Crash Course in Head Trauma Part 1: Pathophysiology and Assessment*

Head Trauma Part 1: Pathophysiology and Assessment

Traumatic brain injury (TBI) is a common presentation in the emergency clinic and head trauma can result from falls, crush injuries or road traffic accidents. TBI has two components; the primary injury which occurs at the time of impact as a result of direct mechanical damage and secondary brain injury which occurs minutes to days following the head trauma. It is the secondary brain injury that treatment aims to reduce. The initial diagnosis is usually straight forward, relying on a combination of history and clinical signs. However, the neurological examination, when approached in a structured manner, gives information not only regarding the location and extent of the TBI, but offers clues as to the prognosis and effectiveness of treatment. This article reviews the basic pathophysiology surrounding TBI in veterinary patients and discusses the steps involved in performing an appropriate neurological assessment.