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

  • Minutes to hours.

Diagnosis

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Treatment

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Outcomes

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Further Reading

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