Search Results (124)

Tetanus is uncommon in dogs, which are considered relatively resistant to tetanospasmin, and detailed descriptions of the diagnostic evaluation of severe generalized cases remain limited. A 5.5-month-old intact male Miniature Schnauzer was presented four days after a puncture wound to the right pelvic limb. On admission the dog was alert but non-ambulatory, with generalized muscle rigidity, tremors, marked cervical hyperextension, hyperactive spinal reflexes, facial muscle spasms and dysphagia. Together with the wound history and rapid progression, these findings supported a presumptive diagnosis of generalized tetanus, clinically classified as Grade III. Serum collected before tetanus antitoxin administration contained no detectable antibodies against Clostridium tetani neurotoxin. Treatment comprised equine tetanus antitoxin, antimicrobials, multimodal sedation and muscle relaxation, enteral nutrition, intensive nursing and physiotherapy. Needle electromyography on day 10 showed increased insertional activity, positive sharp waves and fibrillation potentials, and continuous spontaneous motor unit activity. Despite patient young age and rapid disease progression, clinical improvement was evident from day 10, and the dog was discharged on day 16, ambulatory and eating voluntarily. This case highlights that severe generalized canine tetanus remains principally a clinical diagnosis, while serial neurological examination, clinicopathological monitoring and electromyography can strengthen diagnostic confidence, characterize disease progression and support clinical management. Full article

Post-hemorrhagic hydrocephalus (PHH) is a serious neurological sequela of severe intraventricular hemorrhage (IVH) in premature infants and remains one of the leading indications for ventriculoperitoneal (VP) shunt placement. Evaluating possible VP shunt-related complications can be challenging because clinical manifestations are often nonspecific, neuroimaging may initially appear unchanged, and microbiological cultures may remain negative. We report the case of a 19-month-old male born at 28 weeks’ gestation who developed Grade IV germinal matrix/intraventricular hemorrhage with bilateral intraparenchymal extension, early periventricular cystic leukomalacia, and post-hemorrhagic communicating hydrocephalus requiring multiple cerebrospinal fluid diversion procedures culminating in long-term VP shunt dependence. His medical history was notable for recurrent neonatal meningitis, secondary epilepsy with previous episodes of status epilepticus, secondary adrenal insufficiency, and severe global developmental delay. He presented with fever, recurrent coffee-ground vomiting, abdominal distension, progressive lethargy, reduced responsiveness, and localized erythematous swelling over the cranial VP shunt reservoir, raising concern for possible shunt-related pathology. During hospitalization, he deteriorated with status epilepticus and respiratory failure, with clinical concern for increased intracranial pressure, requiring admission to the Pediatric Intensive Care Unit (PICU). Laboratory investigations demonstrated leukocytosis, elevated C-reactive protein, cerebrospinal fluid pleocytosis, markedly elevated CSF protein, and CSF glucose of 2.0 mmol/L, for which a paired serum glucose value was unavailable, while repeated blood, urine, wound, and CSF cultures remained negative. Initial computed tomography (CT) demonstrated no significant interval change in the chronic hydrocephalus despite progressive neurological deterioration; however, serial neuroimaging later revealed progressive bilateral extra-axial fluid collections with radiological features suggestive of an evolving subacute subdural hemorrhage. The patient was managed with empirical broad-spectrum intravenous antibiotics, aggressive seizure control, stress-dose corticosteroids, respiratory support, and continuous multidisciplinary monitoring. His neurological and respiratory status subsequently improved, and he returned to his pre-admission neurological baseline before discharge with planned further evaluation at a tertiary pediatric neurosurgical center. This case highlights the diagnostic uncertainty surrounding acute neurological deterioration in a child with shunt-dependent PHH. VP shunt-related infection or malfunction remained important but unconfirmed diagnostic considerations, alongside competing or potentially overlapping contributors including status epilepticus, evolving extra-axial collections, respiratory infection, and endocrine or metabolic decompensation. No single etiology was definitively established. The case emphasizes the importance of serial neurological assessment, consideration of alternative diagnoses, repeat neuroimaging, and multidisciplinary evaluation when initial investigations do not establish the cause of deterioration. Full article

Background and Objectives: Cerebrovascular events remain among the most feared complications after transcatheter aortic valve implantation (TAVI). Whether early and post-discharge cerebrovascular events are associated with distinct clinical, echocardiographic, haemodynamic, and procedural predictors remains incompletely clarified. Materials and Methods: This retrospective, observational, two-center cohort study included 556 patients who underwent TAVI for severe symptomatic aortic stenosis between October 2011 and May 2023. The primary outcomes were in-hospital stroke and mid-to-long term stroke occurring after hospital discharge. Stroke diagnoses were established by neurological assessment and confirmed by cranial computed tomography and/or magnetic resonance imaging. Univariable comparisons and Firth penalized multivariable logistic regression analyses were performed to identify predictors of each outcome. Results: In-hospital stroke occurred in 14 patients (2.5%), whereas mid-to-long term stroke occurred in 16 patients (2.9%). In Firth penalized multivariable analysis, baseline mitral regurgitation grade (odds ratio [OR] 2.174, 95% confidence interval [CI] 1.299–3.638; p = 0.003), HbA1c (OR 1.644, 95% CI 1.111–2.433; p = 0.013), and prior cerebrovascular event (OR 4.269, 95% CI 1.150–15.846; p = 0.030) were independently associated with in-hospital stroke. For mid-to-long term stroke, post-dilatation (OR 9.862, 95% CI 2.555–38.067; p < 0.001) and very severe aortic stenosis phenotype (OR 3.649, 95% CI 1.343–9.916; p = 0.011) were independently associated with the outcome. Conclusions: Early and post-discharge cerebrovascular events after TAVI were infrequent but associated with distinct predictor profiles. In-hospital stroke was associated with baseline mitral regurgitation grade, HbA1c, and prior cerebrovascular event, whereas mid-to-long term stroke was associated with post-dilatation and very severe aortic stenosis phenotype. Given the limited number of events, these findings should be interpreted as exploratory and require validation in larger prospective cohorts. Full article

Background: Trigeminal neuralgia is a chronic neuropathic pain disorder characterized by severe recurrent facial pain and substantial impairment in quality of life. Although microvascular decompression (MVD) is an established surgical treatment for medically refractory cases, routine clinical data integrating clinical characteristics, previous interventional treatment history, and early postoperative outcomes remain limited. This study aimed to describe the clinical profile and early postoperative outcomes of patients undergoing MVD for trigeminal neuralgia in a single-center retrospective cohort. Methods: This single-center, single-surgeon retrospective cohort study included 62 adult patients who underwent MVD at Pamukkale University Hospitals between 4 September 2019 and 9 July 2026. Demographic and clinical characteristics, previous interventional procedures, trigeminal nerve division involvement, vascular compression status, surgical opening approach, postoperative Barrow Neurological Institute (BNI) pain intensity scores, visual analog scale (VAS) pain scores, wound-related complications, and exploratory perioperative inflammatory markers were retrospectively collected. Favorable postoperative outcome was defined as BNI Grade I–II. Results: The mean age was 51.9 ± 12.8 years, 66.1% were female, and vascular compression was identified in 87.1%. A previous interventional procedure was documented in 35.5%. Favorable BNI outcomes occurred in 74.2% (95% CI, 62.1–83.4%), and complete pain relief (VAS = 0) in 88.7% (95% CI, 78.5–94.4%). Wound-related complications occurred in 9.7%. No evaluated baseline characteristic was significantly associated with either pain outcome. Paired analyses showed no significant perioperative change in CRP (p = 0.353), whereas NLR increased significantly (p = 0.001). Conclusions: MVD was associated with favorable early postoperative pain outcomes in most patients. However, the retrospective design, modest sample size, and symptom-driven longer-term follow-up limit conclusions regarding prognostic determinants and durability of pain relief. Full article

Background and Clinical Significance: Encephalitis is a rare neurological complication associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. In rare cases, focal neuroinflammation can manifest as a mass-like parenchymal lesion, creating profound diagnostic and treatment dilemmas by mimicking primary central nervous system neoplasms. Case Presentation: A 34-year-old female presented with cephalalgia, nausea, confusion, facial palsy, and a new onset of focal impaired awareness seizures (FIAS). Brain magnetic resonance imaging (MRI) revealed a prominent hyperintense lesion within the left temporal lobe with associated vasogenic edema and focal leptomeningeal enhancement highly suspicious of a low-grade glial neoplasm. Although nasopharyngeal RT-PCT was negative, the presence of serum anti-SARS-CoV-2 IgM and IgG suggested recent subclinical SARS-CoV-2 infection. To resolve diagnostic ambiguity and avoid empiric oncological overtreatment, a stereotactic brain biopsy was performed. Histopathology revealed acute neuroinflammation characterized by reactive gliosis, microglial hyperplasia, and perivascular lymphatic cuffing, with no evidence of neoplastic presence. Quantitative tissue RT-PCR confirmed the presence of SARS-CoV-2 (Ct33). Follow-up imaging demonstrated complete resolution of the abnormalities following conservative treatment with corticosteroids and antiepileptics, though mild clinical symptoms persisted for 12 months thereafter. Conclusions: Encephalitis presents a rare yet critical manifestation of SARS-CoV-2. Establishing definitive etiology remains challenging. Stereotactic biopsy is a valuable tool to guide appropriate treatment in cases of ambiguous imaging and clinical findings. Radiographic resolution may precede complete clinical recovery. Full article

Background and Objectives: The optimal timing of epinephrine in out-of-hospital cardiac arrest (OHCA), and whether it differs by initial rhythm, is uncertain and rests almost entirely on confounded observational data. We synthesized this evidence, noting each study’s time origin. Materials and Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to 15 March 2026 for studies relating epinephrine timing to outcome in adult non-traumatic OHCA. Per-minute, categorical and dose–response random-effects meta-analyses were performed by rhythm, with ROBINS-I and GRADE appraisal. Results: Twenty-five studies were included. For non-shockable rhythm, each 1 min delay was associated with 4.2% lower survival odds (OR 0.958, 95% CI 0.949–0.968; k = 4, I² = 0%), unchanged when restricted to studies sharing one time origin. Early epinephrine was associated with favorable neurological outcome (k = 9, OR 2.76, 95% CI 2.06–3.71; I² = 88%), though the prediction interval crossed the null (0.98–7.79), and the shockable-versus-non-shockable difference did not persist under a common time origin (p = 0.46). Several estimates were biologically implausible (adjusted OR 5.92), indicating substantial residual confounding; GRADE certainty was very low. Conclusions: The per-minute survival gradient in non-shockable rhythm was the most internally consistent estimate—internally consistent rather than reliable, since studies sharing one structural bias can agree without being valid. Every estimate is almost certainly inflated by resuscitation time bias. The evidence supports minimizing avoidable delay but cannot define a timing threshold; trials randomizing timing and individual patient data meta-analyses with harmonized time definitions are needed. Full article

Background/Objectives: Traumatic spinal injury (TSI) is associated with substantial morbidity, but factors contributing to in-hospital complications remain insufficiently defined. This study evaluated factors associated with in-hospital complications after TSI. Methods: We conducted a retrospective cohort study at a tertiary center (January 2018–May 2025). Among 5380 trauma patients screened by computed tomography, 413 admitted patients with TSI were included. The primary outcome was any documented in-hospital complication. Factors were assessed using multivariable logistic regression and reported as adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results: The median age was 28.0 years, 337 were male (81.6%), and four-wheel motorized vehicle accidents were the most common injury mechanism (57.1%). In-hospital complications occurred in 99 patients (24.0%). Pulmonary infection was most common (9.9%), followed by bloodstream infection (4.4%), urinary tract infection (3.9%), and surgical site infection (3.9%). Compared with patients without complications, those with complications had longer hospital stays, higher ICU admissions, longer ICU stays, and lower discharge home. In multivariate logistic regression, complications were associated with worse AIS grade (OR 1.690, 95% CI 1.241–2.302), inpatient physical therapy requirement (OR 4.385, 95% CI 2.494–7.711), greater number of associated non-spinal injuries (OR 1.729, 95% CI 1.463–2.042), and greater cervical vertebral injury burden (OR 1.479, 95% CI 1.061–2.062). Conclusions: Neurological severity, polytrauma burden, and cervical injury were independently associated with complications, supporting early risk stratification and multidisciplinary prevention in high-risk patients. Findings should be interpreted considering the retrospective single-center design, predominantly young male cohort, low spinal cord injury proportion, and limited post-discharge data. Full article

Background and objectives: Optimal oxygen administration during delivery room resuscitation remains a major challenge in very preterm infants. While both hypoxemia and excessive oxygen exposure have been associated with adverse outcomes, the prognostic value of early oxygenation parameters remains unclear. This study aimed to evaluate the association between preductal SpO₂ at 5 min of life and early respiratory and neurological outcomes in preterm infants born at or below 32 weeks of gestation. Materialsandmethods: This retrospective single-centre study included 31 preterm infants born at ≤32 weeks of gestation, identified from 34 consecutive eligible births. Demographic, delivery room, respiratory, laboratory, and neuroimaging data were collected from medical records. The primary outcome was intraventricular hemorrhage (IVH), graded by the Papile classification, during the first week of life. Secondary outcomes included respiratory support requirements, surfactant administration, and capillary blood gas parameters at two hours of life. Associations were evaluated using Spearman rank correlation; because SpO₂@5 and delivery room FiO₂ were strongly related to gestational age, partial correlations controlling for gestational age were additionally performed, together with a group comparison for IVH. Exact two-sided p values are reported. Results: The median gestational age was 28 weeks + 4 days (range: 22 weeks + 1 day to 31 weeks + 5 days), and the median birth weight was 1120 g. IVH of any grade occurred in 20 infants (64.5%), including severe (grade III–IV) IVH in 10 (32.3%). Median delivery room FiO₂ was 35% (IQR 30–50%), and median SpO₂ at 5 min of life was 83% (IQR 75–90%). Lower SpO₂ at 5 min of life was associated with an increased number of surfactant doses (rs = −0.46, p = 0.010), lower capillary pH at two hours of life (rs = 0.39, p = 0.032), and a higher grade of IVH (rs = −0.39, p = 0.030); median SpO₂@5 was 80% in infants with IVH versus 90% in those without (p = 0.057). Higher delivery room FiO₂ was associated with increased use of DuoPAP (rs = 0.36, p = 0.045), mechanical ventilation (rs = 0.41, p = 0.021), and surfactant administration (rs = 0.56, p < 0.001), as well as lower pH (rs = −0.55, p = 0.002) and higher lactate levels (rs = 0.37, p = 0.044) at two hours of life. Because SpO₂@5 and FiO₂ were both strongly correlated with gestational age (rs = 0.54 and −0.76, respectively), all associations were re-examined controlling for gestational age. The associations of SpO₂@5 with IVH grade (partial rs = −0.22, p = 0.247), surfactant doses (partial rs = −0.08, p = 0.678) and 2 h pH (partial rs = 0.19, p = 0.335) were attenuated and no longer significant, as were those of FiO₂ with mechanical ventilation (partial rs = −0.04, p = 0.817) and surfactant doses (partial rs = −0.01, p = 0.945); only the association between FiO₂ and 2 h pH persisted (partial rs = −0.37, p = 0.048). Conclusions: In preterm infants born at or below 32 weeks of gestation, lower SpO₂ at 5 min and higher delivery room oxygen requirements were associated with less favorable respiratory and metabolic outcomes, as well as with IVH. However, apart from the association between FiO₂ and 2 h pH, none of these associations remained statistically significant after adjustment for gestational age, and these findings, from a small and heterogeneous single-centre cohort, should be considered hypothesis-generating. Early oxygenation parameters are best viewed as simple bedside markers of cardiopulmonary adaptation and overall illness severity in very preterm infants, rather than as independent predictors of clinical outcomes. Further prospective studies are needed to confirm these associations and define clinically relevant threshold values. Full article

Background/Objectives: Post-stroke spasticity is a common and disabling complication that impairs functional recovery. Acupuncture is used as a complementary intervention in stroke rehabilitation, but evidence for specific techniques, including acupoint-to-acupoint penetrating acupuncture (AAPA), remains limited. This study evaluated the adjunctive effects and safety of AAPA applied to limb acupoints in patients with post-stroke spasticity receiving conventional care. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted. Nine databases and five clinical trial registries were searched from inception to June 2026. Trials compared AAPA plus conventional care with conventional care alone. The primary outcome was post-treatment spasticity severity. Risk of bias was assessed using RoB 2, and evidence certainty using GRADE. Results: Sixteen studies involving 1170 participants were included. Adjunctive AAPA significantly reduced Modified Ashworth Scale scores (SMD = −0.91, 95% CI: −1.23 to −0.59). Motor function, gait, balance, activities of daily living, and neurological deficits were also improved. However, most studies had a high overall risk of bias, no trial used a sham acupuncture comparator, and substantial heterogeneity was observed for several outcomes. The certainty of evidence for all GRADE-assessed clinical outcomes was very low. Conclusions: The findings suggest possible add-on benefits of AAPA when used with conventional post-stroke care, but the current evidence should be interpreted cautiously and is insufficient to support definitive clinical recommendations. Rigorous multicenter trials in diverse rehabilitation settings with standardized outcomes, systematic safety assessment, and longer follow-up are needed. Full article

Background: This study aimed to evaluate associations between baseline clinical status, radiological findings, prior medical history, procedural characteristics, and recanalization success with neurological outcome at discharge (NIHSS) and functional status at 90 days (mRS). Methods: This single-center retrospective study included 100 consecutive patients with acute ischemic stroke treated with MT within 24 h of symptom onset. Clinical data, CT perfusion parameters, comorbidities, prior therapies, and detailed procedural characteristics (including anesthesia type, recanalization grade, blood pressure variability, hemorrhagic transformation, and procedure duration) were analyzed. Nonparametric tests (Mann–Whitney U, Kruskal–Wallis) and Spearman’s rank correlation were applied. Statistical significance was set at p < 0.05. Results: Early ischemic signs on baseline imaging were associated with higher NIHSS scores at discharge and worse 90-day mRS (p < 0.05). Patients undergoing CT perfusion imaging had higher discharge NIHSS. Admission NIHSS showed a moderate positive correlation with discharge NIHSS (rho = 0.367, p = 0.003). Strong correlations were observed between NIHSS at 24 h and discharge NIHSS (rho = 0.802, p < 0.001), as well as between 24 h NIHSS and 90-day mRS (rho = 0.842, p < 0.001). Successful recanalization was significantly associated with long-term outcomes, with mTICI 3 associated with the lowest 90-day mRS scores (p = 0.003). Intraprocedural blood pressure variability, hemorrhagic transformation, infections, and in-hospital complications were all linked to higher 90-day mRS values. Prolonged procedure duration showed a weak but significant correlation with worse 90-day outcome (rho = 0.232, p = 0.020). In contrast, prior comorbidities and pre-stroke therapy were not significantly associated with outcomes. A multivariable binary logistic regression analysis identified only the NIHSS score at 24 h remained as an independent predictor of favorable functional outcome at 90 days. Conclusions: Baseline stroke severity, early neurological evolution, successful reperfusion, procedural hemodynamic stability, and prevention of in-hospital complications are strongly associated with both early neurological recovery and long-term functional outcome after mechanical thrombectomy. Full article

Background: Cervical dumbbell-shaped neurogenic tumors occurring at two noncontiguous levels are rare, and postoperative cerebrospinal fluid (CSF) collection causing cord compression is an uncommon but serious complication after intradural tumor resection. Case Presentation: A 30-year-old man presented with a 3-month history of progressive gait disturbance. Neurological examination revealed grade 3 paraparesis with upper motor neuron signs. Magnetic resonance imaging (MRI) demonstrated two discrete dumbbell-shaped neurogenic tumors located at the C1-2 and C7-T1 levels. The lesions were simultaneously resected. Complete removal of the C1-2 tumor required total sacrifice of the left C2 nerve root, while the C7-T1 lesion was excised through a T-shaped dural incision. The dura was closed primarily with watertight sutures reinforced with dural sealant, and no CSF leakage was observed during intraoperative Valsalva testing. Two months postoperatively, the patient developed worsening upper back and trapezial pain with severe scapular swelling. MRI revealed a large CSF collection extending from C6 to T5, causing moderate cord compression. Urgent revision surgery was performed. Controlled drainage was attempted to prevent intracranial hypotension, but significant CSF egress occurred. The dural defect was repaired using an autologous muscle plug reinforced with fibrin glue. The patient recovered uneventfully after revision surgery and was discharged without recurrence or complications. Conclusions: This case highlights that delayed, extensive postoperative CSF collection can occur despite apparently watertight primary closure and negative intraoperative Valsalva testing. Clinical vigilance for this complication is essential when patients present with new axial pain or localized swelling following cervical intradural surgery, even in the absence of classic low-pressure headaches. Full article

Background/Objectives: Post-hemorrhagic hydrocephalus (PHH) is a major complication of extreme prematurity associated with significant neurodevelopmental morbidity. Although post-hemorrhagic ventricular dilatation (PHVD) is a recognized consequence of intraventricular hemorrhage (IVH), progression from an apparently low-grade IVH to severe shunt-dependent disease with imaging features suggestive—but not diagnostic—of a non-communicating hydrocephalus pattern is uncommon and presents important diagnostic and management challenges. We report such a case. Case Presentation: A male infant born at 26 weeks’ gestation developed an initially documented Grade II intraventricular hemorrhage that subsequently evolved into progressive post-hemorrhagic ventricular dilatation. Serial cranial ultrasonography demonstrated progressive ventriculomegaly, later confirmed by computed tomography showing marked dilatation of the lateral and third ventricles with severe cortical mantle thinning and a relatively preserved fourth ventricle, raising suspicion of a non-communicating hydrocephalus pattern. Clinical deterioration with progressive macrocephaly and neurological manifestations necessitated temporizing ventricular cerebrospinal fluid drainage, followed by ventriculoperitoneal shunt placement after stabilization and management of secondary complications. Management throughout the clinical course relied on serial neuroimaging, multidisciplinary decision-making, and individualized neurosurgical intervention. Conclusions: This case illustrates that an apparently low-grade neonatal intraventricular hemorrhage may evolve into severe shunt-dependent PHVD and emphasizes the importance of serial neuroimaging surveillance, objective assessment of ventricular progression, and cautious interpretation of imaging findings suggestive—but not diagnostic—of a non-communicating hydrocephalus pattern. It further highlights the diagnostic and therapeutic challenges encountered when atypical radiological evolution complicates the management of PHVD in extremely premature infants. Full article

Dopamine dysregulation is connected to several neurological disorders, including Parkinson’s disease, Huntington’s disease, and addiction. A new, precise, accurate, and specific reversed-phase high-performance liquid chromatographic method was developed for dopamine determination in different biological media (human/mouse plasma and mouse brain homogenate). The chromatographic assay was performed using Avantor ACE^® RP-18 (250 × 4.6 mm, 5 µm) column equipped with a suitable ODS pre-column. The temperature was ambient, and the mobile phase was composed of 10 mM potassium dihydrogen phosphate buffer (pH = 3) with 0.25 g/L sodium octanesulfonate, methanol, and acetonitrile at a volume-to-volume ratio of 75:20:5. Isocratic elution mode, flow rate 1.0 mL/min, and ultraviolet detection (280 nm) were applied. The procedure was validated for linearity, and all calibration curves were linear over the selected range with determination coefficients greater than 0.998. Intraday repeatability, expressed as the coefficient of variation, did not exceed 4.88% for the plasma and 3.32% for the mouse brain homogenate samples across all tested concentration levels. The proposed chromatographic method was evaluated in terms of greenness, whiteness, and blueness using three ecological metrics (the Analytical Greenness software, White Analytical Chemistry model, and Blue Applicability Grade Index). The optimized procedure was proven to be suitable for implementation in the routine analytical practice. Full article

Background/Objectives: Severe brain injury (SBI) in very preterm infants includes heterogeneous lesions with distinct timing, burden and outcomes. We used cranial ultrasound (CUS) to describe SBI entity, documented timing, three-domain burden, deaths following documented withdrawal, withholding or non-escalation of life-sustaining treatment for poor neurological prognosis (neuro-WWLST), and survivor outcomes. Methods: Retrospective single-center cohort (1991–2020) of 2841 very preterm infants (<32 weeks’ gestation and/or birth weight ≤ 1500 g) with complete CUS within 48 h after birth. CUS was summarized by four windows, three domains—parenchymal lesion, intraventricular hemorrhage (IVH) and ventriculomegaly—and three mutually exclusive entities: periventricular hemorrhagic infarction (PVHI), cystic periventricular leukomalacia (cPVL and grade 3 IVH without PVHI/cPVL (IVH3 entity). Cross-outcome analyses used common maximal-burden CUS. Results: SBI occurred in 286/2841 infants (10.1%) and neuro-WWLST death in 45/2841 infants (1.6%); 43/45 occurred within SBI, and 43/89 SBI deaths (48.3%) followed documented neuro-WWLST. Using common maximal-burden CUS, severe three-domain involvement was more frequent among neuro-WWLST deaths than survivors (37.2% vs. 8.6%). Among SBI survivors with follow-up, cerebral palsy (CP) occurred in 87/176 (49.4%) and clinically classified school-age cognitive sequelae in 50/155 (32.3%). Outcomes varied by entity, with mainly ambulatory unilateral CP after PVHI, more frequent non-ambulatory bilateral CP after cPVL, and a heterogeneous IVH3 profile. Severe three-domain involvement identified a small subgroup with higher outcome burden, but outcomes were not deterministic. Conclusions: A structured, descriptive CUS approach separating lesion entity, documented timing and multidomain burden may support transparent cohort-level description of SBI trajectories, documented neuro-WWLST deaths and survivor outcomes. Full article

Intervertebral disc disease remains the most common spinal pathology in dogs and is characterized by degeneration of the intervertebral disc, primarily through chondroid metaplasia of the nucleus pulposus. Current histological grading systems for disc degeneration do not include inflammation, despite its potential relevance in clinical presentation through extradural swelling and compression. In this retrospective study, surgically removed disc extrusion material from 74 dogs was histologically processed and evaluated using a semi-quantitative grading system for disc degeneration and inflammation. A high prevalence of chondroid metaplasia was observed, frequently accompanied by inflammatory infiltrates, hemorrhage, and necrosis. A significant positive correlation (correlation coefficient = 0.636, p < 0.001) was found between the degree of degeneration and the intensity of inflammation. Notably, thoracolumbar extrusions exhibited significantly higher inflammatory scores than cervical cases. In Dachshunds, more severe neurological deficits were associated with lower histological degeneration scores, indicating that neurological severity depends on multiple interacting factors that may differ between breeds. No significant associations were identified with age, sex, breed, body weight, neurological localization, or lesion severity in other groups. These findings suggest that inflammation is an active component in the pathophysiology of intervertebral disc disease. Incorporating inflammatory grading into histological grading systems could refine functional outcome predictions and guide therapeutic decisions. Full article