Early CT in dogs following traumatic brain injury has limited value in predicting short‐term prognosis

Lee, Chae Youn; Llabres?Diaz, Francisco; Wyatt, Sophie; Beltran, Elsa

Abstract

Traumatic brain injury is associated with a high risk of mortality in veterinary patients, however publications describing valid prognostic indicators are currently lacking. The objective of this retrospective observational study was to determine whether early CT findings are associated with short-term prognosis following traumatic brain injury (TBI) in dogs. An electronic database was searched for dogs with TBI that underwent CT within 72 h of injury; 40 dogs met the inclusion criteria. CT findings were graded based on a Modified Advanced Imaging System (MAIS) from grade I (normal brain parenchyma) to VI (bilateral lesions affecting the brainstem with or without any foregoing lesions of lesser grades). Other imaging features recorded included presence of midline shift, intracranial hemorrhage, brain herniation, skull fractures, and percentage of total brain parenchyma affected. Outcome measures included survival to discharge and occurrence of immediate onset posttraumatic seizures. Thirty dogs (75%) survived to discharge. Seven dogs (17.5%) suffered posttraumatic seizures. There was no association between survival to discharge and posttraumatic seizures. No imaging features evaluated were associated with the study outcome measures. Therefore, the current study failed to identify any early CT imaging features with prognostic significance in canine TBI patients. Limitations associated with CT may preclude its use for prognostication; however, modifications to the current MAIS and evaluation in a larger study population may yield more useful results. Despite this, CT is a valuable tool in the detection of structural abnormalities following TBI in dogs that warrants further investigation. K E Y W O R D S canine, head trauma, Modified Glasgow Coma Scale, MRI Abbreviations: CH, calvarial herniation through a fracture site; CTH, caudal transtentorial herniation; FMH, foramen magnum herniation; MAIS, Modified Advanced Imaging System; MGCS, Modified Glasgow Coma Scale; RTH, rostral transtentorial herniation; SFH, subfalcine herniation; TBI, traumatic brain injury.

Citation

Lee, C. Y., Llabres‐Diaz, F., Wyatt, S., & Beltran, E. (2021). Early CT in dogs following traumatic brain injury has limited value in predicting short‐term prognosis. Veterinary Radiology and Ultrasound, 62(2), 181-189. https://doi.org/10.1111/vru.12933

• Journal Article Type: Article
• Acceptance Date: Nov 25, 2020
• Online Publication Date: Nov 26, 2020
• Publication Date: 2021-03
• Deposit Date: Jul 27, 2021
• Journal: Veterinary Radiology & Ultrasound
• Print ISSN: 1058-8183
• Electronic ISSN: 1740-8261
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 62
• Issue: 2
• Pages: 181-189
• DOI: https://doi.org/10.1111/vru.12933
• Keywords: General Veterinary
• Public URL: https://rvc-repository.worktribe.com/output/1548197
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/vru.12933
• Additional Information: Received: 2020-04-15; Accepted: 2020-09-27; Published: 2020-11-26