A case of acute acquired obstructive hydrocephalus in a cat with suspected ischaemic cerebellar infarct

Abstract

Case summary: A case of acquired acute obstructive hydrocephalus that developed as a complication of an ischaemic infarct in the vascular territory of the rostral cerebellar artery is described in an adult domestic shorthair cat. The clinical findings, diagnostic investigations, treatment and prognosis are reported. MRI findings are described in detail.

Relevance and novel information: This is the first report of obstructive hydrocephalus as a complication of an ischaemic infarct in the region of the rostral cerebellar artery in a cat. MRI findings are described in detail with regard to the recognition of the early signs of obstructive hydrocephalus. A brief review of the literature is included, as this complication has been frequently reported in humans.

Figure 1

MRI of the brain demonstrating the suspected cerebellar infarct (*): (a) sagittal; (b) transverse; and (c) dorsal T2-weighted images. Note the hyperintense wedge-shaped lesion visible in the right rostral cerebellum radiating dorsally towards the dorsal surface of the cerebellum and ventrally towards the fourth ventricle (*)

Figure 2

(a) T2-weighted; (b) fluid-attenuated inversion recovery (FLAIR); and (c) T1-weighted transverse images of the brain at the level of the rostral cerebellum. Note the T2 and FLAIR hyperintensity compared with the grey matter and the T1 hypointense wedge-shaped lesion radiating ventrally towards the fourth ventricle (black arrow)

Figure 3

MRI of the brain: (a) midsagittal T2-weighted image; (b) T2-weighted transverse section at the level of the interthalamic adhesion; and (c) T2-weighted dorsal section at the level of the olfactory aperture. (a) Note the interthalamic adhesion that has lost its distinctly circular shape (white arrow), the corpus callosum that is significantly elevated (black arrow) and the overcrowding of the caudal–cranial fossa without cerebellar herniation (black arrow point). (b) Note the flattening of interthalamic adhesion (black arrow), the diminished suprasellar cistern secondary to the third ventricle expansion (+) and the narrowing of cerebral sulci, as well as the obliteration of the subarachnoid space around the dorsal convexity of the cerebral hemisphere. (c) Note the dilatation of the right olfactory recess (white arrow)