Tc. Kriss et Vm. Kriss, EQUINE-RELATED NEUROSURGICAL TRAUMA - A PROSPECTIVE SERIES OF 30 PATIENTS, The journal of trauma, injury, infection, and critical care, 43(1), 1997, pp. 97-99
Thirty million Americans ride horses; 50,000 of these riders are treat
ed in emergency rooms annually, Equestrian activities are uniquely dan
gerous because the participant is unrestrained, often helmetless, and
riding large, unpredictable animals capable of 40-mph speeds and kicki
ng with up to 1 ton of force, Neurologic injuries in equestrians const
itute the majority of severe injuries and fatalities, We prospectively
studied all patients admitted to the University of Kentucky Medical C
enter with equine-related neurosurgical trauma from July 1992 to Janua
ry 1996, Eighteen of 30 patients were male. Age ranged from 3 to 64 ye
ars, Five patients died (17%), and two suffered permanent paralysis, T
here were 24 head injuries (80%) and 9 spinal injuries (30%), The majo
rity of injuries (60%) were caused by ejection or fall from the horse,
Twelve patients (40%) were kicked by a horse, and four patients susta
ined crush injuries, Six patients underwent craniotomy, three had oper
ative spinal stabilization, and five required ventriculostomy. Eleven
patients (37%) were professional riders. Twenty-four patients (80%) we
re not wearing helmets, including all fatalities and craniotomy patien
ts, Our data show that equine-related neurosurgical injuries can be se
vere and fatal because of the significant size, force, and unpredictab
ility of these animals as well as the lack of proper headgear, We reco
mmend that helmets be worn at all times around horses because a signif
icant number of our patients (33%) were injured as bystanders, Risk of
serious injury appears to be a function of cumulative exposure to hor
ses, not level of expertise, Experience is not protective; helmets are
.