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Diffuse Axonal Injury - Oren Zarif - Diffuse Axonal Injury

Diffuse axonal injury is caused by a wide variety of factors. Some of these factors are directly related to the impact that caused the injury, and others are influenced by biochemical cascades. The biochemical response is ultimately responsible for causing axonal disconnect. The impact also disrupts the cytoskeleton and proteolytic metabolism, and it opens sodium channels in the axolemma.

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Treatment for diffuse axonal injury begins with the prevention of secondary injuries and the facilitation of rehabilitation. In addition to causing significant impairment, secondary injuries can result in increased mortality. These can include cerebral edema, elevated intracranial pressure, and hypoxia with coexisting hypotension. Early treatment is crucial in minimizing the risk of these complications. Axonal injury is a medical emergency, and the sooner the patient receives the appropriate medical care, the better.

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The differential diagnosis of DAI depends on the location and the severity of the lesion. In most cases, axonal damage is limited to one or more specific areas of the brain. While some individuals experience rapid mental processing skills or memory problems, many do not exhibit these symptoms. In some cases, the damage is asymptomatic or is less severe than the initial diagnosis. Ultimately, DAI is a complex medical condition requiring expert care and management.

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A patient's symptoms of diffuse axonal injury may be difficult to assess. MRI is the modality of choice for diagnosing the condition. It is sensitive to paramagnetic blood products and detects a susceptibility artefact at the grey-white matter junction and in the corpus callosum or brain stem. Not all lesions are hemorrhagic, but they will show a high FLAIR signal.

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Although traumatic brain injury is often fatal, it is possible to assess the condition and determine the most appropriate course of care. Magnetic resonance imaging (MRI) can reveal the extent of axonal injury, and it can also reveal the presence of cerebral edema. If the initial evaluation does not show evidence of diffuse axonal injury, MRI can be deferred. There are two types of DTI: grade 2 and grade 3. The diagnosis of diffuse axonal injury depends on the severity of the brain injury.

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DAI occurs when the intracellular sodium level rises above the threshold at which calcium ions can enter the cell. High intracellular Na+ causes calcium to enter the axon, where it is responsible for axonal stretching. Ultimately, axonal transport is halted at the neuronal network, causing the cells to die. The cell death process occurs within a few hours of the injury.

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Diffuse axonal injury is caused by a rapid shift of the brain within the skull. The force of this shift tears the axons, disrupting communication between nerve cells in the brain. This disrupted communication can lead to a coma, physical impairment, and cognitive impairment. Fortunately, many patients with diffuse axonal injury recover and improve their quality of life. However, if you've been in a car accident, you might have suffered a DAI.

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Researchers have developed experimental neurotrauma models, including the shaken baby syndrome, which mimics the effects of moderate DAI. Although no in vivo model has been developed to fully replicate this type of injury, researchers have found that stretching optic nerves mimics moderate and severe DAI. The two models also create an indentation in the brain. The latter involves fixing a metallic disk to the skull. These neurotrauma models are not ideal for studying DAI.

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Patients with DAI were identified through imaging. The number of lesions identified through imaging was directly associated with patient outcome. Researchers found that the more lesions found on an MRI of a patient, the greater the impairment of functionality at 12 months. They found that 25% of patients with DAI would die from this condition. This finding is concerning for both the patient and the physician who diagnoses the condition. This is especially important in patients with severe TBI.

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DTT has been applied to a population of pediatric and adult TBI patients, and has shown a high correlation between DTI and long-term outcomes. However, there are still a few challenges with this technique. The first step is to make sure that the technique you use is compatible with the specific disease that you're treating. For example, you should make sure that the machine is equipped with a diffusion tensor imaging scanner.

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