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Abstract
Diffuse axonal injury is the term used to describe prolonged post traumatic coma that is not due to mass lesion or ischemic insults.
There is loss of consciousness from the time of injury that continues beyond 6 hours, this phenomenon may further be taken down into mild, moderate or severe
categories .
DAI is a significant medical problem because of the high level of
debilitation of the patient, the stress that the patient’s family must endure
when the patient is in a persistent vegetative state, and the staggering
medical cost of sustaining an individual in this state. DAI typically consists of several focal white matter 1-15 mm lesions in a characteristic distribution.
Neurological examination remains the most important factor in rapid
assessment of the extent and severity of cerebral injury and is of vital
importance in the subsequent monitoring of improvement or deterioration of
neurological status with the passage of time, the complete, evaluation should
include a well documented assessment of consciousness, motor abilities,
pupillary characteristics, eye movements, and vital signs .
MRI is more sensitive: 30% of head injured patients with normal head
CT scans have signs of DAI on MRI. But MRI may also miss DAI, because
it identifies the injury using signs of edema, which may not be present
The brain attempts to repair itself after a trauma, and is more successful after mild to moderate injury than after severe injury. Scientists
have shown that after diffuse axonal injury neurons can spontaneously adapt
and recover by sprouting some of the remaining healthy fibers of the neuron
into the spaces once occupied by the degenerated axon The goal of brain injury rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially.