Clinical Analysis of Diffuse Axonal Injury(DAI) Diagnosed with Magnetic Resonance Image(MRI)

ABSTRACT

Atotal of 26 patients diagnosed as diffuse axonal injury(DAI) between Nov. 1993 and Dec. 1995, were evaluated retrospectively with special attention given to MRI findings. In clinical aspects, there was male predominance(1.9:1) with the mean age of 28.5 years. The clinical grades based on the Glasgow coma scale(GCS) score were classified as mild(13-15), moderate(9-12) and severe(3-8). The duration of hospitalization and loss of consciousness(LOC) at admission were well correlated with the severity of clinical status. As regards the outcome of patients, twenty patients(77%) recovered as alert, but three patients(12%) died of sepsis. Short duration of LOC less than one day and young age of less than 10 years were good prognostic factors. The MRI findings of DAI were divided into three grades; in grade 1, there was small scattered lesions in the white matter of the cerebral hemisphere, in grade 2, focal lesion in the corpus callosum, and in grade 3, there was an additional focal lesion in the brain stem. The final outcome of grade 3 was poor, but in grade 2, there was wide spectrum between initial clinical status from alertness to semicoma and relative good result.