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Diffuse Axonal Injury

By

Gordon Mao

, MD, Johns Hopkins School of Medicine

Medically Reviewed Jun 2021 | Modified Sep 2022
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Typical Structure of a Nerve Cell

A nerve cell (neuron) consists of a large cell body and nerve fibers—one elongated extension (axon) for sending impulses and usually many branches (dendrites) for receiving impulses. The impulses from the axon cross a synapse (the junction between two nerve cells) to the dendrite of another cell.

Each large axon is surrounded by oligodendrocytes in the brain and spinal cord and by Schwann cells in the peripheral nervous system. The membranes of these cells consist of a fat (lipoprotein) called myelin. The membranes are wrapped tightly around the axon, forming a multilayered sheath. This myelin sheath resembles insulation, such as that around an electrical wire. Nerve impulses travel much faster in nerves with a myelin sheath than in those without one.

Typical Structure of a Nerve Cell

The usual causes of diffuse axonal injury include falls and motor vehicle crashes. Diffuse axonal injury can occur in the shaken baby syndrome Physical abuse Physical abuse , in which violent shaking or throwing of a baby causes brain injury. As a result of diffuse axonal injury, brain cells may die, causing brain swelling, increasing pressure within the skull (intracranial pressure). Increased pressure may compound the injury by decreasing the blood supply to the brain.

Diffuse axonal injury typically causes loss of consciousness that lasts for more than 6 hours. Sometimes the person has other symptoms of brain damage. Increased pressure within the skull may cause coma.

Computed tomography (CT) or magnetic resonance imaging (MRI) is usually done to detect diffuse axonal injury.

Treatment of diffuse axonal injury is similar to treatment of other head injuries Treatment Head injuries that involve the brain are particularly concerning. Common causes of head injuries include falls, motor vehicle crashes, assaults, and mishaps during sports and recreational activities... read more . For example, doctors make sure that breathing and blood pressure are adequate and take steps to keep pressure within the skull from increasing too much.

Surgery is not helpful.

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