Answer of May 1999


Clinical History:

M/65 Road traffic accident, now unconcious.

Figure 1 NECT brain
Figure 2 NECT brain
Figure 3 NECT brain

What is your diagnosis?


                            Figure 1                                                                    Figure 2

                            Figure 3



Diffuse axonal injury


Figure 1 NECT brain shows small hyperdense focus in the right temporal pole and left upper pons of the brain.

Figure 2 NECT brain show further multiple hyperdense foci in the grey-white matter junction of left frontal and right parietal lobes. Incidentally bilateral old lacunar infarcts in the corona radiata are seen.

Figure 2 NECT brain again demontrates the bilateral grey- white matter multiple small haemorrhages at the classic parasaggital region of both frontal lobes.These findings are characteristic of diffuse axonal injury (white matter shearing injury.)