한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제40권1호
  • /
  • Pages.56-61
  • /
  • 2023
  • /
  • 1598-298X(pISSN)
  • /
  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지
DOI QR코드

DOI QR Code

Successful Management of Post-Traumatic Hydrocephalus and Pseudomeningocele Following Traumatic Brain Injury in a Cat

  • Hyoung-Won Seo (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University) ;
  • Jeong-Min Lee (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University) ;
  • Hae-Boem Lee (Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University) ;
  • Yoon-Ho Roh (Division of Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern) ;
  • Tae-Sung Hwang (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Kun-Ho Song (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University) ;
  • Joong-Hyun Song (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University)
  • 투고 : 2022.12.06
  • 심사 : 2023.01.24
  • 발행 : 2023.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

A 5-month-old female domestic short-haired cat presented with a history of seizure episodes for two months following an animal bite injury to the head. There were no remarkable findings on physical and neurological examination or blood analysis. Computed tomography revealed a fracture of the left parietal bone with an inward displacement of the bone fragment while magnetic resonance imaging revealed an enlarged temporal horn of the left lateral ventricle and a pseudomeningocele compressing the adjacent cerebral parenchyma. Subsequently, cerebrospinal fluid analysis results were normal. The patient was diagnosed with traumatic brain injury (TBI), with subsequent post-traumatic hydrocephalus (PTH) and pseudomeningocele. Despite treatment with phenobarbital and levetiracetam, seizures were not sufficiently controlled. Craniectomy for bone fragment removal and duraplasty were performed after a week. The patient then returned to normal condition with no further seizure activity. On repeated MRI two months after discharge, the hydrocephalus of the lateral ventricle and pseudomeningocele were enlarged; however, the patient maintained a good clinical status without any neurological signs. To the best of our knowledge, PTH and intracranial pseudomeningoceles have not yet been reported in cats. PTH and pseudomeningocele are among the complications of TBI and may not have any significant relevance with the clinical signs in this case. Thus, to broaden our knowledge about PTH and pseudomeningocele in cats, we describe serial changes in the clinical findings of this cat over the treatment period.

키워드

과제정보

This research was supported by the National Research Foundation of Korea, funded by a grant from the Korean Government (NRF-2022R1G1A10036821131482092640101).

참고문헌

  1. Annegers JF, Coan SP. The risks of epilepsy after traumatic brain injury. Seizure 2000; 9: 453-457.  https://doi.org/10.1053/seiz.2000.0458
  2. Chapman JC, Diaz-Arrastia R. Military traumatic brain injury: a review. Alzheimers Dement 2014; 10(3 Suppl): S97-S104.  https://doi.org/10.1016/j.jalz.2014.04.012
  3. Choi I, Park HK, Chang JC, Cho SJ, Choi SK, Byun BJ. Clinical factors for the development of posttraumatic hydrocephalus after decompressive craniectomy. J Korean Neurosurg Soc 2008; 43: 227-231.  https://doi.org/10.3340/jkns.2008.43.5.227
  4. Dandy WE, Blackman KD. Internal hydrocephalus: an experimental, clinical and pathological study. Am J Dis Child 1914; 8: 406-482.  https://doi.org/10.1001/archpedi.1914.02180010416002
  5. Han SR, Lee SJ, Yee GT, Choi CY, Sohn MJ, Lee CH. An unusual cervical post-traumatic pseudomeningocele - a case report -. J Korean Neurotraumatol Soc 2009; 5: 115-117.  https://doi.org/10.13004/jknts.2009.5.2.115
  6. Heinonen A, Rauhala M, Isokuortti H, Kataja A, Nikula M, Ohman J, et al. Incidence of surgically treated post-traumatic hydrocephalus 6 months following head injury in patients undergoing acute head computed tomography. Acta Neurochir (Wien) 2022; 164: 2357-2365.  https://doi.org/10.1007/s00701-022-05299-3
  7. Lee HC, Choi ES, Cho KW, Kang BT, Kim JW, Yu CH, et al. Traumatic brain injury in a Pomeranian dog: clinical, computed tomography, and necropsy findings. J Vet Clin 2010; 27: 579-583. 
  8. Lopes C, Viana D, Matos M, Rodrigues F, Pimentel S. Post-traumatic hydrocephalus in a dog. Rev Educ Contin Med Vet Zootec CRMV-SP 2018; 16: 85-86. 
  9. Mazzini L, Campini R, Angelino E, Rognone F, Pastore I, Oliveri G. Posttraumatic hydrocephalus: a clinical, neuroradiologic, and neuropsychologic assessment of long-term outcome. Arch Phys Med Rehabil 2003; 84: 1637-1641.  https://doi.org/10.1053/S0003-9993(03)00314-9
  10. Mehendale NH, Samy RN, Roland PS. Management of pseudomeningocele following neurotologic procedures. Otolaryngol Head Neck Surg 2004; 131: 253-262.  https://doi.org/10.1016/j.otohns.2004.01.018
  11. Menon DK, Schwab K, Wright DW, Maas AI. Position statement: definition of traumatic brain injury. Arch Phys Med Rehabil 2010; 91: 1637-1640.  https://doi.org/10.1016/j.apmr.2010.05.017
  12. Pahys JM, Chicorelli AM, Asghar J, Betz RR, Samdani AF. Cervical pseudomeningocele due to occult hydrocephalus. Spine (Phila Pa 1976) 2008; 33: E394-E396.  https://doi.org/10.1097/BRS.0b013e31817343f3
  13. Park S, Park J, Kim J, Kim J, Son J, Chang D, et al. Penetrating cranial injury due to gunshot in a dog: a case report. Vet Med 2010; 55: 253-257.  https://doi.org/10.17221/2995-VETMED
  14. Pirouzmand F, Tator CH, Rutka J. Management of hydrocephalus associated with vestibular schwannoma and other cerebellopontine angle tumors. Neurosurgery 2001; 48: 1246-1253; discussion 1253-1254.  https://doi.org/10.1227/00006123-200106000-00010
  15. Rufus P, Moorthy RK, Joseph M, Rajshekhar V. Post traumatic hydrocephalus: incidence, pathophysiology and outcomes. Neurol India 2021; 69(Supplement): S420-S428.  https://doi.org/10.4103/0028-3886.332264
  16. Sande A, West C. Traumatic brain injury: a review of pathophysiology and management. J Vet Emerg Crit Care (San Antonio) 2010; 20: 177-190.  https://doi.org/10.1111/j.1476-4431.2010.00527.x
  17. Sharma S, Tiarks G, Haight J, Bassuk AG. Neuropathophysiological mechanisms and treatment strategies for post-traumatic epilepsy. Front Mol Neurosci 2021; 14: 612073. 
  18. Smith LGF, Milliron E, Ho ML, Hu HH, Rusin J, Leonard J, et al. Advanced neuroimaging in traumatic brain injury: an overview. Neurosurg Focus 2019; 47: E17. Erratum in: Neurosurg Focus 2021; 50: E22. 
  19. Svedung Wettervik T, Lewen A, Enblad P. Post-traumatic hydrocephalus - incidence, risk factors, treatment, and clinical outcome. Br J Neurosurg 2022; 36: 400-406.  https://doi.org/10.1080/02688697.2021.1967289
  20. Tang ME, Lobel DA. Severe traumatic brain injury: maximizing outcomes. Mt Sinai J Med 2009; 76: 119-128.  https://doi.org/10.1002/msj.20106
  21. Yoon JE, Lee CY, Sin EG, Song J, Kim HW. Clinical feature and outcomes of secondary hydrocephalus caused by head trauma. Korean J Neurotrauma 2018; 14: 86-92. https://doi.org/10.13004/kjnt.2018.14.2.86