Felis ISSN 2398-2950
Head: trauma
Contributor(s): David Godfrey, Elisa Mazzaferro, Simon Platt
Introduction
- Cause: road traffic accident/hit by car, falls, kicks and gunshot injuries.
- Signs: head trauma may be evident from visible wounds or from a dysfunction of one of the organs in the head, eg the brain, nose or tongue. Acute onset of neurological signs related to area of brain injury.
- Treatment: emergency care should be given to establish an airway and to ensure that breathing and circulation are adequate. Decrease intracranial pressure; remove compressive lesions such as hematomas and depressed fractures; treat cerebral edema; treat seizures if they occur.
- Eye trauma may need urgent treatment to maximize the chances of retaining sight.
- Prognosis: guarded - depends on neurological status at presentation, response to emergency treatment, as well as presence of concurrent systemic injuries.
Pathogenesis
Etiology
- Road traffic accident/hit by car.
- Fight with another cat or bitten by dog.
- Other causes are falls and non-accidental injury (gunshot injury, kicks).
Predisposing factors
General
- Un-neutered male cats more prone to wandering.
Pathophysiology
- The primary injury may initiate a number of secondary pathophysiological sequelae 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).
Intracranial pressure after head trauma
- Increases in intracranial pressure Intracranial pressure measurement are often responsible for clinical decline in many animals after head trauma.
- After head trauma, the volume of the brain tissue compartment increases usually due to edema or hemorrhage.
- As the brain tissue compartment increases, the cerebrospinal fluid and the blood compartments must decrease or intracranial pressure will increase (compensation).
- Once the ability for compensation is exhausted, a further small increase in intracranial volume will result in dramatic elevations of ICP, with the immediate onset of clinical signs.
Timecourse
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 et al (2008) The diagnostic yield of conventional radiographs and computed tomography in dogs and cats with maxillofacial trauma. Vet Surg 37 (3), 294-299 PubMed.
- Platt S R, Abramson C J, Garosi L S (2005) Administering corticosteroids in neurologic diseases. Vet Clin North Am Small Anim Pract 27 (3), 210-220 VetMedResource.
- Syring R A (2005) Assessment and treatment of central nervous system abnormalities in the emergency patient. Vet Clin North Am Small Anim Pract 35 (2), 343-358 PubMed.
- Gordon P N, Dunphy E, Mann F A (2003) A traumatic emergency: handling patients with head injuries. Vet Med 98 (9), 788-799 VetMedResource.
- Syring R S, Otto C M, Drobatz K J (2001) Hyperglycemia in dogs and cats with head trauma: 122 cases (1997-1999). JAVMA 218 (7), 1124-1129 PubMed.
- Dewey C W (2000) Emergency management of the head trauma patient. Principles and practice. Vet Clin North Am Sm Anim Pract 30 (1), 207-225 PubMed.
- Ghajar J (2000) Traumatic brain injury. Lancet 356 (9233), 923-929 PubMed.
- Proulx J & Dhupa N (1998) Severe brain injury - Part 1, Pathophysiology. Comp Cont Ed Pract Vet 20 (8), 897-905 VetMedResource.
- Proulx J & Dhupa N (1998) Severe brain injury - Part 2, Therapy. Comp Cont Ed Pract Vet 20 (9), 993-1006 VetMedResource.
- Hopkins A L (1996) Head trauma. Vet Clin North Am Sm Anim Pract 26 (4), 875-891 PubMed.
- Dewey C W, Budsberg S C & Oliver J E (1992) Principles of head trauma management in dogs and cats - Part 1. Comp Cont Ed Pract Vet 14 (2), 199-207 VetMedResource.
- Rudy R L & Boudrieau R J (1992) Maxillofacial and mandibular fractures. Semin Vet Clin North Am Sm Anim Pract 7 (1), 3-20 PubMed.
- Kapatkin A & Matthiesen D T (1991) Feline high-rise syndrome. Comp Cont Ed Pract Vet 13 (9), 1389-1394 VetMedResource.
Other sources of information
- Shores A (1983) Craniocerebral trauma. In: Current Vet Therapy X: Small Anim Pract. W B Saunders. pp 847-854.