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Canal, Sara (2018) Siringomielia cervicale secondaria a singole masse intracraniche occupanti spazio nel cane: caratteristiche di risonanza magnetica e fattori di rischio. [Ph.D. thesis]

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Abstract (english)

The aims of the present study are 1), to investigate cervical syringomyelia (SM) secondary to single space-occupying intracranial lesions in dogs, and 2), to evaluate potential risk factors based on brain and cervical magnetic resonance imaging (MRI) studies conducted for the diagnosis of these two conditions. As a multicentric retrospective single cohort study, we recruited a population of dogs affected by a single space-occupying brain lesion and we divided it into two groups, based on the presence or absence of cervical SM. These two groups were compared for signalment (age, sex, and cranial morphology) and for MRI findings (relative intracranial mass volume, relative perilesional oedema volume, mass effect, ventriculomegaly and cerebellar herniation). Based on the current knowledge about SM and its aetiopathogenesis, our initial hypothesis considered factors predisposing to cervical SM development being lesions with substantial relative mass volume, localisation in the caudal cranial fossa, cerebellar transforaminal herniation and/or obstructive hydrocephalus.
Our statistical analysis revealed that intracranial mass with relative volumetric index higher than 0.028 and causing cerebellar transforaminal herniation and/or obstructive hydrocephalus predispose to cervical SM formation. Therefore, in presence of these findings on a brain MRI study is indicated to extend the diagnostic imaging protocol to the cervical spine to check for the potential presence of SM. Conversely, the detection of cervical SM, in the absence of any additional cervical disease, addresses the clinician to extend the MRI study to the brain for the search of a potential primary mass lesion.

Abstract (italian)

Lo studio ha l’obiettivo di indagare la siringomielia (SM) cervicale associata a singole lesioni intracraniche occupanti spazio nel cane e, in particolare, di individuare quali possano essere i fattori di rischio deducibili dallo studio di risonanza magnetica (RM) del neurocranio condotto per diagnosticare la patologia cerebrale. A tale scopo è stata selezionata una popolazione di pazienti affetti da singola lesione intracranica, successivamente suddivisa in due gruppi sulla base della presenza o assenza di secondaria SM cervicale. Entrambe le condizioni sono state diagnosticate mediante studio RM, rispettivamente, del neurocranio e rachide cervicale. I due gruppi sono stati quindi confrontati relativamente al segnalamento, alle caratteristiche RM della massa intracranica e agli effetti secondari sulle circostanti strutture cerebrali allo scopo di individuare eventuali fattori predisponenti lo sviluppo di SM. Sulla base delle esistenti teorie eziopatogenetiche riguardanti la SM e dei dati pubblicati in letteratura, le ipotesi zero presupponevano che la localizzazione della massa in fossa posteriore, lesioni voluminose, l’erniazione cerebellare transforaminale e la presenza di idrocefalo ostruttivo potessero essere fattori predisponenti lo sviluppo di SM. Inoltre, analogamente a quanto riportato in letteratura per la sindrome di Chiari associata a SM nel cane, ci si può attendere che le razze brachicefaliche possano avere una maggiore predisposizione allo sviluppo di SM.
Dai risultati ottenuti risulta fortemente raccomandato, in presenza di lesioni intracraniche occupanti spazio con indice volumetrico relativo superiore a 0,028 e causanti erniazione cerebellare e/o idrocefalo ostruttivo, estendere lo studio RM anche al rachide cervicale per individuare la presenza di eventuale SM che può complicare il quadro clinico e condizionare parimenti l’approccio terapeutico al paziente. Al contrario, nei pazienti che si presentano con deficit neurologici indicativi di una mielopatia cervicale e per i quali viene diagnosticata esclusivamente una SM risulta fondamentale estendere lo studio RM al neurocranio per individuare eventuali lesioni predisponenti lo sviluppo di tale anomalia.

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EPrint type:Ph.D. thesis
Tutor:Bernardini, Marco
Ph.D. course:Ciclo 29 > Corsi 29 > SCIENZE VETERINARIE
Data di deposito della tesi:30 January 2018
Anno di Pubblicazione:30 January 2018
Key Words:Cane, idrosiringomielia cervicale, masse intracraniche occupanti spazio, risonanza magnetica
Settori scientifico-disciplinari MIUR:Area 07 - Scienze agrarie e veterinarie > VET/09 Clinica chirurgica veterinaria
Struttura di riferimento:Dipartimenti > Dipartimento di Medicina Animale, Produzioni e Salute
Codice ID:11057
Depositato il:30 Oct 2018 11:02
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