DIFFUSE AXONAL INJURY IN HEAD-INJURY - DEFINITION, DIAGNOSIS AND GRADING
DIFFUSE AXONAL INJURY IN HEAD-INJURY - DEFINITION, DIAGNOSIS AND GRADING
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DOI：
10.1111/j.1365-2559.1989.tb03040.x
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发表时间：
1989-07-01
期刊：
影响因子：
6.4
通讯作者：
MCLELLAN, DR
中科院分区：
文献类型：
--
作者：
ADAMS, JH;DOYLE, D;MCLELLAN, DR
弥漫性轴索损伤是非导弹头部损伤导致的最重要的脑损伤类型之一，除非病理学家确切地知道他在寻找什么，否则可能很难在死后诊断。随着对致命性非导弹性颅脑损伤的经验增加，弥漫性轴索损伤可分为三个等级。在1级中，在大脑半球的白色物质、胼胝体、脑干以及较不常见的小脑中存在轴索损伤的组织学证据;在2级中，在胼胝体中也存在局灶性病变;并且在3级中，在脑干的喙侧的背外侧象限中另外存在局灶性病变。局灶性病变通常只能在显微镜下识别。弥漫性轴索损伤被确定在122一系列的434致命的非导弹头部损伤。sbd.10 1级，29级2和83级3。在这些病例中，有24例在没有显微镜检查的情况下无法做出诊断，而在另外31例中，需要进行显微镜检查以确定其严重程度。
Diffuse axomal injury is one of the most important types of brain damage that can occur as a result of non-missile head injury, and it may be very difficult to diagnose postmortem unless the pathologist knows precisely what he is looking for. Increasing experience with fatal non-missile head injury in man has allowed the identification of three grades of diffuse axonal injury. In grade 1 there is histological evidence of axonal injury in the white matter of the cerebral hemispheres, the corpus callosum, the brain stem and, less commonly, the cerebellum; in grade 2 there is also a focal lesion in the corpus callosum; and in grade 3 there is in addition a focal lesion in the dorsolateral quadrant or quadrants of the rostral brain stem. The focal lesions can often only be identified microscopically. Diffuse axonal injury was identified in 122 of a series of 434 fatal non-missile head injuries.sbd.10 grade 1, 29 grade 2 and 83 grade 3. In 24 of these cases the diagnosis could not have been made without microscopical examination, while in a further 31 microscopical examination was required to establish its severity.