As a result, the management of severe brain injuries in horses is anecdotally reputed to be intensive, expensive, and associated with a guarded to grave prognosis. 1,2 Finally, the management of recumbent horses with neurologic disorders is particularly challenging and labor intensive, often limiting treatment options and duration. Intracranial pressure monitoring has not been used on a routine basis in horses, although it has been studied experimentally. In addition, the large physical size of horses limits the use of important diagnostic aids such as CT and magnetic resonance imaging. Although the pathophysiologic processes of TBI in horses may be considered similar to those in humans and other species, there are some aspects that may be unique to equids. The management of horses with TBI is often based on recommendations established in human and small animal medicine. Treatment of brain-injured horses typically involves provision of supportive care hyperosmolar therapy (ie, treatment with hypertonic agents such as mannitol or hypertonic saline solution) anti-inflammatory drugs seizure management antimicrobial agents and, less commonly, surgical decompression. Findings of clinicopathologic and CSF analyses may provide additional information. The location and severity of brain injury can be determined in most horses via complete physical and neurologic examinations, in conjunction with ancillary diagnostic aids such as radiography, endoscopy, and CT. ![]() On the basis of the anatomic location of the site of impact, the type of injury may be categorized as frontal or poll injury. In horses, head trauma occurs commonly and resultant injury to the CNS should always be suspected. Among horses with TBI, persistent recumbency and fractures involving the basilar bones were associated with a poor prognosis. ![]() Risk factors associated with nonsurvival included recumbency of more than 4 hours' duration after initial evaluation (odds ratio, 18) and fracture of the basilar bone (odds ratio, 7.5).Ĭonclusions and Clinical Relevance-Results suggest that prognosis for survival in horses with acute TBI may be more favorable than previously reported. In the nonsurvivor group, mean PCV was significantly higher, compared with the value in the survivor group (40% vs 33%). Twenty-one (62%) horses survived to discharge from the hospital. Depending on clinical signs, horses received supportive care, osmotic or diuretic treatments, antimicrobials, anti-inflammatory drugs, analgesics, or anticonvulsants. Horses with basilar bone fractures were 7.5 times as likely not to survive as horses without this type of fracture. Findings of conventional survey radiography of the head alone failed to identify all horses with fractures of the calvarium. Results-Median age of affected horses was 12 months. Clinicopathologic variables among horses in survivor and nonsurvivor groups were compared, and risk factors for nonsurvival were determined. Data that included signalment, clinicopathologic findings, diagnosis, treatment, and outcome were analyzed. Procedures-Medical records of horses that had sustained trauma to the head and developed neurologic signs were reviewed. Objective-To investigate the clinical, clinicopathologic, and diagnostic characteristics treatment and outcome associated with acute traumatic brain injury (TBI) in horses and assess risk factors for nonsurvival in TBI-affected horses.
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