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Treatment For Diffuse Axonal Injury - Oren Zarif - Diffuse Axonal Injury


The primary goal of treatment for diffuse axonal injury is to prevent secondary injuries and facilitate rehabilitation. Failure to recognize secondary injuries is a significant cause of increased mortality. These injuries may include cerebral edema, hypoxia with coexisting hypotension, and elevated intracranial pressure. Prompt treatment is essential to minimize these complications. If you suspect that you have suffered a diffuse axonal injury, consult your physician or neurologist as soon as possible.

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There are several ways to diagnose diffuse axonal injury. Magnetic resonance imaging (MRI) uses magnets, radio waves, and a computer screen to produce a picture of the brain. CT scans, however, can result in false negatives. Evoked Potentials (EPs) look at visual and auditory pathways in the brain. EEG measures electrical activity in the brain. Treatment for diffuse axonal injury depends on whether the symptoms develop gradually or are associated with other factors.

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Diffuse axonal injury causes cell death. This disorder is caused by damage to the axons throughout the brain. Damage to the axons occurs by the influx of calcium ions into the neuron. Excess calcium ions activate a cascade of enzymes and cause severe damage. This causes the axons to stretch and ultimately disconnect, resulting in cell death.

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Diffuse axonal injury typically develops in the dorsolateral quadrant of the rostral brainstem near the superior cerebellar peduncles. It appears initially as hemorrhagic lesions, but may evolve into a shrunken area of scarring. DAI does not affect the dorsolateral brainstem alone, but can develop anywhere in the midbrain.

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A CT scan may be normal in a patient with diffuse axonal injury. The CT may not show the lesions in patients with DAI, as the images have poor spatial resolution. MRI is a superior imaging modality for diagnosis and treatment of diffuse axonal injury. Bright T2 foci at gray-white interfaces may be a feature of DAI on MRI. The latter may also show delayed petechial hemorrhages. A CT scan can reveal subtle DAI, but many patients do not have the condition.

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During a patient's recovery after a diffuse axonal injury, rehabilitative therapy can help improve control over the affected parts. Physical therapy is especially useful to help patients recover the ability to move in their affected areas, and it stimulates neuroplasticity in the brain. If the condition is severe, patients may need to undergo a long period of rehabilitative therapies. These therapies may include speech therapy, physical therapy, and occupational therapy.

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Diffuse axonal injury (DAI) can cause physical, mental, and cognitive changes that compromise social reintegration, return to productivity, and quality of life. DAI may persist beyond the acute phase of treatment and for several months after a traumatic event. The brain tissue is functionally impaired for weeks or months, but it gradually recovers. The axonal bulb and microglia clusters may be persistent for months or even years.

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The brain moves rapidly within the skull during a road traffic accident, and it causes differential motion that causes axonal stretching. This swelling causes axons to stretch and tear. This is the primary cause of coma and poor outcome in most patients suffering from closed head trauma. Patients with severe DAI will lose consciousness at the time of impact, and may remain in a persistent vegetative state. A milder form of DAI may be treatable, and rehabilitation may be possible.

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Patients with diffuse axonal injury should be evaluated for any serious traumatic brain injury. Magnetic resonance imaging (MRI) is a helpful tool to diagnose diffuse axonal injury and cerebral edema. However, it should be waited for the initial evaluation. If the patient is experiencing severe traumatic brain injury, MRI is a viable option to treat it. The first step in the treatment process is to determine the extent of the trauma.

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