Diffuse Axonal injury (DAI) results from traumatic brain injury (TBI) caused by blunt force or injury to the brain. The white matter tracts in the brain are most affected by diffuse axonal injury; patients with such injury exhibit neurological dysfunction, which could range from a moderate to severe impairment and generally result in coma or death.
Epidemiology
According to the Centers for Disease Control and Prevention (CDC), approximately 1.5 million traumatic brain injury cases are recorded yearly in the United States. Traumatic brain injury is the most common cause of mortality and disability among children and young adults in the United States. DAI’s prevalence rate remains undefined. Although, it is estimated that around 10% of TBI patients hospitalized have DAI to some degree.
Patients with confirmed DAI are estimated to have a 25% of mortality rate. This prevalence may be underestimated in patients with conditions such as epidural hematomas, subdural hematoma, and other types of TBI who do not possess an accurate diagnosis. As per the autopsy findings, patients with severe traumatic brain injury develop considerable occurrence of Diffuse axonal damage.
Anatomy
Pathophysiology
DAI causes neuronal connections to break down or become fragmented, which impacts numerous functional parts of the brain. Patients with DAI usually exhibit dysfunction in the bilateral neurological investigation of the corpus callosum, brainstem, frontal, and temporal white matter.
The severity of the disease can also be indicated by the Glasgow coma scale (GCS), which indicates the impairment or neurological dysfunction in any TBI. The clinical presentation and pathophysiological lesions in the white matter pathways are incorporated in the Adams classification of diffuse axonal damage (1-3 grades)
Grade 1: Mild DAI with minor white matter changes to the cerebral cortex, cortex callosum, and the brainstem.
Grade 2: Moderate DAI with gross focal lesion in corpus callosum.
Grade 3: Severe DAI with gross focal lesion in corpus callosum and brainstem.
Etiology
Angular or rotational acceleration-deacceleration forces acting on the skull result in stretching of the brain tissue and lead to parallel force to the white matter tracts of the brain.
Diffuse axonal damage is most frequently caused by high-speed vehicle collisions, which results in damage to the axons at the intersection of the grey and white matter of the brain. The commonly impacted region in DAI is the corpus callosum and the brainstem.
Genetics
Prognostic Factors
The prognosis of this condition is poor. In case of severe DAI and surgical intervention, prolonged rehabilitative therapies such as physical, occupational, speech, and psychosocial are required.
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
Future Trends
Media Gallary
References
https://www.ncbi.nlm.nih.gov/books/NBK448102/
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Diffuse Axonal injury (DAI) results from traumatic brain injury (TBI) caused by blunt force or injury to the brain. The white matter tracts in the brain are most affected by diffuse axonal injury; patients with such injury exhibit neurological dysfunction, which could range from a moderate to severe impairment and generally result in coma or death.
According to the Centers for Disease Control and Prevention (CDC), approximately 1.5 million traumatic brain injury cases are recorded yearly in the United States. Traumatic brain injury is the most common cause of mortality and disability among children and young adults in the United States. DAI’s prevalence rate remains undefined. Although, it is estimated that around 10% of TBI patients hospitalized have DAI to some degree.
Patients with confirmed DAI are estimated to have a 25% of mortality rate. This prevalence may be underestimated in patients with conditions such as epidural hematomas, subdural hematoma, and other types of TBI who do not possess an accurate diagnosis. As per the autopsy findings, patients with severe traumatic brain injury develop considerable occurrence of Diffuse axonal damage.
DAI causes neuronal connections to break down or become fragmented, which impacts numerous functional parts of the brain. Patients with DAI usually exhibit dysfunction in the bilateral neurological investigation of the corpus callosum, brainstem, frontal, and temporal white matter.
The severity of the disease can also be indicated by the Glasgow coma scale (GCS), which indicates the impairment or neurological dysfunction in any TBI. The clinical presentation and pathophysiological lesions in the white matter pathways are incorporated in the Adams classification of diffuse axonal damage (1-3 grades)
Grade 1: Mild DAI with minor white matter changes to the cerebral cortex, cortex callosum, and the brainstem.
Grade 2: Moderate DAI with gross focal lesion in corpus callosum.
Grade 3: Severe DAI with gross focal lesion in corpus callosum and brainstem.
Angular or rotational acceleration-deacceleration forces acting on the skull result in stretching of the brain tissue and lead to parallel force to the white matter tracts of the brain.
Diffuse axonal damage is most frequently caused by high-speed vehicle collisions, which results in damage to the axons at the intersection of the grey and white matter of the brain. The commonly impacted region in DAI is the corpus callosum and the brainstem.
The prognosis of this condition is poor. In case of severe DAI and surgical intervention, prolonged rehabilitative therapies such as physical, occupational, speech, and psychosocial are required.
https://www.ncbi.nlm.nih.gov/books/NBK448102/
medtigo
Diffuse Axonal Injury
Updated :
August 18, 2022
Diffuse Axonal injury (DAI) results from traumatic brain injury (TBI) caused by blunt force or injury to the brain. The white matter tracts in the brain are most affected by diffuse axonal injury; patients with such injury exhibit neurological dysfunction, which could range from a moderate to severe impairment and generally result in coma or death.
According to the Centers for Disease Control and Prevention (CDC), approximately 1.5 million traumatic brain injury cases are recorded yearly in the United States. Traumatic brain injury is the most common cause of mortality and disability among children and young adults in the United States. DAI’s prevalence rate remains undefined. Although, it is estimated that around 10% of TBI patients hospitalized have DAI to some degree.
Patients with confirmed DAI are estimated to have a 25% of mortality rate. This prevalence may be underestimated in patients with conditions such as epidural hematomas, subdural hematoma, and other types of TBI who do not possess an accurate diagnosis. As per the autopsy findings, patients with severe traumatic brain injury develop considerable occurrence of Diffuse axonal damage.
DAI causes neuronal connections to break down or become fragmented, which impacts numerous functional parts of the brain. Patients with DAI usually exhibit dysfunction in the bilateral neurological investigation of the corpus callosum, brainstem, frontal, and temporal white matter.
The severity of the disease can also be indicated by the Glasgow coma scale (GCS), which indicates the impairment or neurological dysfunction in any TBI. The clinical presentation and pathophysiological lesions in the white matter pathways are incorporated in the Adams classification of diffuse axonal damage (1-3 grades)
Grade 1: Mild DAI with minor white matter changes to the cerebral cortex, cortex callosum, and the brainstem.
Grade 2: Moderate DAI with gross focal lesion in corpus callosum.
Grade 3: Severe DAI with gross focal lesion in corpus callosum and brainstem.
Angular or rotational acceleration-deacceleration forces acting on the skull result in stretching of the brain tissue and lead to parallel force to the white matter tracts of the brain.
Diffuse axonal damage is most frequently caused by high-speed vehicle collisions, which results in damage to the axons at the intersection of the grey and white matter of the brain. The commonly impacted region in DAI is the corpus callosum and the brainstem.
The prognosis of this condition is poor. In case of severe DAI and surgical intervention, prolonged rehabilitative therapies such as physical, occupational, speech, and psychosocial are required.
https://www.ncbi.nlm.nih.gov/books/NBK448102/
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