Preliminary anatomic investigation of three approaches to the equine cranium and brain for limited craniectomy procedures.

Abstract

OBJECTIVE: To describe surgical approaches to the equine cranium and brain for limited craniectomy. STUDY DESIGN: Descriptive anatomic study. SAMPLE POPULATION: Equine cadavers (n=7). METHODS: Head and neck sections from cadavers were used to establish techniques for exposing areas of the equine brain. Three basic approaches were used: rostrotentorial, suboccipital, and transfrontal. Techniques were adapted from small animal descriptions and modified to account for anatomic differences. RESULTS: Descriptions of the rostrotentorial, suboccipital, and transfrontal approaches to the equine cranium and brain were defined. CONCLUSIONS: Dorsal, caudal, lateral, and rostral aspects of the cranium and underlying cerebral cortex can be accessed using the rostrotentorial, suboccipital, and transfrontal approaches. Access to the dorsal, dorsolateral, and rostral aspects of the cerebral cortex is uncomplicated and more superficial compared with access to the extreme caudolateral cerebrum and cerebellum, which is complicated by the location of the transverse and temporal sinuses and deep exposure. CLINICAL RELEVANCE: Many cases of equine brain disorders involve intracranial abscessation or hematoma formation because of trauma. Components of therapy may include microbial culture and surgical drainage or decompression of the affected area through limited craniectomy procedures. Increased use of advanced imaging in equine brain disease has resulted in earlier diagnosis and more precise lesion localization. Subsequently, the number of horses likely to improve with limited surgical intervention has increased. When surgery is indicated, descriptions of surgical approaches to the equine cranium and brain provide important information.