• 1. Kim JJ, Gean AD. Imaging for the diagnosis and management of traumatic brain injury. Neurotherapeutics 2011; 8:3953.

  • 2. Lee B, Newberg A. Neuroimaging in traumatic brain imaging. NeuroRx 2005; 2:372383.

  • 3. Hunter JV, Wilde EA, Tong KA, et al. Emerging imaging tools for use with traumatic brain Injury research. J Neurotrauma 2012; 29:654671.

  • 4. DiFazio J, Fletcher DJ. Updates in the management of the small animal patient with neurologic trauma. Vet Clin North Am Small Anim Pract 2013; 43:915940.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Walberer M, Blaes F, Stolz E, et al. Midline-shift corresponds to the amount of brain edema early after hemispheric stroke: an MRI study in rats. J Neurosurg Anesthesiol 2007; 19:105110.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Muir W. Trauma: physiology, pathophysiology and clinical implications. J Vet Emerg Crit Care 2006; 16:253263.

  • 7. Thieman K, Echandi RL, Arendse A, et al. Imaging diagnosis—trauma-induced tension pneumocephalus. Vet Radiol Ultrasound 2008; 49:362364.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Friedenberg SG, Butler LA, Wei L, et al. Seizures following head trauma in dogs: 259 cases (1999–2009). J Am Vet Med Assoc 2012; 241:14791483.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Le TH, Gean AD. Neuroimaging of traumatic brain injury. Mt Sinai J Med 2009; 76:145162.

  • 10. Konar M, Lang J. Pros and cons of low-field magnetic resonance imaging in veterinary practice. Vet Radiol Ultrasound 2011;52(suppl 1):S5S14.

    • Search Google Scholar
    • Export Citation
  • 11. Hesselink JR, Dowd CF, Healy ME, et al. MR imaging of brain contusions: a comparative study with CT. AJR Am J Roentgenol 1988; 150:11331142.

  • 12. Parizel PM, Makkat S, Van Miert E, et al. Intracranial hemorrhage, principals of CT and MR interpretation. Eur J Radiol 2001; 11:17701783.

  • 13. Zimmerman RA, Bilaniuk LT. Computed tomographic staging of traumatic epidural bleeding. Radiology 1982; 144:809812.

  • 14. Kim KH. Predictors for functional recovery and mortality of surgically treated traumatic acute subdural hematomas in 256 patients. J Korean Neurosurg Soc 2009; 45:143150.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Bhateja A, Shukla D, Indira BD, et al. Coup and contrecoup head injuries: predictors of outcome. Indian J Neurotrauma 2009; 6:115118.

  • 16. Drew LB, Drew WE. The contrecoup-coup phenomenon: a new understanding of the mechanism of closed head injury. Neurocrit Care 2004; 1:385390.

  • 17. De coene B, Hajnal JV, Gatehouse P, et al. MR of the brain using fluid-attenuated inversion recovery (FLAIR) pulse sequence. AJNR Am J Neuroradiol 1992; 13:15551564.

    • Search Google Scholar
    • Export Citation
  • 18. Bakshi R, Kamran S, Kinkel PR, et al. Fluid attenuation inversion-recovery MR imaging in acute and subacute cerebral intraventricular hemorrhage. AJNR Am J Neuroradiol 1999; 20:629636.

    • Search Google Scholar
    • Export Citation
  • 19. Ashikaga R, Araki Y, Ishida O. MRI of head injury using FLAIR. Neuroradiology 1997; 39:239242.

  • 20. Yuan MK, Lai PH, Chen JY, et al. Detection of subarachnoid hemorrhage at acute and subacute/chronic stages: comparison of four magnetic resonance imaging pulse sequences and computed tomography. J Chin Med Assoc 2005; 68:131137.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Bradford R, Choudhary AK, Dias MS. Serial neuroimaging in infants with abusive head trauma: timing abusive injuries. J Neurosurg Pediatr 2013; 12:110119.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Freeman C, Platt S. Specific emergencies, head trauma. In: Platt S, Garosi L, eds. Small animal neurological emergencies. London: Manson Publishing Ltd, 2012;363382.

    • Search Google Scholar
    • Export Citation
  • 23. Chiewvit P, Tritakarn SO, Nanta-aree S, et al. Degree of midline shift from CT scan predicted outcome in patients with head injuries. J Med Assoc Thai 2010; 93:99107.

    • Search Google Scholar
    • Export Citation
  • 24. Englander J, Cifu DX, Wright JM, et al. The association of early computed tomography scan findings and ambulation, self-care, and supervision needs at rehabilitation discharge and at 1 year after traumatic brain injury. Arch Phys Med Rehabil 2003; 84:214220.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. 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;20552078.

    • Search Google Scholar
    • Export Citation
  • 26. 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; 15:581584.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27. Woischneck D, Firsching R, Schmitz B, et al. The prognostic reliability of the Glasgow coma score in traumatic brain injuries: evaluation of MRI data. Eur J Traum Emerg Surg 2013; 39:7986.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Sande A, West C. Traumatic brain injury: a review of pathophysiology and management. J Vet Emerg Crit Care (San Antonio) 2010; 20:177190.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement

Results of magnetic resonance imaging performed within 48 hours after head trauma in dogs and association with outcome: 18 cases (2007–2012)

Hadar YanaiDepartment of Diagnostic Imaging, Dick White Referrals, Station Farm, London Rd, Six Mile Bottom, Cambridgeshire, CB8 0UH, England.

Search for other papers by Hadar Yanai in
Current site
Google Scholar
PubMed
Close
 DVM
,
Roberto Tapia-NietoDepartment of Diagnostic Imaging, Dick White Referrals, Station Farm, London Rd, Six Mile Bottom, Cambridgeshire, CB8 0UH, England.

Search for other papers by Roberto Tapia-Nieto in
Current site
Google Scholar
PubMed
Close
 DVM
,
Giunio B. CherubiniDepartment of Diagnostic Imaging, Dick White Referrals, Station Farm, London Rd, Six Mile Bottom, Cambridgeshire, CB8 0UH, England.

Search for other papers by Giunio B. Cherubini in
Current site
Google Scholar
PubMed
Close
 DVM
, and
Abby CaineDepartment of Diagnostic Imaging, Dick White Referrals, Station Farm, London Rd, Six Mile Bottom, Cambridgeshire, CB8 0UH, England.

Search for other papers by Abby Caine in
Current site
Google Scholar
PubMed
Close
 MA, VetMB

Abstract

Objective—To review results of MRI performed within 48 hours after head trauma in dogs and identify associations between MRI findings and outcome.

Design—Retrospective case series.

Animals—18 dogs that underwent MRI within 48 hours after known head trauma.

Procedures—Medical records were reviewed for information on signalment, history, clinical findings, MRI findings, treatment, and outcome.

Results—2 dogs were euthanized, 1 died, and 1 had major persistent deficits. The remaining 14 dogs had a good outcome, including 9 that recovered completely and 5 that had minor persistent deficits. The most common MRI abnormalities were intra-axial changes (n = 13) and extra-axial hemorrhage (13). Intra-axial changes were best seen on T2-weighted and fluid attenuation inversion recovery (FLAIR) images. A mass effect was detected in 9 dogs, 6 of which had a midline shift (mean, 2.18 mm). Three dogs had transtentorial herniation, and 2 had transcranial herniation. Extra-axial hemorrhage was best seen on FLAIR images. The most common location was subdural, with subdural extra-axial hemorrhage most often seen on the same side as the injury. Epidural hemorrhage was seen in 2 dogs. The affected area was larger in these dogs than in dogs with subdural hemorrhage. One dog required surgery and the other was euthanized.

Conclusions and Clinical Relevance—Results suggested that in dogs with acute (< 48 hours’ duration) head trauma, T2-weighted and FLAIR images provided the most diagnostic information. Dogs with injuries affecting the caudal fossa or affecting both the rostral and caudal fossae typically had poorer outcomes.

Abstract

Objective—To review results of MRI performed within 48 hours after head trauma in dogs and identify associations between MRI findings and outcome.

Design—Retrospective case series.

Animals—18 dogs that underwent MRI within 48 hours after known head trauma.

Procedures—Medical records were reviewed for information on signalment, history, clinical findings, MRI findings, treatment, and outcome.

Results—2 dogs were euthanized, 1 died, and 1 had major persistent deficits. The remaining 14 dogs had a good outcome, including 9 that recovered completely and 5 that had minor persistent deficits. The most common MRI abnormalities were intra-axial changes (n = 13) and extra-axial hemorrhage (13). Intra-axial changes were best seen on T2-weighted and fluid attenuation inversion recovery (FLAIR) images. A mass effect was detected in 9 dogs, 6 of which had a midline shift (mean, 2.18 mm). Three dogs had transtentorial herniation, and 2 had transcranial herniation. Extra-axial hemorrhage was best seen on FLAIR images. The most common location was subdural, with subdural extra-axial hemorrhage most often seen on the same side as the injury. Epidural hemorrhage was seen in 2 dogs. The affected area was larger in these dogs than in dogs with subdural hemorrhage. One dog required surgery and the other was euthanized.

Conclusions and Clinical Relevance—Results suggested that in dogs with acute (< 48 hours’ duration) head trauma, T2-weighted and FLAIR images provided the most diagnostic information. Dogs with injuries affecting the caudal fossa or affecting both the rostral and caudal fossae typically had poorer outcomes.

Contributor Notes

Presented in abstract form at the European Veterinary Diagnostic Imaging Annual Conference, Cascais, Portugal, August 2013.

Address correspondence to Dr. Yanai (hadardasit@hotmail.com).