Neurosurgery - Brain Surgery
Brain surgery in dogs and cats up to a few years ago was limited to mild trauma cases, until greater accessibility of MRI occurred. Brain trauma in dogs and cats is most commonly caused by car accidents and falls which compared to human data from America where gunshot is the commonest cause.
Timing or deciding to do decompressive surgery in man is still an area of debate and fixation is on the surgical treatments. These would be the same goals of veterinary neurotrauma management and you would find similar treatment options.
Mildly displaced bone fragments usually caused by a fall or a car accident can be removed or if large enough plated back into position. MRI images allow for accurate diagnosis and location of lesions.
Brain Tumours and Cancer in Dogs and Cats
Brain tumours can be removed in some cases leading to symptomatic relief. Veterinary brain surgery was quite uncommon up to a few years ago. With the increased accessibility of MRI the ability to diagnose, locate and subsequently treat brain disorders (and spinal cord diseases) became a real possibility.
Neoplasia (cancer) is three times more common in dogs and cats than humans. The principal determinants of successful resection of brain tumours, is location and biological classification i.e. benign or malignant. Slow growing meningiomas are the best candidates for surgery and the prognosis is good especially in cats. Benign brain tumours of the dog and cat are common such as meninjioma and glioma and can be removed to relieve symptoms and in some cases give excellent survival times.
Adjunctive chemotherapy can extend survival times even further. The extensive experience in man with brain tumours has yet to be analysed sufficiently to make any firm comparisons to the same diseases in pets.
Syringomyelia or Chiari Malformation
Syringomyelia or Chiari like malformation is a very common problem in Cavalier King Charles spaniels, due to breeding programs for a certain head shape. Screening programs have been started in the USA to try and control this international epidemic.
Some success in terms of symptom reduction can be achieved by using occipital decompression surgery, although the outcomes are somewhat unpredictable, and at best sometimes the major achievement is symptom reduction.
In man the main symptoms are headache and posterior fossa decompression with or without duraplasty is the surgical treatment. The difficulty in man with syringomyelia is choosing which cases will benefit from surgery, and lessons learnt in this process may help veterinary surgeons target their surgical cases more efficiently. Complete removal of all tumour tissue can be difficult if not impossible, and adjunctive chemotherapy or radiation therapy should be considered.
Another condition that is frequently seen is syringomyelia which is most commonly associated with Cavaliers. Syringomyelia can only be diagnosed by using MRI. Surgical decompression of the cerebellum and brain stem as treatment for syringomyelia can provide a reduction in symptoms, and is some cases can lead to significant improvement. Surgical treatment of hydrocephalus is possible but there is a significant rate of complications.
These recordings represent only a small period of the surgery. They are intended for fellow surgeons or those with a keen interest in surgery.
This recording may contain graphic images of surgery which some viewers may find offensive.