A carregar...
Publicação
Craniotomias em animais de companhia para remoção de tumores intracranianos extra-axiais do sistema nervoso a propósito de 7 casos clínicos
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 1.9 MB | Adobe PDF |
Resumo(s)
A cirurgia intracraniana tem-se tornado cada vez mais comum com o desenvolvimento dos meios de diagnóstico por imagem e com o maior entendimento sobre os processos fisiopatológicos e prognóstico associado. Os acessos cirúrgicos mais frequentemente praticados são a craniectomia rostrotentorial, utilizada para aceder à convexidade cerebral dorsolateral; a craniotomia transfrontal utilizada para aceder às regiões mais rostrais como os lobos frontais e olfativos; e a craniotomia suboccipital, utilizada para aceder à porção caudal da fossa caudal. Os diferentes acessos podem ser combinados de modo a aceder a regiões encefálicas mais restritas. Com este estudo pretendeu-se realizar uma análise descritiva detalhada de um conjunto de casos clínicos de animais submetidos a craniotomias para remoção de massas extra-axiais, de aspeto neoplásico, diagnosticados presumidamente por ressonância magnética e, dessa forma, criar um registo bibliográfico de fácil consulta sobre um tema muito pouco descrito na literatura nacional. Relativamente ao motivo de consulta, verificou-se que a principal causa foi a ocorrência de ataques epiléticos tendo surgido em 71,4% (5/7) dos animais do total da amostra. 85,7% (6/7) dos animais do total da amostra foram diagnosticados com lesões no prosencéfalo. Ao exame neurológico verificou-se que 42,9% (3/7) dos animais do total da amostra não apresentaram alterações neurológicas. Os achados imagiológicos mais frequentemente observados foram extenso edema perilesional e hérnia subtentorial, ambos com uma frequência de 42,9% (3/7) sobre o total da população. Quanto à natureza da lesão, verificou-se que 85,7% (6/7) dos animais do total da amostra foram diagnosticados com meningioma intracraniano. As abordagens cirúrgicas mais frequentes no total da amostra foram o acesso rostrotentorial em 57,1% (4/7) da população, seguido do acesso transfrontal em 28,6% (2/7) dos animais e acesso suboccipital em 14,3% (1/7) dos animais. Dos casos apresentados 28,6% (2/7) faleceram com deterioração do estado neurológico, contudo, 1 desses casos deveu-se à natureza maligna da lesão neoplásica que só teria sido possível diagnosticar definitivamente por histopatologia. Todos os restantes casos tiveram evolução neurológica positiva, com melhoria dos sinais clínicos e sem complicações pós-cirúrgicas. A análise destes casos sugeriu que a abordagem cirúrgica para este tipo de lesões aparenta ser uma opção viável permitindo oferecer aos pacientes um aumento do tempo de sobrevivência com qualidade de vida. No entanto, devem ser realizados mais estudos com amostras populacionais superiores, diagnosticados com o mesmo processo neoplásico, e sujeitos à mesma técnica cirúrgica para melhor entender quais os fatores que determinam um melhor prognóstico pós-cirúrgico
ABSTRACT - Craniotomies in companion animals for the resection of extra-axial intracranial tumors of the nervous system regarding 7 clinical cases - Intracranial surgery has become increasingly common due to advances in diagnostic imaging, better understanding of the physiopathological processes and associated prognosis. The most frequently practiced surgical accesses include rostrotentorial craniectomy, used to access the dorsolateral convexity of the cerebral hemisphere; transfrontal craniotomy, used to reach more rostral regions such as the frontal and olfactory lobes; and suboccipital craniotomy, used to access the caudal portion of the cranial fossa. These different approaches can be combined to access more restricted brain regions. This study aimed to conduct a detailed descriptive analysis of a set of clinical cases involving animals undergoing craniotomies for the removal of extra-axial masses with a neoplastic appearance, presumably diagnosed through magnetic resonance imaging. The goal was to create a readily accessible bibliographic record on a topic that is rarely discussed in the national literature. Regarding the reason for consultation, it was found that the primary cause was the occurrence of epileptic seizures, present in 71.4% (5/7) of the animals in the total sample. 85.7% (6/7) of the total sample were diagnosed with lesions in the prosencephalon. Neurological examination revealed that 42.9% (3/7) of the animals in the total sample showed no neurological alterations. The most frequently observed imaging findings were extensive perilesional edema and subtentorial herniation, both with a frequency of 42.9% (3/7) of the total population. Regarding the nature of the lesion, 85.7% (6/7) of the animals in the total sample were diagnosed with intracranial meningioma. The most common surgical approaches in the total sample were the rostrotentorial approach in 57.1% (4/7) of the population, followed by the transfrontal approach in 28.6% (2/7) of the animals, and suboccipital approach in 14.3% (1/7) of the animals. Of the cases presented, 28.6% (2/7) resulted in death due to deterioration of neurological status. However, one of these cases was attributed to the malignant nature of the neoplastic lesion, which could only be definitively diagnosed through histopathology. All remaining cases showed positive neurological outcomes with clinical improvement. The analysis of these cases suggests that the surgical approach for this type of lesion appears to be a viable option, providing patients with an increased survival time and improved quality of life. However, further studies with larger population samples diagnosed with the same neoplastic process and subjected to the same surgical technique are needed to better understand the factors determining a better post-surgical prognosis
ABSTRACT - Craniotomies in companion animals for the resection of extra-axial intracranial tumors of the nervous system regarding 7 clinical cases - Intracranial surgery has become increasingly common due to advances in diagnostic imaging, better understanding of the physiopathological processes and associated prognosis. The most frequently practiced surgical accesses include rostrotentorial craniectomy, used to access the dorsolateral convexity of the cerebral hemisphere; transfrontal craniotomy, used to reach more rostral regions such as the frontal and olfactory lobes; and suboccipital craniotomy, used to access the caudal portion of the cranial fossa. These different approaches can be combined to access more restricted brain regions. This study aimed to conduct a detailed descriptive analysis of a set of clinical cases involving animals undergoing craniotomies for the removal of extra-axial masses with a neoplastic appearance, presumably diagnosed through magnetic resonance imaging. The goal was to create a readily accessible bibliographic record on a topic that is rarely discussed in the national literature. Regarding the reason for consultation, it was found that the primary cause was the occurrence of epileptic seizures, present in 71.4% (5/7) of the animals in the total sample. 85.7% (6/7) of the total sample were diagnosed with lesions in the prosencephalon. Neurological examination revealed that 42.9% (3/7) of the animals in the total sample showed no neurological alterations. The most frequently observed imaging findings were extensive perilesional edema and subtentorial herniation, both with a frequency of 42.9% (3/7) of the total population. Regarding the nature of the lesion, 85.7% (6/7) of the animals in the total sample were diagnosed with intracranial meningioma. The most common surgical approaches in the total sample were the rostrotentorial approach in 57.1% (4/7) of the population, followed by the transfrontal approach in 28.6% (2/7) of the animals, and suboccipital approach in 14.3% (1/7) of the animals. Of the cases presented, 28.6% (2/7) resulted in death due to deterioration of neurological status. However, one of these cases was attributed to the malignant nature of the neoplastic lesion, which could only be definitively diagnosed through histopathology. All remaining cases showed positive neurological outcomes with clinical improvement. The analysis of these cases suggests that the surgical approach for this type of lesion appears to be a viable option, providing patients with an increased survival time and improved quality of life. However, further studies with larger population samples diagnosed with the same neoplastic process and subjected to the same surgical technique are needed to better understand the factors determining a better post-surgical prognosis
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Palavras-chave
Craniotomia transfrontal Craniectomia rostrotentorial Craniectomia suboccipita Transfrontal craniotomy Rostrotentorial craniectomy Suboccipital craniectomy
Contexto Educativo
Citação
Silva BSSB. 2024. Craniotomias em animais de companhia para remoção de tumores intracranianos extra-axiais do sistema nervoso a propósito de 7 casos clínicos [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária