title: Ventricular pneumocephalus and septic meningoencephalitis secondary to dorsal rhinotomy and nasal polypectomy in a dog.
abstract: METHODS
  A 4-year-old sexually intact female French Bulldog was evaluated because of lethargy, anorexia, and chronic rhinitis-sinusitis. The dog had nasal discharge of 18 months' duration; dorsal rhinotomies were performed 3 months and 2 weeks prior to referral.
  
  
  RESULTS
  On initial evaluation, intraventricular pneumocephalus and sinusitis were diagnosed; CSF analysis revealed high total protein concentration and mononuclear pleocytosis. The dog's condition improved with treatment. Two weeks after discharge, it was treated by a local veterinarian because of upper airway obstruction; 3 days later, the dog was referred because of seizures. Computed tomography revealed a large fluid-filled, left lateral ventricle and a soft tissue mass protruding through a cribriform plate defect. The mass was histologically consistent with brain tissue. Findings of clinicopathologic analyses were unremarkable. Results of cytologic examination of a CSF sample were indicative of septic, suppurative inflammation, and bacteriologic culture of CSF yielded Escherichia coli.
  
  
  RESULTS
  Amputation of the herniated olfactory bulb and antimicrobial treatment resolved the septic meningoencephalitis, but neurologic deficits recurred 6 weeks later. Definitive correction of the cribriform plate defect with bone and fascial grafts was attempted. Postoperative rotation of the bone graft resulted in cerebral laceration and hemorrhage, and the dog was euthanized.
  
  
  CONCLUSIONS
  Findings suggest that following dorsal rhinotomy and nasal polypectomy surgery, the dog developed herniation of the left olfactory bulb, intra-ventricular pneumocephalus, and septic meningo-encephalitis because of a cribriform plate defect. Care must be taken to prevent rotation of bone grafts used in cribriform defect repair.
authors.affiliation: Department of Clinical Sciences, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, 19104, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Fletcher
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Snyder
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Messinger
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Chiu
authors.forename: Charles H
authors.initials: CH
authors.lastname: Vite
mesh_terms: D000818:Animals; D016025:Bone Transplantation / Q000379:methods / Q000662:veterinary*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D004283:Dog Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D004285:Dogs; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000150:complications / Q000662:veterinary; D017809:Fatal Outcome; D005260:Female; D008590:Meningoencephalitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000662:veterinary*; D009298:Nasal Polyps / Q000150:complications / Q000601:surgery / Q000662:veterinary*; D009460:Neurologic Examination / Q000662:veterinary; D011007:Pneumocephalus / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000662:veterinary*; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000662:veterinary