Editorial Type:
Neurology

Computed tomographic findings in dogs with head trauma and development of a novel prognostic computed tomography–based scoring system

Orit Chai Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Orit Chai in
Current site
Google Scholar
PubMed Close
 DVM
,
Dana Peery Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Dana Peery in
Current site
Google Scholar
PubMed Close
 DVM
,
Tali Bdolah-Abram Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Tali Bdolah-Abram in
Current site
Google Scholar
PubMed Close
 MSc
,
Efrat Moscovich Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Efrat Moscovich in
Current site
Google Scholar
PubMed Close
 DVM
,
Efrat Kelmer Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Efrat Kelmer in
Current site
Google Scholar
PubMed Close
 DVM
,
Sigal Klainbart Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Sigal Klainbart in
Current site
Google Scholar
PubMed Close
 DVM
,
Joshua Milgram Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Joshua Milgram in
Current site
Google Scholar
PubMed Close
 DVM
, and
Merav H. Shamir Neurology and Neurosurgery Department, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot 76100, Israel.

Search for other papers by Merav H. Shamir in
Current site
Google Scholar
PubMed Close
 DVM
DOI:
https://doi.org/10.2460/ajvr.78.9.1085
Volume/Issue:
Volume 78: Issue 9
Online Publication Date:
01 Sep 2017
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

OBJECTIVE To characterize CT findings and outcomes in dogs with head trauma and design a prognostic scale.

ANIMALS 27 dogs admitted to the Koret School Veterinary Teaching Hospital within 72 hours after traumatic head injury that underwent CT imaging of the head.

PROCEDURES Data were extracted from medical records regarding dog signalment, history, physical and neurologic examination findings, and modified Glasgow coma scale scores. All CT images were retrospectively evaluated by a radiologist unaware of dog status. Short-term (10 days after trauma) and long-term (≥ 6 months after trauma) outcomes were determined, and CT findings and other variables were analyzed for associations with outcome. A prognostic CT-based scale was developed on the basis of the results.

RESULTS Cranial vault fractures, parenchymal abnormalities, or both were identified via CT in 24 of 27 (89%) dogs. Three (11%) dogs had only facial bone fractures. Intracranial hemorrhage was identified in 16 (59%) dogs, cranial vault fractures in 15 (56%), midline shift in 14 (52%), lateral ventricle asymmetry in 12 (44%), and hydrocephalus in 7 (26%). Hemorrhage and ventricular asymmetry were significantly and negatively associated with short- and long-term survival, respectively. The developed 7-point prognostic scale included points for hemorrhage, midline shift or lateral ventricle asymmetry, cranial vault fracture, and depressed fracture (1 point each) and infratentorial lesion (3 points).

CONCLUSIONS AND CLINICAL RELEVANCE The findings reported here may assist in determining prognoses for other dogs with head trauma. The developed scale may be useful for outcome assessment of dogs with head trauma; however, it must be validated before clinical application.

Abstract

OBJECTIVE To characterize CT findings and outcomes in dogs with head trauma and design a prognostic scale.

ANIMALS 27 dogs admitted to the Koret School Veterinary Teaching Hospital within 72 hours after traumatic head injury that underwent CT imaging of the head.

PROCEDURES Data were extracted from medical records regarding dog signalment, history, physical and neurologic examination findings, and modified Glasgow coma scale scores. All CT images were retrospectively evaluated by a radiologist unaware of dog status. Short-term (10 days after trauma) and long-term (≥ 6 months after trauma) outcomes were determined, and CT findings and other variables were analyzed for associations with outcome. A prognostic CT-based scale was developed on the basis of the results.

RESULTS Cranial vault fractures, parenchymal abnormalities, or both were identified via CT in 24 of 27 (89%) dogs. Three (11%) dogs had only facial bone fractures. Intracranial hemorrhage was identified in 16 (59%) dogs, cranial vault fractures in 15 (56%), midline shift in 14 (52%), lateral ventricle asymmetry in 12 (44%), and hydrocephalus in 7 (26%). Hemorrhage and ventricular asymmetry were significantly and negatively associated with short- and long-term survival, respectively. The developed 7-point prognostic scale included points for hemorrhage, midline shift or lateral ventricle asymmetry, cranial vault fracture, and depressed fracture (1 point each) and infratentorial lesion (3 points).

CONCLUSIONS AND CLINICAL RELEVANCE The findings reported here may assist in determining prognoses for other dogs with head trauma. The developed scale may be useful for outcome assessment of dogs with head trauma; however, it must be validated before clinical application.

Contributor Notes

Address correspondence to Dr. Chai (orit18m@gmail.com).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Sep 2017

  • 1. Simpson SA, Syring R, Otto CM. Severe blunt trauma in dogs: 235 cases (1997–2003). J Vet Emerg Crit Care (San Antonio) 2009;19:588–602.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 2. Friedenberg SG, Butler AL, Wei L, et al. Seizures following head trauma in dogs: 259 cases (1999–2009). J Am Vet Med Assoc 2012;241:1479–1483.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 3. Platt SR, Radaelli ST, McDonnell JJ. The prognostic value of the modified Glasgow coma scale in head trauma in dogs. J Vet Intern Med 2001;15:581–584.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 4. Sharma D, Holowaychuk MK. Retrospective evaluation of prognostic indicators in dogs with head trauma: 72 cases (January–March 2011). J Vet Emerg Crit Care (San Antonio) 2015;25:631–639.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 5. Hall KE, Holowaychuk MK, Sharp CR, et al. Multicenter prospective evaluation of dogs with trauma. J Am Vet Med Assoc 2014;244:300–308.

  • 6. Steinmetz S, Tipold A, Loscher W. Epilepsy after head injury in dogs: a natural model of posttraumatic epilepsy. Epilepsia 2013;54:580–588.

  • 7. Beltran E, Platt SR, McConnell JF, et al. Prognostic value of early magnetic resonance imaging in dogs after traumatic brain injury: 50 cases. J Vet Intern Med 2014;28:1256–1262.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 8. Yanai H, Tapia-Nieto R, Cherubini GB, et al. Results of magnetic resonance imaging performed within 48 hours after head trauma in dogs and association with outcome: 18 cases (2007–2012). J Am Vet Med Assoc 2015;246:1222–1229.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 9. Management of Concussion/mTBI Working Group. VA/DoD clinical practice guideline for management of concussion/mild traumatic brain injury. J Rehabil Res Dev 2009;46:CP1–CP68.

    • Search Google Scholar
    • Export Citation

  • 10. Kolias AG, Guilfoyle MR, Helmy A, et al. Traumatic brain injury in adults. Pract Neurol 2013;13:228–235.

  • 11. Currie S, Saleem N, Straiton JA, et al. Imaging assessment of traumatic brain injury. Postgrad Med J 2016;92:41–50.

  • 12. Raj R, Siironen J, Skrifvars MB, et al. Predicting outcome in traumatic brain injury: development of a novel computerized tomography classification system (Helsinki computerized tomography score). Neurosurgery 2014;75:632–646; discussion 646–637.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 13. Marshall LF, Marshall SB, Klauber MR, et al. A new classification of head-injury based on computerized-tomography. J Neurosurg 1991;75:S14–S20.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 14. Liesemer K, Riva-Cambrin J, Bennett KS, et al. Use of Rotterdam CT scores for mortality risk stratification in children with traumatic brain injury. Pediatr Crit Care Med 2014;15:554–562.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 15. Platt SR, Radaelli ST, McDonnell JJ. Computed tomography after mild head trauma in dogs. Vet Rec 2002;151:243.

  • 16. Evans HE, de Lahunta A. Miller's anatomy of the dog. 4th ed. Philadelphia: Saunders, 2012; 88.

  • 17. American Kennel Club. Toy breeds. Available at: www.akc.org/dog-breeds/groups/toy. Accessed Dec 4, 2016.

  • 18. Hilario A, Ramos A, Millan JM, et al. Severe traumatic head injury: prognostic value of brain stem injuries detected at MRI. AJNR Am J Neuroradiol 2012;33:1925–1931.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 19. Firsching R, Woischneck D, Klein S, et al. Classification of severe head injury based on magnetic resonance imaging. Acta Neurochir (Wien) 2001;143:263–271.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 20. Maschke M, Mörsdorf M, Timmann M, et al. Posterior fossa trauma. In: Manto M, Gruol D, Schmahmann J, et al, eds. Handbook of the cerebellum and cerebellar disorders. New York: Springer, 2013; 2055–2078.

    • Search Google Scholar
    • Export Citation

  • 21. Ryan CT, Glass EN, Seiler G, et al. Magnetic resonance imaging findings associated with lateral cerebral ventriculomegaly in English Bulldogs. Vet Radiol Ultrasound 2014;55:292–299.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 22. Vullo T, Korenman E, Manzo RP, et al. Diagnosis of cerebral ventriculomegaly in normal adult beagles using quantitative MRI. Vet Radiol Ultrasound 1997;38:277–281.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 23. Kii S, Uzuka Y, Taura Y, et al. Magnetic resonance imaging of the lateral ventricles in beagle-type dogs. Vet Radiol Ultrasound 1997;38:430–433.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 24. Lu D, Lamb CR, Pfeiffer DU, et al. Neurological signs and results of magnetic resonance imaging in 40 Cavalier King Charles Spaniels with Chiari type 1-like malformations. Vet Rec 2003;153:260–263.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 25. Pivetta M, De Risio L, Newton R, et al. Prevalence of lateral ventricle asymmetry in brain MRI studies of neurologically normal dogs and dogs with idiopathic epilepsy. Vet Radiol Ultrasound 2013;54:516–521.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement