Vascular

Question 1

Human term for vascular disease of the brain

Answer 1

• stroke

Question 2

How can vascular disease occur?

Answer 2

• either as spontaneous haemorrhage or focal ischaemia secondary to thromboembolism

Question 3

Prevalence

Answer 3

• both spontaneous haemorrhage and focal ischaemia and secondary to thromboembolism can occur in cats and dogs but are rare

Question 4

Presentation

Answer 4

• per-acute to focal neurological dysfunction (i.e. dog running across field suddenly becomes profoundly ataxic with cerebellar infarcts)

Question 5

Prevalence of spontaneous haemorrhage into the CNS

Answer 5

• very rare in cats and dog as a primary condition
• may be seen secondary to other coagluopathies such as secondary to angiostrongylus

Question 6

In many cases of spontaneous haemorrhage what can give you a warning to check for clinical coagulopathy on bloods?

Answer 6

• other signs of haemorrhages on CE (don’t forget to check the retinas)

Question 7

Tx of spontaneous haemorrhage

Answer 7

• tx of the primary coagulopathy, which also gives indication of prognosis

Question 8

Prevalence of focal ischaemic brain disease

Answer 8

• sudden onset focal ischaemic lesions are rare but do occur
• potentially more common in sight hounds

Question 9

Diagnosis of focal ischaemic brain disease

Answer 9

• can only be made on advanced imaging

Question 10

Tx of focal ischaemic brain disease

Answer 10

• conservative but many will do well with good prognosis for recovery, dependent upon the degree of focal ischaemia

Question 11

Ischaemic encephalopathy post-anaesthetic - causes, CS & tx

Answer 11

• mouth gag use during dentals in cats can result in compromise of the maxillary artery resulting in iatrogenic focal ischaemic encephalopathy
• cats are centrally blind on recovery from anaesthesia
• can occur without use of mouth gag due to hypotension during anaesthesia
• many cats will recover on conservative therapy, but you need to review anaesthetic protocols