DAÑO AXONAL DIFUSO SECUNDARIO A TRAUMATISMO CRANEOENCEFÁLICO Neurología del paciente en situación critica ( Neurocríticos).
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Intracranial hemorrhage Intra-axial Intraparenchymal hemorrhage Intraventricular hemorrhage Extra-axial Subdural hematoma Epidural hematoma Subarachnoid hemorrhage Axojal herniation Cerebral contusion Cerebral laceration Concussion Post-concussion syndrome Second-impact syndrome Dementia pugilistica Chronic traumatic encephalopathy Diffuse axonal injury Abusive head trauma Penetrating head injury.
DAI is classified into grades based on severity of the injury.
Diffuse axonal injury
MRI is the modality of choice for assessing suspected lesio axonal injury even in patients with entirely normal CT of the brain Central Nervous SystemTrauma. Non-hemorrhagic lesions are hypodense. The patients at risk of diffuse axonal injury belong to the same cohort as those who suffer traumatic brain injury and as such young men are very much over-represented.
Actual complete tearing of the axons is only seen in severe cases. The Journal of Neuroscience. Textbook Of Traumatic Brain Injury. Neuroimaging Clinics of North America.
They typically become more evident over the first few days as edema develops around them. Though axoanl processes involved in secondary brain injury are still poorly understood, it is now accepted that stretching of axons during injury causes physical disruption to and proteolytic degradation lesiob the cytoskeleton.
Diffuse axonal injury | Radiology Reference Article |
Management and staging of traumatic brain injury. Case 4 Case 4. Delayed presentation of diffuse axonal injury: While it was once thought that the main axonsl of axonal separation was tearing due to mechanical forces during the trauma, it is now understood that axons are not typically torn upon impact; rather, secondary biochemical cascadeswhich occur in response to the primary injury which occurs as the result of mechanical forces at the moment of trauma and take place hours to days after the initial injury, are largely responsible for the damage to axons.
In the majority of cases, these forces result in damage to the cells and result in edema.
Archives of Clinical Neuropsychology. Thus injury is frequently more severe than is realized, and medical professionals should suspect DAI in any patients whose CT scans appear normal but who have symptoms like unconsciousness. Comparison of matrix metalloproteinase expression during leskon degeneration in the central and peripheral nervous systems.
As such the diagnosis is often not suspected until later when patients fail to recover neurologically as expected.
Diffuse axonal injury is the result of shearing forces, typically from rotational acceleration most often a deceleration. The lobes of the brain most likely to be injured are the frontal and temporal lobes.
Unfortunately, it is not sensitive to subtle diffuse axonal injury and as such, some patients with relatively normal CT scans may have significant unexplained neurological deficit Journal of Neuropathology and Experimental Neurology.
Diffuse axonal injury – Wikipedia
About Blog Go ad-free. Traumatically induced axonal damage: This is to be expected as edema is faster to resolve than hemorrhage. Hemorrhagic lesions will be hyperdense and range in size from a few millimetres to a few centimetres in diameter.
Journal of Neuroscience 24 Figure 1 Figure 1. Traumatic axonal injury induces proteolytic cleavage of the voltage-gated sodium channels modulated by tetrodotoxin and protease inhibitors. To quiz yourself on this article, log in to see multiple choice questions.
Edit article Share article View revision history. Features typically demonstrate elevation of choline peak and reduction of NAA 3. Depending on the severity and distribution of injury see: DAI is difficult to detect since it does not show up well on CT scans or with other macroscopic imaging techniques, though difuwa shows up microscopically.
Susceptibility weighted image SWI of diffuse axonal injury in trauma at 1.
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Mitochondriadendritesand parts of the cytoskeleton damaged in the injury have a limited ability to heal and regenerate, a process which occurs over 2 or leskon weeks. Learning Discoveries Psychological Services. As such, it is usually a safe assumption that if a couple of small hemorrhagic lesions are visible on CT, the degree of damage is much greater.
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