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SA Optho/Neuro > Imaging and Pathological correlates of clinical disease > Flashcards

Imaging and Pathological correlates of clinical disease Flashcards

1
Q

Which brain tumors are often extra-axial

A

Choroid plexus tumors and meningiomas

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2
Q

When would stroke not be on differential list?

A

If there is a chronic history

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3
Q

How do you treat brain tumors near brainstem?

A

Radiation- poor candidates for surgery

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4
Q

What is a common sequele to radiation therapy?

A

Otitis interna/media due to causing local inflammation

-edema in the brain

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5
Q

What causes palor of tissue on histopath?

A

Edema

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6
Q

Where are the locations of central vestibular lesions affecting the cerebellum?

A

Floculonodular lobe or caudal cerebellar pedal

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7
Q

What can cause a ring like appearance on MRI?

A

Microcystic meningioma as well as gliomas

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8
Q

What can vacuolization be a sign of?

A

Edema, or wallerian degeneration

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9
Q

Define Wallerian degeneration

A

Antegrade degeneration of the axon distal to a lesion

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10
Q

What does the babinski reflex tell you?

A

Upper motor neuron sign, tells you that there is a chronic injury present

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11
Q

How do you know if a multifocal spinal chord lesion is present in a patient?

A

If the grade of weakness in the front or back legs is more than one grade worse than the other

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12
Q

What causes shiff- sherington posture?

A

Acute T3-L3 lesion

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13
Q

What are some of the differentials for a dog with an acute, non painful spinal cord disease in the T3-L3 region?

A

FCE, ANNPE, HNP
-ichemic myelopathy
-myelitis
-IVDH
-neoplasia

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14
Q

Which causes hyperintensity of the cord above the disc vs between discs

A

ANNPE and HNP cause hyperintensity directly centered over the disc, FCE between discs

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15
Q

Why does grey matter die first in FCE cases?

A

It is more metabolically active and more easily affected by changes in blood supply

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16
Q

What is the pathogenesis of FCE?

A

An emboli causes a blockage of the spinal cord blood supply, leading to malacia/necrosis
-usually there is more than one emboli affecting multiple regions

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17
Q

Where do the majority of emboli in FCE cases come from?

A

The nucleus pulposis, followed by vertebral endplate and metaplastic vascular endothelium

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18
Q

What are the theories behind how FCEs enter the spinal cord?

A

-Direct penetration
-Chronic inflammation and neovascularization of degenerate discs
-Embryonic remnant vessels present in annulus
-disc herniation into vertebral body sinusoids (Schmorls node) and retrograde entrance into the vertebral venous plexus

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19
Q

Why do discs tend to herniate dorsally?

A

The dorsal annulus is the thinnest part of the annulus

20
Q

What will you see on MRI of a patient with ANNPE?

A

A site of hyperintensity in the spinal cord overlaying a degenerative disc

21
Q

How do you treat FCE/ANNPE cases?

A

Conservative management

22
Q

What is the typical presentation for FCE/ANNPE cases?

A

Dog screamed and then became paraparetic on hind limbs

23
Q

What percent of dogs that retain voluntary motor function after FCE will recover?

A

The large majority! 88%

24
Q

What breeds are typically affected by FCE, ANNP, HNP?

A

Non- chondrodystrophic breeds
-occurs in healthy animals that put supraphysiologic force on its spinal column causing contussive forces
-cant do anything about these surgically

25
Q

Describe the pathogenesis of degenerative disc extrusions/protrusions

A

Degenerative discs that rupture into the spinal cord area causing compression
- can address compression with surgery

26
Q

What is the main differentials for a young cat with multifocal CNS disease?

A

FIP, meningoencephalitis, toxoplasmosis, neurodegenerative disease (lysosomal storage disease), nutritional (thiamine deficiency)

27
Q

With enlarged kidneys, which two differentials do you think of first in a young cat?

A

Lymphoma or FIP

28
Q

What type of inflammation is common in FIP cases?

A

Pyogranulomatous inflammation

29
Q

What MRI changes are expected in a cat with FIP?

A

Vasculitis pattern of changes
- CSF does not null out on the flare image

30
Q

What is expected on analysis of CSF of an FIP kitty?

A

Marked pyogranulomatous pleocytosis

31
Q

What is the prognosis for IVDD with disc herniation without deep pain after surgery?

A

About 50% chance of walking again

32
Q

What is the main long term concern with severe spinal cord injury?

A

Development of myelomalacia

33
Q

What do you often see on MRI of patients with myelomalacia?

A

Blood (hypointensity) as well as hyperintensity of several regions of the spinal cord

34
Q

Is there a treatment for myelomalacia?

A

NO- recommend euthanasia due to shit prognosis

35
Q

What clinical signs can point you towards a diagnosis of ascending and descending myelomalacia?

A

migration of loss of cutaneous trunci reflex cranially, loss of pelvic limb reflexes, flaccid abdomen
-abdominal breathing, depression

36
Q

How long can it take an animal with spinal cord injury to manifest with myelomalacia?

A

Up to 2 weeks

37
Q

Which breed of dog is at the highest risk for development of myelomalacia?

A

French bulldogs

38
Q

What does a head turn usually indicate?

A

A forebrain lesion

39
Q

Which is more common in dogs, immune mediated inflammatory disease or infectious?

A

Immune mediated

40
Q

What do you often see in cases of MUE on MRI?

A

diffuse hyperintensity on T2
- often bilateral, multifocal
-results in contrast enhancement

41
Q

What would you expect to find on CSF tap of patient with MUE?

A

-albumocytologic disassociation
-pleocytosis

42
Q

What is the treatment for MUE?

A

Steroids + another drug

43
Q

What is the prognosis for MUE?

A

Most dogs will die in acute period

44
Q

What is the main histologic finding in MUE cases?

A

Perivascular cuffing

45
Q

What is the most common variant of MUE?

A

Granulomatous meningioencephalitis

46
Q

What is the most common cause of spinal cord disease in cats?

A

Inflammatory lesions

SA Optho/Neuro (8 decks)

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