Diffuse axonal injury

Diffuse axonal injury
Two MRI images of a patient with diffuse axonal injury resulting from trauma, at 1.5 tesla field strength. Left: conventional gradient recalled echo (GRE). Right: Susceptibility weighted image (SWI).
SpecialtyNeurology

Diffuse axonal injury (DAI) is a brain injury in which scattered lesions occur over a widespread area in white matter tracts as well as grey matter.[1][2][3][4][5][6][7] DAI is one of the most common and devastating types of traumatic brain injury[8] and is a major cause of unconsciousness and persistent vegetative state after severe head trauma.[9] It occurs in about half of all cases of severe head trauma and may be the primary damage that occurs in concussion. The outcome is frequently coma, with over 90% of patients with severe DAI never regaining consciousness.[9] Those who awaken from the coma often remain significantly impaired.[10]

DAI can occur across the spectrum of traumatic brain injury (TBI) severity, wherein the burden of injury increases from mild to severe.[11][12] Concussion may be a milder type of diffuse axonal injury.[12][13]

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  4. ^ Christman CW, Grady MS, Walker SA, Holloway KL, Povlishock JT (April 1994). "Ultrastructural studies of diffuse axonal injury in humans". Journal of Neurotrauma. 11 (2): 173–86. doi:10.1089/neu.1994.11.173. PMID 7523685.
  5. ^ Povlishock JT, Christman CW (August 1995). "The pathobiology of traumatically induced axonal injury in animals and humans: a review of current thoughts". Journal of Neurotrauma. 12 (4): 555–64. doi:10.1089/neu.1995.12.555. PMID 8683606.
  6. ^ Vascak M, Jin X, Jacobs KM, Povlishock JT (May 2018). "Mild Traumatic Brain Injury Induces Structural and Functional Disconnection of Local Neocortical Inhibitory Networks via Parvalbumin Interneuron Diffuse Axonal Injury". Cerebral Cortex. 28 (5): 1625–1644. doi:10.1093/cercor/bhx058. PMC 5907353. PMID 28334184.
  7. ^ Smith DH, Hicks R, Povlishock JT (March 2013). "Therapy development for diffuse axonal injury". Journal of Neurotrauma. 30 (5): 307–23. doi:10.1089/neu.2012.2825. PMC 3627407. PMID 23252624.
  8. ^ Povlishock JT, Katz DI (January 2005). "Update of neuropathology and neurological recovery after traumatic brain injury". The Journal of Head Trauma Rehabilitation. 20 (1): 76–94. doi:10.1097/00001199-200501000-00008. PMID 15668572. S2CID 1094129.
  9. ^ a b Wasserman J. and Koenigsberg R.A. (2007). Diffuse axonal injury. Emedicine.com. Retrieved on 2008-01-26.
  10. ^ Vinas F.C. and Pilitsis J. (2006). Penetrating head trauma. Emedicine.com. Retrieved on 2008-01-14.
  11. ^ Smith DH, Meaney DF (December 2000). "Axonal damage in traumatic brain injury". The Neuroscientist. 6 (6): 483–95. doi:10.1177/107385840000600611. S2CID 86550146.
  12. ^ a b Blumbergs PC, Scott G, Manavis J, Wainwright H, Simpson DA, McLean AJ (August 1995). "Topography of axonal injury as defined by amyloid precursor protein and the sector scoring method in mild and severe closed head injury". Journal of Neurotrauma. 12 (4): 565–72. doi:10.1089/neu.1995.12.565. PMID 8683607.
  13. ^ Bazarian JJ, Blyth B, Cimpello L (February 2006). "Bench to bedside: evidence for brain injury after concussion--looking beyond the computed tomography scan". Academic Emergency Medicine. 13 (2): 199–214. doi:10.1197/j.aem.2005.07.031. PMID 16436787.