MR Imaging of Diffuse Axonal Injury: Correlation with Initial Neurological State and Outcome.

Park, Cheok Wong; Kim, Eun Sang; Kim, Jae Hyung; Park, In Sung; Jung, Jin Myung; Han, Jong Woo

Original Article

Journal of Korean Neurosurgical Society 1996;25(5): 977-983.

Cheok Wong Park, Eun Sang Kim, Jae Hyung Kim, In Sung Park, Jin Myung Jung, Jong Woo Han

¹Department of Neurosurgery, College of Medicine, Gyeongsang National University, Chinju, Korea.
²Department of Radiology, College of Medicine, Gyeongsang National University, Chinju, Korea.

ABSTRACT

The authors have evaluated retrospectively the distribution and extent of traumatic lesions in brain MRI of 20 diffuse axonal injury(DAI) patients. DAI most commonly involves the white matter of the frontal lobe and posterior half of the corpus callosum. The lesions on MRI were classified according to the modified Adams staging as follows. Stage 0:no lesion identified(3 cases, 15%); Stage 1 :lesions confined to the lobar white matter(4 cases, 20%);Stage 2 : lesions in the lobar white matter and corpus callosum(9 cases, 45%) ; Stage 3: additional lesions in midbrain and upper pons(4 cases, 20%). Correlations between the modified Adams staging and initial posttraumatic consciousness state, presence of focal neurological deficit and the outcome of the patients were observed. Also, the presence of corpus callosum lesions tends to be associated with subarachnoid and/or intraventricular hemorrhage, T2 weighted image was found to be the most sensitive sequence for detection of DAI lesions.

Key Words: Diffuse axonal injury; MRI; Modified Adams staging; Neurological state