The authors have evaluated retrospectively the distribution and extent of traumatic lesions in brain MRI of 20 diffuse axonal injury(DAI) patients. DAI most commonly involves the white matter of the frontal lobe and posterior half of the corpus callosum. The lesions on MRI were classified according to the modified Adams staging as follows. Stage 0:no lesion identified(3 cases, 15%); Stage 1 :lesions confined to the lobar white matter(4 cases, 20%);Stage 2 : lesions in the lobar white matter and corpus callosum(9 cases, 45%) ; Stage 3: additional lesions in midbrain and upper pons(4 cases, 20%). Correlations between the modified Adams staging and initial posttraumatic consciousness state, presence of focal neurological deficit and the outcome of the patients were observed. Also, the presence of corpus callosum lesions tends to be associated with subarachnoid and/or intraventricular hemorrhage, T2 weighted image was found to be the most sensitive sequence for detection of DAI lesions.
Axons ; Brain ; Consciousness ; Corpus Callosum ; Diffuse Axonal Injury* ; Frontal Lobe ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Mesencephalon ; Retrospective Studies