Magnetic resonance imaging and marsupialization of a hemorrhagic intramedullary vascular anomaly in the cervical portion of the spinal cord of a dog

Abstract

Case description: A 1-year-old female spayed Labrador Retriever was admitted for evaluation of a progressive gait disturbance characterized by tetraparesis and general proprioceptive ataxia in all limbs.

Clinical findings: Neurologic examination suggested a dysfunction of the C6-T2 spinal cord segments, which was slightly worse on the right side. Discomfort was suspected upon lateral flexion of the neck. Two magnetic resonance imaging (MRI) examinations at a 3-week interval revealed an intramedullary fluid-filled cavitary lesion adjacent to C7, containing a blood clot.

Treatment and outcome: Following unsuccessful initial conservative management, surgical marsupialization of the lesion was performed through a dorsal laminectomy, durotomy, and myelotomy at C6 and C7. Histologic evaluation including immunohistochemistry was diagnostic for a vascular anomaly. Initially, the dog was nonambulatory with tetraparesis and became tetraplegic after surgery; movement was regained 6 days later. Four weeks after the procedure, the dog was able to walk unassisted. One year after surgery, the dog was actively running and jumping, with mild residual ataxia in the pelvic limbs.

Clinical relevance: The intramedullary vascular anomaly in this dog was successfully treated with a surgical marsupialization technique. The combination of MRI, histologic evaluation, and immunohistochemistry enabled lesion localization, evaluation of cavity content, and final diagnosis.