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Open Access Highly Accessed Research article

Volume reduction of the jugular foramina in Cavalier King Charles Spaniels with syringomyelia

Martin Jürgen Schmidt1*, Nele Ondreka1, Maren Sauerbrey1, Holger Andreas Volk3, Christoph Rummel2 and Martin Kramer1

Author Affiliations

1 Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Frankfurter Straße 108, 35392, Giessen, Germany

2 Institute for Veterinary Physiology and Biochemistry, Justus-Liebig-University, Frankfurter Straße 100, 35392, Giessen, Germany

3 Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, UK

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BMC Veterinary Research 2012, 8:158  doi:10.1186/1746-6148-8-158

Published: 6 September 2012

Abstract

Background

Understanding the pathogenesis of the chiari-like malformation in the Cavalier King Charles Spaniel (CKCS) is incomplete, and current hypotheses do not fully explain the development of syringomyelia (SM) in the spinal cords of affected dogs. This study investigates an unconventional pathogenetic theory for the development of cerebrospinal fluid (CSF) pressure waves in the subarachnoid space in CKCS with SM, by analogy with human diseases. In children with achondroplasia the shortening of the skull base can lead to a narrowing of the jugular foramina (JF) between the cranial base synchondroses. This in turn has been reported to cause a congestion of the major venous outflow tracts of the skull and consequently to an increase in the intracranial pressure (ICP). Amongst brachycephalic dog breeds the CKCS has been identified as having an extremely short and wide braincase. A stenosis of the JF and a consequential vascular compromise in this opening could contribute to venous hypertension, raising ICP and causing CSF jets in the spinal subarachnoid space of the CKCS. In this study, JF volumes in CKCSs with and without SM were compared to assess a possible role of this pathologic mechanism in the development of SM in this breed.

Results

Computed tomography (CT) scans of 40 CKCSs > 4 years of age were used to create three-dimensional (3D) models of the skull and the JF. Weight matched groups (7–10 kg) of 20 CKCSs with SM and 20 CKCSs without SM were compared. CKCSs without SM presented significantly larger JF -volumes (median left JF: 0.0633 cm3; median right JF: 0.0703 cm3; p < 0.0001) when compared with CKCSs with SM (median left JF: 0.0382 cm3; median right JF: 0.0434 cm3; p < 0.0001). There was no significant difference between the left and right JF within each group. Bland-Altman analysis revealed excellent reproducibility of all volume measurements.

Conclusion

A stenosis of the JF and consecutive venous congestion may explain the aetiology of CSF pressure waves in the subarachnoid space, independent of cerebellar herniation, as an additional pathogenetic factor for the development of SM in this breed.

Keywords:
Achondroplasia; Chiari-like malformation; Caudal occipital malformation