Case Of the Week (COW) 24 April 2016
DIFFUSE AXONAL INJURY
Findings
MRI:
T2/ Flair hyperintensities in the splenium of corpus callosum ,left frontal and right temporal lobe in the grey white matter junction which shows diffusion restriction.
Multiple areas of punctate microhaemorrhages in the right temporopareital region on SWI
Discussion
Diffuse axonal injury (DAI) is a frequent result of traumatic acceleration/deceleration or rotational injuries and a frequent cause of persistent vegetative state in patients often occur at the gray-white matter junction
Shearing leads to edema, axoplasmic leakage, retraction ball formation and wallerian degeneration
Diffuse,Bilateral Majority of lesions (80%) are multiple,Occur at the gray-white matter junction,Lesions are most frequently ovoid, larger centrally than peripherally.
Frequently involved are the Frontal and temporal lobes,Posterior body and splenium of the corpus callosum, Caudate nuclei, Thalamus, Tegmentum, Internal capsule
More frequently associated with hemorrhage
Gradient-echo sequences are very useful in demonstrating paramagnetic effects of petechial hemorrhages
DIFFUSE AXONAL INJURY
Findings
MRI:
T2/ Flair hyperintensities in the splenium of corpus callosum ,left frontal and right temporal lobe in the grey white matter junction which shows diffusion restriction.
Multiple areas of punctate microhaemorrhages in the right temporopareital region on SWI
Discussion
Diffuse axonal injury (DAI) is a frequent result of traumatic acceleration/deceleration or rotational injuries and a frequent cause of persistent vegetative state in patients often occur at the gray-white matter junction
Shearing leads to edema, axoplasmic leakage, retraction ball formation and wallerian degeneration
Diffuse,Bilateral Majority of lesions (80%) are multiple,Occur at the gray-white matter junction,Lesions are most frequently ovoid, larger centrally than peripherally.
Frequently involved are the Frontal and temporal lobes,Posterior body and splenium of the corpus callosum, Caudate nuclei, Thalamus, Tegmentum, Internal capsule
More frequently associated with hemorrhage
Gradient-echo sequences are very useful in demonstrating paramagnetic effects of petechial hemorrhages