Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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March 23, 2009
Diffuse Axonal Injury
- Diffuse axonal injury (DAI) involves the white matter tracts and is associated with acceleration/deceleration and shearing forces commonly seen with motor vehicle accidents.
- Usually seen at the gray-white matter junction, frequently involves the splenium of the corpus callosum, cerebral peduncles, and upper brainstem.
- The majority of cases of DAI are non-hemorrhagic. Only 10-30% contain hemorrhagic foci.
- DAI incidence is underestimated with CT imaging alone. MRI shows many more lesions.
- Diffusion-weighted imaging is very sensitive for detection of non-hemorrhagic DAI, T2*-weighted sequences add sensitivity for hemorrhagic foci.
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