Diffuse axonal injury in head injury: definition, diagnosis and grading

Adams, J.H., Doyle, D., Ford, I. , Gennarelli, T.A., Graham, D.I. and McLellan, D.R. (1989) Diffuse axonal injury in head injury: definition, diagnosis and grading. Histopathology, 15(1), pp. 49-59. (doi: 10.1111/j.1365-2559.1989.tb03040.x)

Abstract

Diffuse axonal injury is one of the most important types of brain damage that can occur as a result of non-missile head injury, and it may be very difficult to diagnose post mortem unless the pathologist knows precisely what he is looking for. Increasing experience with fatal non-missile head injury in man has allowed the identification of three grades of diffuse axonal injury. In grade 1 there is histological evidence of axonal injury in the white matter of the cerebral hemispheres, the corpus callosum, the brain stem and, less commonly, the cerebellum; in grade 2 there is also a focal lesion in the corpus callosum; and in grade 3 there is in addition a focal lesion in the dorsolateral quadrant or quadrants of the rostral brain stem. The focal lesions can often only be identified microscopically. Diffuse axonal injury was identified in 122 of a series of 434 fatal non-missile head injuries–-10 grade 1, 29 grade 2 and 83 grade 3. In 24 of these cases the diagnosis could not have been made without microscopical examination, while in a further 31 microscopical examination was required to establish its severity.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ford, Professor Ian
• Authors: Adams, J.H., Doyle, D., Ford, I., Gennarelli, T.A., Graham, D.I., and McLellan, D.R.
• Subjects: R Medicine > R Medicine (General)
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Histopathology
• ISSN: 0309-0167
• Published Online: 18 March 2011