Key result
In patients with traumatic brain injury, CT scan failed to detect diffuse axonal injury in all 15 cases (0%), whereas autopsy identified focal lesions in the corpus callosum in 60% of cases.
Why the study?
Diffuse axonal injury comprises microscopic damage that renders it almost invisible to current imaging techniques in traumatic brain injury.
Does CT scan accurately detect diffuse axonal injury compared to autopsy in patients with traumatic brain injury?
Observational (n=15)
No
Does CT scan accurately detect diffuse axonal injury compared to autopsy in patients with traumatic brain injury?
Absolute Event Rate: 0% vs 60%
CT scan is ineffective at detecting diffuse axonal injury in traumatic brain injury patients, highlighting the need for MRI when clinically stable.
CT may miss DAI lesions seen at autopsy; leaves open whether MRI improves detection in stable TBI.
BACKGROUND brain injury (TBI), a significant public health problem, is a leading cause of disability and mortality in all regions of globe despite advancement in prevention and treatments. Diffuse Axonal Injury (DAI) is ‘stealth’ pathology of TBI. Although throughout the white matter, it comprises primarily microscopic damage, rendering it almost invisible to current imaging . prospective study of all consecutive patients who presented with antecedent event of head injury to M.K.C.G Medical College Berhampur, was conducted from July 2016 to June 2018. Patients were subjected to CT head scan with bone window autopsy at the Department of Forensic Medicine, with special reference to DAI. of 15 cases in DBI group, only 2 cases (13.33%) had fissure fracture on vault. In the DBI group out of 15 cases, focal in Corpus Callosum (CC) were found in 9 cases (60%) on gross examination and 2 cases (13.33%) had gross focal in brain stem adjacent to superior cerebellar peduncle (SCP). SAH was seen in 8 cases (53%). Brain swelling was seen 5 cases (33.33%). CT scan was found to be normal in all the cases in the DBI group. current study revealed that in case of patients suspected of DAI, CT is not the investigation of choice. MRI of the brain be obtained on an elective basis when the patient is clinically stable because no effective treatment of DAI is currently . The final outcome of the patient depends on the presence or absence of diffuse axonal injury.
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Das et al. (2019) conducted an observational in Traumatic brain injury with suspected diffuse axonal injury (n=15). CT scan vs. Autopsy was evaluated on Detection of focal lesions in the corpus callosum. In patients with traumatic brain injury, CT scan failed to detect diffuse axonal injury in all 15 cases (0%), whereas autopsy identified focal lesions in the corpus callosum in 60% of cases.
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