The shaken brains associated with car accidents, so-called shaken baby syndrome, some sports, and violent falls all share one thing in common: a risk for developing a diffuse axonal brain injury. This complex-sounding term refers to a brain injury that produces brain lesions in bundles of white matter across several brain areas.

Because several brain regions are affected, a diffuse axonal brain injury is always severe, and can even become life-threatening. The specific prognosis, though, depends on the brain regions affected, your overall health, factors such as the quality of care available, and other factors that doctors don't fully understand. While some people may fully recover from these injuries, others struggle with ongoing brain and nervous system issues.

What Causes Diffuse Axonal Brain Injuries?

Though many diffuse axonal brain injury sufferers have experienced a direct blow to the head, such a blow is not necessary to sustain a diffuse axonal brain injury. Instead, these injuries are shaking-related injuries that result from rapid acceleration and deceleration of the brain. This process causes what's known as a shearing injury, as brain tissue slides over itself, creating tracts of lesions in the brain's white matter.

Some common sources of diffuse axonal brain injuries include:

  • Falls that cause the head to whip rapidly back and forward. 
  • Sports-related injuries. 
  • Motor vehicle accidents. 
  • Blows to the head that cause the brain to rapidly and violently move in the skull. 
  • Shaken baby syndrome; because babies' brains are not yet fully developed, shaking can have catastrophic and lifelong consequences, and can even be fatal. 

What Are The Symptoms of a Diffuse Axonal Brain Injury?

Diffuse axonal brain injuries produce symptoms similar to other brain injuries, and patients who suffer such an injury may also have other injuries, such as a concussion or contusion. For this reason, it can take some time to diagnose the injury, and doctors never diagnose such an injury without neural imaging. Even then, the brain lesions don't always become immediately apparent, so it may take several imaging scans to get a proper diagnosis.

If you have suffered a blow to the head or a violent trauma that could have shaken your brain, you must seek prompt medical care. Early intervention can be life-saving. Some symptoms to watch for include:

  • Any signs that a baby has been shaken.
  • A blow to the head, car accident, or other trauma that is likely to shake the brain.
  • Changes in perception or cognition.
  • Unexplained changes in mood or personality.
  • Difficulty recognizing words, places, people, or animals that should otherwise be familiar.
  • Trouble reading or speaking.
  • Changes in memory.
  • Unexplained anxiety or depression.

Over time, these brain injuries can affect virtually every area of functioning, causing catastrophic changes in cognition, personality, and emotion. The extent of the injuries and the way they affect you is primarily dependent on the location of injury. If you are injured in an area that affects motor control, for example, you may have difficulty walking or coordinating your movements.

Treatment and Prognosis for Diffuse Axonal Brain Injuries

Diffuse axonal brain injuries are serious, and often kill the very young and very old. The prognosis, though, depends on the extent of the injury and the degree to which you receive competent medical care and rehabilitative services. Treatment focuses on helping you regain as much brain function as possible by rewiring brain cells so that they can work around your injuries.

Depending on your needs, that treatment may include speech therapy, physical therapy, occupational therapy, family support, psychotherapy, and assistance developing new life skills. You may also receive nutritional and exercise counseling.


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