Diffuse Axonal Injury: Pathological and Clinical Aspects

Abstract

Diffuse axonal and vascular injuries are the initial pathological findings in victims of diffuse brain trauma. Macroscopic findings include deep contusions and multiple petechial hemorrhages primarily involving cerebral white matter, basal ganglia and upper brainstem. Histologically β-amyloid precursor protein staining still remains the gold standard for microscopic detection of diffuse axonal damage. A number of other histological and immunohistochemical techniques have emerged over time aiding the diagnosis of diffuse axonal injury. There has been little success however in the microscopic differentiation of traumatic from non traumatic causes of diffuse axonal injury. This review explains various pathological and clinical aspects of traumatic axonal and vascular injuries including current scenarios in microscopic detection of diffuse axonal injury as well as their limitations.