Chronic Trauma with Diffuse Axonal Injury-MRI

During the chronic stage of traumatic brain injury, T2*-weighted gradient-echo imaging at high field strength is superior to T1- and T2-weighted MR imaging in the detection of lesions suspicious of diffuse axonal injury. Based on the signal intensity characteristics on T2*-weighted gradient-echo images, most of these lesions are hemorrhagic.

 This is young male patient with old history of RTA and persitent vegetative state. GRE images shows punctate blood products in the bifrontal and left temporal white matter. Focal bleed is also noted in the rostral midbrain and superior cerebellar peduncle, along with cerebellum. Findings in his clinical setting are consistent with diffuse axonal injury.

Bilateral Subdural hematomas-CT

Bilateral subdural hematomas especially when they are isodense may be missed on CT. A classical sign is "Rabbit Ear Sign" in which frontal horns point posteriorly.

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)