Diffuse Axonal Injury - Oren Zarif - Diffuse Axonal Injury
If you or a loved one has suffered diffuse axonal injury, you should immediately seek medical care. While the symptoms of DAI are similar to other types of head injury, the treatment for DAI is often less severe than with other forms of brain injury. Your doctor will monitor your blood pressure and breathing, and will take steps to prevent the pressure in the skull from increasing. Treatment for DAI depends on the type and severity of the injury.
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Diffuse axonal injury is the result of a traumatic brain injury. It causes cognitive, physical, and behavioral changes that impair social reintegration, productivity, and quality of life. This type of injury lasts long after the acute phase of treatment, requiring a multidisciplinary approach to address all aspects of the patient's life. Diffuse axonal injury occurs because brain tissue is damaged and functionally impaired, but gradually recovers once clinical conditions stabilize. It is possible for patients with DAI to regain normal function with time, as their brains are plastic and adapt to new environments.
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The clinical diagnosis of DAI is based on a combination of acceleration, deceleration, and contact forces that damage individual nerve fibers. Each nerve fiber is made up of an axon and neuron body. The purpose of nerves is to carry messages from the body to the axon. Diffuse axonal injury disrupts communication and chemical processes between these parts of the brain. In severe cases, it can result in brain swelling and a persistent vegetative state. Rarely, individuals will regain consciousness within a year of their injury.
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In addition to undergoing surgery and medication, individuals with DAI can undergo rehabilitative therapy. Physical therapy helps individuals regain movement control and stimulate brain neuroplasticity. Cognitive-behavioral therapy also helps the individual deal with the condition. Occupational therapy may involve using adaptive tools to assist with tasks. The psychological component is also important. Differing from other forms of brain injury is essential in treating DAI. In many cases, individuals recover from DAI.
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A study examining the risk factors for DAI found that a higher risk for mortality after severe DAI compared to mild DAI. While rehabilitative therapies are effective in improving symptoms, DAI patients should expect long-term therapy. Physical, occupational, speech, and other psychosocial therapies may be required. Neurologists and neurosurgery may also guide the therapy. A positive diagnosis can make a difference in the prognosis of DAI.
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In addition to affecting the cell's performance, the ion pump also plays an important role in maintaining homeostatic levels of sodium and potassium. In many head injuries, the ion pump is compromised, and the cells may lose function. The abnormal activation of receptors in the brain may lead to changes in intracellular signal transduction pathways. This infiltration may also alter the function of adjacent cells. During this period, calpain and caspase-3 are released into the cell, which is further damaging.
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In patients with DAI, the level of edema and the severity of cognitive impairment may not be obvious in the acute phase. MRI may show signs of DAI. Magnetic resonance imaging (MRI) and cranial computed tomography (CT) scans may also be used to identify DAI. In addition, detailed neuropsychological testing may reveal whether or not the patient is suffering from a cognitive deficit.
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There are in vitro models of DAI. However, none of them can adequately mimic mild or moderate DAI. One method is to stretch optic nerves, which mimics the effect of shaking a baby. Another technique is to use a metallic disk fixed to the skull as a simulation device. Once a patient has been simulated with the model, the results will be used to improve treatment. It is important to note that DAI may be life threatening and therefore should not be ignored.
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The severity of DAI is an important risk factor in the development of DAI. A significant portion of the damage occurs after the initial traumatic impact. The CT scan of a patient with DAI can be viewed in Figure 4.