Canis ISSN: 2398-2942

Brain: trauma

Contributor(s): Rodney Bagley, Elisa Mazzaferro, Harry Scott

Introduction

  • Cause: may occur in association with skull fractures.
  • Signs: complications can include ischemia, elevated intracranial pressure and brain herniation.
  • Diagnosis: from history, eg road traffic accident, and clinical signs.
  • Post-traumatic epilepsy may occur weeks or even months after the initial insult.
  • Treatment: fluid therapy, surgery.
  • Prognosis: fair to poor.
  • Other body systems may also be involved, and these injuries should also be treated in order of importance.

Pathogenesis

Pathophysiology

Types of brain herniation
  • Subfalcine.
  • Caudal transtentorial Brain: tentorial herniation.
  • Foramen magnum (can cause respiratory depression).
  • Rostral transtentorial.
  • The response of the brain to most types of insult is usually swelling or edema. This may be made worse by an increase in cerebral blood flow in response to hypoxia.
    Ensure patency of airway is maintained.
  • The rigid cranium does not allow expansion of contents (blood, CSF and brain tissue), so brain edema causes an increase in intracranial pressure.
  • Raised intracranial pressure can lead to brain herniation.
  • Intracranial disease processes may result in mechanical disruption of intracranial tissues (primary injury).
  • This primary injury may initiate a number of secondary pathophysiological sequele such as:
    • Metabolic alterations in neuronal or glial cells.
    • Impairment of vascular supply to normal tissue (ischemia).
    • Impairment of cerebrovascular autoregulation.
    • Hemorrhage (intraparenchymal, intraventricular, extradural or subdural).
    • Irritation (seizure generation).
    • Obstruction of the ventricular system.
    • Edema formation.
    • Production of physiologically active products.
    • Increased intracranial pressure (ICP).
  • See pathophysiology of brain trauma.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bar-Am Y, Pollard R E, Kass P H, Verstraete F J M (2008) The diagnostic yield of conventional radiographs and computed tomography in dogs and cats with maxillofacial trauma. Vet Surg 37, 294-299 PubMed.
  • Platt S R, Abramson C J, Garosi L S (2005) Administering corticosteroids in neurologic diseases. Vet Clin North Small Anim Pract 27 (3), 210-220 VetMedResource.
  • Syring R S (2005) Assessment and treatment of central nervous system abnormalities in the emergency patient. Vet Clin North Am Small Anim Pract 27, 343-358 PubMed.
  • Gordon P N, Dunphy E, Mann F A (2003) A traumatic emergency: handling patients with head injuries. Vet Med 98 (9), 788-798 VetMedResource.
  • Platt S R, Radaelli S T & McDonnell J J (2001) The prognostic value of the modified Glasgow Coma Scale in head trauma in dogs. JVIM 15 (6), 581-584 PubMed.
  • Syring R S, Otto C M, Drobatz K J (2001) Hyperglycemia in dogs and cats with head trauma: 122 cases (1997-1999). JAVMA 218, 1124-1129 PubMed.
  • Hopkins A L (1996) Head trauma. Vet Clin North Am Small Anim Pract 26 (4), 875-891 PubMed.
  • Bagley R S, Harrington M L, Pluhar G E, Keegan R D, Greene S A, Moore M P & Gavin P R (1996) Effect of craniectomy/durotomy alone and in combination with hyperventilation, diuretics, and corticosteroids on intracranial pressure in clinically normal dogs. Am J Vet Res 57 (1), 116-119 PubMed.
  • Dewey C W, Budsberg S C & Oliver Jr J E (1993) Principles of head trauma management in dogs and cats - Part II. Comp Contin Ed 15 (2), 177-193 VetMedResource.
  • Cornick J L (1992) Anesthetic management of patients with neurologic abnormalities. Comp Contin Ed Pract Vet 14 (2), 163-172 VetMedResource.
  • Shores A (1985) Neuroanesthesia - A review of the effects of anesthetic agents on cerebral blood flow and intracranial pressure in the dog. Vet Surg 14 (3), 257-263 VetMedResource.
  • Tornheim P A, Liwnicz B H, Hirsch C S, Brown D L & McLaurin R L (1983) Acute responses to blunt head trauma. Experimental model and gross pathology.​ J Neurosurg 59 (3), 431-438 PubMed.

Other sources of information

  • Braund KG (1994)Clinical Syndromes in Veterinary Neurology.2nd edn. St. Louis: Mosby.
  • Bagley R S (1994)Pathophysiological effects of central nervous system tumor.Proceedings of the 12th Annual Veterinary Medical forum, Washington DC. pp 928-930.
  • Kornegay J N (1993)Pathogenesis of diseases of the central nervous system.In:Textbook of Small Animal Surgery. 2nd edn. Ed D Slatter. Philadelphia: W B Saunders. pp 1022-1037.
  • Shores A (1989)Craniocerebral trauma.In:Current Veterinary Therapy10th edn. Ed R W Kirk. Philadelphia: W B Saunders. pp 847-853.


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