[KSCI] Korea Science Citation Index Service

http://dx.doi.org/10.3340/jkns.2009.46.3.205

Time to Recover Consciousness in Patients with Diffuse Axonal Injury : Assessment with Reference to Magnetic Resonance Grading

Park, Sung-Jun (Department of Neurosurgery, Cheongju Saint Mary's Hospital)
Hur, Jin-Woo (Department of Neurosurgery, Cheongju Saint Mary's Hospital)
Kwon, Ki-Young (Department of Neurosurgery, Cheongju Saint Mary's Hospital)
Rhee, Jong-Joo (Department of Neurosurgery, Cheongju Saint Mary's Hospital)
Lee, Jong-Won (Department of Neurosurgery, Cheongju Saint Mary's Hospital)
Lee, Hyun-Koo (Department of Neurosurgery, Cheongju Saint Mary's Hospital)

Publication Information

Journal of Korean Neurosurgical Society / v.46, no.3, 2009 , pp. 205-209 More about this Journal

Abstract

Objective : This study was conducted to investigate the correlation between the degrees of injury on brain magnetic resonance imaging (MRI) and the time interval to recovery of consciousness in patients with diffuse axonal injury. Methods : From January 2004 to December 2008, 25 patients with diffuse axonal injury were treated at our hospital. We retrospectively investigated the patients' medical records and radiological findings. We divided the patients into three groups according to the grade of MRI finding : grade I, small scattered lesions on the white matter of the cerebral hemisphere; grade II, focal lesions on the corpus callosum; and grade III, additional focal lesions on the brain stem. Result : Seven patients belonged to the grade I group; 10 to the grade II group; and 8 to the grade III group. The mean Glasgow Coma Scale (GCS) score of all patients at the time of admission was 7.28. Recovery of consciousness was observed in 23 of the 25 patients; the remaining two patients never regained consciousness. The time interval to recovery of consciousness (awake status) ranged from 1 day to 125 days (mean 22.1 days) : grade I group patients, within approximately 1 week (mean 3.7 days); grade II group patients, within approximately 2 weeks (mean 12.5 days); and grade III group patients, within approximately 2 months (mean 59.5 days). Conclusion : Our study results suggest a correlation between the mean time interval to recovery of consciousness in patients with diffuse axonal injuries and the degrees of brain injuries seen on MRI. Patients with grade I and II diffuse axonal injuries recovered consciousness within 2 weeks, while patients with grade III injuries required approximately 2 months.

Keywords

Brain stem; Consciousness; Diffuse axonal injury; MRI;

Citations & Related Records

Times Cited By Web Of Science : 3 (Related Records In Web of Science)
Times Cited By SCOPUS : 3

Reference
Cited By SCOPUS

1	Adams H, Mitchell DE, Graham DI, Doyle D : Diffuse brain damage of immediate impact type. Its relationship to "primary brain stem damage" in head injury. Brain 100 : 489-502, 1977 DOI ScienceOn
2	Adams JH, Graham DI, Murray LS, Scott G : Diffuse axonal injury due to nonmissile head injury in humans : an analysis of 45 cases. Ann Neurol 12 : 557-563, 1982 DOI ScienceOn
3	Eisenberg HM, Gary HE Jr, Aldrich EF, Saydjari C, Turner B, Foulkes MA et al. : Initial CT findings in 753 patients with severe head injury. A report from the NIH Traumatic Coma Data Bank. J Neurosurg 73 : 688-698, 1990 DOI PUBMED
4	Eum SW, Lim DJ, Kim BR, Cho TH, Park JY, Suh JK, et al. : Prognostic factors in patients with diffuse axonal injury. J Korean Neurosurg Soc 27 : 1668-1674, 1998
5	Gennarelli TA, Spielman GM, Langfitt TW, Gildenberg PL, Harrington T, Jane JA, et al. : Influence of the type of intracranial lesion on outcome from severe head injury. J Neurosurg 56 : 26-32, 1982 DOI PUBMED
6	Lee HS, Lee KS, Bae HG, Yun IG, Lee IS : Systemic insults in the early death after head injury. J Korean Neurosurg Soc 19 : 1101-1106, 1990
7	Levi L, Guilburd JN, Lemberger A, Soustiel JF, Feinsod M : Diffuse axonal injury : analysis of 100 patients with radiological signs. Neurosurgery 27 : 429-432, 1990 DOI PUBMED
8	Oh KS, Ha SI, Suh BS, Lee HS, Lee JS : The correlation of MRI findings to outcome in diffuse axonal injury patients. J Korean Neurosurg Soc (Suppl I) 30 : S20-S24, 2001
9	Park SW, Park K, Kim YB, Min BK, Hwang SN, Suk JS, et al. : Prognostic factors in diffuse axonal injuries of brain. J Korean Neurosurg Soc 20 : 983-990,1991
10	Williams JM, Gomes F, Drudge OW, Kessler M : Predicting outcome from closed head injury by early assessment of trauma severity. J Neurosurg 61 : 581-585, 1984 DOI PUBMED
11	Kalff R, Kocks W, Pospiech J, Grote W : Clinical outcome after head injury in children. Childs Nerv Syst 5 : 156-159, 1989 DOI ScienceOn
12	Zimmerman RA, Bilaniuk LT, Hackney DB, Goldberg HI, Grossman RI : Head injury : early results of comparing CT and high-field MR. AJR Am Roentgenol 147 : 1215-1222, 1986 DOI ScienceOn
13	Kim HJ, Park IS, Kim JH, Kim KJ, Hwang SH, Kim ES, et al. : Clinical analysis of the prognosis of the patients with cerebral diffuse axonal injuries, based on gradient-echo MR imaging. J Korean Neurosurg Soc 30 : 168-172, 2001
14	Kim CH, Lee HK, Koh YC, Hwang DY : Clinical analysis of diffuse axonal injury (DAI) diagnosed with magnetic resonance image (MRI). J Korean Neurosurg Soc 26 : 241-248, 1997
15	Miller JD, Butterworth JF, Gudeman SK, Faulkner JE, Choi SC, Selhorst JB, et al. : Further experience in the management of severe head injury. J Neurosurg 54 : 289-299, 1981 DOI PUBMED
16	Strich SJ : Diffuse degeneration of the cerebral white matter in severe dementia following head injury. J Neurol Neurosurg Psychiatry 19 : 163-185, 1956 DOI PUBMED
17	Levati A, Farina ML, Vecchi G, Rossanda M, Marrubini MB : Prognosis of severe head injuries. J Neurosurg 57 : 779-783, 1982 DOI PUBMED
18	Zimmerman RA, Bilaniuk LT, Genneralli T : Computed tomography of shearing injuries of the cerebral white matter. Radiology 127 : 393-396, 1978 DOI PUBMED
19	Gennarelli TA, Thibault LE, Adams JH, Graham DI, Thompson CJ, Marcincin RP : Diffuse axonal injury and traumatic coma in the primate. Ann Neurol 12 : 564-574, 1982 DOI ScienceOn
20	Alberico AM, Ward JD, Choi SC, Marmarou A, Young HF : Outcome after severe head injury : relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. J Neurosurg 67 : 648-656, 1987 DOI PUBMED

4	(2010) Journal of receptors and signal transduction Electromagnetic fields: mechanism, cell signaling, other bioprocesses, toxicity, radicals, antioxidants and beneficial effects / 30 (4) , 214
5	(2013) Brain injury : BI Cognitive impact of traumatic axonal injury (TAI) and return to work / 27 (5) , 521
10	(2013) Neural regeneration research : NRR Prognosis in prolonged coma patients with diffuse axonal injury assessed by somatosensory evoked potentia / 8 (10) , 948
None	(2009) Frontiers in neurology Diffusion Tensor Imaging Findings in Post-Concussion Syndrome Patients after Mild Traumatic Brain Injury: A Systematic Review / 7 (None) , 156
5	(2017) Disability and rehabilitation. Assistive technology Robotic gait assistive technology as means to aggressive mobilization strategy in acute rehabilitation following severe diffuse axonal injury: a case study / 12 (5) , 543
12	(2017) International journal of molecular sciences Diffuse Axonal Injury and Oxidative Stress: A Comprehensive Review / 18 (12) , 2600
4	(2009) Brain injury : BI Diffuse axonal injury after traumatic brain injury is a prognostic factor for functional outcome: a systematic review and meta-analysis / 32 (4) , 395
2	(2009) Journal of trauma and injury : JTI Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade / 31 (2) , 51
None	(2009) Therapeutic advances in neurological disorders Higher sensitivity for traumatic cerebral microbleeds at 7 T ultra-high field MRI: is it clinically significant for the acute state of the patients and later quality of life? / 13 (None) , 1756286420911295
None	(2020) Frontiers in neuroscience Role of Insulin in Neurotrauma and Neurodegeneration: A Review / 14 (None) , 547175
5	(2009) Journal of traditional and complementary medicine Early intervention combining Chinese and Western medicine in traumatic brain injury with diffuse axonal injury: A report of three cases / 10 (5) , 504
19	(2009) International journal of molecular sciences Diffuse Axonal Injury: Clinical Prognostic Factors, Molecular Experimental Models and the Impact of the Trauma Related Oxidative Stress. An Extensive Review Concerning Milestones and Advances / 22 (19) , 10865
None	(2009) The American journal of emergency medicine Prevalence of significant traumatic brain injury among patients intubated in the field due to impaired level of consciousness / 52 (None) , 159

1	/ Journal of Receptor and Signal Transduction Research
2	/ Journal of Trauma
3	/ Journal of Trauma