Brain injury – Diffuse Axonal Injury

Diffuse Axonal injury, commonly known as DAI, is one of the most common types of brain injury sustained following a road traffic accident.

DAI occurs when an impact or force causes the brain to move backwards and forwards in the skull. When the brain moves within the skull the nerves in the brain that send messages are disturbed. The movement results in the brain tissue moving around itself which causes a shearing type injury. That movement causes lesions that result in the individual falling unconscious for a long period of time post injury, often falling into a coma.

DAI results in widespread injury to the brain. The back and forth motion of the brain moving in the skull causes brain tissue to die. This causes the brain to swell inside the skull. An individual with DAI often presents with an increased intracranial pressure – high pressure within the brain and skull. This swelling and pressure reduces the blood pressure to the brain which without fast surgical intervention can cause further traumatic injury to the brain and its function.

The initial effect of DAI is unconsciousness therefore medically identifying the injury promptly is key to the long term prognosis of the individual. Most commonly MRI and CT scans are used to analyse the effects of the impact on the brain. An EEG can also be used to monitor the electric activity in the brain.

The essential part of any DAI diagnosis is understanding the impact that the injury has on the individual. A personalised specialist neurological rehabilitative plan should be put into place to support them and their loved ones. Neuro-rehabilitation plans should consist of a multi disciplinary team that could include:

• A Care and Support team who often consist of a specialist Case Manager and Support Workers with experience and understanding of head injury
• Neuropsychologist
• Occupational Therapy
• Vocational Therapy
• Speech and Language Therapy
• Physiotherapy