Disease Information for Diffuse axonal injury/Acute brain trauma

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Clinical Manifestations
Signs & Symptoms
Brief Blood pressure increase/sign:
High blood pressure child
Slow pulse/Bradycardia
Night sweats
Nausea
Vomiting
Vomiting in Children
Altered mental status Mental status change
Inattention
Bradypnea Decreased respiratory rate
Fatigue Tiredness in Children
Pupil Abnormal/Signs
Typical Clinical Presentation
Presentation/Child Concussion CSF pressure high/coma continues
Disease Progression
Course/Catastrophic presentation/onset
Course/Continued/persistent symptoms occur
Course/Lethal possible/not usual
Course/Persistent/symptoms possible
Course/Spontaneous remission possible
Demographics & Risk Factors
Population Group
Child
Population/Pediatrics population
Sex & Age Groups
Population/Child-Infant Only
Population/Children/all
Diagnostic Test Results
Pathology
PATH/Brain Axon retraction ball/terminal bulbs
PATH/Brain Axon signs-diffuse axonal injury
PATH/Brain Axons elongated varicosities-blisters
PATH/Brain/White matter lesion/disease
CT Scan
CT Scan/Head Brain Swelling/Edema
MRI/Head Brain Swelling/Edema
Associated Diseases & Rule outs
Associated Disease & Complications
Acute subdural hematoma/hemorrhage
Amnesia
Cerebral edema
Coma in Children
Coma/Unconscious
Corpus callosum defect/agenesis
Diffuse axonal injury/acute brain trauma
Herniation brain/across falx
Herniation/Brainstem/peduncles/cerebellar tonsils
Herniation/Temporal lobe/tentorum
Hypertension in a child
Increased CNS pressure/Intracranial hypertension
Vegetative state/status
Sudden Death Young Athlete
Traumatic Brain Syndrome
Continued Hypercapnea
Disease Mechanism & Classification
Class
CLASS/Brain/CNS disorder (ex)
CLASS/Cerebral cortex disorder (ex)
CLASS/Corpus callosum defect/agenesis
CLASS/Neurologic (category)
CLASS/Temporal lobe disorder (ex)
CLASS/Frontal sinus involvement
Pathophysiology
Pathophysiology/Axon degeneration nerve endings
Pathophysiology/Calpain-Spectrin mediated proteolysis-CMSP
Pathophysiology/Corpus callosum defect
Pathophysiology/Secondary biochemical cascade
Pathophysiology/Severe acceleration-deceleration forces
Pathophysiology/White matter grey matter interface lesions
Process
PROCESS/Acceleration/rotational trauma (ex)
PROCESS/Blunt trauma process (ex)
PROCESS/Trauma (category)
PROCESS/CNS/White matter disorder (ex)
Synonyms
Synonym
AXONAL INJ DIFFUSE, Axonal Injuries Diffuse, Axonal Injury Diffuse, DAI (Diffuse Axonal Injury), DAIs (Diffuse Axonal Injury), DIFFUSE AXONAL INJ, Diffuse Axonal Injuries, Diffuse Axonal Injury, Injuries Diffuse Axonal, Injury Diffuse Axonal, Synonym/DAI syndrome (TBI)
Definition

unconsciousness continues after severe trauma with imaging indicating only edema; coma after severe closed head injury more common in children than adults;

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Diffuse axonal injury results from acceleration-deceleration forces with shearing and tearing of axons (white matter) and disruption of myelin sheaths; Diffuse cerebral edema results, often without obvious evidence of bleeding; It is one of the most common severe brain injuries in childhood, occurring much more often than intracranial hematomas; Diffuse axonal injury results in diffuse cerebral edema, and the child presents with a globally depressed level of consciousness; Long-term sequelae often result; Increase in intracranial pressure from edema may result in pupillary abnormalities, bradycardia, hypertension, and respiratory and hemodynamic abnormalities;

-----------------merck manual 17th website 2006]-----

Diffuse axonal injury (DAI) is one of the most common and devastating types of brain injury occurring in almost half of all cases of severe head trauma ; It is a type of diffuse brain injury, meaning that damage occurs over a more widespread area than in focal brain injury. DAI, which refers to extensive lesions in white matter tracts, is one of the major causes of unconsciousness and persistent vegetative state after head trauma;

Though diffuse axonal injury seldom leads to death, the outcome is frequently coma with over 90% of patients with severe DAI never regaining consciousness; Those that do wake up often remain significantly impaired ; Unlike brain trauma that occurs due to direct impact and deformation of the brain, DAI is the result of traumatic shearing forces that occur when the head is rapidly accelerated or decelerated, as may occur in auto accidents, falls, and assaults Misalignment of cytoskeletal elements after stretch injury can lead to tearing of the axon and death of the neuron

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External Links Related to Diffuse axonal injury/Acute brain trauma
Google
Wikipedia
Merck
Images
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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