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Evaluation of cerebral blood flow with transcranial Doppler ultrasound in a dog with surgically treated intracranial subdural empyema
  1. Raquel Santiago1,
  2. Carlos Ros2,
  3. Alejandra García de Carellán Mateo3 and
  4. Patricia Laborda-Vidal4
  1. 1Internal Medicine, Ars Veterinaria, Barcelona, Spain
  2. 2Neurology, Universidad Católica de Valencia San Vicente Martir Facultad de Veterinaria, Valencia, Spain
  3. 3Anesthesia and analgesia, Universidad Católica de Valencia San Vicente Martir Facultad de Veterinaria, Valencia, Spain
  4. 4Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad CEU Cardenal Herrera, Alfara del Patriarca, Valencia, Spain
  1. Correspondence to Professor Raquel Santiago; r.santiago{at}


A three-year-old spayed female Yorkshire terrier presented with a three-week history of lethargy and weight loss. Physical examination showed left exophthalmos with left nasal discharge. A lesion in the left brainstem was suspected based on the neurological examination. Pre/postcontrast CT images were consistent with an extensive subdural empyema in the region of the left forebrain, extending from the level of the frontal to the occipital lobe. At presentation, transcranial Doppler (TCD) ultrasound was performed in the left (LMCA) and right middle cerebral arteries (RMCA) showing marked hyperaemia (LMCA velocity: 81.9 cm/s; RMCA velocity: 90.3 cm/s; reference ranges: LMCA velocity 62.3±10.9 cm/s; RMCA velocity 62.5±10.9 cm/s). A left-sided rostrotentorial craniectomy was performed, followed by medical treatment. TCD was monitored daily postoperatively returning to within the reference range five days after surgery (LMCA velocity: 54.9 cm/s; RMCA velocity: 63.6 cm/s). Normalisation of the systolic velocity was associated with clinical improvement. TCD is a useful and non-invasive method for monitoring of cerebral blood flow in patients with intracranial empyema.

  • intracranial empyema
  • cerebral blood flow
  • transcranial Doppler ultrasound
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  • Contributors All authors have collaborated both clinically and scientifically with the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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