Diffuse axonal injury due to nonmissile head injury in humans: An analysis of 45 cases
Abstract
Forty-five cases of diffuse axonal injury (DAI) brought about by nonmissile head injury in humans are analyzed and compared with 132 cases of fatal head injury without DAI. All cases were subjected to a comprehensive neuropathological study. In the patients with DAI a statistically significant lower incidence of lucid interval, fracture of the skull, cerebral contusions, intracranial hematoma, and evidence of high intracranial pressure were found, with a higher incidence of head injury due to road traffic accident. Brain swelling and hypoxic brain damage were not statistically different in the two groups. The features of DAI in humans are compared with the DAI that has been produced in subhuman primates by pure inertial loading brought about by angular acceleration of the head. 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.
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Other studies have shown that the greatest brainstem damage with TBI is often near the dorsolateral surface of the mesopontine junction.
“the observed pattern of injury is in keeping with other studies which have shown the greatest brainstem damage with TBI is often near the dorsolateral surface of the mesopontine junction, 12,13”
From Damage to Arousal-Promoting Brainstem Neurons with Traumatic Brain Injury (2016) · cites this paper as [12]
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- Authors
- Adams, J. H., Graham, D. I., Murray, L. S., & Scott, G.
- Affiliations
- Southern General Hospital (GB)
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 1982-12
- Volume
- 12
- Issue
- 6
- Pages
- 557-563
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W2030312267
- Cited by
- 950
- References
- 0
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 12 · 2023: 17 · 2022: 17 · 2021: 16 · 2020: 23 · 2019: 28 · 2018: 22 · 2017: 32 · 2016: 24 · 2015: 33 · 2014: 33 · 2013: 22 · 2012: 32
- FWCI
- 10.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- diffuse axonal injury, traumatic brain injury, traffic accidents, lucid interval, cerebral contusion, intracranial hematoma, skull fracture, intracranial pressure, cerebral edema, hypoxic brain injury, inertial loads, angular acceleration, subhuman primates, neuropathology
- MeSH terms
- Adolescent, Adult, Aged, Axons, Brain, Brain Concussion, Brain Edema, Brain Injuries, Hypoxia, Brain, Child, Female, Hematoma, Humans, Intracranial Pressure, Male, Middle Aged, Skull Fractures
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