Clinical and radiological assessment of diffuse axonal injury in traumatic brain injury patients: A retrospective study

Abstract

Background: Diffuse Axonal Injury (DAI) is a severe form of traumatic brain injury (TBI), characterised by widespread damage to white matter tracts due to shearing forces. It is often associated with high morbidity and mortality, especially when diagnosis and management are delayed.

Objective: This study aims to evaluate the clinical, demographic, and radiological features of DAI patients and assess their treatment outcomes. Additionally, it investigates the correlation between MRI-based Adams Grading and prognosis using the Glasgow Outcome Scale (GOS).

Methods: A retrospective analysis was conducted on 30 patients diagnosed with DAI and admitted to the Department of Neurosurgery, SVP Hospital, Ahmedabad, from June 2022 to June 2024. Data collected included age, gender, mechanism of injury, initial Glasgow Coma Scale (GCS) score, MRI findings (Adams Grade), treatment modalities, and GOS scores at discharge or follow-up.

Results: DAI was most commonly observed in young adults aged 11–30 years, with road traffic accidents being the leading cause. MRI demonstrated superior diagnostic accuracy compared to CT. Adams Grading showed a strong correlation with clinical outcomes: higher grades (II and III) were associated with poorer GOS scores (1–3), while lower grades (I) had better outcomes (4–5). Early neurocritical care and timely imaging significantly influenced recovery.

Conclusion: DAI predominantly affects young individuals, primarily due to preventable trauma. MRI plays a crucial role in early diagnosis and prognostication. A multidisciplinary approach, including prompt neuro-intensive care and rehabilitation, is essential for improving outcomes in DAI patients.