or trailer accidents where there is often rotational or multi-directional force put on the head and brain.
Focal brain injury occurs when a contusion or hematoma has occurred. Contusion occurs when the brain rapidly accelerates or decelerates in a single direction. into the brain tissue due to blood vessel rupture causes edema and inflammation of the brain, which disrupts the normal function of neurons. Swelling of the brain also causes an increase in intracranial pressure. As the skull is rigid it can only accommodate a finite volume of brain material. Once that capacity is reached the brain tissue and blood vessels become compressed causing further contusion and injury to the brain tissue, causing impairment of brain function, ischemia by compressing and occluding arteries that supply other parts of the brain & metabolic dysfunction.
Predispositions include younger horses and those recovering from anesthesia.
The clinical presentation of head trauma is dependent on the area(s) of the brain affected by the injury. Most cases of equine head trauma affect the and therefore present clinically with signs of cerebral damage. These include dementia, loss of training, loss of recognition of owner/caretaker, blindness, ataxia, head-pressing, circling towards the lesion, seizure, stupor, coma and death. In most cases there will be signs of trauma on the outside of the skull that may include swelling, heat, broken skin, visible, open fracture of the skull, or asymmetry of the skull. In some cases bleeding from the nose or ears can be seen. Intracranial edema or hemorrhage can be noted on brain scans which will lead to an increase in intracranial . Diagnosis is through signs and symptoms, case history and careful examination and observation of the horse for CNS signs. X-rays, CT scan or MRI can also be used to either rule out or determine the amount of brain damage that occurred. Head trauma is a serious injury and requires veterinary care. Treatment is generally supportive, but anti-inflammatory medications may be required to decrease swelling of the brain. Corticosteroids or NSAID’s can be administered for this purpose, but caution must be taken with NSAID’s as some work to thin the blood and may promote haemorrhage into the brain. Dimethyl sulfoxide (DMSO) may be administered to help reduce swelling and promote the clearing of blood from the brain. may also be administered as they lower blood pressure and help to decrease intracranial pressure. If compression on the brain is occurring due to a fracture, surgery will be required to alleviate the pressure. Prognosis for mild cases is good, but poor for those with severe injury as permanent damage may occur.
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