[Diffuse axonal damages to the brain (the clinical picture, diagnosis and outcome)]

On the basis of complex clinical, computed tomographic, catamnestic, and pathomorphological examination of 336 patients with severe cerebrocranial injury the authors substantiate the need to distinguish, along with localized contusions and intracranial hematomas, diffuse axonal injuries of the brain whose biomechanics and pathogenesis are linked with trauma of angular or rotational acceleration-deceleration. The clinical manifestations and the course of diffuse axonal injuries are characterized by protracted coma occurring immediately after the injury with marked disorders of stem functions, postural motor reactions, slow recovery from coma, with the formation of a stable or transitory vegetative state, the development of syndromes of disconnection of the cerebral hemispheres and the brain stem, and severe invalidization of the patients due to mental and neurological deficits.