Diffuse Axonal Injury: Pathological and Clinical Aspects

Diffuse traumatic brain injury refers to widespread pattern of injury throughout the brain caused by traumatic disruption of nerve cells, with particular injury to the axons [1]. There are four principal types of traumatic brain injury: diffuse vascular injury, diffuse axonal injury, hypoxic-ischemic encephalopathy and diffuse brain swelling [2]. Clinically, DAI is characterized by generalized injury to the axons leading to immediate unconsciousness and coma longer than 6 hours of duration. It is most commonly seen in road traffic fatalities and occasionally in assaults or fall from considerable height [3,4]. Though the terms DAI and traumatic axonal injury have been used interchangeably, it has been proved that the diffuse injury to the axons can also occur in a variety of other non traumatic pathological conditions such as cerebral hypoxia, hypoglycemia etc., [5-8]. So the more specific term traumatic diffuse axonal injury or traumatic axonal injury has replaced diffuse axonal injury to specifically highlight axonal damage due to trauma [9].