Diffuse axonal injury - grade 2

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Two weeks of post traumatic amnesia and vague neurological symptoms.

Patient Data

Age: 25 years
Gender: Male

Scattered throughout the supratentorial white matter, predominantly in the centrum semiovale bilaterally, are abnormal foci of high FLAIR signal, some with central hypointensity. Most of the these have corresponding blooming on susceptibility weighted images consistent with microhemorrhages on phase imaging. Further microhemorrhages are noted in the posterior corpus callosum. No convincing posterior fossa microhemorrhages.

Case Discussion

Findings are typical of diffuse axonal injury. These can often be occult on CT, as was the case with this patient with a normal CT brain. 

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