Diffuse axonal injury A clinical and computerised tomography study of 128 patients

A study of clinical, computerised tomography (CT) profile and outcome was made of 128 patients, diagnosed to have diffuse axonal injury based on CT criteria. The mean age was 26 years. A lucid interval was present in 37 patients and hypoxia and/or hypotension was present in 43 patients. The depth of "marker lesions" in CT correlated with Glasgow Coma Score (GCS) (p<0.02) and duration of coma (p<0.01). The presence of associated intracranial haematoma >25 ml portended an adverse outcome. A logistic regression analysis revealed age, GCS, state of perimesencephalic cisterns and pupillary dilation to be independent predictors of poor outcome. Residual sequelae (focal deficits, cognitive deficits, postconcussion syndrome) were evident in nearly half of patients with diffuse axonal injury (DAI) and a lucid interval.