Coexisting Diffuse Axonal Injury (DAI) and Outcome of Severe Head Injury

1992 ◽  
pp. 37-39 ◽  
Author(s):  
Minoru Shigemori ◽  
N. Kikuchi ◽  
T. Tokutomi ◽  
S. Ochiai ◽  
S. Kuramoto
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Axonal Injury ◽  
Diffuse Axonal Injury

Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcome

2010 ◽  
Vol 113 (3) ◽  
pp. 556-563 ◽  
Author(s):  
Toril Skandsen ◽  
Kjell Arne Kvistad ◽  
Ole Solheim ◽  
Ingrid Haavde Strand ◽  
Mari Folvik ◽  
...  
Keyword(s):  
Cohort Study ◽  
Head Injury ◽  
Mr Imaging ◽  
Acute Phase ◽  
Severe Head Injury ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Level Of Consciousness ◽  
Gcs Score ◽  
Stage 1

Object In this prospective cohort study the authors examined patients with moderate to severe head injuries using MR imaging in the early phase. The objective was to explore the occurrence of diffuse axonal injury (DAI) and determine whether DAI was related to level of consciousness and patient outcome. Methods One hundred and fifty-nine patients (age range 5–65 years) with traumatic brain injury, who survived the acute phase, and who had a Glasgow Coma Scale (GCS) score of 3–13 were admitted between October 2004 and August 2008. Of these 159 patients, 106 were examined using MR imaging within 4 weeks postinjury. Patients were classified into 1 of 3 stages of DAI: Stage 1, in which lesions were confined to the lobar white matter; Stage 2, in which there were callosal lesions; and Stage 3, in which lesions occurred in the dorsolateral brainstem. The outcome measure used 12 months postinjury was the Glasgow Outcome Scale–Extended (GOSE). Results Diffuse axonal injury was detected in 72% of the patients and a combination of DAI and contusions or hematomas was found in 50%. The GCS score was significantly lower in patients with “pure DAI” (median GCS Score 9) than in patients without DAI (median GCS Score 12; p < 0.001). The GCS score was related to outcome only in those patients with DAI (r = 0.47; p = 0.001). Patients with DAI had a median GOSE score of 7, and patients without DAI had a median GOSE score of 8 (p = 0.10). Outcome was better in patients with DAI Stage 1 (median GOSE Score 8) and DAI Stage 2 (median GOSE Score 7.5) than in patients with DAI Stage 3 (median GOSE Score 4; p < 0.001). Thus, in patients without any brainstem injury, there was no difference in good recovery between patients with DAI (67%) and patients without DAI (66%). Conclusions Diffuse axonal injury was found in almost three-quarters of the patients with moderate and severe head injury who survived the acute phase. Diffuse axonal injury influenced the level of consciousness, and only in patients with DAI was GCS score related to outcome. Finally, DAI was a negative prognostic sign only when located in the brainstem.

scholarly journals Diffuse Axonal Injury and Early Intracranial Sequelae in Severe Head Injury

1991 ◽  
Vol 31 (7) ◽  
pp. 390-395 ◽  
Author(s):  
Minoru SHIGEMORI ◽  
Takashi TOKUTOMI ◽  
Shinken KURAMOTO ◽  
Takumi MORIYAMA ◽  
Naomi KIKUCHI ◽  
...  
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Axonal Injury ◽  
Diffuse Axonal Injury

scholarly journals Diffuse axonal injury in non-missile head injury.

1991 ◽  
Vol 54 (6) ◽  
pp. 481-483 ◽  
Author(s):  
J H Adams ◽  
D I Graham ◽  
T A Gennarelli ◽  
W L Maxwell
Keyword(s):  
Head Injury ◽  
Axonal Injury ◽  
Diffuse Axonal Injury

scholarly journals Evaluation of Head Injury Criteria for Injury Prediction Effectiveness: Computational Reconstruction of Real-World Vulnerable Road User Impact Accidents

2021 ◽  
Vol 9 ◽  
Author(s):  
Fang Wang ◽  
Zhen Wang ◽  
Lin Hu ◽  
Hongzhen Xu ◽  
Chao Yu ◽  
...  
Keyword(s):  
Head Injury ◽  
Real World ◽  
Head Injuries ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Road User ◽  
Injury Criteria ◽  
Brain Deformation ◽  
Vulnerable Road User ◽  
Head Injury Criteria

This study evaluates the effectiveness of various widely used head injury criteria (HICs) in predicting vulnerable road user (VRU) head injuries due to road traffic accidents. Thirty-one real-world car-to-VRU impact accident cases with detailed head injury records were collected and replicated through the computational biomechanics method; head injuries observed in the analyzed accidents were reconstructed by using a finite element (FE)-multibody (MB) coupled pedestrian model [including the Total Human Model for Safety (THUMS) head–neck FE model and the remaining body segments of TNO MB pedestrian model], which was developed and validated in our previous study. Various typical HICs were used to predict head injuries in all accident cases. Pearson’s correlation coefficient analysis method was adopted to investigate the correlation between head kinematics-based injury criteria and the actual head injury of VRU; the effectiveness of brain deformation-based injury criteria in predicting typical brain injuries [such as diffuse axonal injury diffuse axonal injury (DAI) and contusion] was assessed by using head injury risk curves reported in the literature. Results showed that for head kinematics-based injury criteria, the most widely used HICs and head impact power (HIP) can accurately and effectively predict head injury, whereas for brain deformation-based injury criteria, the maximum principal strain (MPS) behaves better than cumulative strain damage measure (CSDM0.15 and CSDM0.25) in predicting the possibility of DAI. In comparison with the dilatation damage measure (DDM), MPS seems to better predict the risk of brain contusion.

Graded model of diffuse axonal injury for studying head injury-induced cognitive dysfunction in rats

2009 ◽  
Vol 29 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Katsuhiko Maruichi ◽  
Satoshi Kuroda ◽  
Yasuhiro Chiba ◽  
Masaaki Hokari ◽  
Hideo Shichinohe ◽  
...  
Keyword(s):  
Head Injury ◽  
Cognitive Dysfunction ◽  
Axonal Injury ◽  
Diffuse Axonal Injury

1H spectroscopic imaging of acute head injury—evidence of diffuse axonal injury

1999 ◽  
Vol 8 (2) ◽  
pp. 109-115 ◽  
Author(s):  
J. M. Wild ◽  
C. S. A. Macmillan ◽  
J. M. Wardlaw ◽  
I. Marshall ◽  
J. Cannon ◽  
...  
Keyword(s):  
Head Injury ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Spectroscopic Imaging ◽  
Acute Head Injury

Head Injury and Posttraumatic Movement Disorders

Neurosurgery ◽  
2002 ◽  
Vol 50 (5) ◽  
pp. 927-940 ◽  
Author(s):  
Joachim K. Krauss ◽  
Joseph Jankovic
Keyword(s):  
Head Injury ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Severe Head Injury ◽  
Treatment Options ◽  
Diffuse Axonal Injury ◽  
Craniocerebral Trauma ◽  
Causative Factor ◽  
Stereotactic Surgery ◽  
Neurosurgical Treatment

Abstract WE REVIEW THE phenomenology, pathophysiology, pathological anatomy, and therapy of posttraumatic movement disorders with special emphasis on neurosurgical treatment options. We also explore possible links between craniocerebral trauma and parkinsonism. The cause-effect relationship between head injury and subsequent movement disorder is not fully appreciated. This may be related partially to the delayed appearance of the movement disorder. Movement disorders after severe head injury have been reported in 13 to 66% of patients. Although movement disorders after mild or moderate head injury are frequently transient and, in general, do not result in additional disability, kinetic tremors and dystonia may be a source of marked disability in survivors of severe head injury. Functional stereotactic surgery provides long-term symptomatic and functional benefits in the majority of patients. Thalamic radiofrequency lesioning, although beneficial in some patients, frequently is associated with side effects such as increased dysarthria or gait disturbance, particularly in patients with kinetic tremor secondary to diffuse axonal injury. Deep brain stimulation is used increasingly as an option in such patients. It remains unclear whether pallidal or thalamic targets are more beneficial for treatment of posttraumatic dystonia. Trauma to the central nervous system is an important causative factor in a variety of movement disorders. The mediation of the effects of trauma and the pathophysiology of the development of posttraumatic movement disorders require further study. Functional stereotactic surgery should be considered in patients with disabling movement disorders refractory to medical treatment.

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