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

Abstract

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.