Brain magnetic resonance imaging and histopathology findings in a dog with global brain ischaemia following cardiopulmonary arrest

Brain magnetic resonance imaging and histopathology findings in a dog with global brain ischaemia following cardiopulmonary arrest

Background Global brain ischaemia following cardiopulmonary arrest is uncommonly reported in veterinary medicine yet neurologic injury after arrest is a known morbidity. Case report An 18‐week‐old male entire Cavalier King Charles Spaniel‐Poodle was referred following 3 days of neurologic abnormalit...

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Bibliographic Details
Published in:Australian veterinary journal Vol. 100; no. 9; pp. 433 - 439
Main Authors: Goh, J, Eramanis, LM, Milne, M, Stent, A, Boller, M
Format: Journal Article
Language:English
Published: Melbourne Wiley Publishing Asia Pty Ltd 01-09-2022
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Subjects:
Apnea
cardiopulmonary arrest
Cerebellum
Cerebrum
Cytotoxicity
Edema
global brain ischaemia
Hippocampus
histopathology
Ischemia
Magnetic resonance imaging
Morbidity
Neuroimaging
post‐CPA
Sepsis
Substantia nigra
Thalamus
Veterinary medicine
histopathology
magnetic resonance imaging
post-CPA
cardiopulmonary arrest
global brain ischaemia
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Summary:Background Global brain ischaemia following cardiopulmonary arrest is uncommonly reported in veterinary medicine yet neurologic injury after arrest is a known morbidity. Case report An 18‐week‐old male entire Cavalier King Charles Spaniel‐Poodle was referred following 3 days of neurologic abnormalities after cardiopulmonary arrest. After resuscitation, the animal had decerebrate rigidity, a stuporous mentation and intermittent episodes of vocalisation and apnoea. A brain magnetic resonance imaging (MRI) was undertaken 4 days after cardiopulmonary arrest, with standard sequences (T1‐weighted, T2‐weighted and fluid‐attenuated inversion recovery) as well as diffusion‐weighted imaging to better discern ischaemic injury and cytotoxic oedema for prognostic reasons. MRI findings were consistent with global brain ischaemia affecting the hippocampus, cerebellum and substantia nigra, the latter two not previously identified in canine cases of global brain ischaemia. The patient was euthanased on day eight post‐cardiopulmonary arrest due to a lack of neurological improvement and developing sepsis as a complication. Ante‐mortem identification of affected areas of the brain was confirmed on histological examination, with evidence of ischaemic injury seen in the cerebrum, hippocampus, cerebellum, basal nuclei and thalamus. Conclusion This report describes ante‐mortem MRI and postmortem findings in a dog with global brain ischaemia following cardiopulmonary arrest. A multimodal approach to neuroprognostication in patients recovering from cardiopulmonary arrest is recommended.
Bibliography:Correction added on 1 August 2022, after first online publication: A Stent has been added as fourth author.
ISSN:0005-0423
1751-0813
DOI:10.1111/avj.13178