What is Diffuse Axonal Injury?
Wikipedia defines Diffuse axonal injury (DAI) as
one of the most common and devastating types of traumatic brain injury, , meaning that damage occurs over a more widespread area than in focal brain injury. DAI, which refers to extensive lesions in white matter tracts, is one of the major causes of unconsciousness and persistent vegetative state after head trauma. It occurs in about half of all cases of severe head trauma and also occurs in moderate and mild brain injury.
The outcome is frequently coma, with over 90% of patients with severe DAI never regaining 
consciousness. Those who do wake up often remain significantly impaired.
Nowadays, other authors state that DAI can occur in every degree of severity from (very) mild or moderate to (very) severe. Concussion may be a milder type of diffuse axonal injury.
DAI is not easily detected by physicians in mild and moderate cases. Imaging studies and neuropsychological evaluations in addition to observations of relatives, friends and co-workers are some of the devices used when diagnosing DAI. Cases involving mild to moderate brain injuries are harder to tackle than cases in which there is objectively discernible injury such as loss of consciousness, skull fracture, or intracranial bleeding on imaging studies. Often such cases involve allegations of diffuse axonal injury (DAI), an injury to the brain that can occur at the microscopic level and not be detectable even by computerized tomography or magnetic resonance imaging.
Nonetheless, DAI can cause significant changes in personality or cognition which can create significant life change.
My daughter was in a serve motorcycle accident back in Dec 2009. I was told she has severe DAI and that I need to prepare to put her somewhere long term. I am greatful to say that after 8 months she is back in school and functioning as normal as possible.
I am looking for a support group. Please email me if you know of one online.
My ex boy friend, but long time best of friend was recently in a motorcycle accident. he has been diagnosed with DAI. He is now going on 3 weeks in a coma, eyes open, able to move around, but unaware of surroundings or commands and has yet to speak. Are these signs of perhaps progress?
My boyfriend was in in bad accident and was diagonsed with mild DAI. He opens his eyes and gets upset when he sees us. What should i expect?
hello Mellissa, your story gives me hope ..which doctors are not encouraging...my brother was hit by a car and basically broken everywhere...now we are addressing the brain injury which we are told id severe DAI...please let me know if your daughters was severe ..I am so happy to hear she is back at school..
I realize you still have may obsticles..but this is wonderful you have her back...can I talk with you?
Erin...almost 4 weeks in coma..
please Mellissa if your getting this messsage
could you get back to my e-mail...
I e-mailed earlier about my brother...you gave me hope with your daughter's situation...can we talk..
thankyou erin
Hi everyone-
my 27 year old brother was just diagnosed with DAI. Please email me to let me know, we have not given up hope and have been praying everyday since his car accident 10 days....any advice or guidance is greatly appreciated.
Thank you all, and congrats Melissa on your duaghter's recovery. It is a blessing to come across your miracle....it makes my faith stronger
~Jackie
arevalo_jackie@hotmail.com
My 18 year old nephew was in a head on collision on May 11. We were told he had a severe DAI. 2 days ago he squeezed our hands, moved his arms and legs, and tried to sit up. The doctors told us we had a long way to go, but we will not give up hope.
Mellisa your story gave me faith that he will one day be the funny, rambunctious young man I knew. Thank you so much for the story. I will continue to pray for all of your loved ones. The power of prayer can heal.
Brandy,
Thank you for letting me know about your nephew.
Please accept my sincere condolences for your loss. I am happy you are seeing progress in your nephew. Typically recovery goes on for 12 months and then plateaus. Getting therapy as close in time to the injury is significant for the best recovery.
My prayers and wishes are with you and yours.
Tim Titolo
Hi everyone my son Chris was in a car accident on mother's day. Drs say he has severe DAI. Reading discourages me because the prognosis is 10%. They say he has a chance because of his age. Your stories give me hope. My heart is heavy and I am trying to keep faith. God bless all of u.
Hi everyone, my 18 year old son Hunter was in a dirtbike accident last Sunday. He has DAI severe. He is a light in our our small county. Everybody knows and loves him. He has as many adult friends as he does high school friends. He has no enemies and not a rebellious bone in his strong-as-an-ox body. I am absolutely heartbroken. I don't know how I can go on living with him like this. Can somebody out there please send me a testimony of healing. Vandy1989@aol.com
First off- I really do hope and pray that all of your family and friends mentioned here come back and are strongr than ever. This whole coma thing just mystifies me. My good friend Kristin was in a car accident 29 days ago. Shes off her vantalator - but has a feeding tube now. She is non responsive but her eyes are open (not aware though)- and she smiled. Not sure if thats involuentary. ANyway-- any advice? This is just terriable -- i cant beleive shes just laying there- inbetween life and death like that. I am in Israel and shes in the states (cali) - we were neighbors.. i pray for her everyday and wish I could see her. I thought I felt her the other day-- really strongly- but not sure if it was my imagaination. Anyway.. any responce is apreciated. Thanks.
Amanda
My sincere condolences for your friend. It is always difficult to lose someone to a coma. You are never sure if they are there or not.
Since you are in Israel you may not be as up on the Congresswoman from Tuscon who was shot in the head 2 weeks ago: Gabby Gifford. The country has been watching her through the tough battle of recovery. Unfortunately, people typically do not appreciate that small but significant return to pre-injury function is a huge leap from full recovery. Once the brain is severely compromised, and here your friend has been in coma for over a month, there is little chance of full recovery.
And then, when that person regains some consciousness, it becomes draining on those who provide care. Expectations of fuller recovery are typically not met and the whole thing becomes daily reminders of loss.
I hope and pray that your friend is the exception and recovers. God bless you and those who care about Kristin in your dealing with the injury and, of course, Kristin.
Timothy R. Titolo
Timothy R. Titolo
Titolo Law Office
1930 Village Center Circle 3-444
Las Vegas, Nevada 89134
tim@titololawoffice.com
www.titololawoffice.com
Brain Injury Law Blog
Las Vegas Injury Attorney
Hi,
My sister Mary has been diagnosed with DAI. She is 9 days into her coma and we are not getting much information from the doctors. I am waiting on speaking with them to find out if she has moderate to severe DAI. What are typical outcomes if she has moderate? What are typical outcomes if she has severe? She is blinking and opening her eyes some, but there is a blank stare. Her eyes are dilating and moving to light. Also, she tries to move herself. If someone could email me at wilma_sorrell@yahoo.com I would appreciate it.
Thanks,
Wilma
my stepdad was thrown from his motorcycle and almost died he collapsed a lung some kid pulled pout infront of him he isbeen OUT of it due to his head injury, they claim the "profol" isnt so sedated that he couldnt open his eyes but he had no brain swelling just a bleed, and they say DAI is his case he squents his eyes and squeezes my hand they have him on a vent he is a smoker so it isnt in our favour i know he hears us...his heart rate goes up when im talking to him...anywords of encouragement he is such a wonderful man
In Oct 2007 my wife was in a motorcycle accident. She was in a coma for 10 days, during which I was told she broke C2,6,7 and had severe DAI. while in the trauma unit we found that she had no paralsis, and we stated to stand her up on her feet for little bits of time. I had her moved to Barrows nureo in phoenix, a month after her accident. At the time of the move she was on a vent, peg feeding tube and a halo. 3 doctors said I should pull the plug and let her go. But, I could not do that, within a week she was off her ventilator breathing on her own, she would hold my hand and I would stand her up and take her in a wheel chair outside and try to stand or walk. About two months after the accident, when i visited her my phone rang, it was her daughter, and i put the phone next to her for her duaghter to say hi, and she said hi to her daughter and said her name loud and clear. It was the first time I had heard her voice since the accident. Over 4 years later, she now lives in an assisted living home, she had the halo removed and the peg, and she can walk with a little help, it seems her balance is off a little, or the speed at which she can correct her balance, she still talks very little but will talk on the phone. She seems very happy and I am not sure if there is anything else to do but wait.
God Bless all who have been through this.
Hi, My name is Kristi and my nephew,who is 21 years of age was in a horrible car accident on Jan. 29 2012. He is a Marine and is off the ventilator, has a feeding tube in, which is going to be put in his stomach tomorrow. He has a trach in 35% oxygen. He is blinking his eyes more and more each day, but unresponsive. He does not respond to command. He has a almost 1 year old and another on the way. Can anyone tell me anything positive about this situation. I have read all of the stories above and hope that all of your loved ones have or will recover fully.
Thanks for listening.
My father-in-law was in a car accident feb. 10, 2012. An 18wheeler was stuck in the road and his dad swerved to miss but went right under taking off the top of his pickup truck. How my father-in-law survived is a miracle, but he has TBI known as diffuse axonal injury. He can walk now on his own, he eats well, and speaks (not complete sentences). But he list alot of his memory. For the most part he knows who we all are, but doesn't know the year, our daughters age, or what he ate for breakfast. We've been told by some that he may be able to gain his memory back and other doctors have told us that he will never get it back.
Its so hard because my father-in-law was the ideal father and grandfather. my husband and his dad had the ideal father/son relationship and would take yearly trips together. Now his dad doesn't even remember any of these trips when looking at a photograph.
I was just wondering if anyone has had any success with memory loss? Or what we should prepare for? I am hoping he recovers even its if 80% so he can come live with us, remember our laughs and just remember.