Editorial: Women in veterinary neurology and neurosurgery: 2021
Luisa De Risio- Linnaeus Veterinary Limited, Shirley, United Kingdom
Editorial on the Research Topic
Women in veterinary neurology and neurosurgery: 2021
This Frontiers in Veterinary Science Women in Veterinary Neurology and Neurosurgery collection of scientific articles presents the innovative work of female neurologists working in the UK, Europe, and North America. The series comprises 13 articles showcasing original research and case reports in various fields of Veterinary Neurology and Neurosurgery, including advances in diagnostic imaging techniques and novel neurosurgical procedures.
Diffusion MRI is a specific sequence that detects and quantifies water diffusivity, which is the molecular motion (Brownian movement) of water and represents an intrinsic feature of tissues. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) are MRI sequences routinely used in the diagnostic investigation of suspected cerebrovascular accidents (CVA) in people (1). There is limited information on diffusion-weighted characteristics of naturally occurring CVA in dogs. Extrapolation from other species has limitations due to differences in how CVA appears on DWI over time (i.e., from the onset of CVA to the time of MRI) (2). The retrospective study by Boudreau et al. describes DWI MRI findings of spontaneous canine CVA in relation to the time of clinical onset, the DWI type (EPI vs. non-EPI), and the presence or absence of a haemorrhagic component of the lesion. The results of this study help to inform the appropriate clinical interpretation of these sequences by veterinary neurologists and neuroradiologists.
Steroid-responsive meningitis-arteritis (SRMA) is an inflammatory disorder of probable immune mediated origin, commonly recognized in dogs (3). It typically affects young, medium to large breed dogs and can present as an acute or chronic condition (3). The acute form of SRMA is characterized by cervical hyperalgesia, pyrexia, and cerebrospinal fluid (CSF) neutrophilic pleocytosis (4). Some biomarkers have been used to understand the pathogenesis of SRMA and support its diagnosis (5, 6). Clinical and laboratory findings in dogs with a chronic form of SRMA are less specific than those observed in the acute form, making the diagnosis more challenging. The MRI finding of SRMA in dogs include enhancement of the meninges in the cervical region on T1-weighted (T1W) images after intravenous injection of gadolinium, and signal changes of the cervical muscle such as hyperintensity on T2-weighted (T2W) and short tau inversion recovery (STIR) (7), as well as contrast enhancement. The study by Remelli et al. highlights the usefulness of low and high-field MRI in complementing clinical and laboratory findings in the diagnosis of SRMA. In this retrospective study, including 70 dogs with SRMA, the MRI showed abnormalities in 98.6% of dogs, with the majority (87.1%) being MRI features suggestive of meningeal inflammation. T1W FAT-SAT sequences were particularly useful in detecting meningeal enhancement. In addition, the contrast enhancement of the synovium of the cervical articular facets and the epaxial muscles was detected in 48.6% of dogs.
Spinal epidural empyema (SEE) is characterized by the “accumulation of purulent material in the epidural space of the vertebral canal” (8). It can result in neurological deficits and even death if untreated or unresponsive to treatment (9). There is limited information on canine SEE in veterinary literature. A study by Laws et al. describes the clinical and diagnostic findings, treatment (conservative or surgical), and outcomes of dogs with SEE that were presented to five referral hospitals in the UK. This study provides detailed information on the presenting clinical signs, MRI findings, laboratory investigation results, treatment, and long-term outcomes. The results of this study inform client communication and clinical decisions on canine SSE management.
Various neurological conditions such as vertebral fractures and luxations, malformations, neoplasia, and intervertebral disc degenerative and infectious disorders can result in instability of the vertebral column. Different surgical techniques have been described to stabilize the vertebral column of dogs and cats. These procedures require specialistic equipment combined with advanced neurosurgical skills and expertise. One of the main risks of spinal stabilization is the violation of neurovascular structures during implant placement resulting in serious and potentially irreversible neurologic deficits for the patient. Reliable intra and post-operative evaluation of the accuracy of implant placement is necessary for the safe and successful treatment of patients undergoing stabilization of the vertebral column (10). A canine cadaveric imaging and anatomic study by Goffart et al. shows that end-on fluoroscopy, with or without inversion, is a highly accurate technique for the intraoperative evaluation of bicortically placed Steinmann pins' position in the canine thoracolumbar vertebral column. Three-dimensionally printed patient-specific drill guides have been used to improve the accuracy of implant placement in the canine spine (11).
Three-dimensionally printed patient-specific drill guides have recently been proposed to assist with another challenging neurosurgical procedure that involves a steep learning curve. The study by Escauriaza et al. investigated the accuracy of a 3-dimensional dog-specific printed surgical guide to support the surgeon performing transsphenoidal hypophysectomy, which is performed as surgical treatment of pituitary-dependent hyperadrenocorticism. Pituitary-dependent hyperadrenocorticism is a chronic and progressive disorder (12) that can be treated medically or surgically with or without radiation therapy. Surgical treatment to remove the pituitary neoplasm is increasingly used in dogs. However, this surgical procedure is challenging and requires prolonged training and advanced expertise. The methods described in the study by Escauriaza et al. support the identification of the area to drill in the basisphenoid bone to access the salle turcica and the pituitary mass.
This collection of articles promotes the work of female neurology and neurosurgery researchers and contributes to the advancement of diagnosis and treatment of different neurologic conditions (i.e., infectious, inflammatory, neoplastic) of the central and peripheral nervous system.
Author contributions
The author confirms being the sole contributor of this work and has approved it for publication.
Conflict of interest
LD is an employee of Linnaeus Veterinary limited, a provider of veterinary services.
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
1. Vilela P, Rowley HA. Brain ischemia: CT and MRI techniques in acute ischemic stroke. Eur J Radiol. (2017) 96:162–72. doi: 10.1016/j.ejrad.2017.08.014
2. Fiebach JB, Schellinger PD, Jansen O, Meyer M, Wilde P, Bender J, et al. CT and diffusion-weighted MR imaging in randomized order: diffusionweighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke. (2002) 33:2206–10. doi: 10.1161/01.STR.0000026864.20339.CB
3. Tipold A, Schatzberg SJ. An update on steroid responsive meningitis arteritis. J Small Anim Pract. (2010) 51:150–4. doi: 10.1111/j.1748-5827.2009.00848.x
4. Di Terlizzi R, Platt SR. The function, composition and analysis of cerebrospinal fluid in companion animals: part II—analysis. Vet J. (2009) 180:15–32. doi: 10.1016/j.tvjl.2007.11.024
5. Maiolini A, Carlson R, Schwartz M, Gandini G, Tipold A. Determination of immunoglobulin A concentrations in the serum and cerebrospinal fluid of dogs: an estimation of its diagnostic value in canine steroid-responsive meningitis–arteritis. Vet J. (2012) 191:219–24. doi: 10.1016/j.tvjl.2010.12.018
6. Spitzbarth I, Baumgärtner W, Beineke A. The role of pro- and anti-inflammatory cytokines in the pathogenesis of spontaneous canine CNS diseases. Vet Immunol Immunopathol. (2012) 147: 6–24. doi: 10.1016/j.vetimm.2012.04.005
7. Lau J, Nettifee JA, Early PJ, Mariani CL, Olby NJ, Muñana KR. Clinical characteristics, breed differences, and quality of life in North American dogs with acute steroid-responsive meningitis-arteritis. J Vet Intern Med. (2019) 33:1719–27. doi: 10.1111/jvim.15543
8. De Stefani A, Garosi LS, Mcconnell FJ, Diaz FJ, Dennis R, Platt SR. Magnetic resonance imaging features of spinal epidural empyema in five dogs. Vet Radiol Ultrasound. (2008) 49:135–40. doi: 10.1111/j.1740-8261.2008.00339.x
9. Lavely JA, Vernau KM, Vernau W, Herrgesell EJ, Lecouteur RA. Spinal epidural empyema in seven dogs. Vet Surg. (2006) 35:176–85. doi: 10.1111/j.1532-950X.2006.00129.x
10. Hettlich BF, Fosgate GT, Levine JM, Young BD, Kerwin SC, Walker M, et al. Accuracy of conventional radiography and computed tomography in predicting implant position in relation to the vertebral canal in dogs. Vet Surg. (2010) 39:680–7. doi: 10.1111/j.1532-950X.2010.00697
11. Elford JH, Oxley B, Behr S. Accuracy of placement of pedicle screws in the thoracolumbar spine of dogs with spinal deformities with three-dimensionally printed patient-specific drill guides. Vet Surg. (2020) 49:347–53. doi: 10.1111/vsu.13333
Keywords: dog, cat, neurology—clinical, neurosurgical procedures, editorial
Citation: De Risio L (2023) Editorial: Women in veterinary neurology and neurosurgery: 2021. Front. Vet. Sci. 10:1147908. doi: 10.3389/fvets.2023.1147908
Received: 19 January 2023; Accepted: 26 January 2023;
Published: 10 February 2023.
Edited and reviewed by: Andrea Tipold, University of Veterinary Medicine Hannover, Germany
Copyright © 2023 De Risio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Luisa De Risio, 
luisa.derisio@linnaeusgroup.co.uk