Abstract:
A chronic cough, gag, or retch is a common presenting clinical complaint in dogs. Those refractory to conservative management frequently undergo further diagnostic tests to investigate the cause, including CT examination of their head, neck, and thorax for detailed morphological assessment of their respiratory and upper gastrointestinal tract. This case series describes five patients with CT characteristics consistent with an intracranial and jugular foraminal mass of the combined glossopharyngeal (IX), vagus (X), and accessory (XI) cranial nerves and secondary features consistent with their paresis. The consistent primary CT characteristics included an intracranial, extra-axial, cerebellomedullary angle, and jugular foraminal soft tissue attenuating, strongly enhancing mass (5/5). Secondary characteristics included smooth widening of the bony jugular foramen (5/5), mild hyperostosis of the petrous temporal bone (3/5), isolated severe atrophy of the ipsilateral sternocephalic, cleidocephalic, and trapezius muscles (5/5), atrophy of the ipsilateral thyroarytenoideus and cricoarytenoideus muscles of the vocal fold (5/5), and an ipsilateral \"dropped\" shoulder (4/5). Positional variation of the patient in CT under general anesthesia made the \"dropped\" shoulder of equivocal significance. The reported clinical signs and secondary CT features reflect a unilateral paresis of the combined cranial nerves (IX, X, and XI) and are consistent with jugular foramen syndrome/Vernet\'s syndrome reported in humans. The authors believe this condition is likely chronically underdiagnosed without CT examination, and this case series should enable earlier CT diagnosis in future cases.
摘要:
慢性咳嗽,gag,或呕吐是狗常见的临床表现。那些难以保守治疗的人经常接受进一步的诊断测试以调查原因,包括头部的CT检查,脖子,和胸部对其呼吸道和上消化道进行详细的形态学评估。该病例系列描述了5例患者的CT特征与合并舌咽(IX)的颅内和颈静脉椎间孔肿块一致,迷走神经(X),和副(XI)颅神经和次要特征与其轻瘫一致。一致的主要CT特征包括颅内,轴外,小脑延髓角,颈静脉椎间孔软组织减弱,强烈增强质量(5/5)。次要特征包括颈静脉骨孔平滑变宽(5/5),颞骨岩性轻度骨肥厚(3/5),同侧胸脑孤立的严重萎缩,头颅,和斜方肌(5/5),声带同侧甲状腺肌和环状肌萎缩(5/5),和同侧“跌落”的肩膀(4/5)。全身麻醉下患者在CT中的位置变化使“跌落”的肩膀具有模棱两可的意义。报告的临床体征和继发性CT特征反映了合并颅神经的单侧轻瘫(IX,X,和XI),与人类报告的颈静脉孔综合征/Vernet综合征一致。作者认为,如果没有CT检查,这种情况可能会长期诊断不足,这个病例系列应该能够在未来的病例中进行早期CT诊断。