title: Straight from the horse's mouth: neurological injury in equestrian sports.
abstract: OBJECTIVE
  Equestrian sports can result in a variety of injuries to the nervous system due to many factors. We describe our series of 80 patients with injuries sustained during participation in equestrian sports.
  
  
  RESULTS
  All patients seen at the regional trauma center with injuries associated with equestrian sports between 2003 and 2011 were reviewed; 80 patients were identified. Fifty-four per cent were female and the average age was 37 years (2·2-79·3). The mean injury severity score (ISS) was 9·9 ± 0·7. Only two patients had documented helmet use. Glasgow coma score (GCS) was 15 in 93% of patients. The most common neurosurgical injuries were to the cranial vault (28%), including concussions, intracranial hematomas and hemorrhages, and skull, facial, and spine fractures (10%), with the majority (63%) being transverse process fractures. The mechanisms of injury varied: 55% were kicked or stepped on, 28% were thrown or fell off, and 21% were injured by the horse falling on them. The causes ranged from carelessness and lack of attention to animal factors including inadequate training of horses and animal fear. Fourteen per cent required surgery. There were no mortalities and average length of stay was 3·7 ± 0·35 days. All patients were discharged home with 95% requiring no services.
  
  
  CONCLUSIONS
  Equestrian sports convey special risks for its participants. With proper protection and precautions, a decrease in the incidence of central nervous system injuries may be achieved. Neurosurgeons can play key roles in advocating for neurologic safety in equestrian sports.
authors.forename: Vasisht
authors.initials: V
authors.lastname: Srinivasan
authors.forename: Clifford
authors.initials: C
authors.lastname: Pierre
authors.forename: Benjamin
authors.initials: B
authors.lastname: Plog
authors.forename: Kaushik
authors.initials: K
authors.lastname: Srinivasan
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Petraglia
authors.forename: Jason H
authors.initials: JH
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001265:Athletic Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D006736:Horses; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Closed head injury,; Concussion,; Equestrian sports,; Neurosurgical trauma,; Spine trauma
references.citation: J Trauma. 2000 Apr;48(4):740-4
references.pmid: 10780611
references.citation: Curr Sports Med Rep. 2010 Sep-Oct;9(5):299-302
references.pmid: 20827097
references.citation: Disabil Rehabil. 2004 Jan 21;26(2):91-6
references.pmid: 14668145
references.citation: J Trauma. 1989 Feb;29(2):245-7
references.pmid: 2918566
references.citation: Clin J Sport Med. 2011 Jul;21(4):353-5
references.pmid: 21694587
references.citation: Sports Med. 1996 Sep;22(3):187-97
references.pmid: 8883215
references.citation: JAMA. 1978 Oct 20;240(17):1881-2
references.pmid: 567702
references.citation: Injury. 2010 May;41(5):533-9
references.pmid: 19524903
references.citation: Public Health Rep. 1993 Jan-Feb;108(1):121-6
references.pmid: 8434088
references.citation: J Trauma Manag Outcomes. 2009 Feb 19;3:2
references.pmid: 19228424
references.citation: Aust J Public Health. 1993 Sep;17(3):269-71
references.pmid: 8286503
references.citation: J Trauma. 1993 Feb;34(2):227-32
references.pmid: 8459460
references.citation: J Trauma. 2008 Aug;65(2):447-60
references.pmid: 18695484
references.citation: J Trauma. 2004 Mar;56(3):643-7
references.pmid: 15128138
references.citation: Sports Med. 1990 Jan;9(1):36-47
references.pmid: 2408117
references.citation: Inj Prev. 1996 Dec;2(4):286-9
references.pmid: 9346110
references.citation: J Emerg Med. 1994 Mar-Apr;12(2):143-5
references.pmid: 8207147
references.citation: Br J Sports Med. 1987 Mar;21(1):22-4
references.pmid: 3580722
references.citation: Am Fam Physician. 1987 Sep;36(3):209-14
references.pmid: 3630883
references.citation: J Emerg Nurs. 2005 Oct;31(5):442-6
references.pmid: 16198726
references.citation: J Sci Med Sport. 2009 May;12(3):376-82
references.pmid: 18762456
references.citation: Am Surg. 2013 Jan;79(1):76-83
references.pmid: 23317616
references.citation: J Trauma. 2007 Mar;62(3):735-9
references.pmid: 17414356
references.citation: Am J Surg. 2007 May;193(5):636-40
references.pmid: 17434372
references.citation: J Pediatr Surg. 2009 Jan;44(1):148-50
references.pmid: 19159733
references.citation: Inj Prev. 2000 Mar;6(1):59-61
references.pmid: 10728545
references.citation: WMJ. 2005 Feb;104(2):50-4
references.pmid: 15856743