Feary Darien J, Magdesian K Gary, Aleman Monica A, Rhodes Diane M
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
J Am Vet Med Assoc. 2007 Jul 15;231(2):259-66. doi: 10.2460/javma.231.2.259.
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.
Retrospective case series.
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.
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).
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.
研究马急性创伤性脑损伤（TBI）的临床、临床病理及诊断特征、治疗方法及预后情况，并评估TBI患马非存活的危险因素。
回顾性病例系列研究。
34匹患有TBI的马。程序——对头部遭受创伤并出现神经症状的马的病历进行回顾。分析包括信号、临床病理检查结果、诊断、治疗及预后的数据。比较存活组和非存活组马的临床病理变量，确定非存活的危险因素。
患马的中位年龄为12个月。仅进行头部传统X线检查未能发现所有存在颅骨骨折的马。基底骨骨折的马非存活的可能性是无此类骨折马的7.5倍。根据临床症状，马接受了支持性护理、渗透性或利尿治疗、抗菌药物、抗炎药物、镇痛药或抗惊厥药。21匹（62%）马存活至出院。在非存活组中，平均红细胞压积显著高于存活组（40%对33%）。与非存活相关的危险因素包括初次评估后躺卧超过4小时（比值比，18）和基底骨骨折（比值比，7.5）。
结果表明，马急性TBI的存活预后可能比先前报道的更有利。在患有TBI的马中，持续躺卧和涉及基底骨的骨折与预后不良有关。
