Neuro

Diffuse Axonal Injury

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Diffuse Axonal Injury

  • Pathophysiology
  1. Severe Traumatic Brain Injury from rotational acceleration and deceleration forces
  2. Affects the grey matter-white matter junctions
  • Signs
  1. Severe Head Injury (high velocity impact or deceleration injury)
    1. Coma or severe confusion
    2. Glasgow Coma Scale (GCS) 8 or less
  2. Autonomic Dysfunction
    1. Fever
    2. Hypertension
    3. Diaphoresis
  • Imaging
  1. CT Head
    1. Diffuse cerebral swelling
    2. White matter blends into gray
    3. Punctate Hemorrhages
  2. MRI Brain
    1. Punctate Hemorrhages within white matter tracts
  • Management
  1. Neurosurgery Consultation
  2. Intracranial Pressure monitoring and other neurosurgical intervention may be indicated
  • References
  1. Carney (2017) Neurosurgery 80(1): 6-15 [PubMed]