Diffuse Axonal Injury

Diffuse axonal injury (DAI) is a form of traumatic brain injury characterized by widespread shearing of axons due to rotational or acceleration-deceleration forces. Clinically, it presents with coma, impaired consciousness, and variable focal neurological deficits. Pathophysiology involves mechanical disruption of axonal cytoskeleton, secondary neuroinflammation, and progressive axonal degeneration. Diagnosis relies on MRI, particularly susceptibility-weighted imaging, as CT may be insensitive. Management is supportive, focusing on intracranial pressure control, stabilization, and rehabilitation; prognosis depends on injury severity, with severe DAI often resulting in persistent vegetative state or significant neurological impairment.