An injury can be divided into:
1). Primary (contusion, lacerations, or hemorrhage causing acute damage);
2). Secondary (subsequent edema, reperfusion injury, and necrosis).
Causes of head injury in horses include:
1. Direct trauma from a fall;
2. Blows to the head.
The associated injuries include basisphenoid fractures and avulsion of ventral straight muscles of the head. Basisphenoid fractures can result in acute optic nerve damage and cerebral signs. Temporary or permanent blindness may result.
Treatment is supportive care and is focused on minimizing secondary brain damage.
Head injury therapy is designed to minimize secondary CNS damage.
Horses with head injury can be severely ataxic and should be handled and moved with extreme caution.
1. If the horse is down, short-term general anesthesia is best used while moving.
2. If hypoventilation develops, the horse should be intubated and ventilation assisted to prevent hyper-capnea.
3. NSAIDs (Non-Steroidal Anti-Inflammatory drugs) are used to minimize inflammation.
4. Although controversial, corticosteroids may be indicated if used in the immediate phase of injury.
5. Dimethyl sulfoxide (DMSO) is often used to minimize secondary edema.
6. Magnesium has recently been proposed as another therapeutic agent for acute head injury.
7. Wound management( debridement, suture)
8. Fracture treatment