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Neurology and Neurosurgery

Neurology and Neurosurgery

 

Neurology and Neurosurgery overview

  • Willows has an experienced team of small animal Neurology and Neurosurgery clinicians that include:
      • three Neurology Specialists
      • five Surgical / Orthopaedic Specialists
  • We regularly speak at conferences and CPD meetings in the UK and overseas
  • Dogs and cats with all types of neurological problem are welcomed
  • Urgent cases are seen the same day
 
  • An emergency service is provided,
    24 hours a day, 365 days of the year
  • Our hospitalised patients benefit from:
    • intensive care facilities
    • 24-hour veterinary and nursing care
  • Free telephone advice is given with the
    minimum of delay
  • Willows has an experienced team of small animal Neurology and Neurosurgery clinicians that include:
    • three Neurology Specialists
    • five Surgical / Orthopaedic Specialists
  • We regularly speak at conferences and CPD meetings in the UK and overseas
  • Dogs and cats with all types of neurological problem are welcomed
  • Urgent cases are seen the same day
  • An emergency service is provided, 24 hours a day, 365 days of the year
  • Our hospitalised patients benefit from:
    • intensive care facilities
    • 24-hour veterinary and nursing care
  • Free telephone advice is given with the minimum of delay


Personnel

 

RCVS/European Neurology Specialists

 

Neurology/Neurosurgeon Clinician

 

Neurology/Neurosurgeon Resident

Sebastien Behr - RCVS/European/American Neurology Specialists   Raquel Trevail - RCVS/European/American Neurology Specialists   Roberto José-López - DVM MRCVS - Veterinary Neurology Clinician   James Elford - BVetMed MRCVS - Resident in Veterinary Neurology
             

Sebastien Behr

DVM DipECVN MRCVS

 

Raquel Trevail

DVM DipECVN MRCVS


 

Roberto José-López

DVM MRCVS

 

James Elford

BVetMed MRCVS

RCVS/European Neurology Specialists

Sebastien Behr - RCVS/European/American Neurology Specialists

Sebastien Behr
DVM DipECVN MRCVS

Raquel Trevail - RCVS/European/American Neurology Specialists

Raquel Trevail
DVM DipECVN MRCVS

Neurology/Neurosurgeon Clinician

Roberto José-López - DVM MRCVS - Veterinary Neurology Clinician

Roberto José-López
DVM MRCVS


Neurology/Neurosurgeon Resident

James Elford - BVetMed MRCVS - Resident in Veterinary Neurology

James Elford
BVetMed MRCVS

Fully supported by our Orthopaedic Specialists led by Malcolm McKee DSAO, and a team of on-site Imaging, Anaesthesia and Medicine Specialists

 

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Neuroimaging

     

Willows has unsurpassed neuroimaging facilities and personnel:

  • Imaging Specialists Paul Mahoney DVR DipECVDI,
    Andrew Parry DipECVDI, Lizza Baines DVR DipECVDI
  • Highly experienced radiographer Andrew Tanner BSc(Hons)
  • Team of Specialist-led anaesthetists providing optimal anaesthesia care
    for each patient
  • Every MRI and CT study is bespoke and tailored to the patient:
    • our neurology Specialists, imaging Specialists and radiographer liaise throughout the scan
  • We aim to scan all patients where appropriate on the day of their appointment:
    • priority is given to urgent and emergency cases
  • High field magnet MRI scanner (1.5-tesla)
    • fast scanning with extensive range of coils to maximise image quality
  • CT scanner (rapid 16-slice), enabling 3D reconstruction and CT-myelography
  • Advanced imaging studies include:
    • high resolution 3D MRI reconstruction
      • to evaluate fine structures such as cranial and spinal nerves
    • diffusion MRI (ADC mapping)
      • to evaluate cerebrovascular accidents
  Willows high field GE 1.5-tesla MRI scanner

Willows high field GE 1.5-tesla MRI scanner  

MRI – a Cavalier KCS with syringomyelia and Chiari brain malformation. A microchip MRI artefact is present

MRI – a Cavalier KCS with syringomyelia and Chiari brain malformation.
A microchip MRI artefact is present

MRI scan showing hippocampal necrosis in a cat's brain

MRI scan showing hippocampal necrosis in a cat's brain

Diffusion MRI – a sensitive sequence for revealing brain infarction (arrow)

Diffusion MRI – a sensitive sequence for revealing brain infarction (arrow)

 

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Neuroimaging

  • Imaging Specialists Paul Mahoney DVR DipECVDI,
    Andrew Parry DipECVDI, Lizza Baines DVR DipECVDI
  • Highly experienced radiographer Andrew Tanner BSc(Hons)
  • Team of Specialist-led anaesthetists providing optimal anaesthesia care
    for each patient
  • Every MRI and CT study is bespoke and tailored to the patient:
    • our neurology Specialists, imaging Specialists and radiographer liaise throughout the scan
  • We aim to scan all patients where appropriate on the day of their appointment:
    • priority is given to urgent and emergency cases
  • High field magnet MRI scanner (1.5-tesla)
    • fast scanning with extensive range of coils to maximise image quality
  • CT scanner (rapid 16-slice), enabling 3D reconstruction and CT-myelography
  • Advanced imaging studies include:
    • high resolution 3D MRI reconstruction
      • to evaluate fine structures such as cranial and spinal nerves
    • diffusion MRI (ADC mapping)
      • to evaluate cerebrovascular accidents

 

MRI – a Cavalier KCS with syringomyelia and Chiari brain malformation. A microchip MRI artefact is present

Willows high field GE 1.5-tesla MRI scanner  

MRI – a Cavalier KCS with syringomyelia and Chiari brain malformation. A microchip MRI artefact is present

MRI – a Cavalier KCS with syringomyelia and Chiari brain malformation.
A microchip MRI artefact is present

MRI scan showing hippocampal necrosis in a cat's brain

MRI scan showing hippocampal necrosis in a cat's brain

Diffusion MRI – a sensitive sequence for revealing brain infarction (arrow)

Diffusion MRI – a sensitive sequence for revealing brain infarction (arrow)

 

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Spinal surgery

     

Our neurosurgical team is able to perform a broad range of spinal procedures, including the most complex challenging techniques.

  • Ventral slot
  • Hemilaminectomy
  • Disc fenestration
  • Dorsal laminectomy
  • Vertebral fracture and luxation
  • Vertebral malformation
  • Arachnoid cyst, spina bifida, dermoid cyst
  • Lumbosacral stenosis
  • Spinal neoplasia
  Intradural extramedullary tumour (spinal meningioma) in a Boxer

Intradural extramedullary tumour (spinal meningioma) in a Boxer

CT scan of a T10-T11 fracture-luxation in a Staffordshire Bull Terrier.

Post-op CT scan shows vertebral body screws and bone cement

CT scan of a T10-T11 fracture-luxation in a Staffordshire Bull Terrier. Post-op CT scan shows vertebral body screws and bone cement

 

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Spinal surgery

Our neurosurgical team is able to perform a broad range of spinal procedures, including the most complex challenging techniques.

  • Ventral slot
  • Hemilaminectomy
  • Disc fenestration
  • Dorsal laminectomy
  • Vertebral fracture and luxation
  • Vertebral malformation
  • Arachnoid cyst, spina bifida, dermoid cyst
  • Lumbosacral stenosis
  • Spinal neoplasia

 

Intradural extramedullary tumour (spinal meningioma) in a Boxer

Intradural extramedullary tumour (spinal meningioma) in a Boxer

CT scan of a T10-T11 fracture-luxation in a Staffordshire Bull Terrier.

Post-op CT scan shows vertebral body screws and bone cement

CT scan of a T10-T11 fracture-luxation in a Staffordshire Bull Terrier. Post-op CT scan shows vertebral body screws and bone cement

 

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Brain disorders

     
  • Seizure diagnosis and management:
    • MRI and CSF collection supervised by an anaesthetist due to increased risks
    • 1 to 1 nursing and constant rate infusions (CRIs) for unstable epileptic patients
    • we have extensive experience of novel anti-epileptic drugs
  • Inflammatory CNS diseases:
    • meningitis, pachymeningitis, encephalitis
    • multimodal immunosuppressive therapies
    • rapid in-house CSF analysis – Cytospin/cytology
    • we have published on inflammatory CNS diseases1, 2
  • Peripheral and central vestibular conditions
  • Cranial nerve disorders (e.g. facial paralysis, trigeminal neuritis)
  • Paroxysmal conditions (e.g. movement disorders, narcolepsy-cataplexy)
  • Brain malformation (e.g. hydrocephalus, hydranencephaly)
  • Brain neoplasia
  MRI – 6 m.o. WHWT with seizures.

Hydranencephaly visible as a large fluid filled structure involving the cerebrum

MRI – 6 m.o. WHWT with seizures.
Hydranencephaly visible as a large fluid filled structure involving the cerebrum

MRI of the brain of a Lurcher with hypertrophic pachymeningitis (arrows)

MRI of the brain of a Lurcher with hypertrophic pachymeningitis (arrows)

Intracranial haemorrhage in a dog with thrombocytopaenia – T2 gradient echo MRI

Intracranial haemorrhage in a dog with thrombocytopaenia – T2 gradient echo MRI

 

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Brain disorders

  • Seizure diagnosis and management:
    • MRI and CSF collection supervised by an anaesthetist due to increased risks
    • 1 to 1 nursing and constant rate infusions (CRIs) for unstable epileptic patients
    • we have extensive experience of novel anti-epileptic drugs
  • Inflammatory CNS diseases:
    • meningitis, pachymeningitis, encephalitis
    • multimodal immunosuppressive therapies
    • rapid in-house CSF analysis – Cytospin/cytology
    • we have published on inflammatory CNS diseases1, 2
  • Peripheral and central vestibular conditions
  • Cranial nerve disorders (e.g. facial paralysis, trigeminal neuritis)
  • Paroxysmal conditions (e.g. movement disorders, narcolepsy-cataplexy)
  • Brain malformation (e.g. hydrocephalus, hydranencephaly)
  • Brain neoplasia

 

MRI – 6 m.o. WHWT with seizures.

Hydranencephaly visible as a large fluid filled structure involving the cerebrum

MRI – 6 m.o. WHWT with seizures.
Hydranencephaly visible as a large fluid filled structure involving the cerebrum

MRI of the brain of a Lurcher with hypertrophic pachymeningitis (arrows)

MRI of the brain of a Lurcher with hypertrophic pachymeningitis (arrows)

Intracranial haemorrhage in a dog with thrombocytopaenia – T2 gradient echo MRI

Intracranial haemorrhage in a dog with thrombocytopaenia – T2 gradient echo MRI

 

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Brain surgery

     

Indications for brain surgery include:

  • Brain abscess / empyema
  • Certain brain tumours e.g. meningioma in cats and dogs

We are able to optimise the outcome for such challenging cases due to our Specialist training, multi-disciplinary approach, state-of-the-art surgical facilities and 24-hour intensive care provision.

We are happy to discuss the suitability of brain surgery with you or your clients, even if the imaging study has been performed elsewhere.

 

6 m.o. Jack Russell Terrier with a brain tumour.  Preoperative MRI scan6 m.o. Jack Russell Terrier with a brain tumour.

Brain surgery being performed by two of Willows’ neurology SpecialistsBrain surgery being performed by two of Willows’ neurology Specialists

6 m.o. Jack Russell Terrier with a brain tumour.  Photograph of the dog the day following surgery
Preoperative MRI scan and photograph of the dog the day following surgery

 

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Brain surgery

Indications for brain surgery include:

  • Brain abscess / empyema
  • Certain brain tumours e.g. meningioma in cats and dogs

We are able to optimise the outcome for such challenging cases due to our Specialist training, multi-disciplinary approach, state-of-the-art surgical facilities and 24-hour intensive care provision.

We are happy to discuss the suitability of brain surgery with you or your clients, even if the imaging study has been performed elsewhere.

6 m.o. Jack Russell Terrier with a brain tumour.  Preoperative MRI scan 
6 m.o. Jack Russell Terrier with a brain tumour.

Brain surgery being performed by two of Willows’ neurology Specialists
Brain surgery being performed by two of Willows’ neurology Specialists

6 m.o. Jack Russell Terrier with a brain tumour.  Photograph of the dog the day following surgery
Preoperative MRI scan and photograph of the dog the day following surgery

 

 

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Spinal disorders

     

Our Specialists have extensive experience of a wide variety of spinal disorders in dogs and cats3.

  • Disc herniation – acute and chronic
  • Cervical spondylopathy ('wobbler syndrome')
  • Syringomyelia and Chiari malformation
  • Spinal trauma
  • Meningitis, meningomyelitis, discospondylitis
  • Spinal malformations
  • Spinal neoplasia4
  MRI of a Doberman with cervical spondylopathy

MRI of a Doberman with cervical spondylopathy

MRI scan – disc extrusion with severe spinal cord compression at L2-L3

MRI scan – disc extrusion with severe spinal cord compression at L2-L3

 

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Spinal disorders

Our Specialists have extensive experience of a wide variety of spinal disorders in dogs and cats3.

  • Disc herniation – acute and chronic
  • Cervical spondylopathy ('wobbler syndrome')
  • Syringomyelia and Chiari malformation
  • Spinal trauma
  • Meningitis, meningomyelitis, discospondylitis
  • Spinal malformations
  • Spinal neoplasia4

 

MRI of a Doberman with cervical spondylopathy

MRI of a Doberman with cervical spondylopathy

MRI scan – disc extrusion with severe spinal cord compression at L2-L3

MRI scan – disc extrusion with severe spinal cord compression at L2-L3

 

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Neuromuscular disorders

  • Polyneuropathy e.g. polyradiculoneuritis, endocrine neuropathy
  • Junctionopathy e.g. myasthenia gravis
  • Myopathy e.g. polymyositis, masticatory myositis

 

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Neuromuscular investigations

     
  • Advanced Nihon Koden electrodiagnostic unit
    • electromyography (EMG), nerve conduction, F-wave, repetitive stimulations
  • Muscle and nerve biopsy
  EMG – denervation due to a polyneuropathy in a Labrador showing fibrillation potentials and positive sharp waves

EMG – denervation due to a polyneuropathy in a Labrador showing fibrillation potentials and positive sharp waves

 

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Neuromuscular investigations

  • Advanced Nihon Koden electrodiagnostic unit
    • electromyography (EMG), nerve conduction, F-wave, repetitive stimulations
  • Muscle and nerve biopsy

 

EMG – denervation due to a polyneuropathy in a Labrador showing fibrillation potentials and positive sharp waves

EMG – denervation due to a polyneuropathy in a Labrador showing fibrillation potentials and positive sharp waves

 

Recent Publications

  1. Behr, S. and Cauzinille, L. Aseptic suppurative meningitis in juvenile boxer dogs: retrospective study of 12 cases. Journal of the American Animal Hospital Association 42, 277-282, 2006
  2. Behr, S. and others. Treatment of meningoencephalitis of unknown origin in a dog. Veterinary Record 164, 627-629, 2009
  3. Marioni-Henry, K. Feline spinal cord diseases. In: Spinal Diseases. Veterinary Clinics of North America: Small Animal Practice 40, 1011–1028, 2010
  4. Marioni-Henry, K. and others. Tumors affecting the spinal cord of cats: 85 cases (1980–2005). Journal of the American Veterinary Medical Association 232, 237-243, 2008

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