Warach S. Detection of hyperacute primary intraparenchymal hemorrhage by magnetic resonance imaging. Stroke. 1996; 27: 2321-2324 https://doi.org/10.1161/01.STR.27.12.2321
  16. Platt SR, Garosi L. Canine cerebrovascular disease; do dog have strokes? J Am Anim Hosp Assoc. 2003; 39: 337-342 https://doi.org/10.5326/0390337
  17. Poussaint TY, Moeller KK. Imaging of pediatric head trauma. Neuroimag Clin N Am 2002; 12: 271-294 https://doi.org/10.1016/S1052-5149(02)00005-9
  18. Seim HB. Surgery of the brain. In: Small animal surgery, 2nd ed. Philadelphia: mosby. 2002: 1322-1345
  19. Simon RP, Natasha JU. Neurological emergencies. In: BSAVA Manual of Canine and feline neurology, 3rd ed. Gloucester: BSAVA. 2004: 320-336
  20. Swensen SJ, Keller PL, Berquist TH. Magnetic resonance imaging of hemorrhage. AJR Am Roentgenol. 1985; 145: 921-927 https://doi.org/10.2214/ajr.145.5.921
  21. Thomas WB, Adams WH, Gompf RE. Magnetic resonance imaging appearance of intracranial hemorrhage secondary to cerebral vascular malformation in a dog. Vet Radiol Ultrasound. 1997; 38: 371-375 https://doi.org/10.1111/j.1740-8261.1997.tb02100.x
  22. Thomas WB. Nonneoplastic disorders of the brain. Clin Tech Small Anim Pract. 1999; 14: 125-147 https://doi.org/10.1016/S1096-2867(99)80030-9
  23. Williams V, Hogg J. Magnetic resonance imaging of chronic subdural hematoma. Neurosurg Clin N Am. 2000; 11: 491-498
  24. Young RJ, Destian S. Imaging of traumatic intracranial hemorrhage. Neuroimag Clin N Am. 2002; 12: 189-204 https://doi.org/10.1016/S1052-5149(02)00003-5