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Discussion on Research Summary: Recurring blindness due to cholesterinic granulomas | |
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Moderator: DrO |
Posted on Sunday, Jun 10, 2012 - 11:48 am: Cholesterol granulomas are benign cysts that contain fluids, lipids, and cholesterol crystals surrounded by a fibrous lining. In this case it was found in the brain by computed tomography and histopathology.Cholesterol granulomas can form wherever small amounts of blood pool. As the red blood cells break down, cholesterol in the hemoglobin is released. The immune system reacts to the cholesterol as a foreign body, producing an inflammatory response. Associated small blood vessels rupture as a result of the inflammation. Recurrent hemorrhaging makes the mass expand. Often CT and histopathology are not practical given many horse owners goals. The symptoms below easily localize this disease process to the brain and the lack of fever and responsiveness to steroids strongly suggest this is a noninfectious inflammatory disease. However without the CT and histopath this would go largely undiagnosed any further. DrO Vet Ophthalmol. 2012 May 25. Episodic blindness and ataxia in a horse with cholesterinic granulomas. Tofflemire KL, David Whitley R, Wong DM, Waller KR 3rd, Myers RK, Pillatzki AE, Ben-Shlomo G. Source Iowa State University, Lloyd Veterinary Medical Center, 1600 South 16th Street, Ames, IA 50011, USA University of Wisconsin-Madison, School of Veterinary Medicine, Department of Surgical Sciences, 2015 Linden Drive, Madison, WI 53706, USA. Abstract An 11-year-old Oldenburg mare presented following three episodes of acute, transient blindness, ataxia, and disorientation within the preceding 7 months. Clinical improvement, including return of vision, occurred within 1 week of initiating corticosteroid therapy for each of the three episodes. However, mild right-sided miosis was a consistent finding on ophthalmic examinations. Routine clinicopathologic testing revealed no significant abnormalities, and testing of cerebral spinal fluid for selected infectious diseases was unrewarding. Computed tomography of the brain demonstrated a hyperattenuating mass with peripheral mineralization in the rostroventral aspect of each lateral ventricle. The mare was euthanized due to a guarded to poor prognosis. On histopathology, the masses consisted of clusters of cholesterol clefts admixed with leukocytes, mineral deposits, and connective tissue. Cholesterinic granulomas of the lateral ventricles and hyDrOcephaly were diagnosed. Cholesterinic granulomas should be considered a differential diagnosis in horses presenting for intermittent blindness. |