Disease Information for Diffuse axonal injury/Acute brain trauma

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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