Diffuse axonal injury: a case report and MRI findings

Abstract

Diffuse axonal injury (DAI) is one of the most severe types of primary traumatic brain injury. In recent years, MR imaging has been gaining popularity as an adjunctive imaging method in patients with DAI. In this case report, we describe MRI findings of an 11-year-old male patient diagnosed with DAI and discuss the role of different sequences in the evaluation of DAI.

Keywords: Diffuse axonal injury; Diffusion tensor imaging; Diffusion weighted imaging; Magnetic resonance imaging; Susceptibility weighted imaging.

Fig. 1

Multiple punctate hyperdense foci (microhemorrhage) at the gray-white matter junction of bilateral temporal (white arrow, A) and frontal lobes (white arrows, B)

Fig. 2

(A) and (B). Axial FLAIR images showed some punctate hyperintense foci in the subcortical white matter of the right frontal lobe (arrow) and the splenium of the corpus callosum (white arrows). (C) and (D). DWI and ADC maps indicated restricted diffusion within the splenium of the corpus callosum (yellow arrows) (Color version of figure is available online)

Fig. 3

SWI  illustrated multiple hypointense foci of hemorrhagic lesions at the grey-white matter junction of bilateral temporal lobes (white arrows, A), bilateral frontal lobes (green arrows, B), posterior limb of the left internal capsule (yellow arrow, C), the fornix commissure, and the splenium of the corpus callosum (red arrows, D) (Color version of figure is available online)

Fig. 4

Diffusion Tensor Imaging with 3D-Fiber Tractography revealed disrupted white matter fibers in the posteroinferior aspect of the splenium (arrow, A), left crus of the fornix (arrow, B), and subcortical frontal tracts (circle C and arrow D)