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)

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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 > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Histopathology
ISSN:0309-0167
Published Online:18 March 2011

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