Anat Path- DAI Flashcards
Diffuse axonal injury (DAI) is frequently seen in:
a) Falls from heights
b) Sports-related injuries
c) Motor vehicle accidents (MVAs) with unsupported head
d) Penetrating head injuries
C
DAI is characterized by:
a) Focal traumatic lesion
b) Purely midline structure damage
c) Changes in axonal cytoskeleton
d) Isolated tearing of blood vessels
Changes in axonal cytoskeleton
Mitochondrial dysfunction in DAI leads to:
a) Axonal rupture
b) Neuroinflammation
c) Wallerian degeneration
d) Accumulation of spheroids
A
The most severe damage in DAI is typically observed in:
a) Corpus callosum
b) Dorsolateral brainstem
c) Midline structures
d) Other areas
C
Severe DAI is characterized by:
a) Immediate unconsciousness
b) Persistent vegetative state
c) Reticular activating substance dysfunction
d) Widespread vascular injury
A
Which pathology is commonly seen in DAI?
a) Cerebral infarction
b) Petechial hemorrhages
c) Brain herniation
d) Cystic lesions
b) Petechial hemorrhages
Which brain structure is frequently affected by DAI pathology?
a) Hippocampus
b) Frontal lobe
c) Temporal lobe
d) Corpus callosum
D
Microscopically, DAI is characterized by the presence of:
a) Axonal rupture
b) Neurofibrillary tangles
c) Spheroids
d) Glial scars
C
Which immunohistochemical marker is used to detect DAI?
a) GFAP
b) BAPP
c) S100
d) CD68
B
DAI is primarily caused by:
a) Laceration of the brain tissue
b) Increased intracranial pressure
c) Shear forces on the brain
d) Disruption of the blood-brain barrier
C
Which term describes the progressive degeneration of axons in DAI?
a) Axonal swelling
b) Neurodegeneration
c) Wallerian degeneration
d) Axonal rupture
C
Besides DAI, what other type of pathology can be difficult to separate from other traumatic brain injury (TBI) conditions?
a) Cerebral contusion
b) Epidural hematoma
c) Subdural hematoma
d) Subarachnoid hemorrhage
A
What is the characteristic feature of DAI on imaging studies?
a) Hyperdense lesion
b) Ring-enhancing lesion
c) Diffuse white matter abnormalities
d) Midline shift
Diffuse white matter abnormalities
Which of the following is associated with DAI?
a) Extradural hemorrhage
b) Subgaleal hematoma
c) Subarachnoid hemorrhage
d) Epidural hematoma
Subarachnoid hemorrhage
The mechanism of injury in DAI involves:
a) Direct impact to the brain
b) Rapid acceleration-deceleration forces
c) Projectile penetration
d) Infection
b) Rapid acceleration-deceleration forces
Describe the pathophysiology of diffuse axonal injury (DAI).
DAI involves stretching of axons, changes in axonal cytoskeleton, accumulation of mitochondria proximally (spheroids), mitochondrial dysfunction, axonal rupture, neuroinflammation, and Wallerian degeneration. It is a multifaceted process that evolves over time.
What are the common clinical presentations of severe DAI?
Severe DAI typically leads to immediate unconsciousness. Patients may recover or enter a persistent vegetative state. Dysfunction of the reticular activating substance may occur. There may also be additional widespread vascular injury in severe traumatic brain injury (TBI) cases.
Explain the pathological findings associated with diffuse axonal injury (DAI).
Pathologically, DAI is characterized by petechial hemorrhages in the corpus callosum, dorsolateral brainstem, and other areas due to tearing of blood vessels. Microscopically, axonal swellings (spheroids) are observed, which can be detected using BAPP immunohistochemistry.
