Intracranial Subarachnoid Hemorrhage Following Lumbar Myelography in Two Dogs

Packer, Rebecca A.; Bergman, Robert L.; Coates, Joan R.; Essman, Stephanie C.; Weis, Kevin; O’Brien, Dennis P.; Johnson, Gayle C.

doi:10.1111/j.1740-8261.2007.00250.x

Cited by 19 publications

(13 citation statements)

References 26 publications

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“…Myelography is invasive and associated with complications, 4,5,7,20,21 thus nonmyelographic techniques are appealing. Nonselective angiographic CT was investigated following its description in Doberman pinschers with cervical spondylomyelopathy 11 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Different Computed Tomography Techniques and Myelography for the Diagnosis of Acute Canine Myelopathy

Dennison

Drees

Rylander

et al. 2010

Veterinary Radiology &Amp; Ultrasound

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Forty-six dogs with either cervical (C1-C5 or C6-T2) or thoracolumbar (T3-L3) acute myelopathy underwent prospective conventional computed tomography (CT), angiographic CT, myelography, and CT myelography. Findings were confirmed at either surgery or necropsy. Seventy-eight percent of lesions were extradural, 11% were extradural with an intramedullary abnormality, 7% were intramedullary, 2% were intradural-extra-medullary, and 2% had nerve root compression without spinal cord compression. Intervertebral disc herniation was the most frequent abnormality regardless of signalment or neurolocalization. Twenty-one of 23 Hansen type I disc extrusions but none of the Hansen type II disc protrusions were mineralized. Two chondrodystrophic dogs had acute myelopathy attributable to extradural hemorrhage and subarachnoid cyst. CT myelography had the highest interobserver agreement, was the most sensitive technique for identification of compression, demonstrating lesions in 8% of dogs interpreted as normal from myelography and enabling localization and lateralization in 8% of lesions incompletely localized on myelography due to concurrent spinal cord swelling. None of the imaging techniques evaluated permitted definitive diagnosis of spinal cord infarction or meningo-myelitis but myelography and CT myelography did rule out a surgical lesion in those cases. While conventional CT was adequate for the diagnosis and localization of mineralized Hansen type I disc extrusions in chondro-dystrophic breeds, if no lesion was identified, plegia was present due to concurrent extradural compression and spinal cord swelling, or the dog was nonchondrodystrophic, CT myelography was often necessary for correct diagnosis. r

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Section: Discussionmentioning

confidence: 99%

Evaluation of Different Computed Tomography Techniques and Myelography for the Diagnosis of Acute Canine Myelopathy

Dennison

Drees

Rylander

et al. 2010

Veterinary Radiology &Amp; Ultrasound

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“…Myelography has been the standard for diagnosing intervertebral disk herniation in the dog. Complications of myelography include seizures, 4,5 myelopathy, apnea, cardiac arrhythmias, 6 meningitis, death, and intracranial subarachnoid hemorrhage 7 …”

Section: Introductionmentioning

confidence: 99%

“…Complications of myelography include seizures, 4,5 myelopathy, apnea, cardiac arrhythmias, 6 meningitis, death, and intracranial subarachnoid hemorrhage. 7 The accuracy of lesion localization using myelography ranges between 40% and 97% while the accuracy of lat-eralization of herniated disk material ranges from 78% to 100%. 3,[8][9][10] The ventrodorsal myelographic view can also be useful in predicting lateralization of herniated disk material (89% accurate) and in 83% of dogs with unequal gaps in the contrast medium column, disk material was found on the side with the shorter gap; this phenomenon was termed paradoxical contrast obstruction.…”

Section: Introductionmentioning

confidence: 99%

The Relative Sensitivity of Computed Tomography and Myelography for Identification of Thoracolumbar Intervertebral Disk Herniations in Dogs

Israel

Levine

Kerwin

et al. 2009

Vet Radiology Ultrasound

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We compared the relative sensitivity of computed tomography (CT) and myelography for identification of disk herniation in dogs. Criteria for patient selection included presurgical CT, myelography, or both and surgical or necropsy confirmation of disk herniation between the T3 and L6 vertebral articulations. Imaging findings were described as positive or inconclusive. Adverse events such as hypotension, cardiac arrhythmias, seizures, death, and lower urinary tract infection were compared between imaging groups. One hundred and eighty-two dogs met the inclusion criteria, with 116 dogs having myelography performed as the initial diagnostic imaging modality and 66 dogs having CT performed as the initial modality. The relative sensitivity for locating the site of disk herniation was 83.6% when myelography was the first test performed and 81.8% when CT was the first test performed. CT was more sensitive than myelography at detecting lesions in chronically affected dogs (P ¼ 0.025). Myelography was more sensitive than CT at detecting lesions in smaller dogs (o5 kg; P ¼ 0.004). Dogs that received both imaging modalities were significantly more likely to die or be euthanized compared with myelography alone (Po0.001). Both myelography and CT are reasonable diagnostic imaging modalities for locating the site of disk herniation. CT should be considered especially in heavier, more chronically affected dogs. The major limitations of this study include lack of randomization to imaging modality and the use of surgical exploration or necropsy as the gold standard.

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“…Although newer contrast media such as iohexol and iopamidol carry less risk of adverse reactions, seizures are still a risk 7–9 . More severe complications of myelography in dogs include asystole and intracranial subarachnoid hemorrhage 10,11 . Agreement of myelography with surgical findings in localizing intervertebral disk extrusion in dogs ranges between 37% and 100% 12–20 .…”

Section: Introductionmentioning

confidence: 99%

Myelography vs. Computed Tomography in the Evaluation of Acute Thoracolumbar Intervertebral Disk Extrusion in Chondrodystrophic Dogs

Hecht

Thomas

Marioni‐Henry

et al. 2009

Vet Radiology Ultrasound

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Myelography and/or computed tomography (CT) are commonly used to evaluate acute intervertebral disk extrusion in chondrodystrophic dogs. The purpose of this study was to evaluate the sensitivity of myelography and two different CT protocols in determining level and lateralization of acute thoracolumbar intervertebral disk extrusion in comparison with surgical findings, investigate interobserver variability, and determine examination duration times. Results of conventional CT, helical CT, and myelography were compared with surgical findings in 19 chondrodystrophic dogs with acute thoracolumbar intervertebral disk extrusion. Agreement among investigators was determined for different imaging modalities, and examination times were recorded. In the diagnosis of level of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 94.7%, 100%, and 94.7% of dogs, respectively (P = 0.144). In the diagnosis of level and lateralization of disk extrusion there was agreement of myelography, conventional CT, and helical CT with surgical findings in 78.9%, 87.4%, and 85.3% of dogs, respectively (P = 0.328). Interobserver agreement was very good for all imaging modalities (myelography K = 0.87; conventional CT K = 0.86; helical CT K = 0.95). There were significant differences in median examination duration times between helical CT (4 min), conventional CT (8 min), and myelography (32 min) (P < 0.001). Both helical and conventional CT appear to be accurate for evaluation of acute thoracolumbar intervertebral disk extrusion in chondrodystrophic dogs and are faster to perform than myelography.

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Intracranial Subarachnoid Hemorrhage Following Lumbar Myelography in Two Dogs

Cited by 19 publications

References 26 publications

Evaluation of Different Computed Tomography Techniques and Myelography for the Diagnosis of Acute Canine Myelopathy

Evaluation of Different Computed Tomography Techniques and Myelography for the Diagnosis of Acute Canine Myelopathy

The Relative Sensitivity of Computed Tomography and Myelography for Identification of Thoracolumbar Intervertebral Disk Herniations in Dogs

Myelography vs. Computed Tomography in the Evaluation of Acute Thoracolumbar Intervertebral Disk Extrusion in Chondrodystrophic Dogs

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