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Diagnostic Yield and Adverse Effects of MRI-Guided Free-Hand Brain Biopsies through a Mini-Burr Hole in Dogs with Encephalitis.
MedLine Citation:
PMID:  22708694     Owner:  NLM     Status:  Publisher    
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.
T Flegel; A Oevermann; G Oechtering; K Matiasek
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-18
Journal Detail:
Title:  Journal of veterinary internal medicine / American College of Veterinary Internal Medicine     Volume:  -     ISSN:  1939-1676     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708660     Medline TA:  J Vet Intern Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 by the American College of Veterinary Internal Medicine.
Department of Small Animal Medicine, University of Leipzig, Leipzig, Germany.
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