Dyke-Davidoff-Masson-like syndrome in an adult cat

Abstract

Case summary: A 4-year-old cat was presented with acute onset of lateralised neurological central nervous system (CNS) signs and seizures. Haematological and serum biochemical parameters were within normal limits. Imaging diagnostics revealed severe CT and MRI abnormalities of the right brain, similar to Dyke-Davidoff-Masson syndrome (DDMS) in human medicine. This syndrome includes cerebral hemiatrophy with compensatory calvarial hyperostosis and ventriculomegaly. Such changes have previously been reported only once in a single feline case of approximately the same age. In humans, DDMS is described as an embryonic and perinatal developmental disturbance or an acquired injury in early childhood.

Relevance and novel information: This case report shows that without further imaging diagnostics, congenital disorders can be overlooked in some rare cases of adult cats with later onset of their first clinical signs.

Keywords: Dyke-Davidoff-Masson-like syndrome; calvarial hyperostosis; cerebral hemiatrophy; cerebral hypoperfusion; cerebral hypoplasia; neurology; seizures.

Figure 1

Comparative transversal images in (a) soft tissue algorithm before contrast, (b) bone algorithm before contrast, and (c,d) transversal and dorsal reconstructed images in soft tissue algorithm after contrast (the patient’s right is to the left of the image). Note the asymmetry of the calvarium and severe expansion of the diploic space (asterisk). Severe reduction of the volume of the right cranial cavity and of the right forebrain compared with the left side. A large part of the right-sided frontal and parietal lobes was fluid-like attenuating (black arrow), with suspicion of direct communication to a severe dilated right lateral ventricle (white arrow)

Figure 2

(a,b) Dorsal CISS and (c,d) sagittal T2W images. (c, d) The sagittal T2W images are reference images for the dorsal planes (a,b), respectively. (a,b) There is right cerebral hypoplasia with ipsilateral calvarial thickening with widening of the diploic space (white arrow), the subarachnoid space is distended (double-headed arrow) and there is dilatation of the right lateral ventricle (asterisk). For all transverse images, the patient’s right is to the left of the image. For sagittal images, rostral is to the left. CISS = constructive interference in steady state; T1W = T1-weighted; T2W = T2-weighted

Figure 3

(a) Transverse T1W, (b) T2W FLAIR and (c) T2W FS images. Note the midline shift towards the right due to hypoplasia of the right forebrain. The right lateral ventricle is moderately distended (asterisk). Distension of the right subarachnoid space (arrow). (b) There is complete suppression of the CSF signal of the lateral ventricle and moderate suppression of the CSF signal in the subarachnoid space. (c) T1 and T2 FLAIR hyperintense signal of the thickened calvarium (arrowhead) with signal suppression in the T2W FS image. For all images, the patient’s right is to the left of the image. CSF = cerebrospinal fluid; FLAIR = fluid-attenuated inversion recovery; FS = fat-saturated; T1W = T1-weighted; T2W = T2-weighted