EURORAD ESR

Case 14466

Diffuse axonal injury: CT and MRI typical findings

Author(s)
J.A Prat-Matifoll; D. De Bonadona; M. Planes Conangla; J.C Tortajada; E. Castellà Fierro

VALL HEBRÓN HOSPITAL, INSTITUT CATALÀ DE LA SALUT, RADIOLOGY; PASSEIG VALL HEBRÓN 116-119 08035 BARCELONA, Spain; Email:joanalbertpratrx@gmail.com
 
Patient
female, 17 year(s)
 
 
  • Figure 1
    CT: Emergency room

    Multiple tiny hyperdense foci (microhemorrhage, red arrows). From the top to the bottom: Junction between gray–white matter (frontal lobes), corpus callosum (splenium) and right thalamus. Note the intraventricular...

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Complications; Special Focus: Trauma;
     
     
  • Figure 2
    CT after 2 days
     

    More conspicuous intraventricular hemorrhage (yellow arrow) and microhemorrhages in the splenium and right temporal lobe (red arrows).

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Complications; Special Focus: Trauma;

    Intraventricular hemorrhage (yellow arrow) and increasing hypodensity of posterior corpus callosum, caused by edematous changes (red arrows).

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Complications; Special Focus: Trauma;
     
     
  • Figure 3
    MRI after 10 days
     

    Multiple magnetic susceptibility artifacts (hemorrhages). Mainly located in the gray matter–white matter junction of frontotemporal lobes, body/splenium of corpus callosum and right dorsolateral midbrain. Note the...

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Complications; Special Focus: Trauma;

    Tiny hyperintense dots on T1WI in the subarachnoidal space, compatible with subarachnoidal haemorrhage as well as right laminar subdural haemorrhage (yellow arrows).

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Complications; Special Focus: Trauma;

    Conspicuous hyperintense areas on T2-FLAIR sequences demonstrating altered frontotemporal cortico-subcortical junctions, body/splenium of corpus callosum and right thalamus (orange arrow).

     
    Area of Interest: Genital / Reproductive system male; Geriatric; Haematologic; Imaging Technique: MR; Procedure: Complications; Special Focus: Trauma;

    Restricted diffusion within the body and splenium of corpus callosum (red arrows), probably secondary to an underlying cytotoxic oedema and irreversible injury in this location.

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Complications; Special Focus: Trauma;
     
     
  • Figure 4
    MRI after 10 days

    Note the presence of tiny magnetic susceptibility artifacts on SWI (susceptibility weighted imaging) in the right midbrain and right cerebellar peduncle/dentate nucleus (red arrows). These lesions correspond to a...

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Complications; Special Focus: Acute;
     
     
Multiple tiny hyperdense foci (microhemorrhage, red arrows). From the top to the bottom: Junction between gray–white matter (frontal lobes), corpus callosum (splenium) and right thalamus. Note the intraventricular hemorrhage within the right occipital horn.
 
More conspicuous intraventricular hemorrhage (yellow arrow) and microhemorrhages in the splenium and right temporal lobe (red arrows).
 
Intraventricular hemorrhage (yellow arrow) and increasing hypodensity of posterior corpus callosum, caused by edematous changes (red arrows).
 
Multiple magnetic susceptibility artifacts (hemorrhages). Mainly located in the gray matter–white matter junction of frontotemporal lobes, body/splenium of corpus callosum and right dorsolateral midbrain. Note the affection of the right thalamus (white arrow).
 
Tiny hyperintense dots on T1WI in the subarachnoidal space, compatible with subarachnoidal haemorrhage as well as right laminar subdural haemorrhage (yellow arrows).
 
Conspicuous hyperintense areas on T2-FLAIR sequences demonstrating altered frontotemporal cortico-subcortical junctions, body/splenium of corpus callosum and right thalamus (orange arrow).
 
Restricted diffusion within the body and splenium of corpus callosum (red arrows), probably secondary to an underlying cytotoxic oedema and irreversible injury in this location.
 
Note the presence of tiny magnetic susceptibility artifacts on SWI (susceptibility weighted imaging) in the right midbrain and right cerebellar peduncle/dentate nucleus (red arrows). These lesions correspond to a stage 3 (severe) diffuse axonal injury.
 
 
 
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