Margaret Thomas, BS RN CRRN, is a staff nurse at Shepherd Center in Atlanta, GA.
Challenges of Diffuse Axonal Injury Diagnosis
Version of Record online: 27 MAR 2012
2009 Association of Rehabilitation Nurses
Volume 34, Issue 5, pages 179–180, September-October 2009
How to Cite
Thomas, M. and Dufour, L. (2009), Challenges of Diffuse Axonal Injury Diagnosis. Rehabilitation Nursing, 34: 179–180. doi: 10.1002/j.2048-7940.2009.tb00276.x
- Issue online: 27 MAR 2012
- Version of Record online: 27 MAR 2012
- diagnostic challenges;
- diffuse axonal injury;
- traumatic brain injury
“This can't be right. Jay is in a vegetative state following a severe traumatic brain injury (TBI), but his computed tomography scan is essentially normal. How am I going to explain this to his mom?”
This is a conversation I overhear among my rehabilitation nurse colleagues from time to time. Jay has a type of brain trauma called diffuse axonal injury (DAI). Recent statistics from the National Centers for Injury Prevention and Control (NCIPC, 2006) indicate 1.4 million people sustain a TBI each year in the United States. The leading causes of TBI are falls (28%), motor vehicle accidents (20%), being struck by or against an object (19%), and assaults (11%; NCIPC). DAI, one of the most important causes of cognitive dysfunction after TBI (Sugiyama et al., 2007), occurs in a more widespread pattern in certain regions of the brain than the localized zone of focal injuries. It is one of the most devastating forms of TBI and a common cause of vegetative state and severe disability. DAI occurs in 40%–50% of all patients who are hospitalized from TBI (Meythaler, Peduzzi, Eleftheriou, & Novack, 2001).