Prognostic Value of Early Magnetic Resonance Imaging Lesion Topography in Diffuse Axonal Injury: The KASHI...

Area of Science:

• Neuroscience
• Radiology
• Trauma Surgery

Background:

• Diffuse axonal injury (DAI) is a severe form of traumatic brain injury (TBI) with high mortality and morbidity.
• Early prognostic information is critical for managing DAI patients and counseling families.

Purpose of the Study:

• To assess the prognostic value of early MRI-based lesion location in DAI using the KASHI Classification.
• To correlate lesion topography with acute neurological severity, mortality, and long-term functional recovery.

Main Methods:

• A prospective cohort study of 91 DAI patients within 24 hours of TBI.
• Standardized MRI including diffusion tensor imaging was performed.
• Lesions were graded using the KASHI schema; clinical severity (GCS) and outcomes (PTA, 6-month functional status) were recorded.

Main Results:

• Higher KASHI grades correlated with worse acute and long-term outcomes.
• Grade 3C lesions were associated with the lowest GCS scores and 68% in-hospital mortality.
• Thalamic and basal ganglia lesions predicted prolonged PTA and poorer functional recovery.

Conclusions:

• The KASHI Classification provides a reliable framework for predicting DAI severity and recovery.
• Early MRI lesion topography enhances prognostic accuracy in acute TBI care.
• Multicenter validation and integration with automated imaging analytics are recommended.