Hidrocefalia no cão
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Data
2014
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Resumo
A hidrocefalia não é uma doença específica, mas sim uma condição patológica multifatorial com vários mecanismos fisiopatológicos associados. É definida na literatura como uma discrepância entre a produção e absorção de líquido cefalorraquidiano que resulta na dilatação anormal do sistema ventricular dentro do encéfalo e/ou na expansão dos espaços fora do encéfalo com ou sem aumento do tamanho ventricular. Esta condição pode ser classificada consoante vários aspetos, segundo: a etiologia; a morfologia; a localização; a pressão; e, segundo o momento do seu surgimento. Clinicamente, a hidrocefalia pode ser classificada em congénita ou adquirida e na prática de Medicina Veterinária a hidrocefalia de etiologia congénita é diagnosticada com maior frequência do que a hidrocefalia adquirida. Os sinais clínicos observados com maior frequência, devido à grave expansão dos ventrículos laterais, são de origem prosencefálica. No entanto, na hidrocefalia adquirida os sinais clínicos refletem frequentemente a causa subjacente à mesma, uma vez que pode desenvolver-se em qualquer idade devido a patologias como neoplasias e meningoencefalites. Atualmente, as técnicas imagiológicas mais utilizadas para o diagnóstico de hidrocefalia nos animais de companhia são a tomografia computarizada e a ressonância magnética. A implementação de tratamento nesta condição envolve, geralmente, terapia médica e/ou cirúrgica. Nesta dissertação foram descritos três casos clínicos em que, através de uma abordagem diagnóstica por ressonância magnética, foi permitido o estabelecimento de um diagnóstico, no primeiro caso, de hidrocefalia congénita e, no segundo e terceiro casos, de hidrocefalia adquirida secundária a um diagnóstico presuntivo de neoplasia e meningomielite, respetivamente. No primeiro caso os sinais clínicos observados foram de origem prosencefálica e optou-se pelo tratamento cirúrgico através da colocação de um shunt ventriculoperitoneal que envolveu complicações pós-cirúrgicas. Nos casos clínicos n.º 2 e 3, os sinais clínicos refletiam a causa subjacente à hidrocefalia e procedeu-se à implementação de tratamento médico com o objetivo de estabilizar a condição geral do animal e diminuir a pressão intracraniana e a produção de líquido cefalorraquidiano.
Hydrocephalus is not a specific disease but a multifactorial pathologic condition with multiple physiopathologic mechanisms associated to it. In the literature it is defined as a discrepancy between the production and absorption of cerebrospinal fluid which leads to an abnormal dilation of the ventricular system inside the cerebrum and/or an expansion of the spaces out of the cerebrum with or without an increase of the ventricular size. This condition can be classified according to several aspects considering: etiology, morphology, location, pressure and onset. Clinically, hydrocephalus can be classified as congenital or acquired and, in Veterinary Medicine, congenital hydrocephalus is diagnosed more frequently than the acquired type. The most common clinical signs are prosencephalic due to the severe expansion of the lateral ventricles. However, in acquired hydrocephaly, clinical signs often reflect the underlying cause since they can appear at any age secondary to conditions like neoplasia or meningoencephalitis. Nowadays the most used imagiologic techniques to diagnose hydrocephalus in companion animals are computed tomography and magnetic resonance. The treatment of this condition usually requires medical and/or surgical therapy. In this work, three clinical cases were described in which, using magnetic resonance as the diagnostic approach, a diagnosis of congenital hydrocephalus was achieved in the first case whereas in the second and third case an acquired hydrocephalus secondary to a presumptive diagnosis of neoplasia and meningoencephalitis respectively was achieved. In the first case, the clinical signs had prosencephalic origin and surgical treatment was chosen as ideal, being performed a ventriculoperitoneal shunt that had further complications. In clinical cases number two and three, the clinical signs reflected the underlying cause of the hydrocephalus and medical treatment was performed in order to stabilize the general condition of the animal and decrease intracranial pressure and production of cerebrospinal fluid.
Hydrocephalus is not a specific disease but a multifactorial pathologic condition with multiple physiopathologic mechanisms associated to it. In the literature it is defined as a discrepancy between the production and absorption of cerebrospinal fluid which leads to an abnormal dilation of the ventricular system inside the cerebrum and/or an expansion of the spaces out of the cerebrum with or without an increase of the ventricular size. This condition can be classified according to several aspects considering: etiology, morphology, location, pressure and onset. Clinically, hydrocephalus can be classified as congenital or acquired and, in Veterinary Medicine, congenital hydrocephalus is diagnosed more frequently than the acquired type. The most common clinical signs are prosencephalic due to the severe expansion of the lateral ventricles. However, in acquired hydrocephaly, clinical signs often reflect the underlying cause since they can appear at any age secondary to conditions like neoplasia or meningoencephalitis. Nowadays the most used imagiologic techniques to diagnose hydrocephalus in companion animals are computed tomography and magnetic resonance. The treatment of this condition usually requires medical and/or surgical therapy. In this work, three clinical cases were described in which, using magnetic resonance as the diagnostic approach, a diagnosis of congenital hydrocephalus was achieved in the first case whereas in the second and third case an acquired hydrocephalus secondary to a presumptive diagnosis of neoplasia and meningoencephalitis respectively was achieved. In the first case, the clinical signs had prosencephalic origin and surgical treatment was chosen as ideal, being performed a ventriculoperitoneal shunt that had further complications. In clinical cases number two and three, the clinical signs reflected the underlying cause of the hydrocephalus and medical treatment was performed in order to stabilize the general condition of the animal and decrease intracranial pressure and production of cerebrospinal fluid.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, Ciências Veterinárias
Palavras-chave
Cães , Hidrocefalia , Líquido cefalorraquidiano , Ressonância magnética , Derivação ventriculoperitoneal