Traumatic brain injury is the leading cause of death for persons under the age of 45 in the United States. Unfortunately, a dramatic brain injury occurs every 15 seconds and approximately 5 million Americans currently suffer some form of disability related to a TBI. The leading causes are motor vehicle accidents, falls and sports injuries. And, individuals who suffer from dramatic brain injuries can experience an injury which ranges anywhere from the very mild to the very severe.

Just as there are several different causes which results in a dramatic brain injury there are also different traumas that can happen to the brain. A closed head injury occurs when the skull has not been opened or penetrated from the direct trauma to the head and a penetrating head injury is the medical term used when an object has penetrated through the bone and into the brain.

The brain can also suffer a direct trauma, and in direct trauma, a diffuse axonal injury, hypoxia or anoxia as well as secondary injuries related to the initial trauma and edema, hematoma or hydrocephalus. Diffuse axonal injuries will occur in about half of all severe head trauma is making it one of the most common brain injuries no matter the cause. It can also happen during a moderate or a mild brain injury.

A diffuse axonal injury falls under the category of the diffuse brain injury. This means that there is no focal point to the injury to the brain but rather there is injuries throughout the brain matter, in a more widespread pattern. Unfortunately, severe diffuse axonal injury is also one of the leading causes of death in individuals who suffer from a dramatic brain injury. This is because the brain is left with no particular routes to compensate for those parts which have been injured.

The brain is a complex mechanism made out of nerve cells. When nerve impulses leave the cell it travels through a part of the nerve called the axon. In a diffuse axonal injury is these axons are damaged. Typically the injury can cause a loss of consciousness that lasts for more than six hours.

A diffuse axonal injury is not the result of a blow to the head but, instead a result from the brain moving back and forth inside the skull. These are sometimes called acceleration or deceleration injuries. The most common of these are automobile accidents, sports related accidents, falls and child abuse such as shaken baby syndrome. During these sudden movements, acceleration and deceleration, the nerves in the brain are stretched, twisted and damaged, also called shear injury. Under a microscope the axonal damage is called the diffuse axonal injury and although it generally results from a severe whiplash that causes coma recent studies have shown that it can also occur when there’s only been a brief loss of consciousness.

Because a diffuse axonal injury causes damage that is not visualize on CTU or MRI scans the diagnosis is often made clinically. A second method that causes a diffuse axonal injury is during high velocity changes such as a fall from a great height or a high-speed car accident. The damages caused by a sudden change in the density inside each individual brain cell.

Many of these same types of injuries have been discovered in treated and veterans returning from the Iraqi war. Having been exposed to explosive charges, the proximity puts the individual in an area where the pressure or polls from the explosion will cause damage to the brain cells. Although many of these soldiers shown no abnormal changes initially they can suffer from serious injury and long-term effects as a result.

And then diffuse axonal injury the brain can suffer damage through three different processes. Because of the injury the cells in the brain are unable to communicate either electronically or chemically. The disruption in this balance will result in brain cells sending off the wrong signals that will destroy them. After a trauma the body can also release chemicals that are toxic to the brain cells. And the third instance micro-inflammation at the cellular level can cause swelling and increase pressure that results in secondary brain damage. This micro-inflammation is not always visible on MRI or CT scan because it occurs at the cellular level.

The main symptoms of this type of injury is lack of consciousness which can last up to six hours or more. A person who suffers a mild or moderate injury and who is conscious may show others signs depending upon which area of the brain is most affected. Although, for the most part, a CT scan will not give definitive results in the diagnosis of a diffuse axonal injury, physicians continue to monitor a patient’s physical trauma through the use of a CT. an MRI is the preferred test for diagnosing diffuse axonal injury and physicians will also request an evoked potential and electroencephalograms to complete the picture.

Treatment of this particular type of brain injury will begin in the immediate emergent time period and continue through rehabilitation. At this time physicians believe that a diffuse axonal injury can happen in just about every level of severity of traumatic brain injury, even concoction. In a milder more moderate forms recovery is very possible. However, approximately 90% of survivors who suffer a severe injury will remain unconscious and the 10% who regain consciousness are often very severely impaired. These results are a factor of the widespread damage that is done throughout the brain.

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