Learning objectives
The purpose of this educational exhibit is to identify the radiological and pathological features of diffuse axonal injury (DAI).
Background
DAI is a severe form of traumatic brain injury which mostly occurs in high-speed motor vehicle accidents.
It is considered to be one of the most common types of primary neuronal injury in patients with severe head trauma representing approximately one half of all intra-axial traumatic lesions.
Overall incidence is 200 per 100 000 person.
It mostly occurs in younger population and it is the most common cause of persistent vegetative state.
Therefore,
it is a serious medical condition representing a great tragedy for the...
Findings and procedure details
On neuroimaging,
axonal injury is seen as small focal white-matter lesions measuring from 1 to 15 mm in size (Fig.1,
Fig.2,
Fig.3).
Traumatic microbleeds are considered to be important imaging marker for DAI. They are seen as punctate lesions at corticomedullary junction,
corpus callosum,
deep grey matter and brainstem.
DAI is much more visible through MR (magnetic resonance) than CT (computed tomography).
It is estimated that 50-80% of DAI patients have normal CT scan reading upon presentation.
Therefore,
brain magnetic resonance is the best imaging...
Conclusion
Being one of the most severe brain injuries in head trauma patients,
it is essential to promptly recognise and understand DAI presentation on CT and/or MR scans.
References
Su E and Bell M,
Translational Research in Traumatic Brain Injury,
Boca Raton,
CRC Press/Taylor and Francis Group,
2016.
Vieira R de CA et al.,
Diffuse Axonal Injury: Epidemiology,
Outcome and Associated Risk Factors,
Frontiers in Neurology,
vol.
7,
no.
1,
2016,
pp.178.
Davceva N,
Sivevski A and Basheska N.,
Traumatic Axonal Injury,
A Clinical-pathological Correlation,
Journal of Forensic and Legal Medicine,
vol.
48,
no.
5,
2017,
pp.35-40.
Meythaler JM et al.,
Current Concepts: Diffuse Axonal Injury-associated Traumatic Brain Injury,
Archives of Physical Medicine and...