Comparative approach to understanding traumatic injury in the immature, postnatal brain of domestic animals.

Abstract

Traumatic brain injury (TBI) is a frequent occurrence in veterinary medicine, but the mechanisms leading to brain damage after a head impact are incompletely understood, particularly in the postnatal immature and still developing nervous system. This paper reviews neurotrauma studies, largely in paediatric humans and experimental animal models, in order to outline the pathophysiological and biomechanical events likely to be operative in head trauma involving domestic animal species in the postnatal period, as there is almost no other information available in the veterinary literature. Predicting the outcome of TBI is particularly difficult at this developmental time, in large part because recovery is influenced by the stage of brain maturation and neuroplasticity. An important part of the clinical management of TBI is the differentiation of primary brain damage, which occurs at the moment of head impact and is largely refractory to treatment, from the cascade of secondary events, which evolve over time and are potentially preventable and amenable to therapeutic intervention. An understanding of the causes and consequences of secondary brain damage such as hypoxia-ischaemia, brain swelling, elevated intracranial pressure, and infection is critical to limiting the resulting brain injury.