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Diffuse Axonal Injury Pattern Predicts Timing of In-Hospital Neurologic Recovery: A Retrospective Case Series
Mohamed E El-Abtah1, Ahmed Kashkoush2, Jordan C Petitt1
1Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
World Neurosurgery
|June 25, 2023
Summary
Diffuse axonal injury (DAI) grade 1 patients showed faster short-term neurologic recovery. However, final discharge GCS scores were similar across all DAI grades, indicating DAI classification offers short-term prognostic insights.
Area of Science:
- Neurology
- Trauma Surgery
- Radiology
Background:
- Diffuse axonal injury (DAI) is a severe traumatic brain injury with unpredictable outcomes.
- The relationship between DAI's neuroanatomic pattern and recovery timeline is not well understood.
Purpose of the Study:
- To investigate the association between DAI neuroanatomic injury patterns and the timing of neurologic recovery.
Main Methods:
- Retrospective review of 19 DAI patients diagnosed between 2017-2021.
- DAI severity scored using head CT scans by a neuroradiologist.
- In-hospital Glasgow Coma Scale (GCS) tracked throughout the hospital stay.
Main Results:
- Grade 1 DAI patients recovered faster, following commands in an average of 9.3 days versus 17-19 days for grades 2 and 3.
- Grade 1 DAI patients consistently had higher GCS scores during hospitalization.
- Discharge GCS and command following were similar across all DAI grades.
Conclusions:
- Grade 1 DAI is associated with the quickest short-term neurologic improvement.
- DAI classification provides valuable short-term prognostic information for in-hospital recovery.
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