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Apoplexy:

  • It is also known as cerebrovascular accident (CVA) or stroke.
  • It is medical condition in which poor blood flow to brain causes cell death.
  • It can occur in various species and characterized by sudden loss of blood supply to part of brain, leading to neurological dysfunction.

 

Etiology:

  • Thrombosis or embolism: Blood clots (thrombi) and emboli (clumps of material such as fat, bacteria or tumor cells) causes blockage of blood vessel, leading to reduced blood flow to brain.
  • Hemorrhage: It occurs due to rupture of blood vessel in brain, often due to hypertension or head trauma
  • Vascular disease: Conditions like atherosclerosis leads to narrowing or blockage of blood vessels, increasing risk of apoplexy
  • In rare cases, infection in around brain also causes apoplexy
  • Tumors: Brain tumors can compress blood vessels or invade brain tissue, increasing risk of apoplexy.

 

Types of Apoplexy:

  • Two types of apoplexy occur in animals:
    • Pituitary apoplexy: bleeding into pituitary gland which results in neurological impairment.
    • Adrenal apoplexy: Bleeding into adrenal gland.

 

Clinical Findings:

  • Sudden weakness or paralysis, often on one side of body
  • Loss of balance and coordination
  • Altered mental state, including confusion or stupor
  • Seizures
  • Loss of consciousness
  • Abnormal eye movements
  • Head tilt or circling
  • Difficulty swallowing or drooling
  • Specific symptoms vary depending on location and extent of brain injury

 

Diagnosis:

  • Based on clinical findings
  • Neurological examination of animals such as mental status, reflexes, muscle coordination, strength and cranial nerve function.
  • Imaging studies such as CT scan, MRI helps visualize lesion in brain, hemorrhage or other abnormalities
  • Blood test: It is performed to rule out underlying medical conditions that contribute to stroke, such as hypertension or clotting disorders
  • CSF analysis: CSF fluid are obtained through tapping CSF or lumbar puncture to rule out infectious causes.

 

Treatment:

  • Animals with apoplexy requires immediate stabilization which includes oxygen therapy, intravenous fluid, and medications to control seizures
  • ABC care is important in traumatic injury. Airway, breathing and cardiovascular dysfunction should be corrected immediately
  • Anticoagulant or antiplatelet medications may be administered to prevent further clot formation. Aspirin and clopidogrel are most commonly used in veterinary medicine. Aspirin @0.5-10 mg/kg, PO, q24 h in dogs. In cats it is given @ 81 mg, PO, q72h
  • Clopidogrel @ 1.1-3 mg/kg, PO, q24h in dogs and 18.75 mg/cat, PO, q24h in cats
  • In dogs, tissue plasminogen activator (alteplase) is used to dissolve intraocular fibrinous clots. 250mcg/ml Injection, 25mcg/dog, intracamerally in anterior chamber of affected eye, once
  • In case of tumors, surgical intervention is required to remove tumors and repair blood vessel abnormalities
  • Physical therapy and rehabilitation may be beneficial for animals recovering from apoplexy to improve mobility and function.
  • Treating and managing underlying conditions such as hypertension or diabetes can help prevent future strokes

 

 

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