Neurobites – Putative Cerebral Microbleeds





Every week, the BVNS neurologists, residents and interns convene to discuss a human or veterinary neurology/neurosurgery article.

NeuroBites is a digestible synopsis written by Dr. Bush of the article covered in journal club.

Welcome to NeuroBites.

Kerwin SC, et al. Putative Cerebral Microbleeds in Dogs Undergoing Magnetic Resonance Imaging of the Head: A Retrospective Study of Demographics, Clinical Associations, and Relationship to Case Outcome.
J Vet Intern Med 2017;31:1140–1148. DOI: 10.1111/jvim.14730.

Click HERE for the full article.

Dr. Bensfield tackled a great topic – what can we know when we see dark spots on the GRE MRI sequence? The major question and answers from today are below.

What are dark spots that we see on GRE?
They are likely microbleeds in the brain and associated with vascular disease in people.

How common are microbleeds?
They were noted in almost 10% of the patient population getting an MRI at Texas A&M from 2011-2016.

What are any specific risk factors or signs associated with this disease?
Vestibular dysfunction (poor balance) is noted in these patients along with cortical atrophy on MRI. These patients are smaller, older, shih tzu and toy poodles and they have protein in their urine.

Are microbleeds bad?
Yes they are bad – when you have a microbleed you are 2 ½ times more likely to die and your average survival time is only 180 days compared to 720 in dogs without microbleeds.

Can microbleeds be prevented or controlled?
We discussed how difficult it will be for us to say to owners now that we have found this your dog will have a shorted lifespan and sadly we do not know specifically what to do. Two things come to mind. One is to search exhaustively for underlying causes of vascular disease, high blood pressure and risk factors for high blood pressure with abdominal ultrasound, ACTH stimulation, thyroid profile, urine protein to creatinine ratio and perhaps other tests too. Secondly, look for signs of dementia and consider therapy for this problem like anxiety medication, supplements and maybe behavioral modification.

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