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An Overview of Treatments for Diffuse Axonal Injury - Oren Zarif - Diffuse Axonal Injury


Diffuse axonal injury is a common neurological condition, and the treatment focuses on preventing secondary injuries and facilitating rehabilitation. Secondary injuries are associated with increased mortality, and they include cerebral edema, hypoxia with coexistent hypotension, and elevated intracranial pressure. This is why prompt care is essential. To learn more about diffuse axonal injury, read on. The following is an overview of treatments.

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The etiology of diffuse axonal injury is high-speed motor vehicle accidents. The accelerating and decelerating motion causes shearing forces that damage the brain's white matter tracts, resulting in microscopic and gross damage to axons. In these cases, diffuse axonal injury commonly affects the brainstem and corpus callosum. Skull fractures are not an important factor in this type of injury.

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The outcome of diffuse axonal injury is variable. It is defined by the severity of neurological deficits, physical status, quality of life, and return to work. In addition to causing significant disability, it can also affect social reintegration, productivity, and quality of life. Diffuse axonal injury often persists for years after the traumatic event. Although the majority of patients recover to some degree, the recovery time is long.

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Diffuse axonal injury may be accompanied by primary brainstem lesions, including the cerebellum and cerebral hemispheres. However, not all of these primary lesions are associated with DAI. In many cases, it is a combination of both. When the DAI is caused by a specific physical trauma, the brain may experience the same symptoms as if it had been caused by a stroke.

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The symptoms of axonal brain damage vary from person to person. They depend on the area of the brain affected, the severity of the injury, and the health of the person experiencing it. Because of the wide range of symptoms, a doctor may struggle to make a diagnosis unless they can look at the patient's brain in detail. Therefore, they may only use imaging to help them determine the severity of the condition.

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Diffuse axonal injury is a diagnosis that is often made following postmortem pathologic examination of brain tissue. However, a physician may suspect DAI if the patient has suffered a head trauma. Clinical symptoms of DAI range from a headache, dizziness, and nausea to persistent vegetative state. There is no definitive treatment for DAI, but the patient should undergo rehabilitation. Depending on the severity of the injury, patients can recover from their injuries in a few months.

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In vitro models of DAI induce an influx of calcium, but not immediately after the injury. Affected neurons do not show altered Ca-ATPase activity for up to four hours after the injury. High calcium results in compaction of neurofilaments and sidearms, and the loss of axonal microtubules. This results in a cascade of biochemical events that alter intracellular signal transduction pathways. It may also involve glial cells and neurotrophic factors.

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Diffuse axonal injuries are most common in high-impact trauma. In most cases, patients who suffer from DAI experience prolonged periods of unconsciousness or coma. Afterwards, they regain movement and consciousness. While the symptoms of diffuse axonal injury may be asymptomatic, they can be a sign of other conditions, such as axonotmesis. In some cases, DAI can even lead to a total degeneration of the distal segment of the brain.

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Diffuse axonal injury affects multiple regions of the brain and disrupts various connections. Although the primary effects of DAI are often devastating, many patients recover their affected functions and even improve their quality of life. Acute traumatic brain injury may result in a coma. In severe cases, the patient's GCS may be below eight, but most suffer from mild to moderate axonal injury.

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The initial CT may be normal in a patient with DAI if the brainstem or corpus callosum is involved. The patient may show multiple small hypodense foci that correspond to edema at the site of shear injury. Some patients experience associated hemorrhage. Despite the severity of diffuse axonal injury, many patients recover from the condition. In addition to regaining normal memory, many patients with DAI exhibit signs of rapid mental processing.

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Acute traumatic brain injuries are typically fatal, and DIA affects as many as 25 percent of patients. Sadly, these patients are not always identified, since the majority have other types of traumatic brain injury. In the meantime, postmortem studies have shown that DAI patients who suffer severe TBI are at risk for death. While the causes of Diffuse Axonal Injury remain unknown, it is important to know the symptoms of diffuse axonal injury.

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