Diffuse axonal injury

Case contributed by Lam Van Le
Diagnosis almost certain

Presentation

Headache on the third day after a traffic accident. No focal neurological symptoms.

Patient Data

Age: 20 years
Gender: Male
mri
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1
This study is a stack
Sagittal
T1
This study is a stack
Coronal
T2
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Info

Several abnormal signal foci in the left frontoparietal lobe (brain parenchyma), the body of the corpus callosum, show high signal intensity on FLAIR and T2W, low signal on GRE, and restricted diffusion.

Soft tissue swelling of the scalp in the left parietal region.

Bone marrow oedema in the left parietal skull bone.

Case Discussion

The imaging findings in this case are consistent with stage 2 diffuse axonal injury.

Diffuse axonal injury often presents with severe clinical symptoms, including deep coma, while CT imaging may not reveal clear lesions. This makes diagnosis challenging.

MRI of the brain, especially with GRE or SWI sequences, has a higher sensitivity in detecting diffuse axonal injuries. This allows for the identification of microhaemorrhages or vascular lesions that CT may miss.

Differential diagnoses for this condition include:

Accurate identification of these conditions is crucial for developing an appropriate treatment plan.

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