Basilar skull fracture in a Thoroughbred colt: radiography or computed tomography?

A two-year-old Thoroughbred colt was presented to the Equine Clinic, Onderstepoort Veterinary Academic Hospital for head trauma after rearing and falling backwards, hitting his head on the ground. Following medical therapy for acute onset neurological impairment secondary to a suspected basilar skull fracture, the horse was anaesthetised and computed tomography of the skull was performed. A diagnosis of a comminuted basilar skull fracture was made and skull radiographs were taken for comparison. The horse was subsequently euthanased owing to the poor prognosis; necropsy findings were compatible with imaging findings. The value and limitation of computed tomography versus radiography for the diagnosis of basilar skull fracture are discussed in this report.