Diffuse axonal injuries are a type of brain injury, and they’re common in motorcycle accidents and car crashes. They also can be very severe, although that’s not always the case.
So can you recover from a diffuse axonal injury, also known as a DAI? The short answer is that it depends, and the following are some things to know.
A diffuse axonal injury is a type of traumatic brain injury. A traumatic brain injury occurs when there’s a sudden external force that damages the brain. Traumatic brain injuries are one of the most common causes of disability and death.
There are two general types of brain injuries which are a closed brain injury and a penetrating brain injury.
A closed brain injury doesn’t lead to a break in the skull, and it’s often the result of rapid forward or backward movement of the brain inside the skull. That movement can cause bruising and tearing of vessels and tissue. Closed brain injuries are frequently caused by car accidents as well as sports and falls.
A penetrating brain injury is much less common, and it occurs when something goes through the skull, like a bullet.
A DAI is one type of closed brain injury.
A DAI occurs when there’s tearing of the nerve fibers of the brain, which are known as axons. That occurs when the brain moves and rotates inside the skull.
DAIs often lead to a coma and they can damage one or many parts of the brain.
It can be difficult to see these injuries on a CT scan or MRI because they are so tiny.
Along with being the result of motorcycle and car accidents, DAIs can often occur during a violent assault or in a sports accident.
The treatment of a DAI first begins with reducing swelling in the brain. For example, someone might be given steroids to bring that swelling down. If there is untreated brain swelling, it can cause even more damage.
Surgery isn’t available for DAIs, and if the injury is very severe, there’s a high likelihood someone will remain in a vegetative state or will die.
It is, however, possible to recover from a mild or moderate DAI.
Unfortunately, many people who survive this type of injury don’t regain consciousness ever again. Even when some people rarely wake up, they may have long-term problems that rehabilitation can’t help with.
The prognosis for a moderate or severe brain injury is hard to determine. With a mild brain injury, most people start to recover fairly quickly, and they will regain most if not all of their brain function usually within three months at the most.
With a moderate DAI or traumatic brain injury, it’s possible to regain most brain function, but there is usually a need for a variety of types of therapy which can include physical and occupational therapy, neurosurgery, and speech/language therapy.
It’s nearly impossible to predict recovery with severe DAI or TBI. It depends on how long someone spends in a coma, the severity of the damage, and where the trauma is located.
After a severe brain injury, a person may be in a coma. They then might move into a vegetative state, then to a minimally conscious state, and from there some people then regain full consciousness but impairments remain.
A coma means that someone doesn’t open their eyes or follow instructions. They don’t have any communication or intentional movement.
A vegetative state means that someone may regain their sleep-wake cycles, so they might open and close their eyes. They may make sounds, and they could also make facial expressions. Sometimes a person in a vegetative state will move their eyes toward objects or people or react to a sound but they can’t follow instructions.
In many instances, the first sign of consciousness following a vegetative state is visual tracking, meaning a person’s eyes can follow an object or people. Someone who’s regaining consciousness may be able to follow instructions and engage in automatic behaviors, such as scratching.
If someone has less severe DAI, they might go through these stages faster.
Most people don’t stay in a coma for more than four weeks, and usually, the shorter the amount of time someone is unconscious, the less severe the injury.
The short answer is that it’s very difficult to predict the course of recovery for a DAI if it happens at all, which is why motorcycle and car accidents can end so tragically.