Diffuse Axonial Injury

  I have a friend that was in an accident a few weeks ago.  His condition has been diagnosed as Diffuse Axonial Injury.  Could you explain the effects of this condition and give me an idea of the prognosis?  He is responsive to commands and does recognize people.  Thank you!!
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Thanks for your question.  "Diffuse axonal injury" is a rather general term
used to describe neural tissue injury that occurs in the cerebral hemispheres
and in the brainstem following a head trauma.  The mechanism of the injury
is a "shearing" action between the different layers of the brain tissue, and
between the brain tissue and the supplying vasculature.  Thus, the injured
brain often displays multiple petechial  hemorrhages in the perivascular
spaces of the white matter, and involves relatively resistant small, deep
blood vessels.  A major determinant of the extent of diffuse axonal injury
will be the nature and velocity of the impact force.  Assessment of the
damage is best achieved immediately after the event.  Alteration of the
level of consciousness is the primary factor for the gradation/ranking of
the injury, and goes from: less than 5 mins (very mild), to more than 7
days (very severe).  The prognosis and outcome in most patients depends on
the severity of the primary damage, and in the most severe cases, on the
extent of the brainstem involvement.  The brainstem, due to the concentration
of vital control areas, such as the respiratory, the cardiovascular, and
the reticular activating system (responsible for alertness), can be the
most important element to determined survival and level of function.  The
therapeutic management of these patients is largely supportive, so to provide
appropriate cardiovascular, respiratory, renal, immunological, and
nutritional support.
I hope this information is helpful.  Best of luck.
This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.