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Anaesthetic management of a patient undergoing magnetic resonance imaging with suspected intracranial disease

02 July 2021
10 mins read
Volume 12 · Issue 6
Figure 1. Patient positioned in scanner attached to magnetic resonance imaging (MRI) safe multi-parameter machine (3880 MRI Patient Monitor, IRadimed, Florida, USA).

Abstract

Seizing patients with suspected intracranial disease are relatively common within the veterinary profession. Veterinary nurses will be familiar with some of the most common challenges these patients present while hospitalised, however to determine the cause and severity of disease, general anaesthesia is often required. This article will discuss some of the specific considerations during the peri-anaesthetic period of a seizing patient undergoing magnetic resonance imaging, including recommendations for future practice.

Incidence of cerebral neoplasia in dogs is 0.014% (Schubert, 2012), with breeds including the Boxer, Boston Terrier and French Bulldog identified as having an increased risk (Song et al, 2013). The most common presenting sign is seizures, of which onset may be sudden or slow. Diagnosis is typically with magnetic resonance imaging (MRI) requiring general anaesthesia of the patient (Schubert, 2012).

Anaesthesia of patients with intracranial disease can be challenging, therefore understanding relevant pathophysiology, pharmacokinetics, and effects of anaesthesia is imperative. The main aims of anaesthesia in these animals are to maintain cerebral blood flow (CBF) and prevent lifethreatening increases in intracranial pressure (ICP), which could lead to brain herniation (Raisis and Musk, 2017). Problems such as these should be anticipated and an appropriate and effective treatment plan developed before induction of anaesthesia to ensure the best outcome for the patient (Quandt, 2015).

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