Dog unconscious and unsteady after head injury treated with brain

Abstract

A 10-month-old Czech wolf dog was unconscious after being kicked in the head by a horse. The following day, the dog was ataxic and collapsed after several steps. The level of consciousness was decreased. Cranial nerve examination was normal and right postural reactions were decreased. Spinal reflexes were intact in all limbs. The diagnostic work-up included a computed tomography (CT) scan of the head with IV contrast. A lenticular shaped, hyperdense, non-enhancing lesion was observed in the left fronto-parietal region. A diagnosis of intracranial epidural haematoma was made. Two craniotomies were performed on a different day and most of the haematoma was removed. Corticosteroids and antimicrobial therapy were administered. Fifteen days after the surgery, the clinical examinations were unremarkable. Fifteen months later, the owners considered the dog normal. Intracranial subdural or intraparenchymal haematomas have been described in the veterinary literature. To the authors' knowledge, this is the first report of the successful management of an intracranial epidural haematoma in the dog. In humans, these lesions are well described. Common locations are temporal, parietal and frontal regions or a combination of these regions. Patients can be asymptomatic, present with varying clinical signs, or be unconscious. Based on the human literature, following trauma to the head, a CT scan should be performed even if the patient is asymptomatic. Some authors believe that there are not any absolute indications for conservative management versus surgical management.