Correlation of Outcome of Diffuse Axonal Injury with Reference to Magnetic Resonance Grading

Ram Avtar Malav; U S Shukla

Volume : V, Issue : VIII, August - 2016

Correlation of Outcome of Diffuse Axonal Injury with Reference to Magnetic Resonance Grading

Ram Avtar Malav, U S Shukla

Abstract :

Introduction: Diffuse axonal injury is defined as prolonged post–traumatic coma over 6 hours following injury without demonstrable mass lesion.It can be diagnosed using clinical signs and radiological evidence on MRI. Objective: This study was conducted to investigate the correlation between ain magnetic resonance imaging (MRI) grading for diffuse axonal injury and the time interval to recovery of consciousness and outcome in patients with diffuse axonal injury. Methods: Forty patients at our hospital from January 2015 to 2016 June who had been diagnosed with diffuse axonal injury and underwent MRI was included in this study. We retrospectively investigated the patients‘ medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding: grade I, small scattered lesions on the white matter of the cereal hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the ain stem. Result: Out of 40 patients grade one injuries noted in 10 (25%) patients. Their mean GCS score at the time of admission was7.6, and mean time interval to awake status was 3.7 days. Grade two injuries noted in 16 (40%) patients. Their mean GCS score at the time of admission was 7.56 and mean time interval to awake status was14.5 days. Grade three injuries were noted in 14 (35%) patients. Their GCS score at the time of admission was 6.28 and mean time interval to awake status was 38.35 days. Patients� GCS scores in the grade I and II groups began to improve soon after admission as compared to grade III group that did not improve until 1 month after injury. Conclusion: This study shows a correlation between the time intervals to recovery of consciousness in patients with diffuse axonal injury and the degrees of ain injuries seen on MRI,. Patients with diffuse axonal injuries with small hemorrhagic lesions on the hemispheric white matter or corpus callosum (Grade 1 and 2) recovered consciousness within 2 weeks. In contrast, patients with additional lesions on the ain stem (grade 3) did not recover consciousness within 2 months. Outcome better in female compared to male.