From ABC to ICP. Traumatic patients and traumatic brain injury: epidemiological end experimental studies in naturally affected stray small animals

Aims: To describe the main epidemiological variables in a Northern Sardinia stray animals population affected by traumatic injuries (TIs) and traumatic brain injury (TBI); to assess relationship between TBI, Animal Trauma Triage Score (ATT), Modified Glasgow Coma Scale (MGSC), and Magnetic Resonance Imaging (MRI) to give a prognosis; to compare Mannitol 18% and NaCl 3% in decreasing intracranial pressure in animals with natural TBI (pilot study). Animals: 1500 animals, 850 TIs, 110 TBI, 4 in the pilot study. Results: TIs affected 57.5% of stray population involved, particularly cats and males not neutered . Motor vehicle accident was the main cause of trauma. Cats were more subjected to severe and multiple injuries than dogs. Mortality was of 25.8% and ATT score and mortality had a good correlation. TBI can occurs in 12.9% and the 60% as multiple injury. Mortality was of 47.6% and complete neurological recovery occurred in 91.5 % of survivors. A good statistical relationship was found between MRI score and MGCS, ATT score demonstrated good prognostic utility. Intracranial pressure (ICP) direct measurement revealed high ICP in 3 patients; CPP value was low in 4. Mannitol and NaCl 3% caused in 2 patients immediate decrease in ICP and rose in CPP. ICP reduction was similar for both hyperosmotic agent. Conclusion: ATT score, MGCS, MRI, ICP monitoring may therefore be a useful prognostic indicator in animal with TIs and TBI. Further research is needed to compare hyperosmotic drugs