title: [Craniocerebral trauma: magnetic resonance imaging of diffuse axonal injury].
abstract: OBJECTIVE
  Acceleration-deceleration rotational brain trauma is a common cause of disability or death in young adults and often leads to a focal destruction of axons. The resulting pathology, axonal shear injury is referred to as diffuse axonal injury (DAI). The DAI-associated lesions occur bilaterally, are widely dispersed and have been observed in the surface and deep white matter. They are found near to and far from the impact site.
  
  
  METHODS
  When DAI is clinically suspected, magnetic resonance imaging (MRI) is the method of choice for further clarification, especially in patients where cranial computed tomography (CT) is inconspicuous.
  
  
  METHODS
  To investigate the presence of DAI after traumatic brain injury (TBI), a multimodal MRI approach is applied including the common structural and also functional imaging sequences.
  
  
  METHODS
  For structural MRI, fluid-attenuated inversion recovery (FLAIR) weighted and susceptibility contrast imaging (SWI) are the sequences mainly used. The SWI technique is extremely sensitive to blood breakdown products, which appear as small signal voids at three locations, at the gray-white interface, in the corpus callosum and in the brain stem. Functional MRI comprises a group of constantly developing techniques that have great potential in optimal evaluation of the white matter in patients after craniocerebral trauma. These imaging techniques allow the visualization of changes associated with shear injuries, such as functional impairment of axons and decreased blood flow and abnormal metabolic activity of the brain parts affected.
  
  
  RESULTS
  The multimodal MRI approach in patients with DAI results in a more detailed and differentiated representation of the underlying pathophysiological changes of the injured nerve tracts and helps to improve the diagnostic and prognostic accuracy of MRI.
  
  
  CONCLUSIONS
  When DAI is suspected multimodal MRI should be performed as soon as possible after craniocerebral injury.
authors.affiliation: Abteilung für Neuro- und Muskuloskelettale Radiologie, Klinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Allgemeines Krankenhaus, Währinger Gürtel 18-20, 1090, Wien, Österreich, Ammar.Mallouhi@meduniwien.ac.at.
authors.forename: A
authors.initials: A
authors.lastname: Mallouhi
mesh_terms: D006259:Craniocerebral Trauma / Q000473:pathology*; D020833:Diffuse Axonal Injury / Q000473:pathology*; D016489:Head Injuries, Closed / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009104:Multiple Trauma / Q000473:pathology*