When it comes to diagnosis of diffuse axonal injury, much is based on the clinical findings of unconsciousness and coma. The test most often used in diagnosing diffuse axonal injury is the CT scan. These tests examine the auditory, visual, and sensory pathways within the brain. In diffuse axonal injury, these pathways will be disrupted. An EEG or electroencephalogram is also a good test for diffuse axonal injury.
This test uses electrodes attached to the scalp that measures the electrical activity within the brain. In diffuse axonal injury, the EEG will be abnormal.
Initially, measures will be taken to decrease the swelling of the brain. Mannitol, steroids, and other medications are used to decrease swelling and reduce the inflammation of the brain. The patient will be carefully monitored. Surgery will not help this injury. If the diffuse axonal injury is mild or moderate, the patient will enter rehabilitation once they are awake and stable.
In the rehabilitation phase, both the family and the patient will be managed by a multidisciplinary staff that will include nurses, doctors, occupational therapists, physical therapists, and other specialists who will work with the patient to return the patient to a normal state or at least to the maximum level of function they are capable of. Over a period of weeks to months, the patient will improve to a maximum level. A concussion is believed to be the mildest form of diffuse axonal injury.
There are various forms of the severity of this illness, with mild to moderate forms of the disease having the best recovery chances. The mildest cases of diffuse axonal injury usually have few, if any, long-term problems. People with severe injuries often live out their lives in a persistent vegetative state or die at an early age from complications of a coma. I'm Ed Smith , a personal injury lawyer for Northern California.
If you or a member of your family has suffered a brain injury in a car accident, you may be reimbursed for your suffering, medical expenses, pain, and lost wages.
Give me a call today for a free and friendly advice on your situation. I can be reached at or I have been serving individuals and families in the Sacramento area and around Northern California for the past 35 years. You can find reviews from my past clients on the following websites:. With the right knowledge and understanding about diffuse axonal injury, you'll know what to do and expect in case this happens to someone you know.
This injury could be life-threatening, but you can always maximize the treatment resources you have to help the patient recover, at least to the maximum level the patient can handle. So, a doctor will not typically diagnose a condition as a diffuse axonal brain injury without first getting detailed neural imaging of the injury to identify brain lesions. A diffuse axonal brain injury is usually caused by violent blows to the head or other events that shake the brain, such as:.
Basically, any head injury or whiplash event can cause a brain injury that affects more than one region of the brain. For some, recovering from a diffuse axonal brain injury is possible—but there are no guarantees with such injuries. The severity of the brain lesions, which areas of the brain they are in, your treatment, and many other factors can affect whether or not you make a full recovery. Many who suffer extensive brain injuries such as this may have to struggle with ongoing brain and nervous system issues for the rest of their lives.
Advise paramedics about any potential brain or spinal injuries when they arrive. After the injury has been stabilized, the process of rehabilitation can begin. If a loved one suffers a brain injury, be there to support them as best as you can.
Brain injuries of any kind are a serious issue. While many do eventually recover from these injuries, an approximate 50, people die and , more are hospitalized for traumatic injuries to the brain every year—and 80, or more suffer long-term disabilities because of their injuries. To learn more about brain and spinal cord injuries—their effects and their treatments— please check out some of our other resources.
Our first scan data were collected days after injury, which corresponds to the chronic stage of white matter damage. Thus, our results suggest occurrence of microstructural change over the longer term.
Temporal change in VsFA0. This probably indicates that minor microstructural changes correlate with the degree of recovery from PDC. Several previous studies [ 6 , 8 , 10 , 11 , 20 , 25 — 29 ] have reported a positive association of FA with higher cognitive function and outcomes. However, in this study, higher difference of VsFA0.
In other words, a time-dependent decrease in VsFA0. In this respect, our results are not inconsistent with those of several previous reports [ 6 , 8 , 10 , 11 , 20 , 25 — 29 ], which indicated that a time-dependent decrease in FA was associated with poor outcomes as assessed by cognitive function and GOSE.
Although significant recoveries were observed based on Kohnan scores, the changes were not significant when based on GOSE scores, which suggests that improvement in our patients was lower than that reported in previous studies [ 6 , 8 , 10 , 11 , 20 , 25 — 29 ]. Thus, interstudy differences in results may reflect DAI severity. Differences with respect to time elapsed since injury may also have contributed to the divergent findings; we included patients with PDC in the extended chronic phase.
In our participants, induction of a severe inactive state due to brain injury might lead to secondary neurodegeneration that might be detected by DTI. However, the underlying mechanism behind longitudinal alterations in white matter remains unclear. In addition, this study had some limitations. The number of subjects was small, and they had various pathological states, such as contusion, subarachnoid hemorrhage, and intracranial hemorrhage.
Thus, further longitudinal studies are warranted that combine DTI with volumetric measurements and other detailed analyses, such as functional connectivity analysis.
The potential of DTI use as a prognostic tool needs further investigation in studies with a larger number of subjects. In conclusion, on stepwise multiple linear regression analysis, Kohnan score and the difference in AD showed a significant association with the degree of recovery from PDC.
In other words, we demonstrate evidence of temporal microstructural white matter changes in patients with PDC; DTI parameters are useful indices for assessment of white matter alterations in these patients. As a noninvasive modality, DTI provides in vivo quantitative pathophysiological information. Tracking white matter microstructural changes over time has the potential to measure neuroplasticity and repair after TBI and may eventually be utilized to monitor therapeutic responses.
Further research is required to investigate the leads identified in this study. This study was supported by a medical research grant on traffic accidents from the General Insurance Association of Japan. The authors would also like to thank the imaging staff, particularly Tomohiro Chiba, for their skilled MRI acquisition. They also thank Enago for the English language review. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article of the Year Award: Outstanding research contributions of , as selected by our Chief Editors. Read the winning articles. Journal overview. Special Issues. A Corrigendum for this article has been published. Academic Editor: Cheng-Sheng Chen. Received 28 Oct Revised 19 Jan Accepted 22 Jan Published 23 Feb Abstract We investigated the clinical predictors of the degree of recovery in patients with prolonged disorders of consciousness PDC caused by traumatic brain injury.
Methods 2. Patients We retrospectively recruited 14 patients at our institution that had chronic severe PDC resulting from traffic accident-related brain injury. Table 1. Clinical profiles of patients with prolonged consciousness disorders due to brain injury. Table 2. Each diffusion parameter of patients with prolonged consciousness disorders due to brain injury.
Table 3. Table 4. Comparison of diffusion tensor parameters and consciousness disorders. Table 5. Comparison of diffusion tensor parameters in normal healthy participants. Table 6. Correlation between the degree of recovery from prolonged consciousness disorder and each value. Table 7. References M. Warner, C. De La Plata, J. Spence et al. Kinney and M. Adams, B. Jennett, D. McLellan, L. Murray, and D. Bekinschtein, M. Monti et al. Perez, J. Adler, N. Kulkarni et al.
Wilde, S. McCauley, A. Barnes et al. Farbota, A. Sodhi, B. Bendlin et al. Sidaros, A. Engberg, K. Sidaros et al. Arfanakis, V. Haughton, J. Carew, B. Rogers, R. Dempsey, and M. View at: Google Scholar K. Sugiyama, T. Kondo, Y.
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