ABSTRACT
The most typical neurologic signs and variants of computer-tomographic cerebral picture in diffuse axonal lesion of the brain are presented. Dynamics of pathomorphologic changes depending on duration of posttraumatic periods is detected.
Subject(s)
Brain Injuries/pathology , Craniocerebral Trauma/pathology , Adolescent , Adult , Axons/diagnostic imaging , Axons/pathology , Brain/diagnostic imaging , Brain/pathology , Brain Injuries/diagnosis , Child , Coma/diagnosis , Coma/pathology , Craniocerebral Trauma/diagnosis , Female , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
On the basis of complex clinical, computed tomographic, catamnestic, and pathomorphological examination of 336 patients with severe cerebrocranial injury the authors substantiate the need to distinguish, along with localized contusions and intracranial hematomas, diffuse axonal injuries of the brain whose biomechanics and pathogenesis are linked with trauma of angular or rotational acceleration-deceleration. The clinical manifestations and the course of diffuse axonal injuries are characterized by protracted coma occurring immediately after the injury with marked disorders of stem functions, postural motor reactions, slow recovery from coma, with the formation of a stable or transitory vegetative state, the development of syndromes of disconnection of the cerebral hemispheres and the brain stem, and severe invalidization of the patients due to mental and neurological deficits.
Subject(s)
Axons/pathology , Brain Injuries/diagnostic imaging , Acute Disease , Adolescent , Adult , Brain/diagnostic imaging , Brain/pathology , Brain Injuries/mortality , Brain Injuries/pathology , Child , Child, Preschool , Coma/diagnostic imaging , Coma/mortality , Coma/pathology , Female , Fractures, Closed/diagnostic imaging , Fractures, Closed/mortality , Fractures, Closed/pathology , Fractures, Open/diagnostic imaging , Fractures, Open/mortality , Fractures, Open/pathology , Humans , Male , Middle Aged , Prognosis , Skull Fractures/diagnostic imaging , Skull Fractures/mortality , Skull Fractures/pathology , Time Factors , Tomography, X-Ray ComputedABSTRACT
Based on an analysis of 56 cases with diffuse axonal lesions the authors describe symptoms of dissociation of the brain hemispheres and brain stem. Such symptoms occur on transformation of long coma to a steady or transitory vegetative state and are characterized by chaotic activation of the subcortical and stem formations remaining intact and dynamic manifestation of a complex of postural and generalized motor reactions, complex pathological reflexes, oral, oculomotor, pupillary and cerebrospinal automatisms, paroxysmal vegeto-visceral abnormalities along with functional silence of the cortex.
