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      Magnetic resonance imaging appearance of hypertensive encephalopathy in a dog

      case-report

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          A 16-year-old female spayed English Staffordshire terrier was presented for evaluation of a 10-month history of intermittent myoclonic episodes, and a one weeks history of short episodes of altered mentation, ataxia and collapse. Magnetic resonance imaging identified subcortical oedema, predominately in the parietal and temporal lobes and multiple cerebral microbleeds.

          Serum biochemistry, indirect blood pressure measurements and magnetic resonance imaging abnormalities were consistent with hypertensive encephalopathy secondary to chronic kidney disease.

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          Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features.

          W.S. Bartynski (2008)
          Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state coupled with a unique CT or MR imaging appearance. Recognized in the setting of a number of complex conditions (preeclampsia/eclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune disease and high dose chemotherapy) the imaging, clinical and laboratory features of this toxic state are becoming better elucidated. This review summarizes the basic and advanced imaging features of PRES, along with pertinent features of the clinical and laboratory presentation and available histopathology. Many common imaging/clinical/laboratory observations are present among these patients, despite the perception of widely different associated clinical conditions.
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            Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema.

            W Bartynski (2008)
            Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state accompanied by a unique brain imaging pattern typically associated with a number of complex clinical conditions including: preeclampsia/eclampsia, allogeneic bone marrow transplantation, solid organ transplantation, autoimmune diseases and high dose cancer chemotherapy. The mechanism behind the developing vasogenic edema and CT or MR imaging appearance of PRES is not known. Two theories have historically been proposed: 1) Severe hypertension leads to failed auto-regulation, subsequent hyperperfusion, with endothelial injury/vasogenic edema and; 2) vasoconstriction and hypoperfusion leads to brain ischemia and subsequent vasogenic edema. The strengths/weaknesses of these hypotheses are reviewed in a translational fashion including supporting evidence and current available imaging/clinical data related to the conditions that develop PRES. While the hypertension/hyperperfusion theory has been most popular, the conditions associated with PRES have a similar immune challenge present and develop a similar state of T-cell/endothelial cell activation that may be the basis of leukocyte trafficking and systemic/cerebral vasoconstriction. These systemic features along with current vascular and perfusion imaging features in PRES appear to render strong support for the older theory of vasoconstriction coupled with hypoperfusion as the mechanism.
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              Prevalence and risk factors of cerebral microbleeds: an update of the Rotterdam scan study.

              Meike Vernooij, Albert Hofman, Ella Poels … (2010)
              We previously reported on the high prevalence of cerebral microbleeds (CMBs) in community-dwelling people aged 60 years and older. Moreover, we found that their spatial distribution likely reflects differences in underlying etiology. We have since almost quadrupled the number of participants in our study and expanded it to include persons of 45 years and older. We examined the prevalence and determinants of microbleeds in this larger and younger cohort from the general population. In 3979 persons (mean age, 60.3 years), we performed brain MRI at 1.5T, including a sequence optimized for visualization of CMBs. Associations between APOE genotype, cardiovascular risk factors, and markers of cerebrovascular disease with the presence and location of CMBs were assessed by multiple logistic regression adjusted for age, sex, and relevant confounders. Microbleed prevalence gradually increased with age, from 6.5% in persons aged 45 to 50 years to 35.7% in participants of 80 years and older. Overall, 15.3% of all subjects had at least 1 CMB. Cardiovascular risk factors and presence of lacunar infarcts and white matter lesions were associated with microbleeds in a deep or infratentorial region, whereas APOE ε4 and diastolic blood pressure were related to microbleeds in a strictly lobar location. Findings in this larger population are in line with our previous results and, more importantly, extend these to a younger age group. CMBs are already present at middle age, and prevalence rises strongly with increasing age. We confirmed that determinants of the presence of cerebral microbleeds differ according to their location in the brain.
              Article 0 comments Cited 172 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Chloe A Bowman: contactcb99@hotmail.com
                Adrian Witham: awitham@unimelb.edu.au
                Dayle Tyrrell: dayle@unimelb.edu.au
                Sam N Long: snlong@unimelb.edu.au
                Journal
                Journal ID (nlm-ta): Ir Vet J
                Journal ID (iso-abbrev): Ir Vet J
                Title: Irish Veterinary Journal
                Publisher: BioMed Central (London )
                ISSN (Print): 0368-0762
                ISSN (Electronic): 2046-0481
                Publication date (Electronic): 24 April 2015
                Publication date PMC-release: 24 April 2015
                Publication date Collection: 2015
                Volume: 68
                Issue: 1
                Electronic Location Identifier: 5
                Affiliations
                [ ]Neurology Department, University of Melbourne Veterinary Clinic and Hospital, 250 Princes Highway, Werribee, Melbourne, 3030 Australia
                [ ]Internal Medicine Department, University of Melbourne Veterinary Clinic and Hospital, 250 Princes Highway, Werribee, Melbourne, 3030 Australia
                [ ]Diagnostic Imaging Department, University of Melbourne Veterinary Clinic and Hospital, 250 Princes Highway, Werribee, Melbourne, 3030 Australia
                Article
                Publisher ID: 33
                DOI: 10.1186/s13620-015-0033-6
                PMC ID: 4422606
                SO-VID: 226b3ac6-52ba-4ae9-9ae1-67226a889abb
                Copyright © © Bowman et al.; licensee BioMed Central. 2015
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 26 September 2014
                Date accepted : 31 January 2015
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2015

                ScienceOpen disciplines: Veterinary medicine
                Keywords: neurology,canine,magnetic resonance imaging,diffusion weighted imaging
                Data availability:
                ScienceOpen disciplines: Veterinary medicine
                Keywords: neurology, canine, magnetic resonance imaging, diffusion weighted imaging

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