Brainstem disease and diagnoses

What are signs of brainstem dysfunction

• cranial nerve deficits

• gait abnormalities

• postural reaction deficits

• decreased level of conciousness

• alteration in heart and lung functions

What cranial nerves would be affected in a brainstem lesion

CN3-12

From least reactive to most reactive what are the levels of consciousness that can occur in a brainstem lesion

• comatose

• stuporous

• moderately to severely obtunded

What gait abnormalities can you have with a brainstem lesion

• tetraparesis

• hemiparesis

• proprioceptive ataxia

• vestibular ataxia

Dogs with brainstem dysfunction will have postural reaction deficits ______ to the lesion

ipsilateral

dogs with brainstem dysfunction will have CN deficits ________ to the lesion

ipsilateral

What differential are most common in brainstem disease?

• neoplasia

• inflammatory disease

• infectious disease

• vascular

Brainstem disease caused by neoplasia is most likely what type in the dog?

1. meningioma

2. glioma

Brainstem disease caused by neoplasia is most likely what type in the cat?

1. meningioma

2. lymphoma

The most common cause of metastatic neoplasia causing brainstem signs is what?

hemangiosarcoma

brainstem disease caused by inflammatory causes is more common in _______

dogs

brainstem disease caused by infectious causes is more common in __________

cats

What are the most recommended diagnostics to run after you’ve run basic ones?

• MRI

• spinal tap/CSF analysis

• infectious disease test

Normal spinal fluid has a total nucleated cell count less than what?

5

what protein amount is normal in spinal fluid

less than 30

How many RBCs should be present in normal spinal fluid

0

What cells should be predominantly present in spinal fluid analysis

predominantly mononuclear

vascular causes of brain stem disease will be _______________

acute and non progressive

Intracranial neoplasia causing brainstem disease can have a presumptive diagnosis made by _____________ but a definitive diagnosis must be based on __________

• MRI

• histopathology

Meningiomas are the most common tumor in ____ and often have a _________ component

• dogs

• cystic

Meningoencephalomyelitis of unknown origin is an umbrella term for what inflammatory diseases?

• necrotizing encephalitis

• granulomatous meningoencephalomyelitis

MUO typically affects ___ dogs around ___ years old

• small

• 4.5

What are important clinical signs of MUO

• rapidly progressive

• multifocal

• reflect the area of the CNS

MUO is presumed to be _____________

immune mediated

The diagnostic approach of MUO is to localize the lesion through an ______________ and what other modalities?

• neurologic exam

• MRU

• CSF analysis

• infectious disease testing

On MRI MUO appears with what characteristics on MRI

• multifocal

• post contrast enchancement

What CSF analysis would reflect MUO affected animal

• elevated TNCC

• elevated protein

• mononuclear pleocytosis

serum helps rule out what infectious disease when trying to distinguish MUO from infectious meningioencphalomyelitis

• protozoal

• ricettsial

• fungal

CSF helps rule out what infectious disease when trying to distinguish MUO from infectious meningioencphalomyelitis

viral

urine helps rule out what infectious disease when trying to distinguish MUO from infectious meningioencphalomyelitis

fungal

To obtain a definitive diagnosis and determine MUO subtype we need to perform __________

histopathology