病例報告：犬交通性水腦症一例

一頭五歲雌性已結紮之馬爾濟斯犬，因兩年來因持續性癲癇就診。臨床症狀包括漸進性行為改變、癲癇、共濟失調、頭部呈右側偏斜並向右轉圈運動，神經學檢查顯示病畜呆滯，頭部過度伸展、威嚇反應及兩側本體知覺反應喪失。腦電波圖檢查可見額葉中央區出現相反位相的銳波。顱內核磁共振影像檢查顯示側腦室擴大。因病畜對於內科治療無顯著反應而主人要求實施安樂死，並行屍體剖檢，腦部外觀上可見腦溝變平、大腦頂部及第三腦室底部變薄、梨狀葉（pyriform lobe）凹陷及左小腦萎縮；大腦橫切面顯示皮質變薄，雙側側腦室和大腦導水管明顯擴大。組織病理學檢查，左側小腦組織結構瓦解，呈現廣泛性水腫；右側小腦溝狹窄，可見格子細胞散佈。大腦可見腦室及蜘蛛膜腔擴張、室管膜細胞因受壓迫變平，同時腦室周圍可見明顯水腫。大腦實質部則有多處空腔形成，取代正常腦部組織，同時病灶區可見神經膠質細胞增生及泡沫樣格子細胞，此外亦有多發局部性的淋巴球和漿細胞圍管現象。綜合臨床症狀、神經學檢查、腦波圖、顱內核磁共振影像及組織病理學檢查結果，診斷此犬罹患交通性水腦症及腦內積水。

關鍵字

犬；腦波圖；腦內積水；水腦；核磁共振影像

並列摘要

A 5-year-old, spayed female maltese was admitted to the clinic with a history of seizures for two years. The patient showed progressive behavior change, seizures, ataxia, head tilt and circling to right. Neurological examination revealed that the dog was dull with hypermetria of the head, loss of menace reaction and proprioceptive reaction. The electroencephalogram showed phase reversal sharp wave in the central frontal lobe. The magnetic resonance images showed enlargement of both lateral ventricles. Euthanasia was performed because of uncontrolled seizures. The necropsy showed that the cerebral sulci were flattened out and the vertex of cerebrum and the floor of the third ventricle were extremely thin. The pyriform lobes were dimpled and the left cerebellum was atrophic. The cut surface of the cerebrum displayed thin cortex and both clearly dilated lateral ventricles and mesencephalic aqueduct. Histopathologically, the left cerebellum showed disorganization and diffuse edema. The sulci of right cerebellum were narrowed and gitter cells were scattered in the lesion. In the cerebrum, the dilations of ventricle and arachnoid space were evident. The ependymal cells were compressed and became flatted. Periventricular edema was also noted. The cerebral parenchyma showed several cavities taking the place of brain tissue. Gliosis and foamy gitter cells were seen in the lesion and multifocal perivascular cuffs of Iymphocytes and plasma cells were noted. Based on the clinical signs, neurological examination, EEG examination, MR imaging, and pathological examination, communicating hydrocephalus is diagnosed.

並列關鍵字

Dog ； Electroencephalogram ； Hydranencephaly ； Hydrocephalus ； Magnetic resonance imaging

國際替代計量

病例報告：犬交通性水腦症一例

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