The identification of diffuse axonal injury (DAI) can be difficult, especially using conventional imaging (CT or MRI), which usually appears normal. Diffusion tensor imaging (DTI) is useful in identifying white matter abnormalities in patients with DAI. We describe the case of a 17-year-old female with severe closed head injury and right-side hemiparesis, studied with DTI and MR-tractography. In this case, DTI was useful to detect focal and diffuse signs of DAI.
TakayamaHKobayashiMSugishitaM. Diffusion-weighted imaging demonstrates transient cytotoxic edema involving the corpus callosum in a patient with diffuse brain injury. Clin Neurol Neurosurg. 2000: 102: 135–139. doi: 10.1016/S0303-8467(00)00079-2.
2.
AhnYHKimSHHanBS. Focal lesions of the corticospinal tract demonstrated by diffusion tensor imaging in patients with diffuse axonal injury. Neurorehabilitation. 2006; 21 (3): 239–243.
3.
AlbericoAMWardJDChoiSC. Outcome after severe head injury: relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. J Neurosurg. 1987; 67 (5): 648–656. doi: 10.3171/jns.1987.67.5.0648.
4.
VirtaABarnettAPierpaoliC. Visualizing and characterizing white matter fiber structure and architecture in the human pyramidal tract using diffusion tensor MRI. Magn Res Imaging. 1999; 17 (8): 1121–1133. doi: 10.1016/S0730-725X(99)00048-X.
5.
BasserPJ. Inferring microstructural features and the physiological state of tissues from diffusion-weighted images. NMR Biomed. 1995; 8 (7–8): 333–344. doi: 10.1002/nbm.1940080707.
6.
HuismanTSchwammLHSchaeferPW. Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury. Am J Neuroradiol. 2004; 25 (3): 370–376.
7.
ArfanakisKHaughtonVMCarewJD. Diffusion tensor MR imaging in diffuse axonal injury. Am J Neuroradiol. 2002; 23: 794–802.
8.
ChaJHMTsuiEYKPehWCG. Diffuse axonal injury: detection of changes in anisotropy of water diffusion by diffusion-weighted imaging. Neuroradiology. 2003; 45 (1): 34–38.
9.
MoritaniTSmokerWRKSatoY. Diffusion-weighted imaging of acute excitotoxic brain injury. Am J Neuroradiol. 2005; 26 (2): 216–228.
