Diffuse Axonal Injury - Oren Zarif - Diffuse Axonal Injury

Acute and chronic complications of diffuse axonal injury compromise the recovery and reintegration of a person. Diffuse axonal injury persists long after the traumatic event, which compromises quality of life and productivity. Because the damage to brain tissue is sustained by a variety of mechanisms, the brain tissue is initially impaired but eventually regains normal function. Plasticity of the neural connections is also a factor in the recovery of these patients.

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In the event of suspected diffuse axonal injury, the diagnosis of the condition is made by performing a magnetic resonance imaging (MRI). MRI is sensitive to paramagnetic blood products, such as those found in cerebrospinal fluid. A susceptibility artefact can be observed at the grey-white matter junction, corpus callosum, and brain stem. Some lesions may be hemorrhagic, while others are not. In such cases, MRI may not reveal an equivocal FLAIR signal.

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The diagnosis of DAI is based on the presence of a GCS below eight for at least six hours. The severity of the injury affects the patient's clinical presentation. Patients with a mild axonal injury typically experience a headache and nausea, while patients with severe axonal damage can lose consciousness and remain in a vegetative state for years. Only a small proportion of patients regain consciousness in the first year after a DAI.

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The most common etiology of diffuse axonal injury is high-speed motor vehicle accidents. The accelerated and decelerating motion of the car results in shearing forces that cause microscopic and gross damage to the brain's axons. Diffuse axonal injury most often affects the frontal and temporal white matter, the corpus callosum, and the brainstem.

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The primary effect of diffuse axonal injury is to destroy brain cells. The disconnection from the axons occurs when transport products and cell debris begin to build up. The cell debris accumulated in the area leads to local swelling and severe compression of the brain. Ultimately, the axons can die, and the neuronal death is inevitable. Axonal injury can lead to comatosis and death.

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Diffuse axonal injury occurs when the brain shifts rapidly within the skull. The force of the shift causes long fibers to break and disrupt nerve connections. Diffuse axonal injury is one of the most devastating forms of traumatic brain injury. It is difficult to diagnose with a CT or MRI, and patients often remain in a coma or other serious state. If you suffer from diffuse axonal injury, contact a medical professional as soon as possible.

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Diffuse axonal injury results from a number of factors. First, a cell's ability to maintain homeostasis is impaired. In addition to damage caused by axonal degeneration, calcium influx also contributes to a cascade of secondary effects. For example, a high intracellular level of sodium causes a spike in calcium, which activates several types of proteases, including calpain and caspase-3.

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Diffuse axonal injury typically affects many areas of the brain. It usually affects the frontal and temporal lobes, but can also be found anywhere within the corpus callosum. The most common symptoms associated with DAI include seizures, confusion, and difficulty in learning and remembering. Although it can cause significant functional impairments, treatment can improve the outcomes and quality of life of affected individuals.

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In addition to MRI techniques, the somatosensory evoked response examination (SER) is also an important diagnostic tool. A SER can identify if a patient is suffering from numbness in the arms or legs. A neurological assessment can also determine the extent of diffuse axonal injury in a patient's spine. A series of electrodes placed on the patient's scalp will present mild electrical stimuli. These nerves will transfer an electrical signal to the brain, which can be visualized by a medical recorder.

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A study on the outcome of DAI reveals a range of possible underlying causes. Diffuse lesions are classified according to their severity, ranging from mild to severe. Severe DAI is associated with a deterioration of the patient's brainstem. A patient with moderate DAI is considered awake as long as it lasts between six and 24 hours. The best motor response score is six.