What's the most likely diagnosis?

• 19 year old involved in motor vehicle accident

Non-enhanced axial CT of brain

1. Hemorrhagic stroke
2. Diffuse axonal injury
3. Multiple sclerosis
4. Shock
5. Diffuse cerebral edema

Additional Image - Axial CT of brain

 

Additional Image

 

Non-enhanced axial CT of the Brain

 

Answer:

 

2. Diffuse axonal injury

 

 

More (Click Discussion Tab)

Diffuse Axonal Injury

General Considerations

• Result of deceleration injuries, especially in high-speed motor vehicle collisions

• Also a major cause of morbidity in “Shaken Baby Syndrome”

• Most frequent cause of persistent vegetative state following trauma
• Result of rotational shear injuries that most often occur at the gray-white matter junction

• Extent of injury is usually worse than that depicted by imaging

• Shearing leads to edema, axoplasmic leakage, retraction ball formation and wallerian degeneration
• Brainstem function is typically unaffected

 

More ...