Diffuse axonal injury outcome
The outcome of patients after DAI has been linked to the number of lesions identified through imaging. A longitudinal study that analyzed the evolution of traumatic axonal injury using magnetic resonance imaging (MRI) of 58 patients with moderate or severe TBI showed that the greater the number of lesions observed early after trauma, the greater the impairment of functionality after 12 months 11).
A study of 26 DAI patients indicated that the volume and number of lesions identified by MRI performed within 48 h of hospital admission strongly correlated with the level of disability observed at the time of hospital discharge 12).
DAI with hypoxia, as measured by peripheral oxygen saturation, and hypotension with New Injury Severity Score (NISS) value – had a statistically significant association with patient mortality; on the other hand, severity of DAI and length of hospital stay were the only significant predictors for dependence. Therefore, severity of DAI emerged as a risk factor for both mortality and dependence 13).
Clinical evidence of DAI on MRI may only be useful for predicting short-term in-hospital functional outcome. Given no association of DAI and long-term TBI outcomes, providers should be cautious in attributing DAI to future neurologic function, quality of life, and/or survival 14).