Diffuse Axonal Injury - Oren Zarif - Diffuse Axonal Injury

Diffuse axonal injury is a medical condition characterized by a loss of axonal function in a cerebral hemisphere. Symptoms of DAI can include weakness and/or loss of consciousness. Although no definitive cure exists, there are several treatments and rehabilitative therapies available. In the short term, patients may need to undergo physical, occupational, and speech therapy. Recovery signs will help identify whether the patient is recovering.

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Diffuse axonal injury typically affects the rostral part of the brainstem, most commonly near the superior cerebellar peduncles. The lesions usually occur as hemorrhagic plaques and may shrink over time. Diffuse axonal injury is not limited to the rostral brainstem, however. It can affect any part of the midbrain, including the corpus callosum, thalamus, and cortex.

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Diffuse axonal injury causes physical, cognitive, and behavioral changes that impair quality of life, social reintegration, and productivity. The effects of DAI last well beyond the acute treatment phase. In fact, they may last for years after the traumatic event. Although the brain tissue itself recovers from the initial injury, it is not possible to completely restore neural function. Patients will have to accept a new baseline of normal function and accept a new level of functioning.

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In case of DAI, treatment may include regaining consciousness. The patient will likely experience a variety of secondary symptoms such as headaches, dizziness, and fatigue. If the condition is severe, the patient may go into a comatose state. Many patients recover from DAI, while others may face long-term consequences. However, this condition requires medical attention to prevent permanent damage. It is best to seek out medical treatment at the earliest opportunity to restore brain function.

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Although DAI is often difficult to diagnose, it can be distinguished from other types of injuries by postmortem pathologic examination of brain tissue. With knowledge of the mechanisms of head injury, patients with DAI should be suspected of having a rotational closed head injury.

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It is important to distinguish the symptoms of DAI from other kinds of head injuries, especially those involving the spine and neck. If the condition is suspected in a patient with an earlier head injury, a careful investigation of the brain tissue may be needed.

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Diffuse axonal injury has been associated with fatality in 25% of patients. The true incidence of DAI depends on the severity of the injury. Although other forms of TBI may not carry a DAI diagnosis, postmortem studies suggest that DAI is a significant cause of death. In most cases, the treatment for DAI should be aggressive. In addition to treatment, patients should undergo rehabilitative therapy for DAI.

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When DAI occurs, a biochemical response causes the most damage to axons. During an impact, the cytoskeleton collapses and protein levels increase, resulting in axonal disconnect. Several lipases respond to the calcium influx by activating the cytoskeleton and increasing the inflammatory response. This response also promotes the invasion of macrophages and neutrophils.