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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1989 Jul;52(7):838–841. doi: 10.1136/jnnp.52.7.838

Diffuse axonal injury in head trauma.

P C Blumbergs 1, N R Jones 1, J B North 1
PMCID: PMC1031929  PMID: 2769276

Abstract

Diffuse axonal injury (DAI) as defined by detailed microscopic examination was found in 34 of 80 consecutive cases of head trauma surviving for a sufficient length of time to be clinically assessed by the Royal Adelaide Hospital Neurosurgery Unit. The findings indicate that there is a spectrum of axonal injury and that one third of cases of DAI recovered sufficiently to talk between the initial head injury producing coma and subsequent death. The macroscopic "marker" lesions in the corpus callosum and dorsolateral quadrants of the brainstem were present in only 15/34 of the cases and represented the most severe end of the spectrum of DAI.

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Selected References

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  1. Adams H., Mitchell D. E., Graham D. I., Doyle D. Diffuse brain damage of immediate impact type. Its relationship to 'primary brain-stem damage' in head injury. Brain. 1977 Sep;100(3):489–502. doi: 10.1093/brain/100.3.489. [DOI] [PubMed] [Google Scholar]
  2. Adams J. H., Doyle D., Graham D. I., Lawrence A. E., McLellan D. R. Diffuse axonal injury in head injuries caused by a fall. Lancet. 1984 Dec 22;2(8417-8418):1420–1422. doi: 10.1016/s0140-6736(84)91620-9. [DOI] [PubMed] [Google Scholar]
  3. Adams J. H., Doyle D., Graham D. I., Lawrence A. E., McLellan D. R. Microscopic diffuse axonal injury in cases of head injury. Med Sci Law. 1985 Oct;25(4):265–269. doi: 10.1177/002580248502500407. [DOI] [PubMed] [Google Scholar]
  4. Adams J. H., Graham D. I., Murray L. S., Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Ann Neurol. 1982 Dec;12(6):557–563. doi: 10.1002/ana.410120610. [DOI] [PubMed] [Google Scholar]
  5. Gennarelli T. A., Thibault L. E., Adams J. H., Graham D. I., Thompson C. J., Marcincin R. P. Diffuse axonal injury and traumatic coma in the primate. Ann Neurol. 1982 Dec;12(6):564–574. doi: 10.1002/ana.410120611. [DOI] [PubMed] [Google Scholar]
  6. Jellinger K. 14. Pathology and pathogenesis of apallic syndromes following closed head injuries. Monogr Gesamtgeb Psychiatr Psychiatry Ser. 1977;14:88–103. doi: 10.1007/978-3-642-81151-7_15. [DOI] [PubMed] [Google Scholar]
  7. Jellinger K., Seitelberger F. Protracted post-traumatic encephalopathy. Pathology, pathogenesis and clinical implications. J Neurol Sci. 1970 Jan;10(1):51–94. doi: 10.1016/0022-510x(70)90091-2. [DOI] [PubMed] [Google Scholar]
  8. Jennett B., Bond M. Assessment of outcome after severe brain damage. Lancet. 1975 Mar 1;1(7905):480–484. doi: 10.1016/s0140-6736(75)92830-5. [DOI] [PubMed] [Google Scholar]
  9. Mitchell D. E., Adams J. H. Primary focal impact damage to the brainstem in blunt head injuries. Does it exist? Lancet. 1973 Aug 4;2(7823):215–218. doi: 10.1016/s0140-6736(73)93128-0. [DOI] [PubMed] [Google Scholar]
  10. Peerless S. J., Rewcastle N. B. Shear injuries of the brain. Can Med Assoc J. 1967 Mar 11;96(10):577–582. [PMC free article] [PubMed] [Google Scholar]
  11. Pilz P. Axonal injury in head injury. Acta Neurochir Suppl (Wien) 1983;32:119–123. doi: 10.1007/978-3-7091-4147-2_17. [DOI] [PubMed] [Google Scholar]
  12. Povlishock J. T., Becker D. P., Cheng C. L., Vaughan G. W. Axonal change in minor head injury. J Neuropathol Exp Neurol. 1983 May;42(3):225–242. doi: 10.1097/00005072-198305000-00002. [DOI] [PubMed] [Google Scholar]
  13. Recommendation for reference method for determination by centrifugation of packed cell volume of blood. International Committee for Standardization in Haematology Expert Panel on Blood Cell Sizing. J Clin Pathol. 1980 Jan;33(1):1–2. doi: 10.1136/jcp.33.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Reilly P. L., Graham D. I., Adams J. H., Jennett B. Patients with head injury who talk and die. Lancet. 1975 Aug 30;2(7931):375–377. doi: 10.1016/s0140-6736(75)92893-7. [DOI] [PubMed] [Google Scholar]
  15. STRICH S. J. Diffuse degeneration of the cerebral white matter in severe dementia following head injury. J Neurol Neurosurg Psychiatry. 1956 Aug;19(3):163–185. doi: 10.1136/jnnp.19.3.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Teasdale G., Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974 Jul 13;2(7872):81–84. doi: 10.1016/s0140-6736(74)91639-0. [DOI] [PubMed] [Google Scholar]
  17. Zimmerman R. A., Bilaniuk L. T., Genneralli T. Computed tomography of shearing injuries of the cerebral white matter. Radiology. 1978 May;127(2):393–396. doi: 10.1148/127.2.393. [DOI] [PubMed] [Google Scholar]

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