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An Overview of Diffuse Axonal Injury

Categories: Medical Consequences

The Question

What are the characteristics of diffuse axonal brain injury?

Past Studies

Past Studies show that 40% to 50% of traumatic brain injuries requiring hospital admission are diffuse axonal injury (DAI). A DAI is caused by shaking or strong rotation of the head by physical forces, such as with a car crash. Injury occurs because the unmoving brain lags behind the movement of the skull, causing nerve structures to tear. The tearing of the nerve tissue disrupts the brain’s regular communication and chemical processes. DAI is due to a mechanism of mechanical injury, deacceleration-acceleration injury and is most often seen in acceleration-deceleration accidents and shaken baby syndrome. Individuals with DAI experience temporary or permanent widespread brain damage, coma, or death. The impairments depend on the function of the affected nerves. It is common for individuals with DAI to have difficulty with thinking skills, especially for memory and learning new information. Consideration must be given to the process and characteristics of DAI.

This Study

This study consisted of a review of the published research and literature related to diffuse axonal injury. The researchers focused on identifying what physical and functional changes occur in the brain during the process of diffuse axonal injury. By examining and establishing what is known about diffuse axonal injury in the literature, the researchers hope to create a basis for new research and treatment for individuals with traumatic brain injury.The researchers conclude that the name “diffuse axonal injury” is an error. It is not a widespread injury to the whole brain but instead an injury that occurs just in particular locations. DAI is a common consequence of transportation crashes and some sportinjuries. It occurs when the head abruptly moves at a high speed and is followed by a stop in movement. DAIs may not show up on imaging tests, such as CAT Scans because the injury takes place at a microscopic level. The majority of individuals with DAI appear to experience difficulties with memory and rapid mental processing skills.

Who May Be Affected By These Finding

Individuals with diffuse axonal injuries, healthcare providers, researchers

Caveats

The researchers indicate that there is evidence that the type of cellular injury that takes place in DAI, may involve different receptors and brain chemical pathways than do other types of brain injury. The researchers suggest that this may explain the lack of success for medication trials for brain injury.

Bottom Line

The researchers conclude that the name “diffuse axonal injury” is an error. It is not a widespread injury to the whole brain but instead an injury that occurs just in particular locations. The majority of individuals with DAI appear to experience difficulties with memory and rapid mental processing skills.

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Find This Study

Meythaler, J. M., Peduzzi, J. D., Eleftheriou, E., & Novack, T. A. (2001). Current concepts: Diffuse axonal injury—Associated traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 82, 1461-1471.

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