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Diffuse Axonal Injury

By James E. Wilberger, MD, Professor of Neurosurgery;Jannetta Endowed Chair, Department of Neurosurgery;DIO, Chairman Graduate Medical Education Committee;Vice-President, Graduate Medical Education, Drexel University College of Medicine;Allegheny General Hospital;Allegheny Health Network Medical Education Consortium;Allegheny Health Network ; Derrick A. Dupre, MD, Department of Neurosurgery;, Allegheny General Hospital;Drexel University College of Medicine

Diffuse axonal injury is widespread injury to axons, a part of the nerve cells in the brain.

Nerve impulses leave nerve cells through a part of the nerve cell called the axon. In diffuse axonal injury, axons throughout the brain are damaged. The usual causes include falls and motor vehicle crashes. Diffuse axonal injury may contribute to the shaken baby syndrome, in which violent shaking or throwing of a baby causes brain injury (see Physical abuse). As a result of diffuse axonal injury, brain cells may die, causing brain swelling, increasing pressure within the skull. Increasing pressure may compound the injury by decreasing the blood supply to the brain.

Diffuse axonal injury typically causes loss of consciousness that lasts for more than 6 hours. Sometimes the person has other symptoms of brain damage. Increased pressure within the skull may cause coma.

Computed tomography (CT) or magnetic resonance imaging (MRI) is usually done to detect diffuse axonal injury.

Diffuse axonal injury is treated with the general measures used to treat all types of head injuries. Surgery is not helpful.