Diffuse Axonal Injury in Head Trauma

@article{Smith2003DiffuseAI,
  title={Diffuse Axonal Injury in Head Trauma},
  author={Douglas H. Smith and D. Meaney and William H. Shull},
  journal={Journal of Head Trauma Rehabilitation},
  year={2003},
  volume={18},
  pages={307–316}
}
Background:Diffuse axonal injury (DAI) is one of the most common and important pathologic features of traumatic brain injury (TBI). The susceptibility of axons to mechanical injury appears to be due to both their viscoelastic properties and their high organization in white matter tracts. Although axons are supple under normal conditions, they become brittle when exposed to rapid deformations associated with brain trauma. Accordingly, rapid stretch of axons can damage the axonal cytoskeleton… 
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References

SHOWING 1-10 OF 102 REFERENCES
Ultrastructural studies of diffuse axonal injury in humans.
TLDR
Analysis of the progression of traumatic brain injury-induced axonal change at the ultrastructural level in patients surviving from 6 to 88 h suggests that neurofilamentous disruption is a pivotal event in axonal injury.
Traumatically induced axonal injury: pathogenesis and pathobiological implications.
TLDR
This work reviews the pathobiology of traumatically induced axonal injury and considers its attendant consequences in terms of Wallerian degeneration and subsequent deafferentation in the context of mild, moderate and severe traumatic brain injury.
Mechanisms of brain injury.
  • T. Gennarelli
  • Medicine, Biology
    The Journal of emergency medicine
  • 1993
TLDR
Injury-specific treatments are now being designed to alter the various pathophysiological mechanisms of brain injury, which can be affected by delayed effects such as deafferentation or secondary events such as ischemia, swelling, cerebral edema, and increased intracranial pressure.
Axonal injury in the optic nerve: a model simulating diffuse axonal injury in the brain.
TLDR
A new model of traumatic axonal injury has been developed by causing a single, rapid, controlled elongation (tensile strain) in the optic nerve of the albino guinea pig to create reproducible axonal damage in a well-defined anatomical system that obviates many of the difficulties associated with studying the complex morphology of the brain.
Characterization of diffuse axonal pathology and selective hippocampal damage following inertial brain trauma in the pig.
TLDR
The results suggest that the nonimpact inertial loading model used to induce brain trauma in miniature swine is clinically relevant and useful for evaluating mechanisms of inertial brain trauma.
Early detection of axonal injury after human head trauma using immunocytochemistry for β-amyloid precursor protein
TLDR
Results show that βAPP immunocytochemistry may be useful in the detection of traumatic axonal injury in its early stages, before the formation of axonal retraction balls, provided care is taken to exclude other causes of such immunoreactivity.
Diffuse axonal injury in head injury: Definition, diagnosis and grading
TLDR
Diffuse axonal injury was identified in 122 of a series of 434 fatal non‐missile head injuries–‐10 grade 1, 29 grade 2 and 83 grade 3; in 24 of these cases the diagnosis could not have been made without microscope examination, while in a further 31 microscopical examination was required to establish its severity.
Diffuse axonal injury due to nonmissile head injury in humans: An analysis of 45 cases
TLDR
The available evidence indicates that DAI in human beings occurs at the time of head injury and is not due to complicating factors such as hypoxia, brain swelling, or raised intracranial pressure.
Temporal and Regional Patterns of Axonal Damage following Traumatic Brain Injury: A Beta‐amyloid Precursor Protein Immunocytochemical Study in Rats
TLDR
Data indicate that parasagittal F-P brain injury results in widespread axonalDamage, that axonal damage includes both reversible and delayed patterns, and that injury severity is an important factor in determining the severity of the axonal response to TBI.
High Tolerance and Delayed Elastic Response of Cultured Axons to Dynamic Stretch Injury
TLDR
An in vitromodel system that selectively stretches axons bridging two populations of human neurons derived from the cell line N-Tera2 demonstrated a remarkably high tolerance to dynamic stretch injury, and injured axons developed swellings of appearance remarkably similar to that found in brain-injured humans.
...
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3
4
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