Imaging findings in diffuse axonal injury after closed head trauma

P. M. Parizel, Ö Özsarlak, J. W. Van Goethem, L. Van Den Hauwe, C. Dillen, J. Verlooy, P. Cosyns, A. M. De Schepper

Research output: Contribution to journalReview article

153 Citations (Scopus)

Abstract

Even in patients with closed head trauma, brain parenchyma can be severely injured due to disruption of axonal fibers by shearing forces during acceleration, deceleration, and rotation of the head. In this article we review the spectrum of imaging findings in patients with diffuse axonal injuries (DAI) after closed head trauma. Knowledge of the location and imaging characteristics of DAI is important to radiologists for detection and diagnosis. Common locations of DAI include: cerebral hemispheric gray-white matter interface and subcortical white matter, body and splenium of corpus callosum, basal ganglia, dorsolateral aspect of brainstem, and cerebellum. In the acute phase, CT may show punctate hemorrhages. The true extent of brain involvement is better appreciated with MR imaging, because both hemorrhagic and non-hemorrhagic lesions (gliotic scars) can be detected. The MR appearance of DAI lesions depends on several factors, including age of injury, presence of hemorrhage or blood-breakdown products (e.g., hemosiderin), and type of sequence used. Technical aspects in MR imaging of these patients are discussed. Non-hemorrhagic lesions can be detected with fluid attenuated inversion recovery (FLAIR), proton-density-, or T2-weighted images, whereas gradient echo sequences with long TE increase the visibility of old hemorrhagic lesions.

Original languageEnglish
Pages (from-to)960-965
Number of pages6
JournalEuropean Radiology
Volume8
Issue number6
DOIs
Publication statusPublished - 1 Jan 1998
Externally publishedYes

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    Parizel, P. M., Özsarlak, Ö., Van Goethem, J. W., Van Den Hauwe, L., Dillen, C., Verlooy, J., ... De Schepper, A. M. (1998). Imaging findings in diffuse axonal injury after closed head trauma. European Radiology, 8(6), 960-965. https://doi.org/10.1007/s003300050496