Evaluation of cerebral blood flow with transcranialDoppler ultrasound in a dog with surgically treatedintracranial subduralempyema

摘要

A three-year-old spayed female Yorkshire terrierpresented with a three-week history of lethargyand weight loss. Physical examination showed leftexophthalmos with left nasal discharge. A lesion in theleft brainstem was suspected based on the neurologicalexamination. Pre/postcontrast CT images were consistentwith an extensive subdural empyema in the region of theleft forebrain, extending from the level of the frontal tothe occipital lobe. At presentation, transcranial Doppler(TCD) ultrasound was performed in the left (LMCA)and right middle cerebral arteries (RMCA) showingmarked hyperaemia (LMCA velocity: 81.9 cm/s; RMCAvelocity: 90.3 cm/s; reference ranges: LMCA velocity62.3±10.9 cm/s; RMCA velocity 62.5±10.9 cm/s). Aleft-sided rostrotentorial craniectomy was performed,followed by medical treatment. TCD was monitored dailypostoperatively returning to within the reference rangefive days after surgery (LMCA velocity: 54.9 cm/s; RMCAvelocity: 63.6 cm/s). Normalisation of the systolic velocitywas associated with clinical improvement. TCD is a usefuland non-invasive method for monitoring of cerebralblood flow in patients with intracranial empyema.