Medical and surgical emergencies of the nervous system of horses: diagnosis, treatment, and sequelae

Traumatic brain injury in horses: 34 cases (1994-2004)

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.

DESIGN

Retrospective case series.

ANIMALS

34 horses with TBI. Procedures-Medical records of horses that had sustained trauma to the head and developed neurologic signs were reviewed. Data that included signalment, clinicopathologic findings, diagnosis, treatment, and outcome were analyzed. Clinicopathologic variables among horses in survivor and nonsurvivor groups were compared, and risk factors for nonsurvival were determined.

RESULTS

Median age of affected horses was 12 months. Findings of conventional survey radiography of the head alone failed to identify all horses with fractures of the calvarium. Horses with basilar bone fractures were 7.5 times as likely not to survive as horses without this type of fracture. Depending on clinical signs, horses received supportive care, osmotic or diuretic treatments, antimicrobials, anti-inflammatory drugs, analgesics, or anticonvulsants. Twenty-one (62%) horses survived to discharge from the hospital. In the nonsurvivor group, mean PCV was significantly higher, compared with the value in the survivor group (40% vs 33%). 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).

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that prognosis for survival in horses with acute TBI may be more favorable than previously reported. Among horses with TBI, persistent recumbency and fractures involving the basilar bones were associated with a poor prognosis.

Preliminary anatomic investigation of three approaches to the equine cranium and brain for limited craniectomy procedures

OBJECTIVE

To describe surgical approaches to the equine cranium and brain for limited craniectomy.

STUDY DESIGN

Descriptive anatomic study.

SAMPLE POPULATION

Equine cadavers (n=7).

METHODS

Head and neck sections from cadavers were used to establish techniques for exposing areas of the equine brain. Three basic approaches were used: rostrotentorial, suboccipital, and transfrontal. Techniques were adapted from small animal descriptions and modified to account for anatomic differences.

RESULTS

Descriptions of the rostrotentorial, suboccipital, and transfrontal approaches to the equine cranium and brain were defined.

CONCLUSIONS

Dorsal, caudal, lateral, and rostral aspects of the cranium and underlying cerebral cortex can be accessed using the rostrotentorial, suboccipital, and transfrontal approaches. Access to the dorsal, dorsolateral, and rostral aspects of the cerebral cortex is uncomplicated and more superficial compared with access to the extreme caudolateral cerebrum and cerebellum, which is complicated by the location of the transverse and temporal sinuses and deep exposure.

CLINICAL RELEVANCE

Many cases of equine brain disorders involve intracranial abscessation or hematoma formation because of trauma. Components of therapy may include microbial culture and surgical drainage or decompression of the affected area through limited craniectomy procedures. Increased use of advanced imaging in equine brain disease has resulted in earlier diagnosis and more precise lesion localization. Subsequently, the number of horses likely to improve with limited surgical intervention has increased. When surgery is indicated, descriptions of surgical approaches to the equine cranium and brain provide important information.

Fraturas vertebrais em grandes animais: estudo retrospectivo de 39 casos (1987-2002)

Realizou-se estudo retrospectivo (1987-2002) dos aspectos clínicos das fraturas vertebrais em eqüinos, bovinos, ovinos, caprinos e suínos atendidos no hospital veterinário da FMVZ-Unesp de Botucatu. Todos os casos tiveram confirmação radiográfica ou post-mortem. Segundo a espécie, a ordem de acometimento foi: bovina, eqüina, ovina, caprina e suína. As lesões ocorreram desde os 12 dias de idade até os 10 anos, com maior freqüência até os 12 meses. O segmento torácico foi o mais comprometido seguido dos segmentos lombar, cervical e sacral. As fraturas vertebrais devem fazer parte da lista de diagnósticos diferenciais de animais em decúbito, independente da espécie, sexo ou idade.