Dynamics and diagnosis of severe pneumocephalus of unknown etiology in dog
Modern veterinary medicine and its subdivision – veterinary neurology, are constantly evolving. New diagnostic methods are emerging every day, and the list of new, previously unexplored animal diseases is expanding. Much information about the pathogenesis and etiology of diseases is borrowed from human medicine, which is a big problem, because human physiology is different from animals and, as a consequence, the dynamics of the disease are also different. That is why the continuous improvement of veterinary therapy and diagnosis of diseases is relevant and necessary. One of the rare and severe pathologies is pneumocephalus. It is reported that this is a condition in which there is a gradual accumulation of air in the cranial cavity or ventricles of the brain, creating a life-threatening condition. It is considered that pneumocephalus can occur spontaneously but, in most cases, is diagnosed after trauma or surgery with impaired integrity of the skull bones and meninges. This article describes a case of pneumocephalus of unknown etiology in a young dog who suffered a head injury while playing with the owner. During the neurological examination of the animal conducted immediately after the incident was diagnosed with severe central nervous system lesions (sopor, opisthotonus, tetraparesis); magnetic resonance imaging revealed significant brain damage with pronounced ventricular dilatation and the formation of a cavity filled with air. Re-diagnosis after 14 days showed progression of pneumocephalus with gas accumulation in the brain cavities. The contents of the ventricles have a division into liquid (cerebrospinal fluid), and air, progressive inflammatory processes in the brain's parenchyma were not observed; a fistula or canal connecting the cranial cavity and the external environment was not detected. Symptomatic and supportive therapy, carried out during the entire period of the dog's stay in the veterinary clinic, did not have positive results. The animal was euthanized according to medical indications and the owner's wishes.
Aksoy, F., Dogan, R., Ozturan, O., et al. (2013). Tension pneumocephalus: an extremely small defect leading to an extremely serious problem. Am J Otolaryngol, 34(6), 749–752. https://doi.org/10.1016/j.amjoto.2013.07.011
Andrews, J. C., & Canalis, R. F. (1986). Otogenic pneumocephalus. Laryngoscope, 96(5), 521–528. https://doi.org/10.1288/00005537-198605000-00010
Cavanaugh, R. P., Aiken, S. W., & Schatzberg, S. J. (2008). Intraventricular tension pneumocephalus and cervical subarachnoid pneumorrhachis in a bull mastiff dog after craniotomy. J Small Anim Pract, 49, 244–248. https://doi.org/10.1111/j.1748-5827.2007.00467.x
Cunqueiro, A., & Scheinfeld, M. H. (2018). Causes of pneumocephalus and when to be concerned about it. Emerg Radiol, 25, 331–340. https://doi.org/10.1007/s10140-018-1595-x
Fletcher, D. J., Snyder, J. M., Messinger, J. S., Chiu, A. G., & Vite, C. H. (2006). Ventricular pneumocephalus and septic meningoencephalitis secondary to dorsal rhinotomy and nasal polypectomy in a dog. Journal of the American Veterinary Medical Association, 229(2), 240–245. https://doi.org/10.2460/javma.229.2.240
Garosi, L. S., McConnell, F. J., & Lujan, A. (2005). What is your diagnosis? Pneumocephalus. Journal of the American Veterinary Medical Association, 226(7), 1057–1058. https://doi.org/10.2460/javma.2005.226.1057
Garosi, L. S., Penderis, J., Brearley, M. J., Brearley, J. C., Dennis, R., & Kirkpatrick, P. J. (2002). Intraventricular tension pneumocephalus as a complication of transfrontal craniectomy: a case report. Veterinary Surgery, 31(3), 226–231. https://doi.org/10.1053/jvet.2002.32449
Haley, A. C., & Abramson, C. (2009). Traumatic pneumocephalusin a dog. Journal of the American Veterinary Medical Association, 234(10), 1295–1298. https://doi.org/10.2460/javma.234.10.1295
Kohl, S., Köhler, C., & Kiefer, I. (2021). MRI diagnosis of spontaneous intraventricular tension-pneumocephalus in a 10-month-old male Saarloos Wolfdog. Veterinary radiology & ultrasound, 63(3), E20–E23. https://doi.org/10.1111/vru.13040
Kohl, S., Köhler, C., & Kiefer, I. (2021). MRI diagnosis of spontaneous intraventricular tension‐pneumocephalus in a 10‐month‐old male Saarloos Wolfdog. Veterinary Radiology & Ultrasound, 63, E20–E23. https://doi.org/10.1111/vru.13040
Launcelott, Z. A., Palmisano, M. P., Stefanacci, J. D., & Whitney, B. L. (2016). Ventricular pneumocephalus, cervical subarachnoid pneumorrhachis, and meningoencephalitis in a dog follow in rhinotomy for chronic fungal rhinitis. Journal of the American Veterinary Medical Association, 248(4), 430–435. https://doi.org/10.2460/javma.248.4.430
Moral, M., Blanco, C., Martínez, J., & Lorenzo, V. (2021). Delayed traumatic pneumocephalus and cervical pneumorrhachis in a dog, Veterinary Record Case Reports, 9, 3. https://doi.org/10.1002/vrc2.70
Ros, C., dela Fuente, C., Novellas, R., & Añor, S. (2015). What is your diagnosis? Pneumocephalus. Journal of the American Veterinary Medical Association, 246(9), 959–961. https://doi.org/10.2460/javma.246.9.959
Schirmer, C. M., Heilman, C. B., & Bhardwaj, A. (2010). Pneumocephalus: case illustrations and review. Neurocrit Care, 13, 152–158. https://doi.org/10.1007/s12028-010-9363-0
Sena, J. O., Costa, K. C. R., Costa, P. M., Miranda, F. G., Silva, J. F., & Tôrres, R. C. S. (2017). Intraventricular pneumocephalus associated with nasocephalic necrosisin a puppy: a case report. Arquivo Brasileirode Medicina Veterinária e Zootecnia, 69(2), 333–339. https://doi.org/10.1590/1678-4162-8913
Sharma, B. S., Tewari, M. K., Khosla, V. K., Pathak, A., & Kak, V. K. (1989). Tension pneumocephalus following evacuation of chronic subdural haematoma. British journal of neurosurgery, 3(3), 381–387. https://doi.org/10.3109/02688698909002819
Shea, A., Dominguez, E., & Stewart, J. (2018). Spontaneous non‐traumatic tension pneumocephalus in a dog with a nasal meningoencephalocele. Veterinary Record Case Reports, 6(4), e000670. https://doi.org/10.1136/vetreccr-2018-000670
Sprague, A., & Poulgrain, P. (1999). Tension pneumocephalus: a case reportand literature review. Journal of clinical neuroscience, 6(5), 418–420. https://doi.org/10.1016/S0967-5868(99)90040-1
Tanaka, T., Takagi, D., Takeyama, N., & Kitazawa, Y. (1989). “Spontaneous” pneumocephalus associated with aerobic bacteremia. Clinical imaging, 13(2), 134–139. https://doi.org/10.1016/0899-7071(89)90095-8
Wilfried, M. (2018). Diagnostic MRI indogsandcats. BocaRaton: CRC Press.
Copyright (c) 2022 Ukrainian Journal of Veterinary and Agricultural Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.